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CDE Detailed Report
This report contains detailed information about the selected CDEs.
Note: If at least one CDE was selected from a copyright- or trademark-protected instrument/scale then all of the CDEs from that instrument/scale are included in this report.
Disease: Sport Related Concussion
SubDisease: Comprehensive
Sub-Domain: Behavioral Function
CRF: Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Item count: 1392 (174 distinct CDEs)
CDE ID
CDE Name
Variable Name
Definition / Description
Question Text
Permissible Value
Description
Data Type
Instructions
References
Population
Classification (e.g., Core)
Version #
Version Date
Aliases for Variable Name
CRF Module / Guideline
© or TM
Sub-Domain
Domain
Previous Title
Size
Input Restrictions
Min Value
Max Value
Measurement Type
LOINC ID
SNOMED
caDSR ID
CDISC ID
C21117
Subject name
SubjectName
Name of subject/participant.
Pupil's full name, First Middle Last
  
Alphanumeric
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
1.0
6/12/2015
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
 
255
Free-Form Entry
       
C00035
Gender type
GenderTyp
Self-reported gender of the participant/subject. Gender is the socially constructed identity of sex. Gender is equated with phenotypic sex. Gender may differ from the sex of an individual determined genetically.
Pupil's Gender
Male;Female;
Male;Female;
Alphanumeric
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
3.0
8/28/2013
caBIG: PRSN_GENDER_TXT_TP; SCI CDEs: GENDER
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
Gender type
 
Single Pre-Defined Value Selected
     
2200604
 
C00008
Age value
AgeVal
Value for participant/subject's age, calculated as elapsed time since the birth of the participant/subject.
Pupil's Age
  
Numeric Values
Record in months
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
3.0
8/28/2013
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
Age value
 
Free-Form Entry
0
1800
month
    
C00020
Ethnicity USA category
EthnUSACat
Category of ethnicity the participant/subject most closely identifies with
Pupil's Ethnic Group or Race
Hispanic or Latino;Not Hispanic or Latino;Unknown;Not reported;Other, specify;
A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. The term “Spanish origin” can also be used in addition to “Hispanic or Latino.”;A person not meeting the definition for Hispanic or Latino.;Could not be determined or unsure;Not reported;Other, specify;
Alphanumeric
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
3.0
8/28/2013
ETHN_GRP_CAT_TXT
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
Ethnicity USA category
 
Single Pre-Defined Value Selected
     
2192217
 
C19500
Assessment performed date
AssessmentPerformedDate
The date of assessment of the examination being performed.
Today's Date
  
Date or Date & Time
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
1.0
6/18/2014
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
  
Free-Form Entry
       
C00007
Birth date
BirthDate
Date (and time, if applicable and known) the participant/subject was born
Pupil's Birthdate (if known)
  
Date or Date & Time
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
3.0
7/25/2013
caBIG: PER_BIR_DT; SCI CDEs: BIRTHDT
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
Birth date
 
Free-Form Entry
     
793
 
C00012
Education level USA type
EduLvlUSATyp
Highest grade or level of school participant/subject has completed or the highest degree received
Grade in School
1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;Some college, no degree;Associate degree: academic program;Associate degree: occupational/technical/vocational program;Bachelor's degree (e.g., BA, AB, BS, BBA);
1st Grade;2nd Grade;3rd Grade;4th Grade;5th Grade;6th Grade;7th Grade;8th Grade;9th Grade;10th Grade;11th Grade;12th Grade, no diploma;High school graduate;Some college, no degree;Associate degree: academic program;Associate degree: occupational/technical/vocational program;Bachelor's degree (e.g., BA, AB, BS, BBA);
Alphanumeric
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
3.0
7/25/2013
HIGHEST_EDU_LVL_CAT
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
Education level USA type
 
Single Pre-Defined Value Selected
     
3134878
 
C55010
Child Behavior Checklist (CBLC) - Occupation parent 1 type
CBLCOccupationParent1Typ
Type of occupation of parent 1, as part of the Child Behavior Checklist (CBLC)
Parent 1 (or Father) Type of Work
  
Alphanumeric
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Adult
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
 
