CDE Detailed Report

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CDE ID CDE Name Variable Name Definition Short Description Question Text Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guidance) Subdomain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C21086 Frontal Systems Behavior Scale (FrSBE) - Form type FrSBeFormTyp Type of the Frontal Systems Behavior Scale (FrSBE) form Type of the Frontal Systems Behavior Scale (FrSBE) form Form type Self-Rating;Family Rating Self-Rating;Family Rating Numeric Values

Indicate if the form was completed by the subject or by the family member.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21017 Frontal Systems Behavior Scale (FrSBE) - Action idea repetition frequency scale FrSBeRepeatsActionsFreq Frequency of repeating certain actions or getting stuck on certain ideas as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of repeating certain actions or getting stuck on certain ideas as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Repeats certain actions or gets stuck on certain ideas 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C20967 Frontal Systems Behavior Scale (FrSBE) - Action speech embarassment frequency scale FrSBeSayEmbarrassingThingsFreq Frequency of doing or saying embarrassing things as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of doing or saying embarrassing things as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Does or says embarrassing things 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21040 Frontal Systems Behavior Scale (FrSBE) - Impulsiveness frequency scale FrSBeImpulsitiveFreq Frequency of doing things impulsively as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of doing things impulsively as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Does things impulsively 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C20994 Frontal Systems Behavior Scale (FrSBE) - Fabrication incredible story when unable remember frequency scale FrSBeMakeUpStoriesFreq Frequency of making up fantastic stories when unable to remember something as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of making up fantastic stories when unable to remember something as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Makes up fantastic stories when unable to remember something 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21065 Frontal Systems Behavior Scale (FrSBE) - Lack initiative motivation frequency scale FrSBeLacksInitiativeFreq Frequency of having difficulty starting an activity, lacking initiative, motivation as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of having difficulty starting an activity, lacking initiative, motivation as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Has difficulty starting an activity, lacks initiative, motivation 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21092 Frontal Systems Behavior Scale (FrSBE) - Missing answer total count FrSBeMissingItemsTtlCount Total count of unanswered or missing questions as part of Frontal Systems Behavior Scale (FrSBE) form Total count of unanswered or missing questions as part of Frontal Systems Behavior Scale (FrSBE) form Unanswered or missing questions total count Numeric Values

Examine the scoring sheet and circle the item number of each item that was left unanswered. An item should be counted as unanswered (missing) if either one or both of the responses (i.e., "Before illness or injury" or "After illness or injury") is missing. Count the number of circled item numbers and write the total number of missing items in the space provided at the bottom of page 3 of the scoring sheet.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Free-Form Entry

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C21018 Frontal Systems Behavior Scale (FrSBE) - Childish humor frequency scale FrSBeChildishHumorFreq Frequency of being overly silly, has childish sense of humour as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of being overly silly, has childish sense of humour as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Is overly silly, has childish sense of humor 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C20970 Frontal Systems Behavior Scale (FrSBE) - Personal hygience neglect frequency scale FrSBeNeglectPersonlHygieneFreq Frequency of neglecting personal hygiene as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of neglecting personal hygiene as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Neglects personal hygiene 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21041 Frontal Systems Behavior Scale (FrSBE) - Benefit accept criticism frequency scale FrSBeAcceptFeedbackFreq Frequency of benefitting from feedback, accepting constructive criticism from others as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of benefitting from feedback, accepting constructive criticism from others as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Benefits from feedback, accepts constructive criticism from others 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C20996 Frontal Systems Behavior Scale (FrSBE) - Lack interest fun important frequency scale FrSBeDisinterestedInThingsFreq Frequency of losing interest in things that used to be fun or important to him/her as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of losing interest in things that used to be fun or important to him/her as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Has lost interest in things that used to be fun or important to him/her 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21067 Frontal Systems Behavior Scale (FrSBE) - Inappropriate sexual comment frequency scale FrSBeInnapropriateSexJokesFreq Frequency of making inappropriate sexual comments and advances, is too flirtatious as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of making inappropriate sexual comments and advances, is too flirtatious as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Makes inappropriate sexual comments and advances, is too flirtatious 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21094 Frontal Systems Behavior Scale (FrSBE) - Missing answer subscale A count FrSBeMissingItemsScaleACount Count of unanswered or missing questions for Apathy subscale as part of Frontal Systems Behavior Scale (FrSBE) form Count of unanswered or missing questions for Apathy subscale as part of Frontal Systems Behavior Scale (FrSBE) form Unanswered or missing questions subscale A count Numeric Values

