NIH Toolbox executive function measures with developmental extensions: Reliability and validity with preschoolers in emergency housing

ABSTRACT

Research has shown that executive function (EF) skills are associated with resilience in preschoolers experiencing risk and adversity, but these studies have typically relied on large batteries of tasks to measure children’s EF skills. There is a need for brief, reliable EF assessments that can be used in the field with diverse young children. The current study assessed the validity and test-retest reliability of two tablet-based EF tasks from the NIH Toolbox: The Dimensional Change Card Sort (DCCS) and the Flanker Inhibitory Control and Attention Test, each with a developmental extension (Dext) that is triggered when a child struggles with the standardized versions. Dext versions include easier levels intended to improve task accessibility for younger and disadvantaged children. Eighty-six preschoolers residing in emergency housing participated in two study sessions about one week apart, completing tablet-based DCCS-Dext and Flanker-Dext tasks, along with a table-top EF task (Peg-Tapping) and measures of vocabulary and numeracy. The majority of participants triggered the Dext portion of the DCCS and almost half triggered the Dext portion of the Flanker, underscoring the need for extensions of the Toolbox EF tasks to lower the floor of these measures. The Dext EF measures were positively associated with Peg-Tapping, after controlling for age and vocabulary, indicating construct validity. They were also correlated with math achievement, suggesting criterion validity. DCCS-Dext and Flanker-Dext showed moderate test-retest reliability after one week. Together, these findings demonstrate the value of developmental extensions for assessing EF skills among children experiencing risk and adversity.

KEYWORDS:

• Early childhood
• executive function measures
• risk and adversity
• test-retest reliability
• validity

Acknowledgments

The authors are grateful to all of the families who participated and our community collaborators. The research reported here was supported by the National Institutes of Health (NIH) Environmental Influences on Child Health Outcomes (ECHO) Program, Grant U24 OD-023319-01 and the Irving B. Harris Professorship (Masten). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed at https://doi.org/10.1080/09297049.2021.1888905.

Additional information

Funding

This work was supported by the National Institutes of Health [U24 OD-023319-01] and the Irving B. Harris Professorship to A. S. Masten.