TBI Forms

PARTICIPANT CHARACTERISTICS

PARTICIPANT HISTORY AND FAMILY HISTORY

PROTOCOL EXPERIENCE

PARTICIPANT/SUBJECT IDENTIFICATION, ELIGIBILITY, AND ENROLLMENT

OFF TREATMENT/OFF STUDY

OUTCOMES AND END POINTS

DEAFNESS AND COMMUNICATION DISORDERS

Dizziness Handicap Inventory (DHI)
National Health and Nutrition Examination Chemical Senses-Taste and Smell Questionnaire
NIH Toolbox Motor Domain Standing Balance Test
NIH Toolbox Sensation Domain Dynamic Visual Acuity Test
NIH Toolbox Sensation Domain Hearing Handicap Inventory (Supplementary Measure)
NIH Toolbox Sensation Domain Hearing Threshold Test (Audition Supplemental Measures)
NIH Toolbox Sensation Domain Odor Identification Test
NIH Toolbox Sensation Domain Pain Intensity Survey
NIH Toolbox Sensation Domain Pain Interference Survey
NIH Toolbox Sensation Domain Taste Intensity Test
NIH Toolbox Sensation Domain Vision-Related Quality of Life Survey (Supplementary Measure)
NIH Toolbox Sensation Domain Visual Acuity Test
NIH Toolbox Sensation Domain Words In Noise Test
Random Gap Detection Test (RGDT)
Rey Auditory Verbal Learning Test (RAVLT)
Test for Auditory Processing Disorders in Adolescents and Adults (SCAN-A)
Test for Auditory Processing Disorders in Adolescents and Adults (SCAN-A) scoring summary
Test for Auditory Processing Disorders in Adolescents and Adults (SCAN-A) screening
Test for Auditory Processing Disorders in Children-Revised (SCAN-C)
Test for Auditory Processing Disorders in Children-Revised (SCAN-C) scoring summary
Test for Auditory Processing Disorders in Children-Revised (SCAN-C) screening
Tests for Auditory Processing Disorders for Children (SCAN-3:C)-Score Summary
Tests for Auditory Processing Disorders for Children (SCAN-3:C)-Diagnostic Tests
Tests for Auditory Processing Disorders for Children (SCAN-3:C)-Screening
Tests for Auditory Processing Disorders for Children (SCAN-3:C)-Supplementary Tests
Time Compressed Sentence Test
Tinnitus Functional Index
Tinnitus Handicap Inventory
Voice Handicap Index

