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Form Structure: Wechsler Preschool and Primary Scale of IntelligenceFourth Edition- Cancellation subtest

This form structure is an organized set of data definitions for a copyrighted form
Title:
Wechsler Preschool and Primary Scale of IntelligenceFourth Edition- Cancellation subtest
Short Name:
WPPSI4CA
Description:
The WPPSI–IV 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. The Cancellation (CA) subtest requires the subject to mark target objects in a random and structured array. Wechsler, D. (2012). Wechsler Preschool and Primary Scale of Intelligence—fourth 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:
24
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.

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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 Cancellation-Item 1 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section- Completion time value  Cancellation completion time, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) WPPSI4CACompltnTimeVal Recommended CDE
2 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section- Number correct count  Count of number correct, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section WPPSI4CANumCorrectCt Recommended CDE
3 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section- Number incorrect count  Count of number incorrect, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section WPPSI4CANumIncorrectCt Recommended CDE
4 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section- Item CAR score  CAR score, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section WPPSI4CAItemCarScore Recommended CDE

WPPSI-IV Cancellation-Item 2 (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section- Completion time value  Cancellation completion time, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) WPPSI4CACompltnTimeVal Recommended CDE
2 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section- Number correct count  Count of number correct, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section WPPSI4CANumCorrectCt Recommended CDE
3 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section- Number incorrect count  Count of number incorrect, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section WPPSI4CANumIncorrectCt Recommended CDE
4 Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section- Item CAS score  CAS score, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) Cancellation Section WPPSI4CAItemCasScore Recommended CDE

WPPSI-IV Cancellation-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) Cancellation Section- Total raw score  Cancellation total raw score, as part of the Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI - IV) WPPSI4CATtlRawScore Recommended CDE
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