Cited by 248Cognitive Abilities and TestingPsychological Testing and AssessmentDevelopmental and Educational Neuropsychology

I. NIH TOOLBOX COGNITION BATTERY (CB): INTRODUCTION AND PEDIATRIC DATA

Open access
Weintraub, Sandra, Bauer, Patricia J, Zelazo, Philip David, Wallner-Allen, Kathleen, Dikmen, Sureyya S, Heaton, Robert K, Tulsky, David S, Slotkin, Jerry +9 more·2013·Monographs of the Society for Research in Child Development

Abstract

This monograph presents the pediatric portion of the National Institutes of Health (NIH) Toolbox Cognition Battery (CB) of the NIH Toolbox for the Assessment of Neurological and Behavioral Function. The NIH Toolbox is an initiative of the Neuroscience Blueprint, a collaborative framework through which 16 NIH Institutes, Centers, and Offices jointly support neuroscience-related research, to accelerate discoveries and reduce the burden of nervous system disorders. The CB is one of four modules that measure cognitive, emotional, sensory, and motor health across the lifespan. The CB is unique in its continuity across childhood, adolescence, early adulthood, and old age, and in order to help create a common currency among disparate studies, it is also available at low cost to researchers for use in large-scale longitudinal and epidemiologic studies. This chapter describes the evolution of the CB; methods for selecting cognitive subdomains and instruments; the rationale for test design; and a validation study in children and adolescents, ages 3–15 years. Subsequent chapters feature detailed discussions of each test measure and its psychometric properties (Chapters 2–6), the factor structure of the test battery (Chapter 7), the effects of age and education on composite test scores (Chapter 8), and a final summary and discussion (Chapter 9). As the chapters in this monograph demonstrate, the CB has excellent psychometric properties, and the validation study provided evidence for the increasing differentiation of cognitive abilities with age.

AI snapshot

Written from the paper’s full text.

TL;DR

This introductory chapter describes the development of the pediatric portion of the NIH Toolbox Cognition Battery (CB), a brief, freely available battery designed to measure cognition continuously from ages 3 to 85. It reports the subdomain selection process and a validation study in children and adolescents ages 3–15, concluding the CB has excellent psychometric properties and shows increasing differentiation of cognitive abilities with age.

Key findings

  • Expert input (two online Requests for Information sent to 293 experts, followed by telephone interviews with a subset of 44) ranked subdomains as: executive function, episodic memory, language, processing speed, and attention; 57% of respondents also wanted a "general" or "global" cognitive score, met via composite scores (Chapter 8).
  • Visuospatial functions were excluded because only 43% of respondents ranked them among their top four subdomains.
  • The validation study enrolled 476 participants total (ages 3–85); the pediatric sample featured here comprises 208 children ages 3–15 (120 ages 3–6 and 88 ages 8–15), with a subset of 66 children (~32%) retested 7–21 days later.
  • As the chapters in the monograph demonstrate, the CB has excellent psychometric properties, and the validation study provided evidence for increasing differentiation of cognitive abilities with age.

Methods

  • Instrument development: multidisciplinary expert surveys and interviews, a test instrument library review, twice-yearly Steering Committee consensus meetings plus monthly calls, a July 2007 day-long meeting to select instruments for validation, a 2008 public conference, and 2010 conference calls with 16 expert consultants; four special working groups (Cultural, Geriatric, Accessibility, Pediatric) reviewed instruments for diverse populations.
  • Validation study: 476 participants recruited from four sites (NorthShore University HealthSystems in Chicago, Emory University in Atlanta, Kessler Institute for Rehabilitation in New Jersey, and the University of Minnesota), ages 3–85, recruited across age, gender, race, and education strata; validation measures were published neuropsychological tests matched to each CB construct.
  • Analysis: Pearson correlations between age and test performance (calculated separately for children and adults), intraclass correlation coefficients (ICC) for test–retest reliability (ICC < .4 poor, .4–.74 adequate, ≥ .75 excellent), and correlations with established same-construct measures for convergent validity (r < .3 poor, .3–.59 adequate, ≥ .6 excellent), with lower correlations to different-construct measures as evidence of discriminant validity.

