Abstract

Objective: The aim of this study was to establish the utility of the NIH Toolbox as a cognitive screener of executive functions in the clinical context. Additionally, we aimed to investigate whether age and time on transfusion were related to executive function performance. Method: Twenty-eight children and adolescents with sickle cell anemia (SCA) between 8 and 18 years (M = 13.28, SD = 3.05) on transfusion treatment were included. Participants completed five NIH Toolbox tasks (three executive function tasks and two non-executive function control tasks). Results: Mean scores on one of the three executive function measures (inhibitory control) fell below the average range (M = 81.36, SD = 14.01) with approximately 70% of children from both groups below the average range. Scores for processing speed (M = 86.82, SD = 22.01) and cognitive flexibility (M = 85.75, SD = 12.67) were low averages. As expected, scores on non-executive measures (language and memory) fell within the average range. No significant differences were observed between children with silent stroke and no stroke on executive function measures. Older age (p < .01) and length of time on transfusion (p < .05) predicted lower inhibitory control scores. Conclusions: Findings provide evidence for poor development of inhibitory control with age in this patient population. As the NIH Toolbox successfully highlighted expected deficits in this patient population, this study supports the use of this tool as a brief screening measure for children with SCD. The clinical and theoretical implications of the findings are discussed.

摘要

目的：本研究的目的是确定 NIH 工具箱作为临床环境中执行功能的认知筛选器的效用。此外，我们旨在调查年龄和输血时间是否与执行功能表现有关。方法：纳入28 名 8 至 18 岁（M  = 13.28，SD  = 3.05）接受输血治疗的镰状细胞性贫血（SCA）儿童和青少年。参与者完成了五项 NIH 工具箱任务（三项执行功能任务和两项非执行功能控制任务）。结果：三项执行功能测量（抑制控制）之一的平均得分低于平均范围（M  = 81.36，SD  = 14.01)，两组中大约 70% 的儿童低于平均范围。处理速度（M  = 86.82，SD  = 22.01）和认知灵活性（M  = 85.75，SD  = 12.67）的得分均较低。正如预期的那样，非执行性指标（语言和记忆）的分数落在平均范围内。无症状中风儿童和无中风儿童在执行功能测量方面没有观察到显着差异。年龄较大 ( p  < .01) 和输血时间长度 ( p  < .05) 预示着较低的抑制控制评分。结论：研究结果为该患者群体中随着年龄的增长抑制控制的不良发展提供了证据。由于 NIH 工具箱成功地突出了该患者群体的预期缺陷，本研究支持使用该工具作为 SCD 儿童的简短筛查措施。讨论了研究结果的临床和理论意义。