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