Examine the scoring sheet and circle the item number of each item that was left unanswered. An item should be counted as unanswered (missing) if either one or both of the responses (i.e., "Before illness or injury" or "After illness or injury") is missing. Count the number of circled item numbers and write the total number of missing items in the space provided at the bottom of page 3 of the scoring sheet.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Free-Form Entry

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C21020 Frontal Systems Behavior Scale (FrSBE) - Food lack smell taste complaint frequency scale FrSBeFoodHasNoSmellTasteFreq Frequency of complaining that food has no taste or smell as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of complaining that food has no taste or smell as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Complains that food has no taste or smell 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C20973 Frontal Systems Behavior Scale (FrSBE) - Hyperactivity frequency scale FrSBeHyperactiveFreq Frequency of being unable to sit still, is hyperactive as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of being unable to sit still, is hyperactive as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Can't sit still, is hyperactive 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21044 Frontal Systems Behavior Scale (FrSBE) - Activity spontaneous involvement frequency scale FrSBeSpontaneousActivitiesFreq Frequency of getting involved with activities spontaneously (such as hobbies) as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of getting involved with activities spontaneously (such as hobbies) as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Gets involved with activities spontaneously (such as hobbies) 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C20998 Frontal Systems Behavior Scale (FrSBE) - Action not agree with description frequency scale FrSBeSayOneThingDoAnotherFreq Frequency of saying one thing, then doing another thing as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of saying one thing, then doing another thing as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Says one thing, then does another thing 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21069 Frontal Systems Behavior Scale (FrSBE) - Apathy subscale raw score FrSBeApathyRawScore Raw score for Apathy subscale as part of Frontal Systems Behavior Scale (FrSBE) Raw score for Apathy subscale as part of Frontal Systems Behavior Scale (FrSBE) Apathy subscale raw score Numeric Values

Transfer each circled item score from the Before Illness or injury column to the corresponding shaded box in the BEFORE column. Transfer each circled item score from the After illness or injury column to the corresponding shaded box in the AFTER column. Sum the scores for each subscale (A, D, and E) and enter the total in the space provided at the bottom of each column.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Free-Form Entry

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C21097 Frontal Systems Behavior Scale (FrSBE) - Missing answer D count FrSBeMissingItemsScaleDCount Count of unanswered or missing questions for Disinhibition subscale as part of Frontal Systems Behavior Scale (FrSBE) form Count of unanswered or missing questions for Disinhibition subscale as part of Frontal Systems Behavior Scale (FrSBE) form Unanswered or missing questions subscale D count Numeric Values

Examine the scoring sheet and circle the item number of each item that was left unanswered. An item should be counted as unanswered (missing) if either one or both of the responses (i.e., "Before illness or injury" or "After illness or injury") is missing. Count the number of circled item numbers and write the total number of missing items in the space provided at the bottom of page 3 of the scoring sheet.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Free-Form Entry

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C21022 Frontal Systems Behavior Scale (FrSBE) - Swearing frequency scale FrSBeSwearingFreqScl Frequency of swearing as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of swearing as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Swears 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C20974 Frontal Systems Behavior Scale (FrSBE) - Problem deny unaware frequency scale FrSBeDeniesHavingProbsFreq Frequency of denying having problems or is unaware of problems or mistakes as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of denying having problems or is unaware of problems or mistakes as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Denies having problems or is unaware of problems or mistakes 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21046 Frontal Systems Behavior Scale (FrSBE) - Action without other people request frequency scale FrSBeDoesWithoutRequestFreq Frequency of doing things without being requested to do so as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of doing things without being requested to do so as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Does things without being requested to do so 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21002 Frontal Systems Behavior Scale (FrSBE) - Unable finish task frequency scale FrSBeStartNotFinishThingsFreq Frequency of starting things but failing to finish them as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of starting things but failing to finish them as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Starts things but fails to finish them, "peters out" 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21071 Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale raw score FrSBeDisinhibitionRawScore Raw score for Disinhibition subscale as part of Frontal Systems Behavior Scale (FrSBE) Raw score for Disinhibition subscale as part of Frontal Systems Behavior Scale (FrSBE) Disinhibition subscale raw score Numeric Values

