Version 2.78

90172-8 PROMIS parent proxy cognitive function - frequency - version 1.0

Form Coding Instructions

The following items are about the frequency of cognitive concerns

Source: PROMIS

Fully-Specified Name

Component
PROMIS parent proxy cognitive function - frequency - version 1.0
Property
-
Time
4W
System
^Patient
Scale
-
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
PANEL.SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Subset
Panel Type
Organizer

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90135-5 In the past 4 weeks - Your child has trouble remembering the names of people he or she has just met

Fully-Specified Name

Component
Your child has trouble remembering the names of people he or she has just met in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has trouble remembering the names of people he or she has just met
Source
NQCOG62_2Ar;CaPSPC26_2Ar

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90139-7 In the past 4 weeks - Your child walks into a room and forgets what he or she wanted to get or do

Fully-Specified Name

Component
Your child walks into a room and forgets what he or she wanted to get or do in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child walks into a room and forgets what he or she wanted to get or do
Source
NQCOG69_2Ar

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90140-5 In the past 4 weeks - Your child has trouble remembering the names of people he or she knows

Fully-Specified Name

Component
Your child has trouble remembering the names of people he or she knows in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has trouble remembering the names of people he or she knows
Source
NQCOG70_2Ar

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90142-1 In the past 4 weeks - Your child has trouble remembering the date or day of the week

Fully-Specified Name

Component
Your child has trouble remembering the date or day of the week in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has trouble remembering the date or day of the week
Source
NQCOG82_2Ar

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90158-7 In the past 4 weeks - Your child forgets what he or she is going to say

Fully-Specified Name

Component
Your child forgets what he or she is going to say in past 4W - frequency
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child forgets what he or she is going to say
Source
pedsPCF3_FA

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90146-2 In the past 4 weeks - Your child reacts slower than most people his or her age when he or she plays games

Fully-Specified Name

Component
Your child reacts slower than most people his or her age when he or she plays games in past 4W - frequency
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child reacts slower than most people his or her age when he or she plays games
Source
pB11r_FA

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90148-8 In the past 4 weeks - It is hard for your child to find the right words to say what he or she means

Fully-Specified Name

Component
It is hard for your child to find the right words to say what he or she means in past 4W - frequency
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It is hard for your child to find the right words to say what he or she means
Source
pB12_FA

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90162-9 In the past 4 weeks - Your child has to use written lists more often than other people his or her age so he or she will not forget things

Fully-Specified Name

Component
Your child has to use written lists more often than other people his or her age so he or she will not forget things in past 4W - frequency
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has to use written lists more often than other people his or her age so he or she will not forget things
Source
pedsPCF5_FA

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0
90934-1 PROMIS parent proxy short form - cognitive function 7a - version 1.0

90127-2 In the past 4 weeks - It is hard for your child to find his or her way to a place that he or she has visited several times before

Fully-Specified Name

Component
It is hard for your child to find his or her way to a place that he or she has visited several times before in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It is hard for your child to find his or her way to a place that he or she has visited several times before
Source
CaPSPC10_2Ar

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90135-5 In the past 4 weeks - Your child has trouble remembering the names of people he or she has just met

Fully-Specified Name

Component
Your child has trouble remembering the names of people he or she has just met in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has trouble remembering the names of people he or she has just met
Source
NQCOG62_2Ar;CaPSPC26_2Ar

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90134-8 In the past 4 weeks - It is hard for your child to pay attention to one thing for more than 5-10 minutes

Fully-Specified Name

Component
It is hard for your child to pay attention to one thing for more than 5-10 minutes in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It is hard for your child to pay attention to one thing for more than 5-10 minutes
Source
NQCOG44_2Ar

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0
90934-1 PROMIS parent proxy short form - cognitive function 7a - version 1.0

90136-3 In the past 4 weeks - Your child has trouble keeping track of what he or she is doing if he or she gets interrupted

