Validation of the NIH Toolbox in Individuals with Neurologic Disorders

N. E. Carlozzi*, S. Goodnight, K. B. Casaletto, A. Goldsmith, R. K. Heaton, A. W.K. Wong, C. M. Baum, R. Gershon, A. W. Heinemann, D. S. Tulsky

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

51 Scopus citations


Individuals with spinal cord injury (SCI), traumatic brain injury (TBI), and stroke experience a variety of neurologically related deficits across multiple domains of function. The NIH Toolbox for the Assessment of Neurological and Behavioral Function (NIHTB) examines motor, sensation, cognition, and emotional functioning. The purpose of this paper is to establish the validity of the NIHTB in individuals with neurologic conditions. Methods Community-dwelling individuals with SCI (n = 209), TBI (n = 184), or stroke (n = 211) completed the NIHTB. Relative risks for impaired performance were examined relative to a matched control groups. Results The largest group differences were observed on the Motor domain and for the Fluid Cognition measures. All groups were at increased risk for motor impairment relative to normative standards and matched controls. Fluid cognitive abilities varied across groups such that individuals with stroke and TBI performed more poorly than individuals with SCI; increased relative risks for impaired fluid cognition were seen for individuals in the stroke and TBI groups, but not for those in the SCI group. All three neurologic groups performed normally on most measures in the Sensation Battery, although TBI participants evidenced increased risk for impaired odor identification and the stroke group showed more vision difficulties. On the Emotion Battery, participants in all three groups showed comparably poor psychological well-being, social satisfaction, and self-efficacy, whereas the TBI group also evidenced slightly increased negative affect. Conclusions Data provide support for the validity of the NIHTB in individuals with neurologic conditions.

Original languageEnglish (US)
Pages (from-to)555-573
Number of pages19
JournalArchives of Clinical Neuropsychology
Issue number5
StatePublished - Aug 1 2017


  • Assessment
  • Cognition
  • Disability
  • Emotion
  • Motor
  • Outcomes assessment (health care)
  • Sensory
  • Spinal cord injury
  • Stroke
  • Traumatic brain injury

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Psychiatry and Mental health
  • Clinical Psychology


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