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Cognition Battery (NIH Toolbox CB): Validation for Children Between NIH Toolbox CB—1 National Institutes of Health Toolbox— Cognition Battery (NIH Toolbox CB): Validation for Children between 3 and 15 Years Philip David Zelazo1 Patricia J. Bauer2 Editors 1. Philip David Zelazo, Institute of Child Development, University of Minnesota 2. Patricia J. Bauer, Department of Psychology, Emory University Correspondence may be addressed to Philip David Zelazo, Institute of Child Development, University of Minnesota, 51 East River Road, Minneapolis, MN 55455- 0345. E-mail: [email protected], or Patricia J. Bauer, Department of Psychology, Emory University, 36 Eagle Row, Atlanta, GA, 30322, USA; E-mail: [email protected]. NIH Toolbox CB—2 Table of Contents Chapter 1—NIH Toolbox Cognition Battery (CB): Introduction and Pediatric Data Sandra Weintraub, Patricia J. Bauer, Philip David Zelazo, Kathleen Wallner-Allen, Sureyya S. Dikmen, Robert K. Heaton, David S. Tulsky, Jerry Slotkin, David Blitz, Noelle E. Carlozzi, Richard Havlik, Jennifer L. Beaumont, Dan Mungas, Jennifer J. Manly, Cynthia Nowinski, Beth Borosh, and Richard C. Gershon (33 pp., 5 tables, 0 figures) Chapter 2—NIH Toolbox Cognition Battery (CB): Measuring Executive Function and Attention Philip David Zelazo, Jacob E. Anderson, Jennifer Richler, Kathleen Wallner-Allen, Jennifer L. Beaumont, and Sandra Weintraub (36 pp., 2 tables, 3 figures) Chapter 3—NIH Toolbox Cognition Battery (CB): Measuring Episodic Memory Patricia J. Bauer, Sureyya S. Dikmen, Robert K. Heaton, Dan Mungas, Jerry Slotkin, and Jennifer L. Beaumont (28 pp., 0 tables, 2 figures) Chapter 4—NIH Toolbox Cognition Battery (CB): Measuring Language (Vocabulary Comprehension and Reading Decoding) NIH Toolbox CB—3 Richard C. Gershon, Jerry Slotkin, Jennifer J. Manly, David Blitz, Jennifer L. Beaumont, Deborah Schnipke, Kathleen Wallner-Allen, Roberta Golinkoff, Jean Berko Gleason, Kathy Hirsh-Pasek, Marilyn J. Adams, and Sandra Weintraub (39 pp., 2 tables, 5 figures) Chapter 5—NIH Toolbox Cognition Battery (CB): Measuring Working Memory David S. Tulsky, Noelle Carlozzi, Nicolas Chevalier, Kimberly A. Espy, Jennifer L. Beaumont, and Dan Mungas (33 pp., 1 table, 2 figures) Chapter 6—NIH Toolbox Cognition Battery (CB): Measuring Processing Speed Noelle E. Carlozzi, David S. Tulsky, Robert V. Kail, and Jennifer L. Beaumont (29 pp., 3 tables, 2 figures) Chapter 7—NIH Toolbox Cognition Battery (CB): Factor Structure for 3- to 15- year-olds Dan Mungas, Keith Widaman, Philip David Zelazo, David Tulsky, Robert K. Heaton, Jerry Slotkin, David Blitz, and Richard C. Gershon (27 pp., 7 tables, 0 figures) Chapter 8—NIH Toolbox Cognition Battery (CB): Composite Scores of Crystallized, Fluid, and Overall Cognition NIH Toolbox CB—4 Natacha Akshoomoff, Jennifer L. Beaumont, Patricia J. Bauer, Sureyya S. Dikmen, Richard C. Gershon, Dan Mungas, Jerry Slotkin, David Tulsky, Sandra Weintraub, Philip David Zelazo, and Robert K. Heaton (27 pp., 1 table, 2 figures) Chapter 9—NIH Toolbox Cognition Battery (CB): Summary, Conclusions, and Implications for Cognitive Development Patricia J. Bauer and Philip David Zelazo (27 pp., 3 tables, 0 figures) Commentary—Nathan Fox (10 pp., 0 tables, 0 figures) NIH Toolbox CB—5 National Institutes of Heath Toolbox—Cognition Battery (NIH Toolbox CB): Validation for Children between 3 and 15 years Chapter 1 NIH Toolbox Cognition Battery (CB): Introduction and Pediatric Data Sandra Weintraub1, Patricia J. Bauer2, Philip David Zelazo3, Kathleen Wallner-Allen4, Sureyya S. Dikmen5, Robert K. Heaton6, David S. Tulsky7, Jerry Slotkin8, David Blitz8, Noelle E. Carlozzi7 Nathan Fox9, Richard Havlik4, Jennifer L. Beaumont8, Dan Mungas10, Jennifer J. Manly11, Cynthia Nowinski8, Richard C. Gershon8 1. Northwestern Feinberg School of Medicine 2. Department of Psychology, Emory University 3. Institute of Child Development, University of Minnesota 4. Westat, Inc. 5. Department of Rehabilitation Medicine, University of Washington, Seattle 6. Department of Psychiatry, University of California, San Diego 7. University of Michigan, Ann Arbor 8. Department of Medical Social Sciences, Northwestern University 9. University of Maryland, College Park 10. Department of Neurology, University of California, Davis 11. Taub Institute, Columbia University Correspondence may be addressed to Sandra Weintraub, Cognitive Neurology and Alzheimer’s Disease Center, Northwestern Feinberg School of Medicine, Chicago, IL NIH Toolbox CB—6 Abstract This monograph presents the pediatric portion of the National Institutes of Health (NIH) Toolbox Cognition Battery (CB) of the NIH Toolbox for Neurological and Behavioral Function. The NIH Toolbox is an initiative of the Neuroscience Blueprint, a collaborative framework through which 16 NIH Institutes, Centers, and Offices