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Cited by 20Autism Spectrum Disorder ResearchDevelopmental and Educational NeuropsychologyChild and Animal Learning Development

Using the NIH Toolbox to Assess Cognition in Adolescents and Young Adults with Autism Spectrum Disorders

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Solomon, Marjorie, Gordon, Andrew, Iosif, Ana‐Maria, Geddert, Raphael, Krug, Marie K., Mundy, Peter, Hessl, David·2021·Autism Research
DOI 10.1002/aur.2399PMC PMC8106946
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Abstract

Despite the clinically significant impact of executive dysfunction on the outcomes of adolescents and young adults with autism spectrum disorders (ASD), we lack a clear understanding of its prevalence, profile, and development. To address this gap, we administered the NIH Toolbox Cognition Battery to a cross‐sectional Intelligence Quotient (IQ) case‐matched cohort with ASD (n = 66) and typical development (TD; n = 66) ages 12–22. We used a general linear model framework to examine group differences in task performance and their associations with age. Latent profile analysis (LPA) was used to identify subgroups of individuals with similar cognitive profiles. Compared to IQ case‐matched controls, ASD demonstrated poorer performance on inhibitory control (P < 0.001), cognitive flexibility (P < 0.001), episodic memory (P < 0.02), and processing speed (P < 0.001) (components of Fluid Cognition), but not on vocabulary or word reading (components of Crystallized Cognition). There was a significant positive association between age and Crystallized and Fluid Cognition in both groups. For Fluid (but not Crystallized) Cognition, ASD performed more poorly than TD at all ages. A four‐group LPA model based on subtest scores best fit the data. Eighty percent of ASD belonged to two groups that exhibited relatively stronger Crystallized versus Fluid Cognition. Attention deficits were not associated with Toolbox subtest scores, but were lowest in the group with the lowest proportion of autistic participants. Adaptive functioning was poorer in the groups with the greatest proportion of autistic participants. Autistic persons are especially impaired on Fluid Cognition, and this more flexible form of thinking remains poorer in the ASD group through adolescence. Lay Summary: A set of brief tests of cognitive functioning called the NIH Toolbox Cognition Battery was administered to adolescents and young adults with autism spectrum disorders (ASD; n = 66) and typical development (TD; n = 66) ages 12–22 years. Compared to TD, ASD showed poorer performance in inhibiting responses, acting flexibly, memorizing events, and processing information quickly (Fluid Cognition). Groups did not differ on vocabulary or word reading (Crystallized Cognition). Crystallized and Fluid Cognition increased with age in both groups, but the ASD group showed lower Fluid, but not Crystallized, Cognition than TD at all ages. A categorization analysis including all participants showed that most participants with ASD fell into one of two categories: a group characterized by poor performance across all tasks, or a group characterized by relatively stronger Crystallized compared to Fluid Cognition. Adaptive functioning was poorer for participants in these groups, which consisted of mostly individuals with ASD, while ADHD symptoms were lowest in the group with the greatest proportion of TD participants.

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  • The NIHTB-CB has been used extensively to examine neuropsychological functioning of children and adolescents with diverse clinical conditions.

    “The NIHTB-CB has been used extensively to examine the neuropsychological functioning of children and adolescents with diverse characteristics and clinical conditions.”

    From Cognitive weaknesses or impairments on the NIH toolbox cognition battery in children and adolescents: base rates in a normative sample and proposed methods for classification (2025) · cites this paper as Solomon et al., 2021

    The Introduction and Discussion describe using the NIHTB-CB to assess cognition in adolescents and young adults aged 12–22 with autism spectrum disorder and typical development. This supports its use in those groups, but the paper does not establish that it has been used extensively across children and adolescents with diverse clinical conditions. (LLM, conf=0.82)

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Authors
Solomon, M., Gordon, A., Iosif, A., Geddert, R., Krug, M. K., Mundy, P., & Hessl, D.
Affiliations
  • University of California, Davis (US)
  • Duke University (US)
Corresponding author
Solomon, Marjorie
ORCID
Venue
Autism Research
Publisher
Wiley
Published
2020-10-02
Volume
14
Issue
3
Pages
500-511
ISSN
  • 1939-3792 (ISSN-L)
  • 1939-3806
DOI
10.1002/aur.2399
PMC
PMC8106946
OpenAlex
W3090287073
Cited by
20
References
71
Citations by year
2026: 1 · 2025: 9 · 2024: 1 · 2023: 4 · 2022: 3 · 2021: 2
FWCI
1.21
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Autism Research (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (P50 HD103526, R01 HD076189)
  • National Institute of Mental Health (R01 MH103284, R01 MH106518)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
  • Social Sciences › Psychology › Developmental and Educational Psychology › Child and Animal Learning Development
Keywords
autism spectrum disorder, adolescents and young adults, NIH Toolbox Cognition Battery, fluid intelligence, crystallized intelligence, executive dysfunction, inhibitory control, cognitive flexibility, episodic memory, processing speed, cognitive development, cognitive profile, adaptive behavior, attention deficits, age differences in cognition, cognitive aging, typical development
MeSH terms
Autism Spectrum Disorder, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Cognition, Cross-Sectional Studies, Female, Humans, Intelligence Tests, Male, Neuropsychological Tests, Young Adult

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