TM COG Composites 09.27.12

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NIH$Toolbox$

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!Technical$Manual$

Jerry!Slotkin,!PhD,!Michael!Kallen,!PhD,!James!Griffith,!PhD,!Susan!Magasi,!PhD,!John!Salsman,!PhD,!Cindy!Nowinski,!MD,!PhD,!and!Richard!Gershon,!PhD!

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September$27,$2012$

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NIH$Toolbox$Technical$Manual$

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Domain:$

COGNITION$

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Subdomains:$

EXECUTIVE$FUNCTION,$ATTENTION,$EPISODIC$MEMORY,$

LANGUAGE,$PROCESSING$SPEED,$WORKING$MEMORY$

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Measure:$

NIH$Toolbox$Cognition$Composite$Scores$

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Expert$ContributorsLCOGNITION$

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Patricia$Bauer,$PhD$(Emory$University),$Noelle$Carlozzi,$PhD$(University$of$Michigan),$Kevin$

Conway,$PhD$(National$Institute$on$Drug$Abuse,$NIH),$Sureyya$Dikmen,$PhD$(University$of$

Washington),$Emmeline$Edwards,$PhD$(National$Center$for$Complementary$and$Alternative$

Medicine,$NIH),$Nathan$Fox,$PhD$(University$of$Maryland),$Lisa$Freund,$PhD$(National$Institute$

of$Child$Health$and$Human$Development,$NIH),$Richard$Gershon,$PhD$(Northwestern$

University),$Richard$Havlik,$MD$(Westat,$Inc.),$Robert$Heaton,$PhD$(University$of$CaliforniaVSan$

Diego),$Jonathan$King,$PhD$(National$Institute$on$Aging,$NIH),$Jennifer$Manly,$PhD$(Columbia$

University),$Claudia$Moy,$PhD$(National$Institute$of$Neurological$Disorders$and$Stroke,$NIH),$

Dan$Mungas,$PhD$(University$of$CaliforniaVDavis),$Jerry$Slotkin,$PhD$(Northwestern$University),$

David$Tulsky,$PhD$(University$of$Michigan),$Sandra$Weintraub,$PhD$(Northwestern$University),$

Ellen$Witt,$PhD$(National$Institute$on$Alcohol$Abuse$and$Alcoholism,$NIH),$Philip$Zelazo,$PhD$

(University$of$Minnesota)$

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Member$Institutes,$Centers,$and$Offices$

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National$Center$for$Complementary$and$Alternative$Medicine$(NCCAM)$

National$Eye$Institute$(NEI)$

National$Institute$of$Biomedical$Imaging$and$Bioengineering$(NIBIB)$$

Eunice$Kennedy$Shriver$National$Institute$of$Child$Health$and$Human$Development$(NICHD)$$

National$Institute$of$Dental$and$Craniofacial$Research$(NIDCR)$

National$Institute$of$Environmental$Health$Sciences$(NIEHS)$$

National$Institute$of$General$Medical$Sciences$(NIGMS)$

National$Institute$of$Mental$Health$(NIMH)$$

National$Institute$of$Neurological$Disorders$and$Stroke$(NINDS)$$

National$Institute$of$Nursing$Research$(NINR)$$

National$Institute$on$Aging$(NIA)$

National$Institute$on$Alcohol$Abuse$and$Alcoholism$(NIAAA)$

National$Institute$on$Deafness$and$Other$Communication$Disorders$(NIDCD)$

National$Institute$on$Drug$Abuse$(NIDA)$

Office$of$Behavioral$and$Social$Sciences$Research$(OBSSR)$

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This$project$is$funded$in$whole$or$in$part$with$Federal$funds$from$the$Blueprint$for$

Neuroscience$Research$and$the$Office$of$Behavioral$and$Social$Sciences$Research,$National$

Institutes$of$Health,$under$Contract$No.$HHSVNV260V2006V00007VC,$with$additional$support$from$

the$National$Children’s$Study,$under$Contract$No.$HHSVNV267V2007V00027VC.$

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©$2006V2012$National$Institutes$of$Health$and$Northwestern$University$

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This$Technical$Manual$contains$the$following$informational$sections:$

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Section$1:$ Introduction$to$NIH$Toolbox$

Section$2:$ Validation$

Section$3:$ Norming$

Section$4:$ NIH$Toolbox$and$the$National$Children’s$

Study$(NCS)$

Section$5:$ Domain$Definition$

Section$6:$ Subdomain$Definition$

Section$7:$ Measure$Description$

Section$8:$ PostLValidation/PostLNorming$Changes$to$

the$Measure$

Section$9:$ The$Measure’s$Scoring$Model$

Section$10:$ Measure$NormsLFluid$Cognition$

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Section$11:$ Measure$NormsLCrystallized$Cognition$

Section$12:$ Measure$NormsLCognitive$Function$

Section$13:$ Measure$NormsLEarly$Childhood$

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Section$1:$ Introduction$to$NIH$Toolbox$

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NIH$Toolbox$is$a$multidimensional$set$of$brief$measures$assessing$cognitive,$emotional,$motor,$

and$sensory$function$from$ages$3V85.$This$suite$of$onVline$and$royaltyVfree$measures$can$be$

administered$to$study$participants$3$to$85$years$of$age$in$two$hours$or$less,$across$diverse$study$

designs$and$settings.$

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What$is$the$NIH$Toolbox?$

The$NIH$Toolbox$provides$a$standard$set$of$royaltyVfree,$brief,$and$comprehensive$assessment$

tools$that$can$be$used$by$researchers$and$clinicians$in$a$variety$of$settings,$with$a$particular$

emphasis$on$measuring$outcomes$in$longitudinal$epidemiologic$studies$and$prevention$or$

intervention$trials$across$the$lifespan$(ages$3V85).$The$battery$ensures$that$assessment$

methods$and$results$can$be$used$for$comparisons$across$existing$and$future$studies$and$

provides$a$“common$currency”$for$the$study$of$neurological$research$that$promotes$economies$

of$scale$and$enhanced$efficiency$in$measurement.$The$NIH$Toolbox$can$be$used$to$monitor$

neurological$and$behavioral$function$over$time$and$measure$key$constructs$across$

developmental$stages.$This$facilitates$the$study$of$functional$changes$across$the$lifespan,$

including$evaluating$intervention$and$treatment$effectiveness.$

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The$NIH$Toolbox$Batteries$

The$basic$NIH$Toolbox$can$be$administered$within$two$hours$and$divides$tests$into$four$domain$

batteries:$Cognition,$Emotion,$Motor,$and$Sensation.$In$addition,$within$some$domains,$there$

are$supplemental$measures$that$are$available$to$be$administered.$$

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Selection$of$the$NIH$Toolbox$Domains$and$Subdomains$$

Four$domains$were$selected$for$the$NIH$Toolbox:$Cognition,$Emotion,$Motor,$and$Sensation.$

Subdomain$selection$was$based$upon$literature$reviews,$expert$interviews,$and$multiple$formal$

Requests$for$Information$(RFI)$of$NIHVfunded$researchers.$Initial$literature$and$database$

reviews$and$an$RFI$identified$the$subdomains$for$inclusion$in$the$NIH$Toolbox,$existing$

measures$relevant$to$the$project$goals,$and$criteria$for$instrument$selection.$NIH$Project$Team$

members,$external$content$experts,$and$contract$scientists$met$at$a$followVup$consensus$

meeting$to$discuss$potential$subdomains$along$with$the$criteria$affecting$instrument$selection,$

creation,$and$norming.$Additional$expert$interviews$were$undertaken$to$gather$more$detailed$

information$from$clinical$and$scientific$experts$to$help$further$refine$the$list$of$possible$

subdomains.$A$second$consensus$group$meeting$was$held$and$results$directed$the$decision$for$

the$final$NIH$Toolbox$to$assess$four$core$domain$areas$(cognitive,$emotional,$motor,$and$

sensory$health$and$function).$

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Selection$of$Measures$for$the$NIH$Toolbox$