jointly support neuroscience-related research, to accelerate discoveries and reduce the burden of nervous system disorders. The CB is one of four modules that measure cognitive, emotional, sensory, and motor health across the lifespan. The CB is unique in its continuity across childhood, adolescence, early adulthood, and old age, and in order to help create a common currency among disparate studies, it is also freely available to researchers for use in large-scale longitudinal and epidemiologic studies. This chapter describes the evolution of the CB; methods for selecting cognitive subdomains and instruments; the rationale for test design; and a validation study in children and adolescents, ages 3 to 15 years. Subsequent chapters feature detailed discussions of each test measure and its psychometric properties (Chapters 2-6), the factor structure of the test battery (Chapter 7), the effects of age and education on composite test scores (Chapter 8), and a final summary and discussion (Chapter 9). As the chapters in this Monograph demonstrate, the CB has excellent psychometric properties, and the validation study provided evidence for the increasing differentiation of cognitive abilities with age. NIH Toolbox CB—7 NIH Toolbox Cognition Battery (CB): Introduction and Pediatric Data The NIH Toolbox was conceived as an instrument for the systematic collection of data on cognitive, emotional, sensory, and motor health across disparate studies. It was intended to provide a brief assessment tool for large-scale epidemiologic and longitudinal studies for projects in which neurologic function may not necessarily constitute the primary focus but in which its assessment could be useful and also allow cross-study comparisons. The NIH Toolbox was designed as part of the NIH Blueprint initiative in the neurosciences, involving 16 different institutes.1 The Request for Applications from the NIH specified that the NIH Toolbox instruments: (1) include measures relevant to development and health across the life span from ages 3 to 85 years; (2) assess the full range of normal functioning (i.e., the instruments are not intended to screen for disease); (3) cover several different subdomains within each of four domains (cognitive, emotional, sensory, and motor) essential to health and life adaptation; (4) be brief and easy to administer and score; (5) be freely available to researchers; and (6) be modifiable to accommodate advances in science. This monograph focuses on the development of the instruments in the NIH Toolbox that assess cognitive function—the Cognition Battery (CB). An initial challenge in meeting the mandate of the NIH Toolbox was the selection of particular subdomains for assessment. Cognition includes many essential subdomains, some of which require lengthy and complex methods of assessment, so difficult decisions needed to be made regarding which to include at the cost of others. A systematic, research-based process was followed to select the subdomains for assessment. The process NIH Toolbox CB—8 resulted in a focus on (1) executive function and attention, (2) episodic memory, (3) language, (4) working memory, and (5) processing speed. In the first section of this chapter, we describe this process, explain how instruments were selected for the subdomains, and outline the steps taken to ensure the usability of the instruments for diverse populations. A second significant challenge was creating a single set of measures that is valid and appropriate across the entire 3- to 85-year age range. The difficulty of achieving this goal was obvious at the outset from the lack of such measures in most areas of cognition (despite the need for such measures). More typically, constructs are measured with very different tasks at different ages. The second section of this chapter describes the steps taken to develop instruments that meet this goal of use across the lifespan. As discussed in more detail in Chapters 2-6, which are devoted to the individual instruments, some tests were borrowed from the adult literature and adapted for younger examinees, whereas others were selected from the child developmental literature and adapted for older examinees. The final section of the chapter provides an introduction to a test for validation of the CB. The validation study included the full age range of the NIH Toolbox, ages 3 to 85 years, although this monograph focuses on the results of this study for children and young adolescents ages 3 to 15 years. The validation data from the younger and older adult populations will be published in a separate series of papers so that each population can be addressed in greater depth. To preview the conclusion: whereas the mandate to develop brief tasks to be used across the lifespan presented substantial challenges, it also afforded
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