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USE OF THE NIH COGNITION TOOLBOXWITH PEDIATRIC SAMPLES
Natacha Akshoomoff, Ph.D.Department of Psychiatry
and Center for Human DevelopmentUniversity of California, San Diego
2019 Health Measures User Conference
I GP NThe NIH Cognition Toolbox Battery
pingstudy.ucsd.edu
Akshoomoff N, Newman E, Thompson WK, McCabe C, Bloss CS, Chang L, Amaral DG, Casey BJ, Ernst TM, Frazier JA, Gruen JR, Kaufmann WE, Kenet T, Kennedy DN, Libiger O, Mostofsky S, Murray SS,
Sowell ER, Schork N, Dale AM, Jernigan TLfor the Pediatric Imaging, Neurocognition, and Genetics Study
PING Sample CharacteristicsAge Group Mean Age Males Females Total
3-5 years 4.17 24 24 48
5-7 years 5.98 50 50 100
7-9 years 7.96 68 61 129
9-11 years 9.94 73 71 144
11-14 years 12.55 114 82 196
14-17 years 15.47 193 106 193
17-20 years 19.18 99 111 210
OVERALL: 534 486 1020
Flanker: Sustained Attention
AGE
Flanker: Inhibitory Control
AGE
Dimensional Change Card Sort: Cognitive Flexibility
AGE
Picture Sequence Memory Test
AGE
Picture Vocabulary Test
AGE
Oral Reading Recognition Test
AGE
Pattern Comparison Processing Speed Test
AGE
List Sorting Working Memory
DOG
AGE
Age Group
3-6 y 7-9 y 10-13 y 14-17 y 18-21 y
N 148 207 262 229 174
Female (%) 50 50 42 45 55
Parental Education
High school or less 14 14 12 14 21
Some College 27 25 24 26 18
College Graduate 18 24 39 28 24
Advanced Degree 42 36 26 33 37
Family Income
< $10K 12 13 10 11 19
$10K-49K 21 20 17 16 20
$50K-99K 34 28 32 32 23
$100K-149K 20 18 21 19 17
> $150K 13 21 21 22 21
Pairwise Correlations
t ratios: DC-Flanker vs. other correlations
DCCS Flanker
Varimax Rotated Loadings for Each Age Group
Age group (years)
3–6 7–9 10–13 14–17 18–21Factor 1 Factor 1 Factor 2 Factor 1 Factor 2 Factor 1 Factor 2 Factor 1 Factor 2
DCCS .73 .34 .55 .23 .74 .28 .68 .10 .69Flanker .70 .34 .65 .11 .68 .12 .81 .03 .79Pattern Comparison .64 .00 .62 .20 .49 .08 .41 .10 .52Picture Vocabulary .59 .55 .07 .81 .12 .77 .04 .73 .04Oral Reading .83 .78 .15 .63 .14 .66 .13 .84 .08List Sorting .66 .48 .18 .49 .20 .40 .25 .51 .14Picture Sequence Mem .64 .41 .30 .34 .17 .23 .17 .24 .26
ConclusionsYounger children’s performance on the NIH Toolbox Cognition Battery is more intercorrelated and less differentiated compared with older children and adolescents.Executive Function measures were less correlated with the other measures in the older age groups.
These results from the exploratory factor analyses also supported our hypothesis.
This may reflect the progression of functional specialization of neural systems throughout childhood and young adulthood.
N=11,875!
Varimax Rotated Loadings (n=4456; mean age=10.0)
Test Factor 1 Factor 2 Factor 3
DCCS .21 .74 .19Flanker .22 .73 .03Pattern Comparison .00 .82 .08Picture Vocabulary .80 .13 .07Oral Reading .82 .16 .06List Sorting .55 .16 .48Picture Sequence Memory .08 .14 .94
Issues with pediatric samples• Changes in Toolbox methods
Touchscreen (validation study) -> keyboard (norming study) -> iPad version
• Longitudinal data is needed. Practice effects?
• Utility with clinical groups? Advantage over other assessment tools? Use with low-functioning patients?
Supported by: RC2DA029475, R01DA038958, and R01HD061414Thank you to Katy Wortman, Katy Browne, Ed Bedjeti,
Dr. Cindy Nowinski, and Dr. Richard Gershon