Form Structure: Wechsler Preschool and Primary Scale of Intelligence Fourth Edition- Block Design subtest
This form structure is an organized set of data definitions for a copyrighted form
Title:
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition- Block Design subtest
Short Name:
WPPSI4BD
Description:
The WPPSIIV is an innovative measure of cognitive development for preschoolers and young children that's rooted in contemporary theory and research that also places a strong emphasis on child-friendly, developmentally appropriate features and includes new processing speed tasks, the addition of working memory subtests, an expanded factor structure. The extensive enhancements are targeted to benefit both children and examiners. Block Design measures visual-motor coordination. Wechsler, D. (2012). Wechsler Preschool and Primary Scale of Intelligencefourth edition technical manual and interpretive manual. San Antonio,TX: Psychological Corporation. Copyright 2012. Pearson, Inc., and/or its affiliates. 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:
2016-08-08
Owner:
Number of Data Elements:
33
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-IV-Block Design 1-4 (Appears Up To 8 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 Fourth Edition (WPPSI - IV) Block Design Section - Completion time value | Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) | WPPSI4BDCompltTimeVal | Recommended | CDE |
| 4 | Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Design 1-4 score | Score for Design 1-4, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) | WPPSI4BD1to4Score | Recommended | CDE |
WPPSI-IV-Block Designs 5 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Completion time value | Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) | WPPSI4BDCompltTimeVal | Recommended | CDE |
| 2 | Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Design 5 score | Score for Design 5, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) | WPPSI4BD5Score | Recommended | CDE |
WPPSI-IV-Block Designs 6-8 (Appears Up To 3 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 Fourth Edition (WPPSI - IV) Block Design Section - Completion time value | Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) | WPPSI4BDCompltTimeVal | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Design 6-8 and 10 score | Score for Design 6-8 and 10, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) | WPPSI4BD6to8And10Score | Recommended | CDE |
WPPSI-IV-Block Designs 9 (Appears Up To 2 Times)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Trial number (numeric) | The number representing the sequence for any repeated measure test or assessment when it is performed multiple times. | TrialNumber | Recommended | CDE |
| 2 | Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Completion time value | Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) | WPPSI4BDCompltTimeVal | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Design 9 score | Score for Design 9, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) | WPPSI4BD9Score | Recommended | CDE |
WPPSI-IV-Block Designs 10 (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Completion time value | Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) | WPPSI4BDCompltTimeVal | Recommended | CDE |
| 2 | Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Design 6-8 and 10 score | Score for Design 6-8 and 10, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) | WPPSI4BD6to8And10Score | Recommended | CDE |
WPPSI-IV-Block Designs 11-17 (Appears Up To 7 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 Fourth Edition (WPPSI - IV) Block Design Section - Completion time value | Time to complete, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) | WPPSI4BDCompltTimeVal | Recommended | CDE |
| 3 | Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Design 11-17 score | Score for Design 11-17, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) | WPPSI4BD11to17Score | Recommended | CDE |
WPPSI-IV-Block Design- Scoring (Appears Up To 1 Time)
| # | Title | Short Description | Variable Name | Required? | Type |
|---|---|---|---|---|---|
| 1 | Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Block Design Section - Total raw score | Total raw score, as part of Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition (WPPSI - IV) | WPPSI4BDTotalRawScore | Recommended | CDE |
Keywords
