Development and validation of the NIH Baby Toolbox® Executive Function and Memory measures

Existing standardized assessments of Executive Function and Memory (EF-Mem) for infants and toddlers tend to be limited in scope, can be burdensome to administer, and/or do not often utilize modern technology. Here, we describe the development and validation of the novel iPad-based EF-Mem measures in the NIH Baby Toolbox® for infants and young children 1-42 months old. English and Spanish versions of gaze-based (Familiarization) and touch-based measures (Mullen Visual Reception, Visual Delayed Response, Delayed Memory Task) were adapted for iPad administration. A nationally representative sample of children (N = 2515 recruited; N = 2448 who completed at least one EF-Mem measure; n = 1993 English, n = 455 Spanish) were administered the Baby Toolbox EF-Mem measures as part of the full battery of Baby Toolbox measures. Most caregivers completed the Ages and Stages Questionnaire 3rd edition (ASQ-3), and separate subsets of children were administered the Bayley Scales for Infant Development 4th Edition (Bayley-4, n = 120 recruited; n = 117 that completed both EF-Mem and the Bayley-4) or were administered the Baby Toolbox battery again 1-14 days later to assess test-retest reliability (n = 220 recruited; n = 187 who completed any EF-Mem measure twice). Measure-level scores showed expected correlations with age for gaze and touch measures. EF-Mem scores showed expected correlations with the Bayley-4 for both gaze and touch, indicating convergent validity, and varied meaningfully based on the ASQ-3 classifications. Test-retest reliability for all measures and empirical reliability of the touch scores were moderate. Automatic coding and scoring, ease of administration, reliability, and validity of Baby Toolbox EF-Mem make these measures valuable for developmental assessment.