Fully-Specified Name

Component
Your child has trouble keeping track of what he or she is doing if he or she gets interrupted in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has trouble keeping track of what he or she is doing if he or she gets interrupted
Source
NQCOG65_2Ar

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0
90934-1 PROMIS parent proxy short form - cognitive function 7a - version 1.0

90137-1 In the past 4 weeks - It is hard for your child to do more than one thing at a time

Fully-Specified Name

Component
It is hard for your child to do more than one thing at a time in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It is hard for your child to do more than one thing at a time
Source
NQCOG66_2Ar

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90143-9 In the past 4 weeks -When your child has a big project to do, he or she has trouble deciding where to start

Fully-Specified Name

Component
When your child has a big project to do, he or she has trouble deciding where to start in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks -When your child has a big project to do, he or she has trouble deciding where to start
Source
NQCOG85_2Ar

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90144-7 In the past 4 weeks - Your child has to read things several times to understand them

Fully-Specified Name

Component
Your child has to read things several times to understand them in past 4W - frequency
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has to read things several times to understand them
Source
pB10_FA

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0
90934-1 PROMIS parent proxy short form - cognitive function 7a - version 1.0

90150-4 In the past 4 weeks - Your child forgets things easily

Fully-Specified Name

Component
Your child forgets things easily in past 4W - frequency
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child forgets things easily
Source
pB8_FA

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0
90934-1 PROMIS parent proxy short form - cognitive function 7a - version 1.0

90168-6 In the past 4 weeks - Your child has to work really hard to pay attention or he or she makes mistakes

Fully-Specified Name

Component
Your child has to work really hard to pay attention or he or she makes mistakes in past 4W - frequency
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has to work really hard to pay attention or he or she makes mistakes
Source
pedsPCF8_FA

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0
90934-1 PROMIS parent proxy short form - cognitive function 7a - version 1.0

90138-9 In the past 4 weeks - Your child forgets what his or her parents or teachers ask him or her to do

Fully-Specified Name

Component
Your child forgets what his or her parents or teachers ask him or her to do in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child forgets what his or her parents or teachers ask him or her to do
Source
NQCOG68_2_1Ar

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90164-5 In the past 4 weeks - Your child has trouble remembering to do things like school projects or chores

Fully-Specified Name

Component
Your child has trouble remembering to do things like school projects or chores in past 4W - frequency
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has trouble remembering to do things like school projects or chores
Source
pedsPCF6_FA

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0
90934-1 PROMIS parent proxy short form - cognitive function 7a - version 1.0

90128-0 In the past 4 weeks - Your child has trouble remembering where he or she put things, like his or her watch or his or her homework

Fully-Specified Name

Component
Your child has trouble remembering where he or she put things, like his or her watch or his or her homework in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has trouble remembering where he or she put things, like his or her watch or his or her homework
Source
CaPSPC11_2Ar

Normative Answer List LL5131-9

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All of the time 1 LA6154-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90160-3 In the past 4 weeks - It takes your child longer than other people to get his or her school work done

Fully-Specified Name

Component
It takes your child longer than other people to get his or her school work done in past 4W - frequency
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It takes your child longer than other people to get his or her school work done
Source
pedsPCF4_FA

Normative Answer List LL5133-5

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All the time 1 LA14726-6
Not applicable LA4720-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90166-0 In the past 4 weeks - Your child has trouble paying attention to the teacher

Fully-Specified Name

Component
Your child has trouble paying attention to the teacher in past 4W - frequency
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has trouble paying attention to the teacher
Source
pedsPCF7_FA

Normative Answer List LL5133-5

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All the time 1 LA14726-6
Not applicable LA4720-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90154-6 In the past 4 weeks - Your child has a hard time keeping track of his or her homework

Fully-Specified Name

Component
Your child has a hard time keeping track of his or her homework in past 4W - frequency
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has a hard time keeping track of his or her homework
Source
pedsPCF1_FA

Normative Answer List LL5133-5

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All the time 1 LA14726-6
Not applicable LA4720-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90156-1 In the past 4 weeks - Your child forgets to bring things to and from school that he or she needs for homework