255
Free-Form Entry
       
C55011
Child Behavior Checklist (CBLC) - Occupation parent 2 type
CBLCOccupationParent2Typ
Type of occupation of parent 2, as part of the Child Behavior Checklist (CBLC)
Parent 2 (or Mother) Type of Work
  
Alphanumeric
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Adult
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
 
255
Free-Form Entry
       
C17733
Person completing form name
PrsnCompletingFormName
Name of person completing the form
This form filled out by:
  
Alphanumeric
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Adult
Exploratory
3.0
8/30/2013
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
 
255
Free-Form Entry
       
C55012
Child Behavior Checklist (CBLC) - Respondent gender category
CBLCRespondentGenderCategory
Category for the respondent's gender, as part of the Child Behavior Checklist (CBLC)
Your gender:
Male;Female;
Male;Female;
Alphanumeric
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Adult
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C55013
Child Behavior Checklist (CBLC) - Respondent school role type
CBLCRespondentSchoolRoleTyp
Type of role performed by the respondent at the child's school, as part of the Child Behavior Checklist (CBLC)
Your role at the school:
Classroom Teacher;Special Educator;Teacher's Aide;Counselor;Administrator;Other, specify;
Classroom Teacher;Special Educator;Teacher's Aide;Counselor;Administrator;Other, specify;
Alphanumeric
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Adult
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C55014
Child Behavior Checklist (CBLC) - Respondent school role other text
CBLCRespondentSchoolRoleOTH
The free-text field related to 'Child Behavior Checklist (CBLC) - Respondent school role type' specifying other text, as part of the Child Behavior Checklist (CBLC)
Your role at the school: Other (specify):
  
Alphanumeric
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Adult
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
 
255
Free-Form Entry
       
C55015
Child Behavior Checklist (CBLC) - Know child month duration
CBLCKnowChildMonthDur
Duration in months for which the respondent has known the child, as part of the Child Behavior Checklist (CBLC)
For how many months have you known this pupil?
  
Numeric Values
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Adult;Pediatric
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
  
Free-Form Entry
  
Months
    
C55016
Child Behavior Checklist (CBLC) - Familiar child degree code
CBLCFamiliarChildDegreeCode
Code for the degree of familiarity of the respondent to the child, as part of the Child Behavior Checklist (CBLC)
How well do you know him/her?
1;2;3;
Not Well;Moderately Well;Very Well;
Numeric Values
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Adult;Pediatric
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C55017
Child Behavior Checklist (CBLC) - Child time in class service week duration
CBLCChildTimeInClassSvcWkDur
Duration in hours per week that the child spends in the respondent's class or service, as part of the Child Behavior Checklist (CBLC)
How much time does he/she spend in your class or service per week?
  
Numeric Values
Your answers will be used to compare the pupil with other pupils whose teachers have completed similar forms. The information on this form will also be used for comparison with other information about this pupil. Please answer as well as you can, even if you lack full information. Scores on individual items will be combined to identify general patterns of behavior.
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Adult;Pediatric
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
  
Free-Form Entry
0.1
30
Hours per week
    
C55018
Child Behavior Checklist (CBLC) - School class service type
CBLCSchoolClassServiceTyp
Type of class or service provided by the respondent at the child's school, as part of the Child Behavior Checklist (CBLC)
What kind of class or service is it?
  
Alphanumeric
Please be specific, e.g., regular 5th grade, 7th grade math, learning disability, counseling, etc.
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
 
255
Free-Form Entry
       
C55019
Child Behavior Checklist (CBLC) - Child referral education assistance code
CBLCChildRefrlEductnAsstncCode
Code for whether, to the respondent's knowledge, the child has ever been referred for educational assistance outside of a regular classroom, such as special class placement, services, or tutoring, as part of the Child Behavior Checklist (CBLC)
Has he/she ever been referred for special class placement, services, or tutoring?
Don't know;0;1;
Don't know;No;Yes—what kind and when?;
Alphanumeric
Your answers will be used to compare the pupil with other pupils whose teachers have completed similar forms. The information on this form will also be used for comparison with other information about this pupil. Please answer as well as you can, even if you lack full information. Scores on individual items will be combined to identify general patterns of behavior.
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C55020
Child Behavior Checklist (CBLC) - Child referral education assistance describe text
CBLCChildRefrlAsstnceDscrbTxt
The free-text field related to 'Child Behavior Checklist (CBLC) - Child referral education assistance indicator' for describing educational assistance for which the child was referred, as part of the Child Behavior Checklist (CBLC)
Yes—what kind and when?
  