Limitations

  • The paper states that limitations of the battery are discussed in the final chapter (Chapter 9); this introductory chapter does not itself enumerate them.
  • Evident from the text: not all ages were sampled in the validation study, and education levels in the pediatric table are defined as highest parental education.
  • Evident from the text: this monograph reports only the pediatric (ages 3–15) validation results; adult validation data are to be published separately, so conclusions here do not cover the full 3–85 range.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1111/mono.12031

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

1 of 21 cited sources checked · 1 supported · 0 flagged

  • Findingnone given

    The validation study provided evidence for the increasing differentiation of cognitive abilities with age.

    “As the chapters in this monograph demonstrate, the CB has excellent psychometric properties, and the validation study provided evidence for the increasing differentiation of cognitive abilities with age.”
    Quote in the paperSubstantial claim
  • Findingown data

    Fifty-seven percent of respondents listed a "general" or "global" cognitive score as desirable.

    “Fifty-seven percent of respondents also listed a “general” or “global” cognitive score as desirable.”
    Quote in the paperSubstantial claim
  • Findingown data

    Only 43% of respondents ranked visuospatial functions among their top four subdomains.

    “Only 43% of respondents ranked visuospatial functions among their top four subdomains, so this subdomain was not included in the final list.”
    Quote in the paperSubstantial claim
  • Findingreasoning

    The need for a global cognitive score was met through development of cognition composite scores.

    “The need for a global cognitive score was met through development of cognition composite scores, described in Chapter 8.”
    Quote in the paperSubstantial claim
  • Findingreasoning

    Two aspects of language were selected for the CB: auditory single word comprehension and single word reading aloud.

    “Two aspects of language were selected for the CB, due in part to the ease with which they can be measured across the lifespan: auditory single word comprehension (i.e., receptive vocabulary) and single word reading aloud (oral reading recognition; see Gershon et al., Chapter 4, this volume).”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 22
  • May combine two claims. 8
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Oral reading proficiency is a marker of educational opportunity in minority populations and can be used to adjust for group differences when comparing individuals of different ethnic and racial backgrounds.

    “Oral reading proficiency also is a marker of educational opportunity in minority populations and can be used to adjust for group differences when comparing individuals of different ethnic and racial backgrounds (Manly, Byrd, Touradji, & Stern, 2004; Manly et al., 1999).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Manly, Byrd, Touradji, & Stern, 2004 source
    • cites Manly et al., 1999 source
  • Classified as probably not a substantial claim.

    Findingreasoning

    The process resulted in a focus on executive function and attention, episodic memory, language, working memory, and processing speed.

    “The process resulted in a focus on (1) executive function and attention, (2) episodic memory, (3) language, (4) working memory, and (5) processing speed.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingreasoning

    The information gathered from experts allowed identification of cognitive domains ranked in order of their importance as judged by experts, and determination of desirable characteristics for the final instruments.

    “The information gathered from experts allowed us to identify cognitive domains ranked in order of their importance as judged by experts, and to determine the characteristics that would be desirable for the final instruments.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    The construct represented in the CB is the simple reaction time required to make a same-different comparison between two visually presented stimuli.

    “The construct represented in the CB is the simple reaction time required to make a same-different comparison between two visually presented stimuli (see Carlozzi, Tulsky, Kail, & Beaumont, Chapter 6, this volume).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    When language development is delayed, the impact on further skill acquisition and academic progress can be profound.