NEUROPSYCHOLOGICAL IMPAIRMENT

ANAM Code Substitution Delayed
ANAM Code Substitution Learning
ANAM Matching to Sample
ANAM Mathematical Processing
ANAM Procedural Reaction Time
ANAM Simple Reaction Time
ANAM Simple Reaction Time 2nd Administration
Beery-Buktenica Developmental Test
Brief Visuospatial Memory Test-Revised (BVMT-R)
California Verbal Learning Test-Second Edition
California Verbal Learning Test Children's version (CVLT-C) Data
California Verbal Learning Test Children's version (CVLT-C) Scores
Contingency Naming Test
Controlled Oral Word Association Test (COWAT)
Delis-Kaplan Executive Function Systems (DKEFS)-Verbal Fluency
Delis-Kaplan Executive Function System (D-KEFS) Color-Word Interference Test (CWIT)
Delis-Kaplan Executive Function System (DKEFS) Sorting Test
Delis-Kaplan Executive Function System (D-KEFS) Tower Test
Delis-Kaplan Executive Function System (D-KEFS) Trail Making Test
Delis-Kaplan Executive Function System (D-KEFS) Twenty Questions Test
Delis-Kaplan Executive Function System (D-KEFS) Word Context Test
Delis-Kaplan Executive Functioning Systems (DKEFS) Design Fluency Test Scoring
Delis-Kaplan Executive Functioning Systems (DKEFS) Proverbs Test
Grooved Pegboard Test (GPT)
NIH Toolbox Cognition Domain Auditory Verbal Learning Test (Rey)
NIH ToolBox Cognition Domain Dimensional Change Card Sort Test
NIH ToolBox Cognition Domain Flanker Inhibitory Control and Attention Test
NIH ToolBox Cognition Domain List Sorting Working Memory Test
NIH ToolBox Cognition Domain Oral Reading Recognition Test (English)
NIH ToolBox Cognition Domain Oral Reading Recognition Test (Spanish)
NIH ToolBox Cognition Domain Oral Symbol Digit Test
NIH ToolBox Cognition Domain Pattern Comparison Processing Speed Test
NIH ToolBox Cognition Domain Picture Sequence Memory Test
NIH Toolbox Cognition Domain Picture Vocabulary Test
Symbol Digit Modalities Test (SDMT)
Task of Executive Control (TEC)
TBI-QOL Item Bank v1.0-Ability to Participate in Social Roles and Activities-Short Form 10a
TBI-QOL Item Bank v1.0-Anger-Short Form 10a
TBI-QOL Item Bank v1.0-Anxiety-Short Form 10a
TBI-QOL Item Bank v1.0-Attention/Concentration-Short Form 6a
TBI-QOL Item Bank v1.0-Cognition: General Concerns-Short Form 10a.
TBI-QOL Item Bank v1.0-Communication-Short Form 9a
TBI-QOL Item Bank v1.0-Depression-Short Form 10a
TBI-QOL Item Bank v1.0-Emotional & Behavioral Dyscontrol-Short Form 10a
TBI-QOL Item Bank v1.0-Executive Function-Short Form 10a
TBI-QOL Item Bank v1.0-Fatigue-Short Form 10a
TBI-QOL Item Bank v1.0-Grief/Loss-Short Form 9a
TBI-QOL Item Bank v1.0-Headache Pain-Short Form 10a
TBI-QOL Item Bank v1.0-Independence-Short Form 8a
TBI-QOL Item Bank v1.0-Learning/Memory-Short Form 6a
TBI-QOL Item Bank v1.0-Pain Interference-Short Form 10a
TBI-QOL Item Bank v1.0-Positive Affect and Well-Being-Short Form 9a
TBI-QOL Item Bank v1.0-Resilience-Short Form 10a
TBI-QOL Item Bank v1.0-Satisfaction with Social Roles and Activities Short Form 10a
TBI-QOL Item Bank v1.0-Self-Esteem-Short Form 10a
TBI-QOL Item Bank v1.0-Stigma-7a
TBI-QOL Item Bank v1.0-Upper Extremity-Short Form 9a
TBI-QOL Item Bank v1.0-Mobility-Short Form 10a
Test of Everyday Attention for Children (TEA-Ch)
Test of Strategic Learning-Adult Version
Test of Strategic Learning-Youth Version
Trail Making Test (TMT)
Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-II)-Matrix Reasoning
Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-II)-Similarities
Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-II)-Vocabulary
Wechsler Abbreviated Scale of Intelligence I (WASI-I) Block Design
Wechsler Abbreviated Scale of Intelligence I (WASI-I) Vocabulary subtest
Wechsler Adult Intelligence Fourth Edition (WAIS-IV) summary scores and analysis
Wechsler Adult Intelligence Scale Fourth Edition (WAIS-IV) Digit Span
Wechsler Adult Intelligence Scale Fourth Edition (WAIS-IV) Letter-Number Sequencing
Wechsler Adult Intelligence Scale IV (WAIS-IV) Arithmetic
Wechsler Adult Intelligence Scale IV (WAIS-IV) Block Design
Wechsler Adult Intelligence Scale IV (WAIS-IV) Cancellation
Wechsler Adult Intelligence Scale IV (WAIS-IV) Comprehension
Wechsler Adult Intelligence Scale IV (WAIS-IV) Figure Weights
Wechsler Adult Intelligence Scale IV (WAIS-IV) Information
Wechsler Adult Intelligence Scale IV (WAIS-IV) Matrix Reasoning
Wechsler Adult Intelligence Scale IV (WAIS-IV) Picture Completion
Wechsler Adult Intelligence Scale IV (WAIS-IV) Similarities
Wechsler Adult Intelligence Scale IV (WAIS-IV) Visual Puzzles
Wechsler Adult Intelligence Scale IV (WAIS-IV) Vocabulary
Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) Coding
Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV) Symbol Search
