Sensitivity of the NIH Toolbox to Detect Cognitive Change in Individuals With Intellectual and Developmental...

Area of Science:

• Neuroscience
• Developmental Psychology
• Clinical Psychology

Background:

• Individuals with intellectual disability (ID) exhibit delayed cognitive development, necessitating sensitive outcome measures for intervention studies.
• Existing validated cognitive measures for this population are limited, hindering research progress.
• The NIH Toolbox Cognition Battery (NIHTB-CB) was developed to assess cognitive function across diverse populations.

Purpose of the Study:

• To evaluate the sensitivity of the NIHTB-CB in detecting developmental changes in individuals with fragile X syndrome (FXS), Down syndrome (DS), and other ID (OID).
• To provide evidence supporting the NIHTB-CB's utility as an outcome measure in treatment trials for ID.
• To compare the NIHTB-CB's performance against a reference standard measure.

Main Methods:

• Administered the NIHTB-CB and Stanford-Binet Intelligence Scales, Fifth Edition (SB5) to 256 individuals (ages 6-27) with FXS, DS, and OID.
• Retested 197 participants after a 2-year developmental period.
• Assessed developmental changes using latent change score models and evaluated 2-year growth at ages 10, 16, and 22.

Main Results:

• NIHTB-CB demonstrated effect sizes for growth comparable to or exceeding the SB5 across cognitive domains.
• Significant gains were observed in OID, with delayed gains in attention/inhibitory control for FXS and receptive vocabulary for DS.
• DS showed unique growth in early adulthood in working memory and attention/inhibitory control, mirroring SB5 patterns.

Conclusions:

• The NIHTB-CB is a sensitive tool for measuring cognitive development in individuals with various types of ID.
• Its performance suggests potential for identifying meaningful developmental trajectories across cognitive domains and ID etiologies.
• Further research is needed to establish sensitivity to change in treatment studies and link scores to daily functioning.