    “Indeed, when language development is delayed, the impact on further skill acquisition and academic progress can be profound (e.g., Dickinson, Golinkoff, & Hirsh-Pasek, 2010; Gleason & Ratner, 2009).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Dickinson, Golinkoff, & Hirsh-Pasek, 2010 source
    • cites Gleason & Ratner, 2009

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    EF deficits are seen in patients with acquired focal damage to prefrontal cortex who experience profound impairment in behavioral regulation despite the preservation of many basic intellectual functions.

    “EF deficits are seen in patients with acquired focal damage to prefrontal cortex who experience profound impairment in behavioral regulation despite the preservation of many basic intellectual functions (see Stuss & Knight, 2002).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Stuss & Knight, 2002

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Auditory single word comprehension develops prior to overt speech usage in hearing individuals.

    “Auditory single word comprehension develops prior to overt speech usage in hearing individuals (Fenson et al., 1994).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fenson et al., 1994 source
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Episodic memory is susceptible to a variety of diseases, including encephalitis and temporolimbic epilepsy, and, in adulthood, Alzheimer's disease.

    “This subdomain shows dramatic changes over the first two decades of life (see Bauer, Larkina, & Deocampo, 2011, for a review) and is also susceptible to a variety of diseases, including encephalitis and temporolimbic epilepsy, and, in adulthood, Alzheimer’s disease (e.g., see Weintraub, Wicklund, & Salmon, 2012).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Weintraub, Wicklund, & Salmon, 2012

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Episodic memory for single object-specific actions is apparent in infants in the first year of life.

    “Episodic memory for single object-specific actions is apparent in infants in the first year of life (e.g., Carver & Bauer, 1999).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Carver & Bauer, 1999

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisereasoning

    The CB is available at low cost to researchers for use in large-scale longitudinal and epidemiologic studies.

    “The CB is unique in its continuity across childhood, adolescence, early adulthood, and old age, and in order to help create a common currency among disparate studies, it is also available at low cost to researchers for use in large-scale longitudinal and epidemiologic studies.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    The CB is unique in its continuity across childhood, adolescence, early adulthood, and old age.

    “The CB is unique in its continuity across childhood, adolescence, early adulthood, and old age, and in order to help create a common currency among disparate studies, it is also available at low cost to researchers for use in large-scale longitudinal and epidemiologic studies.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    EF can be divided into three partially independent components: cognitive flexibility, inhibitory control, and working memory.

    “Recent factor-analytic work with adults suggests that EF can be divided into three partially independent components: cognitive flexibility, inhibitory control, and working memory (Miyake et al., 2000).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Miyake et al., 2000 source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In children, impairments in EF or delays in its development have been linked to ADHD, autism spectrum disorders, Conduct Disorder, and other psychiatric conditions and symptoms.

    “In children, impairments in EF or delays in its development have been linked to attention deficit hyperactivity disorder (ADHD) (Doyle, 2006), autism spectrum disorders, Conduct Disorder, and other psychiatric conditions and symptoms.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Doyle, 2006
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Working memory is a component of executive function.

    “Although working memory is a component of executive function (e.g., Miyake et al., 2000), it is often studied on its own, or as a type of memory.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Miyake et al., 2000 source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisereasoning

    The subdomains of executive function and attention are described together because one of the EF measures is also a measure of selective attention.

    “The subdomains of executive function (EF) and attention are described together because one of the EF measures is also a measure of selective attention.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Disorders such as dyslexia hinder otherwise talented individuals from achieving educational and career goals.

    “Disorders such as dyslexia hinder otherwise talented individuals from achieving educational and career goals (e.g., Meisinger, Bloom, & Hynd, 2010; Ziegler et al., 2008).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Meisinger, Bloom, & Hynd, 2010 source
    • cites Ziegler et al., 2008 source
  • Classified as probably not a substantial claim.

    Study design and conductnone given

    A systematic, research-based process was followed to select the subdomains for assessment.

    “A systematic, research-based process was followed to select the subdomains for assessment.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisenone given

    The NIH Toolbox was conceived as an instrument for the systematic collection of data on cognitive, emotional, sensory, and motor health across disparate studies.

