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How do 3-year-olds do on the NIH Toolbox Cognitive Battery?

Lindsey Becker1, Emma Condy2, Aaron Kaat3

  • 1Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.

Child Neuropsychology : a Journal on Normal and Abnormal Development in Childhood and Adolescence
|July 25, 2022
PubMed
Summary
This summary is machine-generated.

The NIH Toolbox cognitive assessment is challenging for most 3-year-olds, with many unable to pass practice items or perform above chance on executive function tasks. Modifications are recommended for this age group.

Keywords:
NIH Toolboxassessmentcognitionexecutive functionpreschool

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Area of Science:

  • Developmental Psychology
  • Cognitive Neuroscience
  • Pediatric Assessment

Background:

  • The NIH Toolbox cognitive battery offers an Early Childhood Composite score for ages 3-7.
  • Feasibility of the NIH Toolbox in 3-year-olds, the youngest segment, is understudied.

Purpose of the Study:

  • To evaluate the performance and feasibility of the NIH Toolbox cognitive subtests in a large sample of 3-year-old children.
  • To identify specific subtests posing challenges for this age group.

Main Methods:

  • Assessed 609 three-year-olds (mean age 39.6 months) using four subtests from the NIH Toolbox Early Childhood Composite.
  • Included two executive function tasks (Flanker, Dimensional Change Card Sort) and Picture Sequence Memory, Picture Vocabulary Test.

Main Results:

  • Up to 30% of children failed practice items on Flanker, Dimensional Change Card Sort, and Picture Sequence Memory.
  • 3% failed practice items on Picture Vocabulary Test.
  • 70-80% scored at or below chance on executive function and Picture Sequence Memory tasks.

Conclusions:

  • Three of the four NIH Toolbox subtests are difficult for average 3-year-olds, suggesting skills may not be sufficiently developed.
  • Recommended modifications to the NIH Toolbox are needed to improve feasibility and effectiveness for assessing cognitive differences in 3-year-olds.