Feasibility of National Institutes of Health toolbox cognition battery in pediatric brain injury rehabilitation settings
Abstract
Objective Cognitive impairments are a devastating consequence of acquired brain injury (ABI) in children. Current pediatric tools for assessing cognitive impairments are generally time intensive and applicable only to a restricted age span. The National Institutes of Health Toolbox-Cognition Battery (NIHTB-CB) is a standardized, tablet-based cognitive assessment that has been normed across the life span in the general population and validated in adults with brain injuries. However, its clinical utility and validity has not yet been demonstrated in pediatric patients with brain injuries. The current study examines the feasibility of NIHTB-CB administration in both a pediatric inpatient and day treatment rehabilitation setting. Design The NIHTB-CB was attempted in 40 children with ABI aged 4-18 years within 1 year of injury in pediatric rehabilitation settings. Results Of the 40 participants tested, 38 (95%) were able to complete the full battery and 28 were able to complete it in 1 session. The average time to complete the NIHTB-CB for our sample was 40.2 min. Barriers to completion included both external (scheduling conflicts) and internal (fatigue, attention, and behavioral) limitations. Cohort results are consistent with expected impairments following ABI. Conclusions This study demonstrates the feasibility of using the NIHTB-CB in postacute pediatric inpatient rehabilitation and day-treatment clinical settings following ABI. The NIHTB-CB has the potential to provide a quic…
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In a small heterogeneous sample of children with acquired brain injury, the NIH TB-CB was feasible to administer in inpatient rehabilitation settings and day treatment rehabilitation facilities, with 95% of children tested able to complete the test.
“In a small heterogeneous sample of children with acquired brain injury, the NIH TB-CB was shown to be feasible to administer in inpatient rehabilitation settings and day treatment rehabilitation facilities (95% of children tested were able to complete the test);”
From Evaluating cognitive performance using the National Institutes of Health Toolbox Cognitive Battery in children with traumatic brain injury (2025) · cites this paper as Watson et al., 2020
In a small heterogeneous sample of children with acquired brain injury, children with acquired brain injury had poorer performance on fluid cognition than crystallized cognition on the NIH TB-CB.
“while the study was underpowered to determine statistical differences in cognition, children with ABI had poorer performance on fluid cognition than crystallized cognition (Watson et al., 2020).”
From Evaluating cognitive performance using the National Institutes of Health Toolbox Cognitive Battery in children with traumatic brain injury (2025) · cites this paper as Watson et al., 2020
Previous studies found that using the NIH TB-CB is feasible in an inpatient rehabilitation hospital setting and day treatment rehabilitation facilities, where frequent interruptions for nursing care, therapies, etc., are reduced.
“However, previous studies found that using the NIH TB-CB is feasible in an inpatient rehabilitation hospital setting and day treatment rehabilitation facilities, where frequent interruptions for nursing care, therapies, etc., are reduced (Watson et al., 2020).”
From Evaluating cognitive performance using the National Institutes of Health Toolbox Cognitive Battery in children with traumatic brain injury (2025) · cites this paper as Watson et al., 2020
Research on NIHTB-CB performances among children and adolescents has supported the feasibility of using the NIHTB-CB in pediatric rehabilitation settings.
“(iv) the feasibility of using the NIHTB-CB in pediatric rehabilitation settings (Watson et al., 2020).”
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 Watson et al., 2020
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Chadwick, L., Roth, E., Minich, N. M., Taylor, H. G., Bigler, E. D., Cohen, D. M., Bacevice, A., Mihalov, L. K., Bangert, B. A., Zumberge, N. A., et al. (2021) · Journal of Neurotrauma · doi:10.1089/neu.2020.7513 · Cited by 50 · see citing works
Petersen, B., Vo, N.-T. N., Anton, N., Yeates, K. O., & Treble-Barna, A. (2025) · Journal of the International Neuropsychological Society · doi:10.1017/s135561772510146x · Cited by 1 · see citing works
Cook, N. E., Iverson, G. L., & Karr, J. E. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1473095
- Authors
- Watson, W., Pedowitz, A., Nowak, S., Neumayer, C., Kaplan, E., & Shah, S.
- Affiliations
- Blythedale Children's Hospital (US)
- Venue
- Rehabilitation Psychology
- Published
- 2020-02
- Volume
- 65
- Issue
- 1
- Pages
- 22-30
- ISSN
- 0090-5550 (ISSN-L)
- 1939-1544
- OpenAlex
- W2999102134
- Cited by
- 10
- References
- 2
- Citations by year
- 2025: 4 · 2024: 1 · 2022: 3 · 2021: 2
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Rehabilitation Psychology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- NIH Toolbox Cognition Battery, pediatric acquired brain injury, cognitive impairment assessment, tablet-based cognitive assessment, feasibility, pediatric rehabilitation, day treatment, inpatient rehabilitation, assessment time, children
- MeSH terms
- Adolescent, Brain Injuries, Child, Child, Preschool, Cognition Disorders, Feasibility Studies, Female, Humans, Male, National Institutes of Health (U.S.), Neuropsychological Tests, Psychometrics, United States, Reproducibility of Results
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