More$than$1,400$existing$measures$were$identified$and$evaluated$for$potential$inclusion$in$the$

NIH$Toolbox.$The$selection$criteria$included$a$measure’s$applicability$across$the$life$span,$

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psychometric$soundness,$brevity,$ease$of$use,$applicability$in$diverse$settings$and$with$different$

groups,$and$lack$of$intellectual$property$constraints.$There$was$also$a$preference$for$

instruments$that$were$already$validated$and$normed$for$use$with$individuals$between$3$and$85$

years$old.$Results$of$the$instrument$selection$process$yielded$draft$development$plans$

established$for$the$NIH$Toolbox$measures.$$

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Early$Childhood$Use$

NIH$Toolbox$measure$development$focused$special$attention$on$assessing$young$children,$to$

ensure$that$all$tests$given$are$developmentally$appropriate$for$ages$3V7.$A$special$team$of$early$

childhood$assessment$consultants$was$engaged$to$provide$testing$guidelines$for$the$very$

young,$to$offer$input$on$measure$development,$and$to$review$all$NIH$Toolbox$measures$to$

ensure$they$fit$the$needs$of$young$children.$Advanced$statistical$methods$were$used$to$

emphasize$continuity$of$measurement,$allowing$Toolbox$users$to$confidently$conduct$

longitudinal$measurement$from$age$3$through$the$life$span$while$assessing$the$same$domain$

constructs.$

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Section$2:$ Validation$

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Validation$studies$were$conducted$for$all$NIH$Toolbox$Cognition$domain$measures,$to$assure$

that$these$important$tools$for$research$met$rigorous$psychometric$standards.$Studies$were$

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conducted$across$the$entire$age$range$and$were$statistically$compared$against$“gold$standard”$

measures$wherever$available.$$

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For$specifics$regarding$Cognition$domain$measure$validation,$see$Weintraub$et$al.,$Cognition$

Assessment$Using$the$NIH$Toolbox,$Neurology,$in$press.$This$manuscript$describes$measure$

development$studies$undertaken$(e.g.,$expert$panels$for$content$development$and$validation;$

cognitive$interviews;$small$and$largeVscale$pilot$testing)$and$psychometric$characteristics$(e.g.,$

internal$consistency$and$testVretest$reliability;$convergent$and$divergent$validity).$

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Section$3:$ Norming$

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NIH$Toolbox$conducted$a$large$national$standardization$study$in$both$English$and$Spanish$

languages$to$allow$for$normative$comparisons$on$each$assessment.$A$sample$of$4,859$

participants,$ages$3V85$–$representative$of$the$U.S.$population$based$on$gender,$ethnicity,$race,$

and$socioeconomic$status$–$was$administered$all$of$the$NIH$Toolbox$measures$at$sites$around$

the$country$(n$=$2,917$EnglishVspeaking$children,$ages$3V17;$n$=$496$SpanishVspeaking$children,$

ages$3V7;$n$=$1,038$EnglishVspeaking$adults,$ages$18V85;$n$=$408$SpanishVspeaking$adults,$ages$

18V85).$NIH$Toolbox$normative$scores$are$now$available$for$each$year$of$age$from$3$through$17,$

as$well$as$for$age$ranges$18V29,$30V39,$40V49,$50V59,$60V69,$and$70V85,$allowing$for$targeted$

and$accurate$comparisons$to$the$U.S.$population.$

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Specifics$regarding$NIH$Toolbox$norming$sampling$methods$(e.g.,$stratification$by$age,$gender,$

and$language$preference;$sampling$a$minimum$of$25V100$individuals$per$targeted$demographic$

and$language$subgroup)$and$norming$analytic$methods$(e.g.,$postVstratification$adjustment$

using$iterative$proportional$fitting,$i.e.,$“raking”)$can$be$found$in$the$following$publication:$

Beaumont$et$al.,$Norming$Plans$for$the$NIH$Toolbox,$Neurology,$in$press.$

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Section$4:$ NIH$Toolbox$and$the$National$Children’s$

Study$(NCS)$

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In$collaboration$with$NIH$Toolbox$scientists,$NCS$investigators$selected$measures$from$PROMIS$

and$NIH$Toolbox$for$a$Maternal$Health$Profile,$the$Maternal$SelfVReported$Health$Battery.$This$

profile$assesses$Physical$Health$(Physical$function,$Fatigue,$Sleep$disturbance,$SleepVrelated$

impairment),$Mental$Health$(Anger,$Anxiety,$Depression,$Positive$affect,$Perceived$stress,$SelfV

efficacy),$and$Social$Health$(Social$support$and$companionship,$Social$isolation).$The$Maternal$

SelfVReported$Health$Battery$was$field$tested$in$fall$2011,$using$an$online$sample$of$1000$

women$(200$preVconception,$150$pregnant$women$(50$per$trimester),$and$650$mothers$with$a$

child$between$0V36$months$of$age).$In$addition,$NIH$Toolbox$norming$was$jointly$sponsored$by$

the$NCS$and$included:$3,413$children$in$singleVyear$age$bands$(from$3V17$years);$1,446$adults$in$

seven$age$bands,$including$the$mothers$of$children$also$being$tested;$and$105$pregnant$

women.$The$NIH$Toolbox$sampling$plan$matched$distributions$of$race/ethnicity$and$level$of$

education$for$each$age$band.$

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Section$5:$ Domain$Definition$

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Domain:$ COGNITION$

Cognition$refers$to$the$mental$processes$involved$in$gaining$knowledge$and$comprehension.$It$

includes$processes$such$as$thinking,$knowing,$remembering,$judging,$and$problemVsolving.$

These$higherVlevel$functions$of$the$brain$encompass$language,$imagination,$perception,$and$the$

planning$and$execution$of$complex$behaviors.$Measurement$of$cognition$is$essential$to$any$

study$of$health$and$wellVbeing$and$should$be$included$in$largeVscale$epidemiologic$studies$and$

experimental$studies$of$health$and$development,$even$when$the$target$of$the$study$is$not$

cognition$itself.$The$Cognition$domain$includes$measures$of:$

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EXECUTIVE$FUNCTION$$

Measured$by:$$

NIH$Toolbox$Flanker$Inhibitory$Control$and$Attention$Test$

NIH$Toolbox$Dimensional$Change$Card$Sort$Test$$

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ATTENTION$

Measured$by:$


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EPISODIC$MEMORY$$

Measured$by:$

NIH$Toolbox$Picture$Sequence$Memory$Test$$

NIH$Toolbox$Auditory$Verbal$Learning$Test$(Rey)$(Supplemental$Measure)$

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LANGUAGE$

Measured$by:$

NIH$Toolbox$Picture$Vocabulary$Test$

NIH$Toolbox$Oral$Reading$Recognition$Test$

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PROCESSING$SPEED$

Measured$by:$

NIH$Toolbox$Pattern$Comparison$Processing$Speed$Test$

NIH$Toolbox$Oral$Symbol$Digit$Test$(Supplemental$Measure)$

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WORKING$MEMORY$$

Measured$by:$

NIH$Toolbox$List$Sorting$Working$Memory$Test$

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Section$6:$ Subdomain$Definitions$

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Subdomain:$ EXECUTIVE$FUNCTION$$

Executive$Function$is$the$capacity$to$plan,$organize,$and$monitor$the$execution$of$behaviors$

that$are$strategically$directed$in$a$goalVoriented$manner.$NIH$Toolbox$focuses$on$set$shifting$

(i.e.,$the$capacity$for$switching$among$multiple$aspects$of$a$strategy$or$task)$and$the$inhibition$

of$automatic$response$tendencies$that$may$interfere$with$achieving$a$goal.$In$NIH$Toolbox,$

Executive$Function$is$measured$by:$$

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NIH$Toolbox$Dimensional$Change$Card$Sort$Test$$