Transfer each circled item score from the Before Illness or injury column to the corresponding shaded box in the BEFORE column. Transfer each circled item score from the After illness or injury column to the corresponding shaded box in the AFTER column. Sum the scores for each subscale (A, D, and E) and enter the total in the space provided at the bottom of each column.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Free-Form Entry

15 75
C21099 Frontal Systems Behavior Scale (FrSBE) - Missing answer subscale E count FrSBeMissingItemsScaleECount Count of unanswered or missing questions for Executive Dysfunction subscale as part of Frontal Systems Behavior Scale (FrSBE) form Count of unanswered or missing questions for Executive Dysfunction subscale as part of Frontal Systems Behavior Scale (FrSBE) form Unanswered or missing questions subscale E count Numeric Values

Examine the scoring sheet and circle the item number of each item that was left unanswered. An item should be counted as unanswered (missing) if either one or both of the responses (i.e., "Before illness or injury" or "After illness or injury") is missing. Count the number of circled item numbers and write the total number of missing items in the space provided at the bottom of page 3 of the scoring sheet.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Free-Form Entry

0 46
C21024 Frontal Systems Behavior Scale (FrSBE) - Misbehavior apology frequency scale FrSBeApologizeWhenMisbehavFreq Frequency of apologizing for misbehaviour (for example, apologizes for swearing) as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of apologizing for misbehaviour (for example, apologizes for swearing) as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Apologizes for misbehavior (for example, apologizes for swearing) 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C20975 Frontal Systems Behavior Scale (FrSBE) - Sits around doing nothing frequency FrSBeSitDoNothingFreq Frequency of sitting around doing nothing as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of sitting around doing nothing as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Sits around doing nothing 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21049 Frontal Systems Behavior Scale (FrSBE) - Sensitive other people need frequency scale FrSBeSensitiveToOthrsNeedsFreq Frequency of being sensitive to the needs of other people as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of being sensitive to the needs of other people as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Is sensitive to the needs of other people 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21073 Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale raw score FrSBeExecutiveDysfunctRawScore Raw score for Executive Dysfunction subscale as part of Frontal Systems Behavior Scale (FrSBE) Raw score for Executive Dysfunction subscale as part of Frontal Systems Behavior Scale (FrSBE) Total raw score Numeric Values

Transfer each circled item score from the Before Illness or injury column to the corresponding shaded box in the BEFORE column. Transfer each circled item score from the After illness or injury column to the corresponding shaded box in the AFTER column. Sum the scores for each subscale (A, D, and E) and enter the total in the space provided at the bottom of each column.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Free-Form Entry

17 85
C21005 Frontal Systems Behavior Scale (FrSBE) - Lack emotion concern frequency scale FrSBeShowLittleEmotionFreq Frequency of showing little emotion, is unconcerned and unresponsive as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of showing little emotion, is unconcerned and unresponsive as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Shows little emotion, is unconcerned and unresponsive 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21101 Frontal Systems Behavior Scale (FrSBE) - Apathy subscale invalid score indicator FrSBeScaleAInvalidInd Indicator if Apathy subscale is invalid (has more than 3 questions missing) as part of Frontal Systems Behavior Scale (FrSBE) Indicator if Apathy subscale is invalid (has more than 3 questions missing) as part of Frontal Systems Behavior Scale (FrSBE) Apathy subscale invalid indicator No;Yes;Unknown No;Yes;Unknown Numeric Values

