Motor-free composites from the National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) for people with disabilities.
Noelle E Carlozzi, Siera Goodnight, Anya Umlauf and 5 others
PMID 29265867WHAT IT FOUND
For spinal cord injury patients with motor impairment, motor-free NIH Toolbox scores were in the normal range, while standard motor-dependent scores were below average.
They still omit executive function.
Key findings
01For adults with spinal cord injury and motor impairment, standard motor-dependent scores were below average (T scores 39.31 to 46.58), while motor-free scores were normal (T scores 49.23 to 52.32).
02Motor-Free composites closely matched Original composites across groups, with correlations at least 0.74 and substantial agreement in classifying cognitive impairment for the combined brain injury group.
03The Motor-Free composites replace motor-dependent processing speed but do not include executive function tests.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study only included people with spinal cord injury, traumatic brain injury, or stroke, and it did not examine how injury severity changes the scores. The motor-free composites leave out executive function because no motor-free executive function tests are available in this battery. The Oral Symbol Digit Modalities Test was not fully conormed with the NIH Toolbox because only a small part of the normative sample completed it. For participants with motor impairment, missing timed motor test scores were replaced with a score 1 point below the lowest observed score, which may affect comparisons. Participants were not assessed for suboptimal effort or litigation status, although examiners did not note poor effort. The study did not test reliability over time or how these scores change with treatment.
The easy way to misread this
Do not read these motor-free scores as a full cognitive assessment or as proof that a treatment works. They substitute for motor-dependent processing speed tests, omit executive function, and were developed for people who cannot complete the standard timed tests.