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Subdomain:$ ATTENTION$

Attention$refers$to$the$allocation$of$one’s$limited$capacities$to$manage$the$abundance$of$

environmental$stimulation.$It$is$the$foundation$for$all$mental$processes.$There$are$several$

forms$of$attention,$including$sustained,$selective,$and$divided.$Sustained$attention$is$closely$

linked$to$the$level$of$wakefulness$or$the$maintenance$of$an$alert$state.$Selective$attention$

serves$to$direct$sensory$and$thought$processes$to$a$particular$stimulus$or$sector$of$the$visual$

field$so$that$action$can$be$taken.$Divided$attention$is$the$ability$to$attend$to$more$than$one$

stimulus,$spatial$sector,$or$modality$simultaneously,$and$overlaps$with$Executive$Function.$In$

NIH$Toolbox,$Attention$is$measured$by:$

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Subdomain:$ EPISODIC$MEMORY$$

Episodic$Memory$refers$to$cognitive$processes$involved$in$the$acquisition,$storage,$and$retrieval$

of$new$information.$It$involves$conscious$recollection$of$information$learned$within$a$context.$

The$term$"learning"$refers$to$the$acquisition$of$skills$and$knowledge,$while$the$term$"memory"$

refers$to$the$persistence$of$this$learning$over$time$and/or$the$facility$with$which$one$is$able$to$

spontaneously$recall$the$information$following$a$delay.$Episodic$Memory$can$be$verbal,$as$in$

remembering$a$conversation$or$a$list$of$grocery$items,$or$nonverbal,$as$in$imagining$a$place$one$

visited$or$a$picture$one$saw$a$week$ago.$In$NIH$Toolbox,$Episodic$Memory$is$measured$by:$

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NIH$Toolbox$Picture$Sequence$Memory$Test$$

NIH$Toolbox$Auditory$Verbal$Learning$Test$(Rey)$(Supplemental$Measure)$

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Subdomain:$ LANGUAGE$

Language$refers$to$a$set$of$mental$processes$that$translate$thought$into$symbols$(e.g.,$words,$

gestures)$that$can$be$shared$among$individuals$for$purposes$of$communication.$NIH$Toolbox$

focuses$on$two$aspects$of$language.$The$first$is$receptive$word$knowledge,$which$is$

fundamental$to$learning$and$has$a$very$high$association$with$overall$intelligence$(or$what$has$

been$called$the$"gVfactor").$The$second$aspect$taps$reading,$which$is$defined$as$the$cognitive$

process$of$deriving$meaning$from$text,$and$is$reflective$of$the$level$and$quality$of$prior$

educational$experiences.$An$oral$reading$measure$provides$a$fairly$robust$indication$of$verbal$

intelligence$that$is$relatively$undisturbed$by$many$medical$conditions$that$affect$the$brain.$In$

NIH$Toolbox,$Language$is$measured$by:$

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NIH$Toolbox$Picture$Vocabulary$Test$

NIH$Toolbox$Oral$Reading$Recognition$Test$

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Subdomain:$ PROCESSING$SPEED$

Processing$Speed$is$defined$as$either$the$amount$of$time$it$takes$to$process$a$set$amount$of$

information,$or,$conversely,$the$amount$of$information$that$can$be$processed$within$a$certain$

amount$of$time.$It$is$a$measure$that$reflects$mental$efficiency.$Processing$Speed$is$central$for$

many$cognitive$functions$and$domains$and$is$sensitive$to$change$and/or$disease.$In$NIH$

Toolbox,$Processing$Speed$is$measured$by:$

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NIH$Toolbox$Pattern$Comparison$Processing$Speed$Test$

NIH$Toolbox$Oral$Symbol$Digit$Test$(Supplemental$Measure)$

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Subdomain:$ WORKING$MEMORY$$

Working$Memory$refers$to$the$ability$to$store$information$until$the$amount$of$information$to$

be$stored$exceeds$one’s$capacity$to$hold$that$information.$Working$Memory$also$refers$to$the$

capacity$of$an$individual$to$process$information$across$a$series$of$tasks$and$modalities,$hold$the$

information$in$a$shortVterm$buffer,$manipulate$the$information,$and$hold$the$products$in$the$

same$shortVterm$buffer.$With$its$notion$of$an$active$computational$workspace,$Working$

Memory$is$a$conceptual$update$to$the$construct$"shortVterm$memory"$that$refers$to$a$passive$

storage$buffer.$In$NIH$Toolbox,$Working$Memory$is$measured$by:$

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NIH$Toolbox$List$Sorting$Working$Memory$Test$

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Section$7:$ Measure$Description$

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COGNITION$Batteries$and$Composite$Scores$

The$NIH$Toolbox$Cognition$Battery$for$ages$8V85$includes$all$seven$core$measures$described$

above.$For$ages$3V7,$the$NIH$Toolbox$Early$Childhood$Battery$is$recommended.$This$battery$

includes$the$Picture$Vocabulary,$Flanker,$Dimensional$Change$Card$Sort,$and$Picture$Sequence$

Memory$measures$and$takes$approximately$20$minutes$to$administer$to$young$children.$In$

addition$to$scores$for$individual$measures$as$described$above,$each$cognition$battery$provides$

composite$scores,$which$allow$for$general$interpretation/evaluation$of$overall$cognitive$

functioning,$and$an$even$higher$level$of$reliability$than$is$possible$with$any$given$individual$

measure.$The$four$composite$scores$provided$are$as$follows:$

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NIH$Toolbox$Fluid$Cognition$Composite$Score$

NIH$Toolbox$Crystallized$Cognition$Composite$Score$

NIH$Toolbox$Cognitive$Function$Composite$Score$

NIH$Toolbox$Early$Childhood$Composite$Score$

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The$NIH$Toolbox$Fluid$Cognition$Composite$Score$includes$all$of$the$tests$noted$above$that$are$

fluid$ability$measures:$Flanker,$Dimensional$Change$Card$Sort,$Picture$Sequence$Memory,$List$

Sorting,$and$Pattern$Comparison.$$

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The$NIH$Toolbox$Crystallized$Cognition$Composite$Score$includes$the$Picture$Vocabulary$Test$

and$the$Oral$Reading$Recognition$Test.$$

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The$NIH$Toolbox$Cognitive$Function$Composite$Score$includes$all$of$the$tests$listed$above$under$

both$the$Fluid$and$Crystallized$composites.$$

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The$NIH$Toolbox$Early$Childhood$Composite$Score$is$derived$from$the$four$cognition$measures$

that$comprise$the$Early$Childhood$Battery:$Picture$Vocabulary,$Flanker,$DCCS,$and$Picture$

Sequence$Memory.$It$is$designed$primarily$for$Toolbox$users$assessing$children$ages$3V7.$$

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Section$8:$ PostLValidation/PostLNorming$Changes$to$

the$Measure$

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No$notable$PostVValidation/PostVNorming$changes$were$made$to$these$batteries$and$composite$

measures.$

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Section$9:$ The$Measure’s$Scoring$Model$

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Measurement$theory$applied$for$scoring:$

Classical$Test$Theory$(CTT)$

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CTT$scoring$approach$employed:$

Average$(i.e.,$the$average$of$the$normalized$score$of$each$of$the$composite’s$respective$

component$measures)$

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Measure$length:$

Fixed$(number$of$composite$components)$

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Response$data:$

Continuous$

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Scores$computed/available$for$each$composite*:$

AgeVAdjusted$Scale$Score$(mean=100,$standard$deviation=15)$

Fully$Adjusted$Scale$Score$(mean=100,$standard$deviation=15)$

Unadjusted$Scale$Score$(mean=100,$standard$deviation=15)$

National$Percentile$Rank$(corresponds$to$the$AgeVAdjusted$Scale$Score)$

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*Details$on$these$scores$and$their$interpretations$are$available$in$the$NIH$Toolbox$Scoring$and$

Interpretation$Guide.$

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Section$10:$ Measure$NormsLFluid$Cognition$