If the total number of missing items is 6 or more, the FrSBe can? not be appropriately scored or interpreted and should therefore be considered invalid. Otherwise, assign an item raw score value of "1" for each of the 5 or fewer items with missing responses on the scoring sheet. If there are 3 or more items with missing responses on a particular subscale (A, D, or E), that subscale should be considered invalid and should not be interpreted. However, BEFORE and AFTER raw scores for that subscale should still be calculated (by assigning item raw score values of "1" to the missing items) and used in the calculation of the FrSBe Total score, as long as the total number of missing items on the rating form does not exceed 5.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21027 Frontal Systems Behavior Scale (FrSBE) - Concentration continue with distraction frequency scale FrSBePayingAttentionFreq Frequency of paying attention, concentrates even when there are distractions as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of paying attention, concentrates even when there are distractions as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Pays attention, concentrates even when there are distractions 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C20976 Frontal Systems Behavior Scale (FrSBE) - Disorganized frequency scale FrSBeDisorganizedFreq Frequency of being disorganized as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of being disorganized as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Is disorganized 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21052 Frontal Systems Behavior Scale (FrSBE) - Gets along well with others frequency scale FrSBeGetsAlongWithOthersFreq Frequency of getting along well with others as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of getting along well with others as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Gets along well with others 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21076 Frontal Systems Behavior Scale (FrSBE) - Total raw score FrSBeTotalRawScore Total raw score as part of Frontal Systems Behavior Scale (FrSBE) Total raw score as part of Frontal Systems Behavior Scale (FrSBE) Total raw score Numeric Values

Transfer each circled item score from the Before Illness or injury column to the corresponding shaded box in the BEFORE column. Transfer each circled item score from the After illness or injury column to the corresponding shaded box in the AFTER column. Sum the scores for each subscale (A, D, and E) and enter the total in the space provided at the bottom of each column.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Free-Form Entry

46 230
C21007 Frontal Systems Behavior Scale (FrSBE) - Forgetful until prompt frequency scale FrSBeForgetUnlessPromptedFreq Frequency of forgetting to do things but then remembering when prompted or when it is too late as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of forgetting to do things but then remembering when prompted or when it is too late as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Forgets to do things but then remembers when prompted or when it is too late 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21103 Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale invalid score indicator FrSBeScaleDInvalidInd Indicator if Disinhibition subscale is invalid (has more than 3 questions missing) as part of Frontal Systems Behavior Scale (FrSBE) Indicator if Disinhibition subscale is invalid (has more than 3 questions missing) as part of Frontal Systems Behavior Scale (FrSBE) Disinhibition subscale invalid indicator No;Yes;Unknown No;Yes;Unknown Numeric Values

If the total number of missing items is 6 or more, the FrSBe can? not be appropriately scored or interpreted and should therefore be considered invalid. Otherwise, assign an item raw score value of "1" for each of the 5 or fewer items with missing responses on the scoring sheet. If there are 3 or more items with missing responses on a particular subscale (A, D, or E), that subscale should be considered invalid and should not be interpreted. However, BEFORE and AFTER raw scores for that subscale should still be calculated (by assigning item raw score values of "1" to the missing items) and used in the calculation of the FrSBe Total score, as long as the total number of missing items on the rating form does not exceed 5.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21032 Frontal Systems Behavior Scale (FrSBE) - Action thoughtful frequency scale FrSBeThinkBeforeActingFreq Frequency of thinking things through before acting (for example, considers finances before spending money) as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of thinking things through before acting (for example, considers finances before spending money) as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Thinks things through before acting (for example, considers finances before spending money) 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C20978 Frontal Systems Behavior Scale (FrSBE) - No concern urine bowel control loss frequency scale FrSBeNoConcrnLosCntrlBowelFreq Frequency of losing control of urine or bowels and seems unconcerned as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of losing control of urine or bowels and seems unconcerned as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Loses control of urine or bowels and seems unconcerned 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21053 Frontal Systems Behavior Scale (FrSBE) - Age appropriate behavior frequency scale FrSBeActsAppropriatAgeFreq Frequency of acting appropriately for his/her age as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of acting appropriately for his/her age as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Acts appropriately for his/her age 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21078 Frontal Systems Behavior Scale (FrSBE) - Apathy subscale T score FrSBeApathyTScore T score for Apathy subscale as part of Frontal Systems Behavior Scale (FrSBE) T score for Apathy subscale as part of Frontal Systems Behavior Scale (FrSBE) Apathy subscale T score Numeric Values