Fully-Specified Name

Component
Your child forgets to bring things to and from school that he or she needs for homework in past 4W - frequency
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child forgets to bring things to and from school that he or she needs for homework
Source
pedsPCF2_FA

Normative Answer List LL5133-5

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All the time 1 LA14726-6
Not applicable LA4720-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90152-0 In the past 4 weeks - It is hard for your child to concentrate in school

Fully-Specified Name

Component
It is hard for your child to concentrate in school in past 4W - frequency
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It is hard for your child to concentrate in school
Source
pB9_FA

Normative Answer List LL5133-5

Answer Code Score Answer ID
None of the time 5 LA6297-1
A little of the time 4 LA14732-4
Some of the time 3 LA14733-2
Most of the time 2 LA14734-0
All the time 1 LA14726-6
Not applicable LA4720-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90173-6 PROMIS parent proxy cognitive function - severity - version 1.0

Form Coding Instructions

The following items are about the severity of cognitive concerns

Source: PROMIS

Fully-Specified Name

Component
PROMIS parent proxy cognitive function - severity - version 1.0
Property
-
Time
4W
System
^Patient
Scale
-
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
PANEL.SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Subset
Panel Type
Organizer

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90132-2 In the past 4 weeks - It is hard for your child to understand pictures that show how to make something

Fully-Specified Name

Component
It is hard for your child to understand pictures that show how to make something in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It is hard for your child to understand pictures that show how to make something
Source
NQCOG42_2Ar

Normative Answer List LL3325-9

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90159-5 In the past 4 weeks - Your child forgets what he or she is going to say

Fully-Specified Name

Component
Your child forgets what he or she is going to say in past 4W - severity
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child forgets what he or she is going to say
Source
pedsPCF3A

Normative Answer List LL3325-9

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90147-0 In the past 4 weeks - Your child reacts slower than most people his or her age when he or she plays games

Fully-Specified Name

Component
Your child reacts slower than most people his or her age when he or she plays games in past 4W - severity
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child reacts slower than most people his or her age when he or she plays games
Source
pB11rA

Normative Answer List LL3325-9

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90149-6 In the past 4 weeks - It is hard for your child to find the right words to say what he or she means

Fully-Specified Name

Component
It is hard for your child to find the right words to say what he or she means in past 4W - severity
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It is hard for your child to find the right words to say what he or she means
Source
pB12A

Normative Answer List LL3325-9

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90163-7 In the past 4 weeks - Your child has to use written lists more often than other people his or her age so he or she will not forget things

Fully-Specified Name

Component
Your child has to use written lists more often than other people his or her age so he or she will not forget things in past 4W - severity
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has to use written lists more often than other people his or her age so he or she will not forget things
Source
pedsPCF5A

Normative Answer List LL3325-9

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90131-4 In the past 4 weeks - It is hard for your child to learn new things

Fully-Specified Name

Component
It is hard for your child to learn new things in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It is hard for your child to learn new things
Source
NQCOG40_2Ar

Normative Answer List LL3325-9

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90133-0 In the past 4 weeks - It is hard for your child to pay attention to something boring he or she has to do

Fully-Specified Name

Component
It is hard for your child to pay attention to something boring he or she has to do in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It is hard for your child to pay attention to something boring he or she has to do
Source
NQCOG44_2_2Ar

Normative Answer List LL3325-9

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90141-3 In the past 4 weeks - It is hard for your child to add or subtract numbers in his or her head

Fully-Specified Name

Component
It is hard for your child to add or subtract numbers in his or her head in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It is hard for your child to add or subtract numbers in his or her head
Source
NQCOG78_2_1Ar

Normative Answer List LL3325-9

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90145-4 In the past 4 weeks - Your child has to read things several times to understand them

Fully-Specified Name

Component
Your child has to read things several times to understand them in past 4W - severity
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has to read things several times to understand them
Source
pB10A

