Psychometric Properties of the NIH Toolbox Cognition and Emotion Batteries Among Children and Adolescents with Congenital Heart Defects

Abstract

Objective: The NIH Toolbox offers brief, computerized measures of cognitive and psychosocial functioning. However, its psychometric properties were established among typically developing children and adolescents. The current study provides the first comprehensive assessment of its psychometric properties among young patients with congenital heart defects (CHD). Study Design: We prospectively recruited 58 patients with CHD and 80 healthy controls between the ages of 6 and 17. Participants completed the NIH Toolbox Cognition and Emotion Batteries, a battery of clinician-administered neuropsychological tests, and ratings of their quality of life. Their parents also completed ratings of their functioning. Results: On the Cognition Battery, we found expectable group differences and developmentally expected gains across ages. For the most part, composites and subtests were significantly correlated with neuropsychological measures of similar constructs. Higher scores were generally associated with ratings of better day-to-day functioning among children with CHD. On the Emotion Battery, we found no significant group differences, echoing prior research. For the most part, scales showed acceptable internal consistency among both groups. There was adequate construct coherence for most of questionnaires among healthy control but not participants with CHD. Correlations with a comparison tool were largely within expectable directions. Conclusion: The NIH Toolbox may provide a valid and useful assessment of cognitive functioning among children and adolescents with CHD. While it may offer reliable and valid scales of psychosocial functioning, further research is needed to understand the meaningfulness of the scales for participants with CHD.

Functional network organization is locally atypical in children and adolescents with congenital heart disease

“…While prior studies indicate structural brain network reorganization, our findings suggest that the global functional network remains largely undifferentiated, with predominantly regional differences. Regional, rather than global differences, may explain higher variance observed in CHD patient scores, but still within normal limits on tests of intelligence (Badaly et al, 2022; Wallace et al, 2023)…”

“…Other investigations have similarly identified regional discrepancies in CHD brains while utilizing the NIHTB. The NIHTB has previously found applications in neurocognitive and psychosocial studies within CHD populations (Badaly et al, 2022; Calderon et al, 2019; Cousino et al; Sahel et al, 2023; Siciliano et al, 2021; Wallace et al, 2023). In a recent comprehensive evaluation of the psychometric properties of the NIHTB-CB and NIHTB-EB among children with CHD, researchers concluded that while the NIHTB may have certain limitations, it remains a valuable tool for CHD analysis and has several correlations and insights (Wallace et al, 2023).…”

“…The NIHTB has previously found applications in neurocognitive and psychosocial studies within CHD populations (Badaly et al, 2022; Calderon et al, 2019; Cousino et al; Sahel et al, 2023; Siciliano et al, 2021; Wallace et al, 2023). In a recent comprehensive evaluation of the psychometric properties of the NIHTB-CB and NIHTB-EB among children with CHD, researchers concluded that while the NIHTB may have certain limitations, it remains a valuable tool for CHD analysis and has several correlations and insights (Wallace et al, 2023). A separate investigation revealed a notable connection between changes in regional cerebral blood flow (rCBF) and NIHTB scores among children and adolescents diagnosed with congenital heart disease.…”

“…Written informed consent was obtained from all participants for being included in the study. We have published previous analyses of this prospectively recruited cohort (Sahel et al, 2023; Schmithorst et al, 2022; Wallace et al, 2023). Exclusion criteria were applied, patients born preterm, and patients who did not undergo cognitive testing.…”

Cerebral Spinal Fluid Volumetrics and Paralimbic Predictors of Executive Dysfunction in Congenital Heart Disease: A Machine Learning Approach Informing Mechanistic Insights

“…As previously described 18 , executive function (EF) outcomes were measured using standardized cognitive tasks from the NIH Toolbox, the Delis-Kaplan Executive Function System (D-KEFS), the WISC-IV as well as parent-completed ratings from the Behavior Rating Inventory of Executive Function (BRIEF-2) (Table 1B). We considered four subdomains of EF: cognitive flexibility, working memory, inhibition, planning and problem-solving.…”