To plot an individual's FrSBe profile, one must first convert the raw scores to T scores using the normative tables located in the appendixes of this manual. Identify the appropriate normative tables according to the rating form used (Self-Rating or Family Rating Form), the gender, age, and education level of the rated individual, and the Total scale or subscale needed. Locate the specific raw score for the Total scale in the Total scale appendix table. Then, locate the corresponding T score for the selected raw score for the Total scale. Enter the T score in the space provided just below the corresponding raw score on the bottom of the profile form. Use the same procedure to convert the subscale raw scores to T scores.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Free-Form Entry

21 158
C21009 Frontal Systems Behavior Scale (FrSBE) - Inflexible frequency scale FrSBeInflexibleFreq Frequency of being inflexible, unable to change routines as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of being inflexible, unable to change routines as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Is inflexible, unable to change routines 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21104 Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale invalid score indicator FrSBeScaleEInvalidInd Indicator if Executive Dysfunction subscale is invalid (has more than 3 questions missing) as part of Frontal Systems Behavior Scale (FrSBE) Indicator if Executive Dysfunction subscale is invalid (has more than 3 questions missing) as part of Frontal Systems Behavior Scale (FrSBE) Executive Dysfunction subscale invalid indicator No;Yes;Unknown No;Yes;Unknown Numeric Values

If the total number of missing items is 6 or more, the FrSBe can? not be appropriately scored or interpreted and should therefore be considered invalid. Otherwise, assign an item raw score value of "1" for each of the 5 or fewer items with missing responses on the scoring sheet. If there are 3 or more items with missing responses on a particular subscale (A, D, or E), that subscale should be considered invalid and should not be interpreted. However, BEFORE and AFTER raw scores for that subscale should still be calculated (by assigning item raw score values of "1" to the missing items) and used in the calculation of the FrSBe Total score, as long as the total number of missing items on the rating form does not exceed 5.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21035 Frontal Systems Behavior Scale (FrSBE) - Memory strategy use frequency scale FrSBeUseMemoryStrategiesFreq Frequency of using strategies to remember important things (for example, writes notes to self) as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of using strategies to remember important things (for example, writes notes to self) as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Uses strategies to remember important things (for example, writes notes to self) 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C20980 Frontal Systems Behavior Scale (FrSBE) - Not able multi-task frequency scale FrSBeCantMultitaskFreq Frequency of being unable to do two things at once (for example, talk and prepare a meal) as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of being unable to do two things at once (for example, talk and prepare a meal) as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Cannot do two things at once (for example, talk and prepare a meal) 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21056 Frontal Systems Behavior Scale (FrSBE) - Begin spontaneous conversation frequency scale FrSBeSpontaneousConversatnFreq Frequency of starting conversations spontaneously as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Frequency of starting conversations spontaneously as part of Frontal Systems Behavior Scale (FrSBE) - Apathy subscale Starts conversations spontaneously 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Adult Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21080 Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale T score FrSBeDisinhibitionTScore T score for Disinhibition subscale as part of Frontal Systems Behavior Scale (FrSBE) T score for Disinhibition subscale as part of Frontal Systems Behavior Scale (FrSBE) Disinhibition subscale T score Numeric Values

To plot an individual's FrSBe profile, one must first convert the raw scores to T scores using the normative tables located in the appendixes of this manual. Identify the appropriate normative tables according to the rating form used (Self-Rating or Family Rating Form), the gender, age, and education level of the rated individual, and the Total scale or subscale needed. Locate the specific raw score for the Total scale in the Total scale appendix table. Then, locate the corresponding T score for the selected raw score for the Total scale. Enter the T score in the space provided just below the corresponding raw score on the bottom of the profile form. Use the same procedure to convert the subscale raw scores to T scores.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Free-Form Entry

