Publications by authors named "Aaron Kaat"

Purpose: Bookmarking is a qualitative method used to assign descriptive labels to ranges of patient-reported outcome (PROM) scores. We aimed to evaluate variability between bookmarking samples and test score ranges where there was variability in expert opinion in previous studies.

Methods: We conducted two bookmarking sessions with patients who experienced orthopaedic fractures (n = 11) and one session with orthopaedic clinicians (n = 10).

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  • The study evaluated the validity of German and Spanish translations of 35 new high-functioning items in the PROMIS Physical Function item bank by comparing responses from diverse samples in Argentina, Germany, and the U.S.
  • Data was collected from 3601 participants, with equal distribution among language versions, and differential item functioning (DIF) was analyzed through a comprehensive multiverse analysis.
  • Findings indicated that while some items showed consistent DIF across languages, its overall impact was minimal, and physical functioning scores were higher in Argentina compared to the U.S. and Germany, supporting the items' universal applicability across different populations.
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Executive function (EF) has been extensively linked to various behavioral, clinical, and educational outcomes. There have been, however, few systematic investigations into how best to score EF tasks using speed and accuracy performance, particularly how to generate a summary and norm-referenced score. Using data from an updated norming study for the NIH Toolbox Version 3 (NIHTB V3) with the general U.

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  • The study examines how caregiver and child outcomes from a communication intervention differ when measured in family-selected settings versus standardized contexts for autistic toddlers and their caregivers.
  • After an 8-week telehealth intervention with 22 dyads, results indicated no significant differences in intervention outcomes between the two contexts, though many families selected activities not available in standardized settings.
  • The findings highlight the need for a broader approach to measuring intervention outcomes that reflects real family interactions and routines, ensuring they are meaningful and applicable to everyday life.
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Background And Objectives: -related disorders (-RDs) entail severe impairments in multiple domains that could serve as nonseizure outcomes in clinical trials. This study evaluated the fitness for purpose of several clinical instruments with both standardized and alternative scoring and with some measures used out of their intended age range for assessing communication in -affected participants.

Methods: Parents of -affected children were recruited through FamilieSCN2A Foundation outreach for a combined cross-sectional and longitudinal study.

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Validation of the Mobile Toolbox Faces and Names associative memory test is presented. Ninety-two participants self-administered Faces and Names in-person; 956 self-administered Faces and Names remotely but took convergent measures in person; and 123 self-administered Faces and Names remotely twice, 14 days apart. Internal consistency (.

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  • Researchers need better ways to measure children's development consistently across different studies.
  • The NIH is creating a new tool called the Baby Toolbox to help assess infants and toddlers, which will be ready by late 2024.
  • This new tool aims to make it easier to compare results from different studies and improve how we evaluate child development.
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Objective: The ability to remotely monitor cognitive skills is increasing with the ubiquity of smartphones. The Mobile Toolbox (MTB) is a new measurement system that includes measures assessing Executive Functioning (EF) and Processing Speed (PS): Arrow Matching, Shape-Color Sorting, and Number-Symbol Match. The purpose of this study was to assess their psychometric properties.

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Background: Intellectual and developmental disabilities (IDDs) are associated with both cognitive challenges and difficulties in conceptual, social, and practical areas of living, commonly referred to as adaptive behavior (DSM-5). Although cross-sectional associations between intelligence or cognition and adaptive behavior have been reported in IDD populations, no study to date has examined whether developmental changes in cognition contribute to or track with changes in adaptive behavior. The present study sought to examine associations of longitudinal developmental change in domains of cognition (NIH Toolbox Cognition Battery, NIHTB-CB) and adaptive behavior domains (Vineland Adaptive Behavior Scales-3; VABS-3) including Socialization, Communication, and Daily Living Skills (DLS) over a two year period in a large sample of children, adolescents and young adults with IDD.

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  • Early identification of atypical disruptive behaviors in autistic toddlers is essential for timely access to screenings and interventions, and the study focuses on a new dimensional assessment tool called MAP-DB-IT to measure these behaviors on a spectrum.* -
  • In the study, 82 autistic toddlers underwent an 8-week caregiver-mediated intervention, during which mothers completed the MAP-DB-IT and ITSEA measures to track changes in disruptive behaviors at three different time points.* -
  • Results indicated that the MAP-DB-IT has strong internal consistency and shows valid correlations with ITSEA measures, confirming its effectiveness in assessing and monitoring disruptive behaviors in autistic toddlers.*
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Introduction: Arranging Pictures is a new episodic memory test based on the NIH Toolbox (NIHTB) Picture Sequence Memory measure and optimized for self-administration on a personal smartphone within the Mobile Toolbox (MTB). We describe evidence from three distinct validation studies.

Method: In Study 1, 92 participants self-administered Arranging Pictures on study-provided smartphones in the lab and were administered external measures of similar and dissimilar constructs by trained examiners to assess validity under controlled circumstances.

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Measurement invariance (MI) is a psychometric property of an instrument indicating the degree to which scores from an instrument are comparable across groups. In recent years, there has been a marked uptick in publications using MI in intellectual and developmental disability (IDD) samples. Our goal here is to provide an overview of why MI is important to IDD researchers and to describe some challenges to evaluating it, with an eye towards nudging our subfield into a more thoughtful and measured interpretation of studies using MI.