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The$following$Tables$and$Figure$present$NIH$Toolbox$normative$data$associated$with$this$

measure:$

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Table$1.$ Composite$Unadjusted$Scale$Score,$and$Fully$Adjusted$Scale$Score$

Summary$(N,$Mean,$Standard$Deviation)$by$Age$Group$(3,$4,$5,$6,$7,$8,$9,$

10,$11,$12,$13,$14,$15,$16,$17,$18L29,$30L39,$40L49,$50L59,$60L69,$70L85,$

All)$

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Table$2.$ Composite$Unadjusted$Scale$Score$Statistics$(N,$Mean,$Standard$

Deviation,$Minimum/Maximum$Observed,$25th/50th/75th$Percentile)$per$

Age$Group$(3,$4,$5,$6,$7,$8,$9,$10,$11,$12,$13,$14,$15,$16,$17,$18L29,$30L39,$

40L49,$50L59,$60L69,$70L85,$All)$

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Figure$1.$ Composite$Mean$Unadjusted$Scale$Scores$across$All$Age$Groups$(3,$4,$5,$

6,$7,$8,$9,$10,$11,$12,$13,$14,$15,$16,$17,$18L29,$30L39,$40L49,$50L59,$60L69,$

70L85)$

$

$ $

Table 1. NIH Toolbox Cognition Fluid Composite

by Age Group

Fluid Composite Unadjusted Scale

Score

Fluid Composite Fully Adjusted Scale

Score

N Mean SD N Mean SD

Age Group

164 70.41 4.43 150 98.15 7.81 3

4 198 77.80 2.57 183 99.42 6.29

5 166 82.62 2.66 152 99.73 7.60

6 155 87.41 2.73 138 100.18 6.57

7 196 90.06 2.21 176 101.20 6.05

8 186 94.70 2.94 179 101.24 7.20

9 191 97.88 3.40 178 101.45 7.12

10 206 100.17 3.83 193 101.23 7.54

11 195 103.51 4.34 184 100.78 7.89

12 202 106.80 4.46 193 100.76 8.25

13 204 109.04 5.37 196 100.94 8.89

14 200 111.58 4.79 193 100.24 8.07

15 200 113.58 5.70 194 101.36 9.03

16 193 116.71 6.15 184 99.98 9.47

17 194 117.72 6.51 187 100.78 9.80

18 - 29 254 116.91 23.13 244 100.20 33.91

30 - 39 293 111.94 16.38 278 100.23 26.03

40 - 49 232 108.85 17.29 221 99.90 27.13

50 - 59 178 101.44 14.98 162 100.62 27.39

60 - 69 135 99.10 12.34 126 101.33 24.53

70 - 85 173 93.44 8.73 156 100.30 18.20

All 4115 105.85 14.21 3867 100.40 16.45

Table 2. NIH Toolbox Cognition Fluid Composite – Age 3

English Spanish Total

All Males Females Total Males Females Total Males Females

N 52 47 99 35 30 65 87 77 164

Mean 69.46 72.50 70.59 70.30 68.08 69.55 69.62 71.78 70.41

Standard Deviation 6.09 3.90 5.24 3.02 2.47 2.79 5.06 3.50 4.43

Minimum Observed 51.90 56.49 51.90 51.90 46.21 46.21 51.90 46.21 46.21

25th Percentile 63.64 68.51 65.72 65.72 63.05 65.72 63.64 68.03 65.72

50th Percentile (Median) 69.28 72.86 71.23 69.84 69.61 69.84 69.53 72.01 71.10

75th Percentile 76.20 77.24 76.20 74.94 74.11 74.61 75.72 76.75 76.20

Maximum Observed 83.70 85.66 85.66 88.46 77.01 88.46 88.46 85.66 88.46




N 60 56 116 39 43 82 99 99 198

Mean 78.24 78.18 78.22 75.84 75.38 75.65 77.87 77.70 77.80



25th Percentile 75.53 75.03 75.53 72.01 72.19 72.19 75.38 74.82 75.26


75th Percentile 81.45 81.04 81.45 78.69 79.15 78.97 81.18 80.66 81.04





N 51 57 108 28 30 58 79 87 166

Mean 82.74 83.19 82.93 81.01 80.27 80.70 82.50 82.79 82.62



25th Percentile 79.77 79.02 79.35 77.14 77.31 77.14 79.11 79.02 79.11


75th Percentile 85.68 86.28 85.82 84.39 85.42 85.20 85.01 86.22 85.82





N 42 50 92 29 34 63 71 84 155

Mean 87.83 87.87 87.85 84.48 86.55 85.36 87.23 87.64 87.41



25th Percentile 84.45 84.92 84.49 81.55 82.94 82.33 84.09 84.49 84.38


75th Percentile 91.58 90.96 90.96 87.14 90.32 88.99 90.09 90.49 90.32





N 55 53 108 43 45 88 98 98 196

Mean 90.54 90.43 90.50 88.43 87.79 88.17 90.17 89.88 90.06



25th Percentile 88.12 87.85 87.85 85.91 84.77 85.68 87.52 87.32 87.32


75th Percentile 92.75 92.55 92.75 91.67 91.40 91.55 92.68 92.51 92.51





N 93 93 186 0 0 0 93 93 186

Mean 94.49 94.98 94.70 94.49 94.98 94.70

Standard Deviation 3.24 2.62 2.94 3.24 2.62 2.94

Minimum Observed 82.62 84.19 82.62 82.62 84.19 82.62

25th Percentile 91.10 91.35 91.27 91.10 91.35 91.27

50th Percentile (Median) 94.17 94.41 94.17 94.17 94.41 94.17

75th Percentile 97.90 98.20 97.92 97.90 98.20 97.92

Maximum Observed 110.35 113.91 113.91 110.35 113.91 113.91




N 91 100 191 0 0 0 91 100 191

Mean 97.51 98.39 97.88 97.51 98.39 97.88



25th Percentile 93.44 93.93 93.71 93.44 93.93 93.71


75th Percentile 101.56 101.90 101.56 101.56 101.90 101.56





N 99 107 206 0 0 0 99 107 206

Mean 99.70 100.84 100.17 99.70 100.84 100.17



25th Percentile 95.25 96.19 95.27 95.25 96.19 95.27


75th Percentile 103.97 104.90 104.10 103.97 104.90 104.10





N 99 96 195 0 0 0 99 96 195

Mean 102.70 104.71 103.51 102.70 104.71 103.51



25th Percentile 97.48 99.52 97.68 97.48 99.52 97.68


75th Percentile 107.50 109.84 107.92 107.50 109.84 107.92





N 95 107 202 0 0 0 95 107 202

Mean 105.67 108.25 106.80 105.67 108.25 106.80



25th Percentile 100.50 102.72 101.16 100.50 102.72 101.16


75th Percentile 109.31 112.40 111.49 109.31 112.40 111.49





N 114 90 204 0 0 0 114 90 204

Mean 108.50 110.11 109.04 108.50 110.11 109.04