    “The NIH Toolbox was conceived as an instrument for the systematic collection of data on cognitive, emotional, sensory, and motor health across disparate studies.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The CB team derived criteria for validation studies, including acceptable levels of test-retest reliability and convergent and discriminant validity.

    “During that meeting, the CB team derived criteria for validation studies, including acceptable levels of test–retest reliability and convergent and discriminant validity.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Mental processing time can be separated from motor response time, and it varies with the number of mental operations required by a given task.

    “Although PS paradigms often are based on motor reaction time, Sternberg’s (1966) elegant paradigm demonstrated that mental processing time can be separated from motor response time, and that it varies with the number of mental operations required by a given task.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sternberg, 1966 source
  • May combine two claims.

    Study design and conductnone given

    Eligible participants were 3-85 years of age and sample recruitment was distributed across age, gender, race, and education strata.

    “Eligible participants were 3–85 years of age and sample recruitment was distributed across age, gender, race, and education strata.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Developing instruments for use across the broad age range of 3-85 years presented significant challenges.

    “Developing instruments for use across the broad age range of 3–85 years presented significant challenges.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Not all ages were sampled in this study.

    “As Table 3 indicates, not all ages were sampled in this study; also, education levels indicated in the table are defined as highest parental education.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Working memory depends on prefrontal cortex, and is vulnerable to disruption from a wide range of cerebral insults.

    “Like executive function more broadly, working memory depends on prefrontal cortex, and is vulnerable to disruption from a wide range of cerebral insults (see Tulsky et al., Chapter 5, this volume).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Tulsky et al., Chapter 5

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductown data

    There were 120 three- to six year olds and 88 eight- to fifteen year olds in the pediatric validation sample.

    “There were a total of one hundred twenty 120 three- to six year olds and 88 eight- to fifteen year olds.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationnone given

    The guidance provided by the Pediatric Working Group and other working groups significantly improved the NIH Toolbox overall and strengthened its ability to obtain valid assessments from diverse populations.

    “The guidance provided by the Pediatric Working Group, as well as the other working groups, significantly improved the NIH Toolbox overall and strengthened its ability to obtain valid assessments from diverse populations—not just from children.”
    Quote in the paperNot a substantial claim
26 of 26
  • The paper relies on this without support.

    There is a lack of measures that are valid and appropriate across the entire 3- to 85-year age range in most areas of cognition.

    “The difficulty of achieving this goal was obvious at the outset from the lack of such measures in most areas of cognition (despite the need for such measures).”
  • The paper relies on this without support.

    Constructs are typically measured with very different tasks at different ages.

    “More typically, constructs are measured with very different tasks at different ages.”
  • The paper relies on this without support.

    Episodic memory is critical for the acquisition of knowledge and for building adaptive skills.

    “Episodic memory, the capacity for storing and retrieving information, is critical for the acquisition of knowledge and for building adaptive skills.”
  • The paper relies on this without support.

    Language develops rapidly over the first 3 years of life, although further changes occur throughout childhood.

    “Language develops rapidly over the first 3 years of life, although further changes occur throughout childhood, and language proficiency is a fundamental skill that supports many other aspects of cognitive, social, and behavioral function.”
  • The paper relies on this without support.

    Language proficiency is a fundamental skill that supports many other aspects of cognitive, social, and behavioral function.

    “Language develops rapidly over the first 3 years of life, although further changes occur throughout childhood, and language proficiency is a fundamental skill that supports many other aspects of cognitive, social, and behavioral function.”
  • The paper relies on this without support.

    Working memory is often studied on its own, or as a type of memory.

    “Although working memory is a component of executive function (e.g., Miyake et al., 2000), it is often studied on its own, or as a type of memory.”
  • The paper relies on this without support.

