Test accommodations for individuals with neurological conditions completing the NIH Toolbox-Cognition Battery: An evaluation of frequency and appropriateness.
Susan Magasi, Mark Harniss, David S Tulsky and 3 others
PMID 29265866WHAT IT FOUND
Most people with SCI, TBI, or stroke completed the NIH Toolbox-Cognition Battery without changes, but among those given accommodations, many changed the test in ways that could invalidate scores.
Key findings
01450 participants received a standardized administration of the entire cognitive battery, and 154 received a non-standard administration on at least one measure.
02Of 87 accommodated administrations, 49 breached standardization enough to invalidate test scores.
03Fatigue and impulsivity were not addressed by the Reasonable Accommodations Guidelines, but they affected some participants' ability to follow standardized protocols.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The analysis was descriptive and could not measure how accommodations changed scores. Examiner notes were not collected in a standardized reporting format, so some records were richer than others. The sample excluded people who could not meet basic reading and vision screening, so it may not represent people with more severe sensory or language barriers. The Reasonable Accommodations Guide was not integrated into the computer administration platform, so administrators made decisions in the moment. The study did not compare accommodated and non-accommodated scores.
The easy way to misread this
Do not conclude that accommodations make cognitive scores more valid. The study did not test the effects of accommodations on scores; it only reviewed how often administrators changed the standard procedure.