25th Percentile 102.29 102.98 102.84 102.29 102.98 102.84


75th Percentile 114.29 115.27 114.29 114.29 115.27 114.29





N 103 97 200 0 0 0 103 97 200

Mean 111.64 111.50 111.58 111.64 111.50 111.58



25th Percentile 105.17 105.10 105.17 105.17 105.10 105.17


75th Percentile 118.18 117.57 118.02 118.18 117.57 118.02





N 99 101 200 0 0 0 99 101 200

Mean 113.93 113.11 113.58 113.93 113.11 113.58



25th Percentile 106.19 106.13 106.19 106.19 106.13 106.19


75th Percentile 118.78 119.76 119.76 118.78 119.76 119.76





N 97 96 193 0 0 0 97 96 193

Mean 117.39 115.70 116.71 117.39 115.70 116.71



25th Percentile 109.49 108.05 108.90 109.49 108.05 108.90


75th Percentile 124.24 122.88 123.55 124.24 122.88 123.55





N 99 95 194 0 0 0 99 95 194

Mean 118.49 116.41 117.72 118.49 116.41 117.72



25th Percentile 109.93 107.48 108.76 109.93 107.48 108.76


75th Percentile 128.11 125.15 127.19 128.11 125.15 127.19


Table 2. NIH Toolbox Cognition Fluid Composite – Age 18-29



N 58 111 169 17 68 85 75 179 254

Mean 121.13 116.05 118.41 109.41 105.47 106.56 120.20 114.32 116.91



25th Percentile 109.64 108.62 109.01 100.32 99.23 99.47 109.43 106.67 108.12


75th Percentile 129.22 121.35 125.92 116.15 112.02 112.79 129.22 120.29 125.10





N 52 154 206 21 66 87 73 220 293

Mean 112.88 112.51 112.63 110.16 104.58 106.47 112.56 111.63 111.94



25th Percentile 103.80 106.59 105.19 102.84 97.28 97.92 103.80 105.87 104.69


75th Percentile 122.40 118.49 119.74 121.81 109.49 111.74 122.40 117.82 118.88





N 60 110 170 24 38 62 84 148 232

Mean 109.48 110.18 109.88 97.83 100.95 99.43 108.22 109.35 108.85



25th Percentile 101.60 102.59 102.02 91.64 94.67 93.19 100.77 101.96 101.12


75th Percentile 116.78 117.13 116.85 102.92 107.24 105.10 116.61 116.67 116.65





N 57 80 137 18 23 41 75 103 178

Mean 100.68 102.88 101.68 101.00 95.67 98.61 100.70 102.31 101.44



25th Percentile 96.77 96.84 96.81 96.07 92.55 94.21 96.77 95.18 95.64


75th Percentile 105.47 108.65 107.49 105.16 101.92 103.86 105.47 107.83 106.89





N 45 65 110 10 15 25 55 80 135

Mean 99.25 99.96 99.60 90.39 90.57 90.48 98.75 99.47 99.10



25th Percentile 94.77 97.04 95.24 85.15 84.56 85.15 94.67 96.49 95.00


75th Percentile 103.23 103.80 103.23 92.01 97.87 96.38 102.90 102.06 102.90





N 77 80 157 6 10 16 83 90 173

Mean 93.06 94.34 93.59 86.35 88.17 87.37 92.94 94.14 93.44



25th Percentile 86.84 90.85 88.69 82.64 84.06 84.06 86.84 89.92 88.31


75th Percentile 98.42 98.84 98.56 87.50 93.69 92.70 98.42 98.33 98.42


Table 2. NIH Toolbox Cognition Fluid Composite – NCS Sample of

Mothers English Spanish All

N 79 34 113

Mean 112.97 104.04 110.28

Standard Deviation 10.57 9.03 10.90

Minimum Observed 86.89 87.98 86.89

25th Percentile 105.91 96.37 103.13

50th Percentile (Median) 112.96 103.28 109.98

75th Percentile 119.77 108.87 117.48

Maximum Observed 147.16 128.92 147.16

Table 2. NIH Toolbox Cognition Fluid Composite – NCS Sample of

Pregnant Women English Spanish All

N 81 41 122

Mean 112.49 105.39 110.10



25th Percentile 107.54 98.17 104.69


75th Percentile 117.80 111.74 115.62


Table 1 Least Squares Means

22$$

Section$11:$ Measure$NormsLCrystallized$Cognition$

$


measure:$

$



10,$11,$12,$13,$14,$15,$16,$17,$18L29,$30L39,$40L49,$50L59,$60L69,$70L85,$

All)$

$



Age$Group$(3,$4,$5,$6,$7,$8,$9,$10,$11,$12,$13,$14,$15,$16,$17,$18L29,$30L39,$

40L49,$50L59,$60L69,$70L85,$All)$

$


6,$7,$8,$9,$10,$11,$12,$13,$14,$15,$16,$17,$18L29,$30L39,$40L49,$50L59,$60L69,$

70L85)$

$

$ $

Table 1. NIH Toolbox Cognition Crystalized

Composite by Age Group

Crystalized Composite

Unadjusted Scale Score

Crystalized Composite Fully

Adjusted Scale Score

N Mean SD N Mean SD

Age Group

151 73.85 6.21 140 102.03 10.98 3

4 163 75.65 4.05 151 98.02 8.55

5 162 79.61 3.28 149 97.38 7.55

6 154 83.39 3.34 137 96.37 7.44

7 196 86.74 2.84 176 97.16 6.64

8 160 87.54 2.90 153 96.71 6.40

9 165 92.32 2.91 154 97.57 6.48

10 174 94.27 3.37 165 97.65 6.69

11 173 97.53 3.32 164 98.33 7.05

12 179 98.99 3.75 171 98.18 7.26

13 174 102.21 4.28 166 98.57 7.72

14 178 104.80 4.03 172 98.84 7.69

15 178 105.53 4.44 174 98.59 8.38

16 170 108.09 5.23 162 98.36 8.75

17 167 108.09 4.68 161 98.29 8.44

18 - 29 241 111.25 17.44 231 98.28 28.95

30 - 39 280 113.84 15.34 266 98.43 25.09

40 - 49 207 115.01 17.91 197 98.24 29.47

50 - 59 166 114.35 22.79 153 98.09 35.28

60 - 69 124 115.88 23.36 118 97.92 38.07

70 - 85 143 114.97 16.15 130 98.28 25.45

All 3705 109.93 14.80 3490 98.21 17.90

Table 2. NIH Toolbox Cognition Crystalized Composite – Age 3



N 53 47 100 29 22 51 82 69 151

Mean 74.79 70.84 73.35 76.21 78.37 76.93 75.00 71.82 73.85



25th Percentile 68.35 67.48 67.87 69.76 71.39 71.39 68.35 67.56 68.35


75th Percentile 76.89 73.56 75.87 82.68 85.20 83.35 77.02 74.55 76.20





N 53 50 103 29 31 60 82 81 163

