Measure Development & Research

Development

The NIH Toolbox^® for Assessment of Neurological and Behavioral Function (NIH Toolbox^®) was developed through a large, collaborative, multi-institutional (256 scientists and staff at over 80 institutions) initiative to develop state-of-the-science tools to measure important neurological and behavioral indicators of cognitive, motor, emotional, and sensory health from ages 3-85. Developed with funding from the NIH Blueprint for Neuroscience Research, the NIH Toolbox is intended to meet the needs of investigators for standard, brief, easy-to-use measures that can be used in a variety of settings and at minimal cost. The six-year development process, led by Dr. Richard Gershon, had two phases. Phase I employed qualitative methods, including two online requests for information from experts (n=232 and 143); interviews with clinicians and scientists (n=44); and two in-person consensus meetings, to identify the sub-domains for inclusion in the NIH Toolbox, along with the criteria affecting instrument selection, creation, and norming.

Extensive literature and database reviews were then conducted and revealed a limited set of existing measures that met the NIH Toolbox criteria. Existing measures were modified to meet the criteria and new instruments were developed, using Item Response Theory (IRT) methods when applicable. In Phase II, candidate measures underwent pilot testing (e.g., for feasibility across the age range) and initial evaluation of psychometric properties. This evaluation included calibration of IRT-based measures, validation against gold standard and other measures, and assessment of test-retest reliability. This process has been described in special issues of Neurology, and, for the Cognition measures, in the Monographs of the Society for Research in Child Development and the Journal of the International Neuropsychological Society.

Norming

As part of development, the NIH Toolbox project conducted a large national norming study in both English and Spanish languages. A sample of 4,859 participants, ages 3-85, representative of the US population based on gender, race/ethnicity, and socioeconomic status was administered all of the NIH Toolbox measures at sites around the country. NIH Toolbox normative scores are available for each year of age from 3 through 17, as well as for ages 18-29, 30-39, 40-49, 50-59, 60-69, 70-79, and 80-85. This allows for targeted, accurate comparisons for any research study participant group against the US population.

NIH Toolbox iPad App

The NIH Toolbox, comprised of 108 measures (English and Spanish) across the four domains, was publicly released as a web-based measurement system in 2012. This initial version has subsequently been converted to an iPad app – the NIH Toolbox iPad App – available through the Apple app store.

Citing an NIH Toolbox Measure

If you used an NIH Toolbox measure and need to use a citation concerning the measure, the Neurology supplement can be used for the NIH Toolbox batteries. More detailed information about the development and validation of the Cognition Battery and individual cognition measures can be found in the Monographs of the Society for Research in Child Development special issue for 3-15 year-olds and the Journal of the International Neuropsychological Society issue for adults. Validation is an ongoing process, so additional articles may become available. Please search NIH Toolbox Publications or PubMed for additional references.