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Arithmetic section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Block design section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Cancellation section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Cancellation section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Coding section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Coding section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Comprehension section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Information section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Letter-number Sequencing section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Matrix Reasoning section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Picture Completion section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Picture Concepts section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Symbol Search section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Symbol Search section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Vocabulary section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV) Word Reasoning section
Wechsler Intelligence Scale for Children-Fourth edition (WISC-IV)-Summary Scores
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition (WPPSI-IV) Vocabulary section
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition Age 2 to 3
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition Age 4 to 7
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition - Block Design subtest
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition Bug Search
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition Comprehension subtest
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition Information subtest
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition - Matrix Reasoning subtest
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition Object Assembly subtest
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition - Picture Concepts subtest
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition - Picture Memory subtest
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition - Picture Naming subtest
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition - Receptive Vocabulary subtest
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition - Similarities subtest
Wechsler Preschool and Primary Scale of Intelligence Fourth Edition - Zoo Location subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition Age 2 to 3
Wechsler Preschool and Primary Scale of Intelligence Third Edition Age 4 to 7
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Block Design subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Coding subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Comprehension subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Information subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Matrix Reasoning subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Object Assembly subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Picture Completion subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Picture Concepts subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Picture Naming subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Receptive Vocabulary subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Similarities subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Symbol Search subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Vocabulary subtest
Wechsler Preschool and Primary Scale of Intelligence Third Edition - Word Reasoning subtest
Wechsler Preschool and Primary Scale of IntelligenceFourth Edition - Animal Coding subtest
Wechsler Preschool and Primary Scale of IntelligenceFourth Edition - Cancellation subtest
Wechsler Test of Adult Reading (WTAR)
Wide Range Achievement Test 4 (WRAT4)-Math Computation Subtest
Wide Range Achievement Test 4 (WRAT4)-Score Summary Table
Wide Range Achievement Test 4 (WRAT4)-Sentence Comprehension Subtest
Wide Range Achievement Test 4 (WRAT4)-Spelling Subtest
Wide Range Achievement Test 4 (WRAT4)-Word Reading
Wide Range Assessment of Memory and Learning, Second Edition - Design Memory and Recognition
Wide Range Assessment of Memory and Learning, Second Edition - Finger Windows
Wide Range Assessment of Memory and Learning, Second Edition - Number letter
Wide Range Assessment of Memory and Learning, Second Edition - Picture Memory and Recognition
Wide Range Assessment of Memory and Learning, Second Edition - Sentence Memory
Wide Range Assessment of Memory and Learning, Second Edition - Sound Symbol and Delay Recall
Wide Range Assessment of Memory and Learning, Second Edition - Story Memory and Delay Recall
Wide Range Assessment of Memory and Learning, Second Edition - Summary score
Wide Range Assessment of Memory and Learning, Second Edition - Symbolic Working Memory
Wide Range Assessment of Memory and Learning, Second Edition - Verbal Learning and Delay Recall
Wide Range Assessment of Memory and Learning, Second Edition - Verbal Working Memory