Mean 74.53 73.75 74.22 82.36 87.80 84.55 75.59 75.75 75.65



25th Percentile 71.07 72.61 71.70 77.75 83.18 78.86 71.70 73.47 72.16


75th Percentile 77.72 77.45 77.45 89.55 93.98 91.76 78.63 78.82 78.82





N 51 57 108 26 28 54 77 85 162

Mean 78.53 78.76 78.63 85.85 86.57 86.15 79.49 79.77 79.61



25th Percentile 77.06 75.35 76.44 80.85 82.09 82.09 77.06 75.38 76.48


75th Percentile 80.64 81.30 81.19 89.99 90.40 89.99 82.11 81.90 82.11





N 42 50 92 28 34 62 70 84 154

Mean 82.12 81.77 81.97 90.65 89.58 90.18 83.60 83.12 83.39



25th Percentile 79.82 80.38 79.99 86.77 85.56 86.34 80.09 80.40 80.38


75th Percentile 84.38 83.84 84.22 95.59 95.25 95.25 86.74 84.22 85.36





N 55 53 108 43 45 88 98 98 196

Mean 85.08 86.09 85.45 92.59 91.66 92.21 86.43 87.26 86.74



25th Percentile 82.81 82.38 82.57 89.40 88.55 89.36 83.36 83.42 83.36


75th Percentile 87.67 88.86 87.98 96.09 94.73 95.25 89.87 91.05 90.22





N 83 77 160 0 0 0 83 77 160

Mean 87.01 88.36 87.54 87.01 88.36 87.54



25th Percentile 82.95 84.97 84.09 82.95 84.97 84.09


75th Percentile 90.10 91.16 91.05 90.10 91.16 91.05





N 82 83 165 0 0 0 82 83 165

Mean 91.95 92.86 92.32 91.95 92.86 92.32



25th Percentile 88.25 89.49 88.70 88.25 89.49 88.70


75th Percentile 96.02 95.51 96.02 96.02 95.51 96.02





N 84 90 174 0 0 0 84 90 174

Mean 94.80 93.46 94.27 94.80 93.46 94.27



25th Percentile 90.65 90.91 90.65 90.65 90.91 90.65


75th Percentile 98.22 96.74 97.12 98.22 96.74 97.12





N 88 85 173 0 0 0 88 85 173

Mean 97.48 97.60 97.53 97.48 97.60 97.53



25th Percentile 93.35 92.96 93.23 93.35 92.96 93.23


75th Percentile 102.42 101.86 101.98 102.42 101.86 101.98





N 82 97 179 0 0 0 82 97 179

Mean 98.00 100.20 98.99 98.00 100.20 98.99



25th Percentile 94.77 95.91 95.26 94.77 95.91 95.26


75th Percentile 102.36 103.49 103.22 102.36 103.49 103.22





N 101 73 174 0 0 0 101 73 174

Mean 102.97 100.55 102.21 102.97 100.55 102.21



25th Percentile 98.76 96.94 97.82 98.76 96.94 97.82


75th Percentile 108.03 104.30 107.59 108.03 104.30 107.59





N 91 87 178 0 0 0 91 87 178

Mean 105.25 104.08 104.80 105.25 104.08 104.80



25th Percentile 99.78 99.56 99.74 99.78 99.56 99.74


75th Percentile 109.63 108.98 109.37 109.63 108.98 109.37





N 84 94 178 0 0 0 84 94 178

Mean 105.86 105.11 105.53 105.86 105.11 105.53



25th Percentile 99.06 99.30 99.15 99.06 99.30 99.15


75th Percentile 112.15 109.36 111.40 112.15 109.36 111.40





N 81 89 170 0 0 0 81 89 170

Mean 109.42 106.35 108.09 109.42 106.35 108.09



25th Percentile 103.25 100.44 103.02 103.25 100.44 103.02


75th Percentile 115.24 112.32 113.53 115.24 112.32 113.53





N 88 79 167 0 0 0 88 79 167

Mean 108.81 106.75 108.09 108.81 106.75 108.09



25th Percentile 103.79 100.36 101.96 103.79 100.36 101.96


75th Percentile 114.08 111.80 113.01 114.08 111.80 113.01


Table 2. NIH Toolbox Cognition Crystalized Composite – Age

18-29



N 54 109 163 16 62 78 70 171 241

Mean 113.72 109.66 111.49 108.58 109.86 109.50 113.32 109.69 111.25



25th Percentile 109.81 103.99 105.75 100.23 103.90 102.37 107.00 103.99 105.40


75th Percentile 121.39 114.86 116.78 112.72 114.97 114.86 120.67 114.86 116.74



30-39



N 49 151 200 20 60 80 69 211 280

Mean 114.69 113.69 114.01 113.72 111.83 112.49 114.58 113.50 113.84



25th Percentile 108.65 106.97 107.54 104.68 105.21 104.68 108.23 106.49 106.97


75th Percentile 120.58 120.43 120.58 119.22 117.13 119.05 120.58 120.13 120.43



40-49



N 55 105 160 17 30 47 72 135 207

Mean 115.59 115.09 115.30 111.76 111.79 111.78 115.25 114.83 115.01



25th Percentile 107.95 108.33 107.95 101.41 107.18 103.79 107.95 107.69 107.69


75th Percentile 121.77 120.80 120.85 124.53 120.03 121.02 121.77 120.80 120.85



50-59



N 55 76 131 16 19 35 71 95 166

Mean 114.34 114.73 114.52 111.27 113.42 112.18 114.11 114.64 114.35



25th Percentile 109.24 107.29 108.48 99.52 105.25 102.31 108.48 106.15 108.08


75th Percentile 121.39 123.47 121.46 124.09 119.97 122.30 121.39 123.47 121.46



60-69



N 44 64 108 7 9 16 51 73 124

Mean 116.55 115.97 116.27 107.94 103.02 105.92 116.18 115.56 115.88



25th Percentile 106.47 109.19 108.41 101.59 99.62 99.69 106.47 109.18 107.92


75th Percentile 126.17 123.34 124.73 115.75 103.79 111.88 125.42 122.63 124.63



70-85



N 60 71 131 5 7 12 65 78 143

Mean 115.06 115.47 115.24 103.77 103.32 103.54 114.83 115.14 114.97



25th Percentile 107.08 106.67 107.08 99.09 97.54 98.25 106.85 106.67 106.85


75th Percentile 124.39 122.78 124.39 109.18 109.47 109.47 124.39 122.78 124.33


Table 2. NIH Toolbox Cognition Crystalized Composite – NCS

Sample of Mothers English Spanish All

N 80 33 113

Mean 112.96 113.16 113.02



25th Percentile 106.24 106.96 106.72


75th Percentile 119.07 120.13 119.55


Table 2. NIH Toolbox Cognition Crystalized Composite – NCS Sample of Pregnant Women English Spanish All