Alphanumeric
Your answers will be used to compare the pupil with other pupils whose teachers have completed similar forms. The information on this form will also be used for comparison with other information about this pupil. Please answer as well as you can, even if you lack full information. Scores on individual items will be combined to identify general patterns of behavior.
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
 
255
Free-Form Entry
       
C55076
Child Behavior Checklist (CBLC) - School grade repeat code
CBLCSchoolGradeRepeatCode
Code for the respondent's knowledge of whether the child has repeated a grade, as part of the Child Behavior Checklist (CBLC)
Has he/she repeadted any grades?
Don't know;0;1;
Don't know;No;Yes—grades and reasons:;
Alphanumeric
Your answers will be used to compare the pupil with other pupils whose teachers have completed similar forms. The information on this form will also be used for comparison with other information about this pupil. Please answer as well as you can, even if you lack full information. Scores on individual items will be combined to identify general patterns of behavior.
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C55021
Child Behavior Checklist (CBCL) - School grade repeat describe text
CBCLSchoolGradRptDscrbTxt
The free-text field related to 'School repeat grade indicator' for describing the grade repeated by the child and the reasons for doing so, as part of the Child Behavior Checklist (CBCL)
Yes—grades and reasons:
  
Alphanumeric
Your answers will be used to compare the pupil with other pupils whose teachers have completed similar forms. The information on this form will also be used for comparison with other information about this pupil. Please answer as well as you can, even if you lack full information. Scores on individual items will be combined to identify general patterns of behavior.
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
 
255
Free-Form Entry
       
C55022
Child Behavior Checklist (CBCL) - Academic performance subject type
CBLCAcdmcPrfrmncSbjctTyp
Type of academic subject for which the respondent is rating the child's performance, as part of the Child Behavior Checklist (CBCL)
Academic subject
  
Alphanumeric
No instructions available
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
 
50
Free-Form Entry
       
C55023
Child Behavior Checklist (CBCL) - Academic performance subject code
CBLCAcdmcPrfrmncSbjctCode
Code for the academic performance of the child in the subject captured in 'Child Behavior Checklist (CBCL) - Academic performance subject type', as part of the Child Behavior Checklist (CBCL)
Current academic performance
1;3;4;5;2;
Far below grade;At grade level;Somewhat above grade;Far above grade;Somewhat below grade;
Numeric Values
Your answers will be used to compare the pupil with other pupils whose teachers have completed similar forms. The information on this form will also be used for comparison with other information about this pupil. Please answer as well as you can, even if you lack full information. Scores on individual items will be combined to identify general patterns of behavior.
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C55024
Child Behavior Checklist (CBCL) - Work hard relative pupil typical same age code
CBLCWrkHrdRelPplTypSamAgeCode
Code for how hard the child works relative to typical pupils of the same age, as part of the Child Behavior Checklist (CBCL)
How hard is he/she working?
4;1;2;3;5;6;7;
About average;Much less;Somewhat less;Slightly less;Slightly more;Somewhat more;Much more;
Numeric Values
Compared to typical pupils of the same age
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
C55025
Child Behavior Checklist (CBCL) - Behave appropriate relative pupil typical same age code
CBLCBhvAptRelPplTypSamAgeCode
Code for the appropriateness of the child's behavior relative to typical pupils of the same age, as part of the Child Behavior Checklist (CBCL)
How appropriately is he/she behaving?
4;1;2;3;5;6;7;
About average;Much less;Somewhat less;Slightly less;Slightly more;Somewhat more;Much more;
Numeric Values
Compared to typical pupils of the same age
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org
Pediatric
Exploratory
1.0
4/18/2017
Aliases for variable name not defined
Child Behavior Checklist (CBCL) Teacher Report Form for Ages 6–18
Behavioral Function
Outcomes and End Points
  
Single Pre-Defined Value Selected
       
07-19-2019
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