PATIENT REPORTED OUTCOMES

Neuro-QoL Communication Short Form
Neuro-QoL Emotional and Behavioral Dyscontrol Long Form
Neuro-QoL Emotional and Behavioral Short Form
Neuro-Qol Item Bank v1.0-Anxiety
Neuro-Qol Item Bank v1.0-Depression
Neuro-Qol Item Bank v1.0-Fatigue
Neuro-Qol Item Bank v1.0-Participate in Social Roles and Activities
Neuro-QoL Item Bank v2.0-Cognitive Function-Long Form
Neuro-QoL Item Bank v2.0-Cognitive Function-Short Form
Neuro-QoL Lower Extremity Function Long Form
Neuro-QoL Lower Extremity Function Short Form
Neuro-QoL Pediatric Anger Short Form
Neuro-QoL Pediatric Anxiety Long Form
Neuro-QoL Pediatric Anxiety Short Form
Neuro-QoL Pediatric Cognitive Function Long Form
Neuro-QoL Pediatric Cognitive Function Short Form
Neuro-QoL Pediatric Depression Long Form
Neuro-QoL Pediatric Depression Short Form
Neuro-QoL Pediatric Fatigue Long Form
Neuro-QoL Pediatric Fatigue Short Form
Neuro-QoL Pediatric Lower Extremity Function Short Form
Neuro-QoL Pediatric Pain Short Form
Neuro-QoL Pediatric Social Relations Interaction with Peers Long Form
Neuro-QoL Pediatric Social Relations Interaction with Peers Short Form
Neuro-QoL Pediatric Stigma Long Form
Neuro-QoL Pediatric Stigma Short Form
Neuro-QoL Pediatric Upper Extremity Function Short Form
Neuro-QoL Positive Affect and Well Being Long Form
Neuro-QoL Positive Affect and Well Being Short Form
Neuro-QoL Satisfaction with Social Roles and Activities Long Form
Neuro-QoL Satisfaction with Social Roles and Activities Short Form
Neuro-QoL Sleep Disturbance Short Form
Neuro-QoL Stigma Long Form
Neuro-QoL Stigma Short Form
Neuro-QoL Upper Extremity Function Long Form
Neuro-QoL Upper Extremity Function Short Form
PROMIS Ability to Participate in Social Roles and Activities Short Form 8a
PROMIS Bank v1.0-Emotional Distress-Anxiety
PROMIS Bank v1.0-Emotional Distress-Depression
PROMIS Bank v1.0-Satisfaction with Participation in Discretionary Social Activities
PROMIS Bank v1.0-Satisfaction with Participation in Social Roles
PROMIS Bank v1.0-Sleep Disturbance
PROMIS Bank v1.0-Sleep Related Impairment
PROMIS Bank v1.1-Anger
PROMIS Global Health Short Form 8a