N 81 38 119

Mean 112.90 108.44 111.48



25th Percentile 106.81 103.36 105.55


75th Percentile 119.05 114.55 117.68


Figure 1 Least Squares Means

23$$

Section$12:$ Measure$NormsLCognitive$Function$

$


measure:$

$



10,$11,$12,$13,$14,$15,$16,$17,$18L29,$30L39,$40L49,$50L59,$60L69,$70L85,$

All)$

$



Age$Group$(3,$4,$5,$6,$7,$8,$9,$10,$11,$12,$13,$14,$15,$16,$17,$18L29,$30L39,$

40L49,$50L59,$60L69,$70L85,$All)$

$


6,$7,$8,$9,$10,$11,$12,$13,$14,$15,$16,$17,$18L29,$30L39,$40L49,$50L59,$60L69,$

70L85)$

$

$ $

Table 1. NIH Toolbox Cognitive Function

Composite by Age Group

Cognitive Function Composite


Cognitive Function Composite Fully


N Mean SD N Mean SD

Age Group

162 71.33 4.16 151 100.25 9.89 3

4 168 76.23 2.64 156 97.86 7.76

5 166 80.78 2.28 152 98.22 7.74

6 155 84.97 2.31 138 97.80 7.14

7 196 87.81 1.90 176 98.84 6.56

8 160 90.29 2.37 153 98.16 7.07

9 165 94.09 2.55 154 98.93 6.75

10 174 96.08 2.98 165 98.87 7.00

11 173 99.60 3.34 164 99.58 7.39

12 179 102.05 3.73 171 99.42 7.93

13 174 105.15 4.36 166 99.81 7.98

14 178 108.36 4.40 172 99.70 7.98

15 179 109.52 4.87 175 99.66 8.28

16 170 113.63 6.15 162 99.54 9.28

17 167 113.93 5.66 161 99.33 8.79

18 - 29 242 115.75 21.46 231 99.09 31.61

30 - 39 282 115.00 16.88 267 99.36 25.23

40 - 49 207 114.18 20.14 197 98.98 29.09

50 - 59 166 109.31 21.10 153 99.21 32.41

60 - 69 124 108.94 19.64 118 99.54 32.32

70 - 85 143 105.07 13.17 130 99.65 22.67

All 3730 109.24 14.77 3512 99.21 17.40

Table 2. NIH Toolbox Cognitive Function Composite – Age 3



N 53 47 100 34 28 62 87 75 162

Mean 71.44 70.89 71.24 71.53 72.14 71.73 71.46 71.09 71.33



25th Percentile 65.73 68.68 66.62 66.25 68.12 66.25 66.25 68.41 66.62


75th Percentile 75.82 75.57 75.57 77.10 77.64 77.17 75.82 75.92 75.82





N 53 50 103 30 35 65 83 85 168

Mean 75.97 75.34 75.72 78.16 80.50 79.16 76.27 76.16 76.23



25th Percentile 73.57 72.98 73.57 75.56 77.09 76.54 73.85 73.67 73.71


75th Percentile 79.57 78.12 79.06 80.62 83.67 81.98 79.58 79.27 79.58





N 51 57 108 28 30 58 79 87 166

Mean 80.36 80.67 80.49 82.69 82.48 82.61 80.69 80.92 80.78



25th Percentile 78.66 77.85 78.32 78.00 80.58 79.34 78.66 77.85 78.52


75th Percentile 82.44 82.63 82.61 86.09 86.31 86.09 82.74 82.85 82.75





N 42 50 92 29 34 63 71 84 155

Mean 84.59 84.49 84.55 86.63 87.31 86.92 84.96 84.98 84.97



25th Percentile 82.57 82.59 82.57 84.23 84.54 84.23 82.57 83.30 82.59


75th Percentile 87.97 85.92 86.48 90.01 91.01 90.21 87.97 87.21 87.71





N 55 53 108 43 45 88 98 98 196

Mean 87.28 87.69 87.43 89.76 88.98 89.44 87.72 87.96 87.81



25th Percentile 85.23 86.15 85.32 86.65 87.04 86.65 85.36 86.23 85.78


75th Percentile 89.19 89.52 89.19 92.34 90.86 91.82 90.25 90.27 90.27





N 83 77 160 0 0 0 83 77 160

Mean 90.00 90.75 90.29 90.00 90.75 90.29



25th Percentile 87.05 88.22 87.70 87.05 88.22 87.70


75th Percentile 92.54 92.78 92.67 92.54 92.78 92.67





N 82 83 165 0 0 0 82 83 165

Mean 93.69 94.67 94.09 93.69 94.67 94.09



25th Percentile 90.20 91.91 90.65 90.20 91.91 90.65


75th Percentile 96.78 96.54 96.78 96.78 96.54 96.78





N 84 90 174 0 0 0 84 90 174

Mean 96.17 95.94 96.08 96.17 95.94 96.08



25th Percentile 93.35 93.91 93.62 93.35 93.91 93.62


75th Percentile 98.81 98.49 98.59 98.81 98.49 98.59





N 88 85 173 0 0 0 88 85 173

Mean 99.15 100.26 99.60 99.15 100.26 99.60



25th Percentile 94.63 95.91 95.57 94.63 95.91 95.57


75th Percentile 102.42 104.51 103.48 102.42 104.51 103.48





N 82 97 179 0 0 0 82 97 179

Mean 100.92 103.43 102.05 100.92 103.43 102.05



25th Percentile 96.72 99.17 97.70 96.72 99.17 97.70


75th Percentile 105.58 106.51 106.32 105.58 106.51 106.32





N 101 73 174 0 0 0 101 73 174

Mean 105.42 104.58 105.15 105.42 104.58 105.15



25th Percentile 100.36 99.55 100.18 100.36 99.55 100.18


75th Percentile 110.88 109.14 110.62 110.88 109.14 110.62





N 91 87 178 0 0 0 91 87 178

Mean 108.66 107.87 108.36 108.66 107.87 108.36



25th Percentile 102.53 103.33 102.72 102.53 103.33 102.72


75th Percentile 113.95 112.12 112.85 113.95 112.12 112.85





N 85 94 179 0 0 0 85 94 179

Mean 109.84 109.11 109.52 109.84 109.11 109.52



25th Percentile 101.53 103.16 102.78 101.53 103.16 102.78


75th Percentile 115.64 115.60 115.64 115.64 115.60 115.64





N 81 89 170 0 0 0 81 89 170

Mean 115.12 111.67 113.63 115.12 111.67 113.63



25th Percentile 107.26 102.92 106.27 107.26 102.92 106.27


75th Percentile 122.78 120.17 121.39 122.78 120.17 121.39





N 88 79 167 0 0 0 88 79 167

Mean 114.69 112.52 113.93 114.69 112.52 113.93



25th Percentile 107.39 104.99 106.85 107.39 104.99 106.85


75th Percentile 120.03 120.19 120.03 120.03 120.19 120.03


Table 2. NIH Toolbox Cognitive Function Composite – Age 18-29



N 54 109 163 17 62 79 71 171 242

Mean 120.01 114.11 116.77 108.94 108.32 108.50 119.07 113.22 115.75



25th Percentile 111.71 106.58 109.82 102.86 103.35 103.23 110.49 105.77 108.13


75th Percentile 127.15 120.05 123.88 111.11 112.98 112.98 126.96 119.69 123.38





N 49 151 200 21 61 82 70 212 282

Mean 116.44 115.17 115.57 113.03 108.96 110.42 116.02 114.52 115.00



25th Percentile 106.65 107.75 107.26 107.79 101.25 102.92 106.85 106.25 106.32


75th Percentile 123.51 122.05 123.11 117.33 115.32 115.96 123.51 120.96 122.89





N 55 105 160 17 30 47 72 135 207

Mean 114.64 114.98 114.84 105.80 107.69 106.83 113.87 114.42 114.18



25th Percentile 105.46 106.45 106.01 96.59 99.87 98.59 103.46 105.28 105.14


75th Percentile 122.65 123.00 123.00 117.10 113.54 116.64 122.65 121.56 121.63





N 55 76 131 16 19 35 71 95 166

Mean 108.70 110.51 109.52 107.41 105.46 106.58 108.60 110.17 109.31



25th Percentile 104.48 100.47 103.43 97.66 99.41 99.23 104.31 100.47 102.65


75th Percentile 112.16 119.50 116.51 112.53 110.49 112.53 112.20 119.10 116.51





N 44 64 108 7 9 16 51 73 124

Mean 109.48 109.27 109.38 99.79 94.73 97.71 109.07 108.81 108.94



25th Percentile 102.22 103.71 102.71 95.15 92.48 92.78 102.18 102.98 102.46


75th Percentile 117.38 114.98 115.51 107.14 98.81 102.18 115.51 114.89 115.39





N 60 71 131 5 7 12 65 78 143

Mean 105.07 105.60 105.30 94.72 95.91 95.34 104.86 105.34 105.07



25th Percentile 98.12 98.04 98.12 91.75 87.81 90.94 98.12 98.04 98.04


75th Percentile 113.00 110.76 110.88 97.14 100.80 97.14 112.82 110.76 110.88


Table 2. NIH Toolbox Cognitive Function Composite – NCS


N 80 34 114

Mean 114.77 109.53 113.20



25th Percentile 107.91 103.43 106.01


75th Percentile 123.29 116.40 119.53


Table 2. NIH Toolbox Cognitive Function Composite – NCS Sample of Pregnant Women English Spanish All