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C21010 Frontal Systems Behavior Scale (FrSBE) - Law authority difficulty frequency scale FrSBeTroubleWithAuthorityFreq Frequency of getting in trouble with the law or authorities as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Frequency of getting in trouble with the law or authorities as part of Frontal Systems Behavior Scale (FrSBE) - Disinhibition subscale Gets in trouble with the law or authorities 1;2;3;4;5 Almost never;seldom;Sometimes;Frequently;Almost always Numeric Values

As part of (your or your family member's) evaluation, it would be helpful to have your observations about (your or his/her) behavior. This questionnaire will allow us to better understand (your or your relative's) behavior. You will be asked to rate the frequency of (your or his/her) behavior on a scale of 1 to 5 where 1 is Almost never, 2 is Seldom, 3 is Sometimes, 4 is Frequently, and 5 is Almost always. You will be asked to rate (your or his/her) behavior at two points in time: before (your or his/her) illness, injury, or problems began and at the present time, or after the illness or injury occurred. Be sure you complete both columns on the form since they are both important for measuring changes in (your or your relative's) behavior. Please read each of the phrases on the form that are used to describe a person's behavior. The questionnaire asks, "How often (do you or does your relative) engage in the behavior described at each point in time?'' Circle the number in each column, Before illness or injury and After illness or injury, that corresponds to your rating for the behavior described.

Grace J, Malloy PF. Frontal Systems Behavior Scale professional manual. Lutz, FL: Psychological Assessment Resources, Inc.; 2001. Copyright 2001 by PAR, (http://www4.parinc.com/) Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21105 Frontal Systems Behavior Scale (FrSBE) - Invalid score indicator FrSBeInvalidInd Indicator if Frontal Systems Behavior Scale (FrSBE) is invalid (has more than 5 questions missing) Indicator if Frontal Systems Behavior Scale (FrSBE) is invalid (has more than 5 questions missing) Frontal Systems Behavior Scale (FrSBE) is invalid indicator No;Yes;Unknown No;Yes;Unknown Numeric Values

If the total number of missing items is 6 or more, the FrSBe can? not be appropriately scored or interpreted and should therefore be considered invalid. Otherwise, assign an item raw score value of "1" for each of the 5 or fewer items with missing responses on the scoring sheet. If there are 3 or more items with missing responses on a particular subscale (A, D, or E), that subscale should be considered invalid and should not be interpreted. However, BEFORE and AFTER raw scores for that subscale should still be calculated (by assigning item raw score values of "1" to the missing items) and used in the calculation of the FrSBe Total score, as long as the total number of missing items on the rating form does not exceed 5.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

C21036 Frontal Systems Behavior Scale (FrSBE) - Planning ability frequency scale FrSBeAblePlanAheadFreq Frequency of being able to plan ahead as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Frequency of being able to plan ahead as part of Frontal Systems Behavior Scale (FrSBE) - Executive Dysfunction subscale Is able to plan ahead 5;4;3;2;1 Almost never;Seldom;Sometimes;Frequently;Almost always Numeric Values

Reverse scoring. The instructions may be simplified or repeated as often as necessary until the rater fully understands them. As noted earlier, the examiner should remain available to answer any questions the patient or rater may have (regardless of any cognitive limitations they may have) as they complete the appropriate rating form. It should be noted that there is a visual break on the second page of each rating form between Items 32 and 33, along with the instruction "Read each of the following items carefully before responding." This is to ensure that the rater is alert to the shift in item content, namely from items reflecting negative or maladaptive behaviors (Items 1-32) to items reflecting more positive or adaptive behaviors (Items 33-46). It is recommended that the examiner visually inspect the rater's responses to Items 33-46 to confirm that the pattern of ratings has changed in the appropriate direction. If it appears that the rater has not responded to these items in the expected direction, then the examiner should review with the rater his or her individual responses to these items.

Adult;Pediatric Supplemental 1.00 2015-05-26 09:55:58.0 Frontal Systems Behavioral Scale (FrSBe) [php] [php_1]

Single Pre-Defined Value Selected

CSV