PSYCHIATRIC AND PSYCHOLOGICAL STATUS

Alcohol Use Disorders Identification Test-Consumption Questions (AUDIT-C)
Alcohol Use Disorders Identification Test: Self-Report Version (AUDIT)
Alcohol, Smoking, and Substance Use Involvement Screening Test (ASSIST)
Beck Depression Inventory II (BDI-II)
Brief Symptoms Inventory-18 (BSI-18)
Center for Epidemiologic Studies-Depression Scale (CES-D)
Child Behavior Checklist (CBCL) for Ages 1.5 to 5 Years
Child Behavior Checklist (CBCL) for Ages 6-18 Years
Children's Affective Lability Scale (CALS)
Children's Motivation Scale (CMS)
Clinician-Administered PTSD Scale for DSM-IV
Family Assessment Device (FAD)
Kiddie-SADS-Present and Lifetime Version (K-SADS-PL) Diagnostic Interview
Minnesota Multiphasic Personality Inventory 2 Restructured Form (MMPI-2-RF)
Modified Overt Aggression Scale (MOAS)
Mood and Feelings Questionnaire Short Version (SMFQ)
Neurobehavioral Rating Scale (NRS)
NIH ToolBox Emotion Domain Anger Survey Fixed Form Ages 8-17
NIH ToolBox Emotion Domain Anger Survey Parent Report Ages 3-7
NIH ToolBox Emotion Domain Anger Survey Parent Report Ages 8-12
NIH Toolbox Emotion Domain Anger-Affect Survey CAT 18-85
NIH ToolBox Emotion Domain Anger-Hostility Survey Short Form 18-85
NIH Toolbox Emotion Domain Anger-Physical Aggression Survey Short Form Ages 18-85
NIH Toolbox Emotion Domain Apathy Survey 18-85
NIH Toolbox Emotion Domain Emotion Control Survey Ages 8-17
NIH Toolbox Emotion Domain Emotion Control Survey Parent Report Ages 8-12
NIH Toolbox Emotion Domain Emotional Support Survey 18-85
NIH Toolbox Emotion Domain Emotional Support Survey 8-17
NIH Toolbox Emotion Domain Empathic Behaviors Parent Report CAT Ages 3-12
NIH ToolBox Emotion Domain Fear Affect Survey CAT 18-85
NIH ToolBox Emotion Domain Fear Affect Survey SF 18-85
NIH Toolbox Emotion Domain Fear Over-Anxious Parent Report SF Ages 3-7
NIH ToolBox Emotion Domain Fear Separation Anxiety Parent Report Fixed Form Ages 3-7
NIH ToolBox Emotion Domain Fear Survey Parent Report CAT Ages 8-12
NIH Toolbox Emotion Domain Fear Survey Short/Fixed Form Ages 8-17 version 1.1
NIH Toolbox Emotion Domain Fear-Somatic Arousal Survey Ages 18-85
NIH Toolbox Emotion Domain Friendship Survey Short Form Ages 18-85
NIH Toolbox Emotion Domain Friendship Survey Short Form Ages 8-17
NIH Toolbox Emotion Domain General Life Satisfaction Parent Report Ages 3-12
NIH Toolbox Emotion Domain General Life Satisfaction Survey CAT Ages 13-17
NIH Toolbox Emotion Domain General Life Satisfaction Survey CAT Ages 18-85
NIH Toolbox Emotion Domain General Life Satisfaction Survey Short Form Ages 8-12
NIH Toolbox Emotion Domain Instrumental Support Survey SF Ages 18-85
NIH Toolbox Emotion Domain Loneliness Survey Ages 18-85
NIH Toolbox Emotion Domain Loneliness Survey Ages 8-17
NIH Toolbox Emotion Domain Maternal Relationship Survey Ages 8-17
NIH Toolbox Emotion Domain Meaning and Purpose Survey CAT 18-85
NIH Toolbox Emotion Domain Meaning and Purpose Survey SF 18-85
NIH Toolbox Emotion Domain Negative Parental Relationship Survey Ages 3-12
NIH Toolbox Emotion Domain Paternal Relationship Survey Ages 8-17
NIH Toolbox Emotion Domain Peer Rejection Survey Parent Report Ages 3-12
NIH Toolbox Emotion Domain Perceived Hostility Survey Ages 8-17
NIH Toolbox Emotion Domain Perceived Hostility Survey SF Ages 18-85
NIH Toolbox Emotion Domain Perceived Rejection Survey Ages 18-85
NIH Toolbox Emotion Domain Perceived Rejection Survey Ages 8-17
NIH Toolbox Emotion Domain Perceived Stress CAT (Parent Report for children ages 8-12)
NIH Toolbox Emotion Domain Perceived Stress Survey CAT Ages 13-17
NIH Toolbox Emotion Domain Positive Affect Survey CAT Ages 13-17
NIH Toolbox Emotion Domain Positive Affect Survey CAT Ages 18-85
NIH Toolbox Emotion Domain Positive Affect Survey Parent Report Ages 3-7.
NIH Toolbox Emotion Domain Positive Affect Survey Parent Report Ages 8-12
NIH Toolbox Emotion Domain Positive Affect Survey Short Form Ages 8-12
NIH Toolbox Emotion Domain Positive Parental Relationship Survey Ages 3-12
NIH Toolbox Emotion Domain Positive Peer Interaction Survey Parent Report Ages 3-12
NIH Toolbox Emotion Domain Sadness Survey CAT 18-85
NIH Toolbox Emotion Domain Sadness Survey Parent Report CAT Ages 8-12
NIH Toolbox Emotion Domain Sadness Survey Parent Report SF Ages 3-7
NIH Toolbox Emotion Domain Sadness Survey SF Ages 8-17
NIH Toolbox Emotion Domain Self Efficacy Parent Report CAT Ages 8-12
NIH Toolbox Emotion Domain Self Efficacy Survey CAT 13-17
NIH Toolbox Emotion Domain Self Efficacy Survey CAT 18-85
NIH Toolbox Emotion Domain Self Efficacy Survey CAT 8-12
NIH Toolbox Emotion Domain Sibling Rejection Survey Ages 3-12
NIH Toolbox Emotion Domain Social Withdrawal Survey Parent Report Ages 3-12
NIH Toolbox Emotion Domain Specific Life Satisfaction Survey Ages 13-17
NIH Toolbox Emotion Domain Specific Life Satisfaction Survey Ages 18-85
NIH Toolbox Emotion Domain Specific Life Satisfaction Survey Ages 8-12
NIH Toolbox Emotion Domain Specific Life Satisfaction Survey Parent Report Ages 3-7
NIH Toolbox Emotion Domain Specific Life Satisfaction Survey Parent Report Ages 8-12
Patient Health Questionnaire-9 (PHQ-9)
Patient Health Questionnaire (PHQ)
Personal Health Questionnaire Depression Scale (PHQ-8)
Posttraumatic Stress Disorder Checklist (PCL) Civilian Version
PTSD Checklist-Military (PCL-M)
PTSD Checklist-PCL Scoring
PTSD Checklist-Stressor Specific (PCL-S)
Screen for Child Anxiety Related Emotional Disorders (SCARED)
Strengths and Difficulties Questionnaire (SDQ)-Follow up Version
Strengths and Difficulties Questionnaire (SDQ)-Full Version
Strengths and Difficulties Questionnaire (SDQ)-Single Version
Substance Abuse Questions from the TBI Model Systems Database
UCLA PTSD INDEX FOR DSM IV (Child Version, Revision 1)

PROSPECTIVE ASSESSMENTS FOR SUICIDAL IDEATION AND BEHAVIOR

PROSPECTIVE ASSESSMENTS FOR SUICIDAL IDEATION AND BEHAVIOR