Form Structure: Wechsler Preschool and Primary Scale of Intelligence Third Edition- Object Assembly subtest
This form structure is an organized set of data definitions for a copyrighted form
Resource:
FITBIR
Title:
Wechsler Preschool and Primary Scale of Intelligence Third Edition- Object Assembly subtest
Short Name:
WPPSI3OA
Description:
WPPSI-III is a measure of intelligence in young children that is more age-appropriate and user-friendly. In Object Assembly section, the child is presented with the pieces of a puzzle in a standard arrangement and fits the pieces together to form a meaningful whole within 90 seconds. Typical instances involve four different pieces to fit together. Wechsler, D. (2002). Wechsler Preschool and Primary Scale of Intelligence?third edition technical and interpretive manual. San Antonio, TX: Psychological Corporation. Copyright 2002 by NCS Pearson, Inc. 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:
2016-07-29
Owner:
Number of Data Elements:
52
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 |
WPPSI-III-Object Assembly Item1-2 (Appears Up To 4 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 | Trial number (numeric) | The number representing the sequence for any repeated measure test or assessment when it is performed multiple times. | TrialNumber | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Completion time | Object assembly completion time, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACompletionTime | Recommended | CDE |
| 4 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Correct juncture range 1 number | Number of correct junctures for range 1, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACorrectJunctrRange1Num | Recommended | CDE |
| 5 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Range 1 item score | Item score for range 1, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OARange1ItemScore | Recommended | CDE |
WPPSI-III-Object Assembly Item 3 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Completion time | Object assembly completion time, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACompletionTime | Recommended | CDE |
| 2 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Correct juncture range 1 number | Number of correct junctures for range 1, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACorrectJunctrRange1Num | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Range 1 item score | Item score for range 1, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OARange1ItemScore | Recommended | CDE |
WPPSI-III-Object Assembly Item 4 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Completion time | Object assembly completion time, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACompletionTime | Recommended | CDE |
| 2 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Correct juncture range 3 number | Number of correct junctures for range 3, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACorrectJunctrRange3Num | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Range 3 item score | Item score for range 3, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OARange3ItemScore | Recommended | CDE |
WPPSI-III-Object Assembly Item 5-6 (Appears Up To 2 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 Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Completion time | Object assembly completion time, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACompletionTime | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Correct juncture range 2 number | Number of correct junctures for range 2, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACorrectJunctrRange2Num | Recommended | CDE |
| 4 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Range 2 item score | Item score for range 2, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OARange2ItemScore | Recommended | CDE |
WPPSI-III-Object Assembly Item 7 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Completion time | Object assembly completion time, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACompletionTime | Recommended | CDE |
| 2 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Correct juncture range 3 number | Number of correct junctures for range 3, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACorrectJunctrRange3Num | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Range 3 item score | Item score for range 3, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OARange3ItemScore | Recommended | CDE |
WPPSI-III-Object Assembly Item 8 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Completion time | Object assembly completion time, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACompletionTime | Recommended | CDE |
| 2 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Correct juncture range 2 number | Number of correct junctures for range 2, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACorrectJunctrRange2Num | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Range 2 item score | Item score for range 2, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OARange2ItemScore | Recommended | CDE |
WPPSI-III-Object Assembly Item 9 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Completion time | Object assembly completion time, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACompletionTime | Recommended | CDE |
| 2 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Correct juncture range 3 number | Number of correct junctures for range 3, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACorrectJunctrRange3Num | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Range 3 item score | Item score for range 3, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OARange3ItemScore | Recommended | CDE |
WPPSI-III-Object Assembly Item 10 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Completion time | Object assembly completion time, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACompletionTime | Recommended | CDE |
| 2 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Correct juncture range 4 number | Number of correct junctures for range 4, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACorrectJunctrRange4Num | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Range 4 item score | Item score for range 4, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OARange4ItemScore | Recommended | CDE |
WPPSI-III-Object Assembly Item 11-12 (Appears Up To 2 Times)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Completion time | Object assembly completion time, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACompletionTime | Recommended | CDE |
| 2 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Correct juncture range 3 number | Number of correct junctures for range 3, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACorrectJunctrRange3Num | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Range 3 item score | Item score for range 3, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OARange3ItemScore | Recommended | CDE |
WPPSI-III-Object Assembly Item 13 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Completion time | Object assembly completion time, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACompletionTime | Recommended | CDE |
| 2 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Correct juncture range 5 number | Number of correct junctures for range 5, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACorrectJunctrRange5Num | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Range 3 item score | Item score for range 3, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OARange3ItemScore | Recommended | CDE |
WPPSI-III-Object Assembly Item 14 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Completion time | Object assembly completion time, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACompletionTime | Recommended | CDE |
| 2 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Correct juncture range 6 number | Number of correct junctures for range 6, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OACorrectJunctrRange6Num | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Range 4 item score | Item score for range 4, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OARange4ItemScore | Recommended | CDE |
WPPSI-III-Object Assembly- scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Object Assembly Section - Completion time | Object assembly total raw score, as part of the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) | WPPSI3OATtlRawScore | Recommended | CDE |
Keywords
