Form Structure: Wechsler Intelligence Scale for Children -Fourth edition (WISC-IV) Arithmetic section
This form structure is an organized set of data definitions for a copyrighted form
			
			
		Resource:
							
								
									FITBIR
	    							
							
						Title:
						
							Wechsler Intelligence Scale for Children -Fourth edition (WISC-IV) Arithmetic section
						
					Short Name:
						
							WISCIVAR
						
					Description:
						
							WISC-IV measures a child's intellectual ability. Symbol Search subtest measures speed and accuracy with which the child processes nonverbal information. Wechsler, D. (2003). Wechsler Intelligence Scale for Children?Fourth Edition: Technical and interpretive manual. San Antonio, TX: Psychological Corporation. Copyright 2003 by The Psychological Corporation, a Harcourt Assessment Company http://www.pearsonclinical.com/ 
						
					Disease:
						
						
							Traumatic Brain Injury
						
						
					Organization:
							
								FITBIR
							
						Required Program Form:
						
						
							
								No
							
						
					Standardization:
						
							Standard NINDS CDE
						
					Labels:
						Form Type:
						
							Clinical Assessment
						
					Version:
						
							1.0
						
					Date Created:
						
							2016-07-25
						
					Owner:
						Number of Data Elements:
						
							22
						
					eForms:
						
							
							
								N
							
						
					
						Logically grouped data elements with defined frequency at which they repeat.
						
	
         
         
         
         
         	
         
         
          
          
         
         
         
         
         
                        
	
	
	
		
			
				
				
				
					
						
							
				
				
				
			
		
	
	
		
	
	
		
	
	
		
	
	
	
	
		
			
				
			
				
				
					
						
						
						
							
								
									
						
						
						
					
					
				
			
				
				
					
						
						
						
							
								
									
						
						
						
					
					
				
			
				
				
					
						
						
						
							
								
									
						
						
						
					
					
				
			
		
	
	
					
			    | # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | GUID | Global Unique ID which uniquely identifies a subject | GUID | Required | CDE | 
| 2 | Subject identifier number | An identification number assigned to the participant/subject within a given protocol or a study. | SubjectIDNum | Optional | CDE | 
| 3 | Age in years | Value for participant's subject age recorded in years. | AgeYrs | Recommended | CDE | 
| 4 | Vital status | Status of participant/subject as alive or dead | VitStatus | Optional | CDE | 
| 5 | Visit date | Actual interview or visit date | VisitDate | Recommended | CDE | 
| 6 | Site name | The name of the site for the study | SiteName | Recommended | CDE | 
| 7 | Days since baseline | The number of days since baseline | DaysSinceBaseline | Optional | CDE | 
| 8 | Case control indicator | Indicator of whether subject is in the case or control arm of the study. | CaseContrlInd | Optional | CDE | 
| 9 | General notes text | General notes | GeneralNotesTxt | Optional | CDE | 
Additional Element Groups
Listed below are your additional element groups.
Form Administration (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Language form administration ISO code | Code (ISO 639-2) for the language that was used for CRF/instrument/scale/etc. administration | LangCRFAdministratISOCode | Recommended | CDE | 
| 2 | Language form administration ISO code other text | The free-text field related to 'Language used for CRF/instrument/scale/etc. administration ISO code' specifying other text. | LangCRFAdministratISOCodeOTH | Recommended | CDE | 
| 3 | Context type | The context to which the questions were answered | ContextType | Recommended | CDE | 
| 4 | Context type other text | The free-text related to ContextType specifying other text | ContextTypeOTH | Recommended | CDE | 
| 5 | Data source | Source of the data provided on the case report form | DataSource | Recommended | CDE | 
| 6 | Data source other text | The free-text field related to Data source specifying other text. Source of the data provided on the case report form | DataSourceOTH | Recommended | CDE | 
WISC-IV Arithmetic (Appears Up To 34 Times)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Test item number (numeric) | The test (or assessment) item number representing the sequence for the items/questions of each test/assessmet/questionnaire being asked | TestItemNum | Recommended | CDE | 
| 2 | Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Arithmetic Section- Completion time | Completion time, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Arithmetic subtest | WISCIVARCompltnTime | Recommended | CDE | 
| 3 | Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Arithmetic Section - Response text | Response text, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Arithmetic subtest | WISCIVARRespnsTxt | Recommended | CDE | 
| 4 | Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Symbol Search Section - Item score | Item score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Arithmetic subtest | WISCIVARItemScore | Recommended | CDE | 
| 5 | Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Arithmetic Section - Process score | Process score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Arithmetic subtest | WISCIVARProcessScore | Recommended | CDE | 
WISC-IV Arithmetic-Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type | 
|---|---|---|---|---|---|
| 1 | Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Arithmetic Section - Total raw score | AR total raw score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) | WISCIVARTtlRawScore | Recommended | CDE | 
| 2 | Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) Arithmetic Section - Process total raw score | ART total raw score, as part of the Wechsler Intelligence Scale For Children- Fourth Edition (WISC-IV) | WISCIVARProcessTtlRawScore | Recommended | CDE | 
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