Clinical Relevance of NIH Toolbox Cognition Battery Developmental Change in Intellectual and Developmental Disabilities: Associations with Verbal Reasoning.
Andrew Dakopolos, Numfon Vilay, Iris Chen and 7 others
PMID 42593886WHAT IT FOUND
Over two years, NIH Toolbox Crystallized Cognition scores tracked growth in verbal knowledge and verbal reasoning in 263 people with intellectual disabilities.
The brief iPad test is a valid outcome measure for monitoring verbal cognitive development in this population.
Key findings
01Two-year change in NIH Toolbox Crystallized Cognition was significantly associated with change in Verbal Knowledge (β = 7.92, p = .009) and with change in Verbal Fluid Reasoning (β = 4.91, p = .018).
02Higher baseline Crystallized Cognition predicted greater growth in both verbal domains, while higher baseline verbal scores predicted less growth in their own domain but more Crystallized Cognition growth, suggesting a compensatory pattern across the two years.
03The study did not control for the services or interventions participants received between visits, so the observed developmental changes may partly reflect untracked treatment effects rather than natural maturation alone.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only two assessment time points, which limits statistical power and the ability to model the shape of change over time. Services and interventions received between visits were not tracked or controlled for, so observed gains may reflect treatment effects rather than natural development. Participants were restricted to mental age of 3.0 years or above, excluding those with more significant delays. Only the Crystallized Cognition component was examined; the Fluid Cognition tests were not evaluated for developmental sensitivity. The study is observational and cannot establish that the NIH Toolbox CC is sensitive to a specific intervention's effects.
The easy way to misread this
Do not read these associations as validation that the NIH Toolbox Crystallized Cognition is a proven treatment-outcome measure. The study observed natural development over two years without controlling for the services or interventions participants received between visits, so the changes may reflect untracked treatment effects rather than the test's sensitivity to a specific intervention.