Normative Answer List LL3325-9

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90151-2 In the past 4 weeks - Your child forgets things easily

Fully-Specified Name

Component
Your child forgets things easily in past 4W - severity
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child forgets things easily
Source
pB8A

Normative Answer List LL3325-9

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90169-4 In the past 4 weeks - Your child has to work really hard to pay attention or he or she makes mistakes

Fully-Specified Name

Component
Your child has to work really hard to pay attention or he or she makes mistakes in past 4W - severity
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has to work really hard to pay attention or he or she makes mistakes
Source
pedsPCF8A

Normative Answer List LL3325-9

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90165-2 In the past 4 weeks - Your child has trouble remembering to do things like school projects or chores

Fully-Specified Name

Component
Your child has trouble remembering to do things like school projects or chores in past 4W - severity
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has trouble remembering to do things like school projects or chores
Source
pedsPCF6A

Normative Answer List LL3325-9

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90130-6 In the past 4 weeks - It is hard for your child to take notes in class

Fully-Specified Name

Component
It is hard for your child to take notes in class in past 4W
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It is hard for your child to take notes in class
Source
NQCOG40_2_1Ar

Normative Answer List LL5132-7

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9
Not applicable LA4720-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90161-1 In the past 4 weeks - It takes your child longer than other people to get his or her school work done

Fully-Specified Name

Component
It takes your child longer than other people to get his or her school work done in past 4W - severity
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It takes your child longer than other people to get his or her school work done
Source
pedsPCF4A

Normative Answer List LL5132-7

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9
Not applicable LA4720-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90153-8 In the past 4 weeks - It is hard for your child to concentrate in school

Fully-Specified Name

Component
It is hard for your child to concentrate in school in past 4W - severity
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - It is hard for your child to concentrate in school
Source
pB9A

Normative Answer List LL5132-7

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9
Not applicable LA4720-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90167-8 In the past 4 weeks - Your child has trouble paying attention to the teacher

Fully-Specified Name

Component
Your child has trouble paying attention to the teacher in past 4W - severity
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has trouble paying attention to the teacher
Source
pedsPCF7A

Normative Answer List LL5132-7

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9
Not applicable LA4720-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90155-3 In the past 4 weeks - Your child has a hard time keeping track of his or her homework

Fully-Specified Name

Component
Your child has a hard time keeping track of his or her homework in past 4W - severity
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child has a hard time keeping track of his or her homework
Source
pedsPCF1_FA

Normative Answer List LL5132-7

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9
Not applicable LA4720-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90157-9 In the past 4 weeks - Your child forgets to bring things to and from school that he or she needs for homework

Fully-Specified Name

Component
Your child forgets to bring things to and from school that he or she needs for homework in past 4W - severity
Property
Find
Time
4W
System
^Patient
Scale
Ord
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Survey Question

Text
In the past 4 weeks - Your child forgets to bring things to and from school that he or she needs for homework
Source
pedsPCF2_FA

Normative Answer List LL5132-7

Answer Code Score Answer ID
Not at all 5 LA6568-5
A little bit 4 LA13863-8
Somewhat 3 LA13909-9
Quite a bit 2 LA13902-4
Very much 1 LA13914-9
Not applicable LA4720-4

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0

90171-0 PROMIS parent proxy cognitive function - version 1.0 T-score

Fully-Specified Name

Component
PROMIS parent proxy cognitive function - version 1.0 T-score
Property
Tscore
Time
Pt
System
^Patient
Scale
Qn
Method
PROMIS.PARENTPROXY

Basic Attributes

Class
SURVEY.PROMIS
Type
Surveys
First Released
Version 2.65
Last Updated
Version 2.65
Order vs. Observation
Observation

Member of these Panels

LOINC Long Common Name
90170-2 PROMIS parent proxy item bank - cognitive function - version 1.0
90934-1 PROMIS parent proxy short form - cognitive function 7a - version 1.0

Example Units

Unit Source
{Tscore} Example UCUM Units