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The demand for remote assessment tools has increased, yet there is a lack of standardized adaptations for remote administration. This pilot study investigates the equivalency of in-person and remote cognitive assessments using the NIH Toolbox Cognition Battery (NIHTB-CB) among children aged 7 to 17 years. Forty-seven children (51.1% female; M age = 12.26, SD age = 3.23) were assessed in two formats: in-person at a study site and remotely from home, with the order of assessments counterbalanced. The NIHTB-CB was used for in-person evaluations, while a newly developed version, the NIH Toolbox Participant/Examiner (NIHTB-P/E) App , was used for remote assessments through built-in teleconferencing features. The results showed considerable consistency between in-person and remote scores across all NIHTB-CB tests. Certain differences were noted, including longer test durations for remote assessments and potential practice effects on some measures. Overall, preliminary findings from this pilot study support thefeasibility of administering the NIHTB-CB remotely using the NIHTB-P/E App, providing a viable option to traditional in-person cognitive assessments in pediatric populations.

Background Motor impairments are emerging predictors of amnestic mild cognitive impairment (aMCI) and dementia of the Alzheimer's type (DAT), with these groups demonstrating worse performance on metrics such as gait speed and endurance relative to cognitively normal (NC) controls (Windham et al., 2022). Racial disparities, including systemic inequities in healthcare access and chronic disease prevalence, contribute to worse motor performance in Black individuals (Blanco et al., 2012). This study examines NIH Toolbox Motor Battery (NIHTB‐MB) performance across racial and diagnostic groups (e.g., NC, aMCI, DAT), hypothesizing poorer motor performance in Black participants and linear motor decline across diagnostic categories. Method The sample included 557 older adults ages 65‐99 (41.1% male) from the Assessing Reliable Measurement in Alzheimer's Disease and Cognitive Aging (ARMADA) study. Participants completed NIHTB‐MB measures of balance, gait speed, endurance, grip strength, and fine motor dexterity. After controlling for age and sex, racial differences between Black (n = 123) and White (n = 232) NC participants were assessed using multiple linear regression, while diagnostic group differences (NC: n = 355; aMCI: n = 137; DAT: n = 65) were examined using ANCOVA with post‐hoc comparisons. Result Motor performance declined with age across all measures (p < .001). Black participants scored higher than White on Standing Balance, t(69)=‐2.91, p = .005, with no other racial differences in motor performance. Across diagnostic groups, individuals with DAT performed worse than NC on balance (p = .007), dominant/non‐dominant grip strength (p = .005/.05), dominant/non‐dominant dexterity (p = .003/< .001), and endurance (p < .001) measures. Participants with DAT also performed worse than those with aMCI on dominant/non‐dominant dexterity (p = .049/< .001), endurance (p = .002), and balance (p = .05). Gait speed did not differ across groups, and no motor differences were observed between NC and aMCI groups. Conclusion Contrary to expectation, Black older adults exhibited better balance than White, though missing values were highest for this measure. Motor decline was primarily observed in individuals with DAT, who performed worse on fine motor dexterity, grip strength, endurance, and balance compared to NC and aMCI groups. These findings suggest that motor difficulty may serve as a marker of DAT, while NIHTB‐MB performance in aMCI remains largely preserved. Thus, more sensitive metrics, such as dual task conditions, may better characterize early motor changes in aMCI.

Motor impairments are emerging predictors of amnestic mild cognitive impairment (aMCI) and dementia of the Alzheimer's type (DAT), with these groups demonstrating worse performance on metrics such as gait speed and endurance relative to cognitively normal (NC) controls (Windham et al., 2022). Racial disparities, including systemic inequities in healthcare access and chronic disease prevalence, contribute to worse motor performance in Black individuals (Blanco et al., 2012). This study examines NIH Toolbox Motor Battery (NIHTB-MB) performance across racial and diagnostic groups (e.g., NC, aMCI, DAT), hypothesizing poorer motor performance in Black participants and linear motor decline across diagnostic categories. The sample included 557 older adults ages 65-99 (41.1% male) from the Assessing Reliable Measurement in Alzheimer's Disease and Cognitive Aging (ARMADA) study. Participants completed NIHTB-MB measures of balance, gait speed, endurance, grip strength, and fine motor dexterity. After controlling for age and sex, racial differences between Black (n = 123) and White (n = 232) NC participants were assessed using multiple linear regression, while diagnostic group differences (NC: n = 355; aMCI: n = 137; DAT: n = 65) were examined using ANCOVA with post-hoc comparisons. Motor performance declined with age across all measures (p < .001). Black participants scored higher than White on Standing Balance, t(69)=-2.91, p = .005, with no other racial differences in motor performance. Across diagnostic groups, individuals with DAT performed worse than NC on balance (p = .007), dominant/non-dominant grip strength (p = .005/.05), dominant/non-dominant dexterity (p = .003/< .001), and endurance (p < .001) measures. Participants with DAT also performed worse than those with aMCI on dominant/non-dominant dexterity (p = .049/< .001), endurance (p = .002), and balance (p = .05). Gait speed did not differ across groups, and no motor differences were observed between NC and aMCI groups. Contrary to expectation, Black older adults exhibited better balance than White, though missing values were highest for this measure. Motor decline was primarily observed in individuals with DAT, who performed worse on fine motor dexterity, grip strength, endurance, and balance compared to NC and aMCI groups. These findings suggest that motor difficulty may serve as a marker of DAT, while NIHTB-MB performance in aMCI remains largely preserved. Thus, more sensitive metrics, such as dual task conditions, may better characterize early motor changes in aMCI.

PurposeTo develop the PROMIS Pediatric Stigma (PPS) and Skin (PPS-Skin) by constructing a common metric for measuring stigma in children with various conditions, while capturing the unique features of each condition.MethodsData from 860 children, ages 8–17, with a diagnosis of epilepsy, pNF (neurofibromatosis type 1 associated neurofibroma plexform), MD (muscular dystrophy), cancer, or skin conditions recruited from three projects were analyzed. Children with epilepsy, pNF and MD (sample-1) completed the original 18-item Neuro-QoL Stigma, while children with cancer and skin conditions (e.g., atopic dermatitis, psoriasis, and genetic skin disorders; sample-2) completed a 16-item version and 6 additional skin related items. Exploratory factor analysis (EFA) and confirmatory analysis (CFA) were used to evaluate unidimensionality of 24 stigma items. Differential item functioning (DIF) was used to evaluate measurement equivalence on group, gender, age, and conditions. Item response theory model (IRT) was used to construct the final measure.ResultsSufficient unidimensionality was supported by both EFA and CFA. No items showed significant DIF indicating stable measurement properties across groups of comparison. All items fit the IRT model and were able to be calibrated together to form the PPS which consists of 18 core items. The PPS-Skin (18 cores items + 6 skin items) was developed by calibrating 6 skin items onto the common metric as the PPS.ConclusionsWe used IRT techniques to successfully develop the PPS and the PPS-Skin, which share a common metric and account for unique and common concerns related to chronic conditions.