    From preschool age on, most working memory tasks either require retaining and reorganizing items before recalling them, or completing some processing activity in between presentations of the to-be-recalled items.

    “From preschool age on, most working memory tasks either require retaining and reorganizing items before recalling them (e.g., backward digit span task), or completing some processing activity in between presentations of the to-be-recalled items (e.g., listening span task).”
  • The paper relies on this without support.

    Such tasks tap into both information processing and storage, and yield a measure of working memory span that corresponds to the maximal amount of accurately recalled information.

    “Such tasks tap into both information processing and storage, and yield a measure of working memory span that corresponds to the maximal amount of accurately recalled information.”
  • The paper relies on this without support.

    Working memory shows age-related improvements across childhood and age-related declines during senescence.

    “Working memory shows age-related improvements across childhood (as well as age-related declines during senescence).”
  • The paper relies on this without support.

    Children differ from adults in many ways, including social, emotional, and selfregulatory ways that may affect performance on tasks designed to measure cognition.

    “Children differ from adults in many ways, including social, emotional, and selfregulatory ways that may affect performance on tasks designed to measure cognition.”
  • The paper relies on this without support.

    Children are able to demonstrate competence for constructs at younger ages when simple, easy-to-follow instructions are used and when task materials are engaging, concrete, and familiar.

    “For example, children are able to demonstrate competence for constructs at younger ages when simple, easy-to-follow instructions are used and when task materials are engaging, concrete, and familiar.”
  • The paper relies on this without support.

    Compared to healthy young adults, most children and even adolescents have shorter attention spans, are more easily distracted by external stimuli, and are less proficient at regulating their attention, behavior, and level of motivation to the task at hand.

    “In addition, compared to healthy young adults, most children and even adolescents have shorter attention spans, are more easily distracted by external stimuli, and are less proficient at regulating their attention, behavior, and level of motivation to the task at hand.”
  • The paper relies on this without support.

    Cognition includes many essential subdomains, some of which require lengthy and complex methods of assessment.

    “Cognition includes many essential subdomains, some of which require lengthy and complex methods of assessment, so difficult decisions needed to be made regarding which to include at the cost of others.”
13 of 13

Cites

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Research works printed but not linked: 1

  1. Gleason, 2009, The development of language

Cited by

Sorted by citations

Authors
Weintraub, S., Bauer, P. J., Zelazo, P. D., Wallner-Allen, K., Dikmen, S. S., Heaton, R. K., Tulsky, D. S., Slotkin, J., Blitz, D. L., Carlozzi, N. E., Havlik, R. J., Beaumont, J. L., Mungas, D., Manly, J. J., Borosh, B. G., Nowinski, C. J., & Gershon, R. C.
Affiliations
Northwestern University (US)
Venue
Monographs of the Society for Research in Child Development
Published
2013-08
Volume
78
Issue
4
Pages
1-15
ISSN
  • 0037-976X (ISSN-L)
  • 1540-5834
OpenAlex
W2124548479
Cited by
248
References
31
Citations by year
2026: 22 · 2025: 31 · 2024: 22 · 2023: 22 · 2022: 35 · 2021: 26 · 2020: 22 · 2019: 15 · 2018: 19 · 2017: 11 · 2016: 15 · 2015: 3 · 2014: 3 · 2013: 2
FWCI
10.36
Type
journal article
Language
en
Open access
Locations
  • Monographs of the Society for Research in Child Development (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institute on Aging (P30AG010129, R01AG010220)
  • National Institute of Mental Health (P30MH062512)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
  • Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords
NIH Toolbox Cognition Battery, cognitive development, test battery validation, test design, psychometric properties, factor structure, longitudinal cognitive assessment, children and adolescents
MeSH terms
Adolescent, Child, Child, Preschool, Cognition, Emotions, Female, Humans, Language, Male, Memory, Short-Term, National Institutes of Health (U.S.), Neuropsychological Tests, United States, Executive Function, Memory, Episodic

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