Division of Translational Medicine, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, Bethesda, MD, USA.
Child Neuropsychol. 2023 May;29(4):521-542. doi: 10.1080/09297049.2022.2100337. Epub 2022 Jul 25.
The NIH Toolbox includes a cognitive battery that provides an Early Childhood Composite score for children age 3-7. However, very few studies have evaluated feasibility when it is used in the youngest segment of this age range-3-year-olds. The current study evaluated performance on the four cognitive subtests composing the early childhood composite, two of which assess executive function, in a large sample of 3-year-olds enrolled in a Vanguard pilot of the National Children's Study. Results found that in a cohort of 609 3-year-olds (mean age = 39.6 months, SD = 1.6, 53% male, 64% White, 87% Non-Hispanic) who were administered four subtests included in the Early Childhood Composite, up to approximately 30% were unable to pass practice items on the Flanker, Dimensional Change Card Sort, and Picture Sequence Memory, whereas only approximately 3% were unable to pass practice items on the Picture Vocabulary Test. Furthermore, of those that did pass practice and achieve scores on the subtests, approximately 70% and 80% performed at or below chance level on the executive function tasks (Flanker and Dimensional Change Card Sort) and Picture Sequence Memory, respectively. Ultimately, the average 3-year-old has difficulty with three of the four NIH Toolbox tasks composing the Early Childhood Composite and may not yet have developed the requisite skills. These findings indicate that changes compatible with the developmental level of preschoolers are recommended to increase the feasibility and effectiveness of the NIH Toolbox in measuring individual cognition differences in 3-year-old children.
NIH 工具包包括一个认知测试组，可提供 3-7 岁儿童的幼儿综合评分。然而，很少有研究评估过在该年龄段的最小年龄段（3 岁）使用时的可行性。本研究评估了在参加国家儿童研究先锋计划的大量 3 岁儿童中，四项组成幼儿综合评分的认知子测试中的四项的表现，其中两项评估执行功能。结果发现，在一个由 609 名 3 岁儿童（平均年龄=39.6 个月，标准差=1.6，53%为男性，64%为白人，87%为非西班牙裔）组成的队列中，他们接受了四项包含在幼儿综合评分中的子测试，多达约 30%的儿童无法通过侧抑制、维度变化卡片分类和图片序列记忆的练习项目，而只有约 3%的儿童无法通过图片词汇测试的练习项目。此外，在那些通过练习并在子测试中获得分数的儿童中，约 70%和 80%的儿童在执行功能任务（侧抑制和维度变化卡片分类）和图片序列记忆上的表现分别低于或等于机会水平。最终，平均 3 岁的儿童在组成幼儿综合评分的四项 NIH 工具包任务中，有三项任务存在困难，可能尚未发展出必要的技能。这些发现表明，推荐与学龄前儿童的发展水平兼容的更改，以增加 NIH 工具包在测量 3 岁儿童个体认知差异方面的可行性和有效性。