N 81 38 119

Mean 114.57 107.18 112.21



25th Percentile 108.50 102.72 106.01


75th Percentile 120.20 110.58 118.33



24$$

Section$13:$ Measure$NormsLEarly$Childhood$

$


measure:$

$



10,$11,$12,$13,$14,$15,$16,$17,$18L29,$30L39,$40L49,$50L59,$60L69,$70L85,$

All)$

$



Age$Group$(3,$4,$5,$6,$7,$8,$9,$10,$11,$12,$13,$14,$15,$16,$17,$18L29,$30L39,$

40L49,$50L59,$60L69,$70L85,$All)$

$


6,$7,$8,$9,$10,$11,$12,$13,$14,$15,$16,$17,$18L29,$30L39,$40L49,$50L59,$60L69,$

70L85)$

$

Table 1. NIH Toolbox Cognition Early Childhood Composite by Age Group

Early Childhood Composite


Early Childhood Composite Fully


N Mean SD N Mean SD

Age Group

158 70.24 4.41 147 98.76 10.16 3

4 168 77.33 2.99 156 100.65 7.83

5 166 82.53 2.52 152 101.81 7.29

6 155 86.84 2.62 138 101.58 6.71

7 196 88.99 1.96 176 101.91 5.74

8 160 92.71 2.57 153 101.45 6.80

9 165 96.20 3.04 154 101.58 6.31

10 174 97.97 3.03 165 101.07 6.46

11 173 102.07 4.24 164 101.74 7.73

12 179 105.35 4.38 171 101.43 8.28

13 174 107.54 5.32 166 101.41 8.65

14 178 110.31 4.49 172 100.75 7.68

15 179 111.48 5.36 175 101.07 8.64

16 170 115.76 6.52 162 101.20 9.64

17 167 116.41 6.28 161 100.98 9.39

18 - 29 241 116.27 22.73 231 100.36 33.15

30 - 39 282 113.92 17.04 267 100.62 24.99

40 - 49 207 111.40 18.87 197 100.09 27.33

50 - 59 166 105.40 18.07 153 100.68 28.82

60 - 69 124 103.66 14.42 118 101.87 26.30

70 - 85 143 99.23 10.13 130 101.86 19.08

All 3725 107.64 14.37 3508 100.80 16.64

Table 2. NIH Toolbox Cognition Early Childhood Composite – Age

3



N 53 47 100 32 26 58 85 73 158

Mean 69.15 71.73 70.09 71.04 70.81 70.96 69.48 71.60 70.24



25th Percentile 64.53 68.05 65.16 67.26 65.73 66.75 64.53 67.83 65.44


75th Percentile 73.95 76.16 75.72 77.83 76.20 76.20 75.09 76.16 75.72



4



N 53 50 103 30 35 65 83 85 168

Mean 77.57 76.79 77.26 76.89 78.73 77.68 77.47 77.10 77.33



25th Percentile 75.30 73.06 74.32 74.59 74.38 74.38 74.59 73.27 74.32


75th Percentile 81.57 80.72 81.42 79.94 82.59 81.16 81.57 81.30 81.42



5



N 51 57 108 28 30 58 79 87 166

Mean 82.56 82.41 82.49 83.30 81.91 82.73 82.66 82.34 82.53



25th Percentile 80.48 79.60 80.10 78.33 79.71 78.50 80.48 79.60 79.91


75th Percentile 85.00 85.78 85.00 86.72 86.80 86.80 85.69 85.78 85.69



6



N 42 50 92 29 34 63 71 84 155

Mean 86.98 86.47 86.76 86.87 87.63 87.19 86.96 86.67 86.84



25th Percentile 83.29 83.98 83.67 84.09 84.92 84.12 83.29 83.98 83.98


75th Percentile 91.42 91.13 91.34 91.20 91.63 91.29 91.41 91.13 91.33



7



N 55 53 108 43 45 88 98 98 196

Mean 88.83 88.71 88.79 89.91 89.73 89.84 89.02 88.93 88.99



25th Percentile 87.05 86.81 86.81 86.92 88.18 87.65 86.92 86.82 86.82


75th Percentile 91.50 91.18 91.34 93.01 92.01 92.70 91.86 91.41 91.52



8



N 83 77 160 0 0 0 83 77 160

Mean 92.56 92.94 92.71 92.56 92.94 92.71



25th Percentile 89.60 89.60 89.60 89.60 89.60 89.60


75th Percentile 95.41 96.06 95.50 95.41 96.06 95.50



9



N 82 83 165 0 0 0 82 83 165

Mean 95.92 96.60 96.20 95.92 96.60 96.20



25th Percentile 92.08 93.00 92.34 92.08 93.00 92.34


75th Percentile 98.03 99.39 99.31 98.03 99.39 99.31



10



N 84 90 174 0 0 0 84 90 174

Mean 97.74 98.33 97.97 97.74 98.33 97.97



25th Percentile 94.19 93.69 94.01 94.19 93.69 94.01


75th Percentile 101.36 101.97 101.40 101.36 101.97 101.40



11



N 88 85 173 0 0 0 88 85 173

Mean 101.40 103.05 102.07 101.40 103.05 102.07



25th Percentile 95.30 98.14 96.82 95.30 98.14 96.82


75th Percentile 106.70 107.31 107.02 106.70 107.31 107.02



12



N 82 97 179 0 0 0 82 97 179

Mean 104.05 106.93 105.35 104.05 106.93 105.35



25th Percentile 99.12 101.51 100.44 99.12 101.51 100.44


75th Percentile 107.45 112.34 110.05 107.45 112.34 110.05



13



N 101 73 174 0 0 0 101 73 174

Mean 107.43 107.78 107.54 107.43 107.78 107.54



25th Percentile 100.77 103.17 101.43 100.77 103.17 101.43


75th Percentile 113.73 113.60 113.73 113.73 113.60 113.73



14



N 91 87 178 0 0 0 91 87 178

Mean 110.49 110.02 110.31 110.49 110.02 110.31



25th Percentile 105.47 104.35 104.84 105.47 104.35 104.84


75th Percentile 116.14 114.39 115.24 116.14 114.39 115.24



15



N 85 94 179 0 0 0 85 94 179

Mean 111.52 111.43 111.48 111.52 111.43 111.48



25th Percentile 104.08 104.49 104.33 104.08 104.49 104.33


75th Percentile 117.13 116.31 117.01 117.13 116.31 117.01



16



N 81 89 170 0 0 0 81 89 170

Mean 117.71 113.21 115.76 117.71 113.21 115.76



25th Percentile 111.49 107.01 108.62 111.49 107.01 108.62


75th Percentile 127.46 120.79 123.98 127.46 120.79 123.98



17



N 88 79 167 0 0 0 88 79 167

Mean 116.85 115.60 116.41 116.85 115.60 116.41



25th Percentile 109.50 107.66 108.77 109.50 107.66 108.77


75th Percentile 125.07 124.56 125.07 125.07 124.56 125.07



18-29



N 54 108 162 17 62 79 71 170 241

Mean 119.84 114.98 117.18 111.13 109.26 109.81 119.10 114.09 116.27



25th Percentile 108.96 107.06 108.41 103.28 102.65 102.78 108.45 106.44 107.06


75th Percentile 128.06 122.67 124.50 115.41 116.82 115.41 128.06 121.86 124.00



30-39



N 49 151 200 21 61 82 70 212 282

Mean 115.06 114.20 114.47 113.54 107.18 109.45 114.87 113.47 113.92



25th Percentile 106.07 107.96 107.45 105.46 101.12 101.66 106.07 107.01 106.07


75th Percentile 122.82 121.13 121.96 124.37 112.54 117.00 122.82 120.52 121.17



40-49



N 55 105 160 17 30 47 72 135 207

Mean 111.67 112.34 112.06 101.72 105.97 104.03 110.80 111.85 111.40



25th Percentile 102.04 104.55 104.48 93.68 100.19 94.43 102.00 104.48 103.36


75th Percentile 118.15 119.15 119.15 108.68 112.78 112.49 118.09 117.78 118.07



50-59



N 55 76 131 16 19 35 71 95 166

Mean 104.11 106.86 105.36 108.13 102.90 105.90 104.41 106.59 105.40



25th Percentile 98.91 97.89 98.26 99.11 97.00 98.55 98.91 97.88 98.49


75th Percentile 110.00 113.86 112.05 118.51 106.53 111.23 110.00 113.86 112.05



60-69



N 44 64 108 7 9 16 51 73 124

Mean 103.51 104.49 103.99 96.58 93.17 95.18 103.21 104.13 103.66



25th Percentile 97.05 100.39 98.17 92.99 87.73 92.57 96.99 100.36 98.02


75th Percentile 109.27 108.08 109.03 100.29 95.68 100.29 109.10 107.45 108.51



70-85



N 60 71 131 5 7 12 65 78 143

Mean 99.08 99.75 99.37 90.68 95.68 93.28 98.91 99.64 99.23



25th Percentile 93.17 95.88 94.45 85.84 86.18 85.84 93.17 95.88 93.78


75th Percentile 105.59 104.71 105.32 95.32 108.72 96.44 105.59 104.71 105.27


Table 2. NIH Toolbox Cognition Early Childhood Composite – NCS


N 79 34 113

Mean 113.57 107.16 111.64



25th Percentile 105.75 102.20 104.08


75th Percentile 120.53 112.54 118.41


Table 2. NIH Toolbox Cognition Early Childhood Composite – NCS

Sample of Pregnant Women English Spanish All

N 81 38 119

Mean 113.79 108.35 112.05



25th Percentile 108.48 101.10 106.19


75th Percentile 119.76 113.25 117.57



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