Development and validation of the NIH Baby Toolbox® Executive Function and Memory measures

• Published in: Infant behavior & development Vol. 80; p. 102118
• Main Authors: Flynn, Rachel M., Han, Y. Catherine, Kaat, Aaron J., Mansolf, Maxwell, Dworak, Elizabeth M., Pila, Sarah, Yao, Lihua, Carlson, Stephanie M., Oakes, Lisa M., Gershon, Richard C., Zelazo, Philip David
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2025
• Subjects: Assessment; Child Development; Child, Preschool; Executive Function; Female; Humans; Immediate learning; Infant; Male; Memory; National Institutes of Health (U.S.); Neurodevelopmental Disorders - diagnosis; Neuropsychological Tests - standards; NIH Baby Toolbox; Reference Standards; Reference Values; Reproducibility of Results; United States; United States; Executive function; Immediate learning; NIH Baby Toolbox; Memory; Assessment
• ISSN: 0163-6383; 1879-0453; 1879-0453
• DOI: 10.1016/j.infbeh.2025.102118

Existing standardized assessments of Executive Function and Memory (EF-Mem) for infants and toddlers tend to be limited in scope, can be burdensome to administer, and/or do not often utilize modern technology. Here, we describe the development and validation of the novel iPad-based EF-Mem measures in the NIH Baby Toolbox® for infants and young children 1–42 months old. English and Spanish versions of gaze-based (Familiarization) and touch-based measures (Mullen Visual Reception, Visual Delayed Response, Delayed Memory Task) were adapted for iPad administration. A nationally representative sample of children (N = 2515 recruited; N = 2448 who completed at least one EF-Mem measure; n = 1993 English, n = 455 Spanish) were administered the Baby Toolbox EF-Mem measures as part of the full battery of Baby Toolbox measures. Most caregivers completed the Ages and Stages Questionnaire 3rd edition (ASQ-3), and separate subsets of children were administered the Bayley Scales for Infant Development 4th Edition (Bayley-4, n = 120 recruited; n = 117 that completed both EF-Mem and the Bayley-4) or were administered the Baby Toolbox battery again 1–14 days later to assess test-retest reliability (n = 220 recruited; n = 187 who completed any EF-Mem measure twice). Measure-level scores showed expected correlations with age for gaze and touch measures. EF-Mem scores showed expected correlations with the Bayley-4 for both gaze and touch, indicating convergent validity, and varied meaningfully based on the ASQ-3 classifications. Test-retest reliability for all measures and empirical reliability of the touch scores were moderate. Automatic coding and scoring, ease of administration, reliability, and validity of Baby Toolbox EF-Mem make these measures valuable for developmental assessment. •Baby Toolbox Executive Function and Memory measures are normed for 1–42 months.•Measures had expected moderate correlations with age.•Measures had moderate test-retest reliability and convergent validity.•Is a brief, effective measure of early executive function and memory.