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Category: Project

Description: Neuropsychologists commonly evaluate raw scores on cognitive tests in relation to a defined reference group to make qualitative interpretations about an individual’s performance. However, these interpretations are only as relevant as the standardized frame of reference used for comparison,which relies on sample size and representativeness. There is growing recognition that the use of conventional norms (e.g., age, sex, years of education, and race) as proxies to capture a broader range of cultural and socioeconomic variability is suboptimal, limiting sample representativeness. The present study evaluated the incremental utility of family income, family conflict, and bidimensional acculturation, above and beyond age, gender, maternal years of education, and race on NIH-Toolbox cognitive performance. A regression-based norming procedure was used as this method may provide more precise estimates of cognitive performance relative to traditional normative tables. Greater family income and lower scores on the Family Environment Scale predicted better performance on the NIH Toolbox subtests, though the effect sizes were very small (r < .05). Scores on the Vancouver Index of Acculturation were not predictive of cognitive performance. Lastly, there were no significant differences between the original NIH Toolbox and new demographically corrected T-scores (Mdiff < 0.50). By traditional statistical standards, the NIH-TB appears to be robust to these sociocultural differences in children between ages 9–10. Practical and clinical contexts in which these small effects may have meaningful impact are discussed.