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Timely detection of cognitive impairment (CI) is critical for the wellbeing of elderly individuals. The MyCog assessment employs two validated iPad-based measures from the NIH Toolbox for Assessment of Neurological and Behavioral Function (NIH Toolbox). These measures assess pivotal cognitive domains: Picture Sequence Memory (PSM) for episodic memory and Dimensional Change Card Sort Test (DCCS) for cognitive flexibility.

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Objective: We describe the development of a new computer adaptive vocabulary test, Mobile Toolbox (MTB) Word Meaning, and validity evidence from 3 studies.

Method: Word Meaning was designed to be a multiple-choice synonym test optimized for self-administration on a personal smartphone. The items were first calibrated online in a sample of 7,525 participants to create the computer-adaptive test algorithm for the Word Meaning measure within the MTB app.

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Objective: We sought to develop and validate the Crohn's Disease-Health Index (CD-HI), a disease-specific, patient-reported outcome measure that serially measures Crohn's disease (CD) symptomatic burden in adults with CD.

Background: As therapeutic interventions are tested among patients with CD, responsive outcome measures are needed to track disease progression and therapeutic gain during clinical trials.

Patients And Methods: We conducted a national cross-sectional study of individuals with CD to identify the most prevalent and impactful symptoms of CD.

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Background: Intellectual and developmental disabilities (IDDs) are associated with both cognitive challenges and difficulties in conceptual, social, and practical areas of living (DSM-5). Individuals with IDD often present with an intellectual disability in addition to a developmental disability such as autism or Down syndrome. Those with IDD may present with deficits in intellectual functioning as well as adaptive functioning that interfere with independence and living skills.

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Objective: To identify the frequency and relative importance of symptoms experienced by adults with fibromyalgia (FM) and determine factors associated with a higher disease burden.

Methods: We conducted semistructured interviews with 15 participants with FM, collecting 1479 quotes regarding the symptomatic burden of FM. We then performed an international cross-sectional study involving 1085 participants with FM to determine the prevalence and relative importance (scale 0-4) of 149 symptoms representing 14 symptomatic themes.

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Cognitive research with developmental samples requires improved methods that support large-scale, diverse, and open science. This paper offers initial evidence to support the Mobile Toolbox (MTB), a self-administered remote smartphone-based cognitive battery, in youth populations, from a pilot sample of 99 children (M = 11.79 years; 36% female; 53% White, 33% Black or African American, 9% Asian, and 15% Hispanic).

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  • Accurate measurement of social communication in autistic children is crucial for assessing skills and setting intervention goals, but structured assessments may increase irritability and affect communication scores.
  • A study evaluated 114 autistic toddlers using both a structured task (CSBS) and a naturalistic play-based interaction (MCX), finding that irritability was significantly higher during the structured assessment.
  • Results indicated that higher irritability during the CSBS was linked to lower social communication scores, suggesting that certain assessment types can negatively impact children's performance and highlighting the need for more representative measures.
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  • Caregiver-mediated early interventions help caregivers use specific strategies to enhance communication skills in young autistic children.
  • A clinical trial aimed to identify which strategies were most effective for improving both short-term and long-term communication outcomes in these children.
  • The study found that caregiver prompts can significantly benefit children's language development, contributing to a better understanding of early intervention's role in enhancing child communication.
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Objective: Our objective was to evaluate the psychometric properties of the culturally adapted NIH Toolbox African Languages® when used in Swahili and Dholuo-speaking children in western Kenya.

Method: Swahili-speaking participants were recruited from Eldoret and Dholuo-speaking participants from Ajigo; all were <14 years of age and enrolled in primary school. Participants completed a demographics questionnaire and five fluid cognition tests of the NIH Toolbox® African Languages program, including Flanker, Dimensional Change Card Sort (DCCS), Picture Sequence Memory, Pattern Comparison, and List Sorting tests.

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While attention dysregulation is a promising early indicator of neurodevelopmental risk, in particular attention-deficit/hyperactivity disorder (ADHD), it is difficult to characterize clinical concern due to its developmental expectability at the transition to toddlerhood. Thus, explicating the typical:atypical continuum of risk indicators is among the key future directions for research to promote early identification and intervention, and prevent decrements in the attainment of developmental milestones into early childhood. In this paper, we present the Multidimensional Assessment Profiles-Attention Regulation Infant-Toddler (MAPS-AR-IT) Scale, a novel parent-report survey of dimensional, developmentally specified indicators of attention (dys)regulation.

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Introduction: Outpatient monitoring of children using invasive home mechanical ventilation (IHMV) is recommended, but access to care can be difficult. This study tested if remote (home-based) data collection was feasible and acceptable in chronic IHMV management.

Methods: A codesign study was conducted with an IHMV program, home nurses, and English- and Spanish-speaking parent-guardians of children using IHMV (0-17 years; n = 19).

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  • The study investigates the validity of using Patient-Reported Outcome Measurement Information System (PROMIS) scales for comparing physical function, upper extremity function, and pain interference across the United States, United Kingdom, and Germany for individuals aged 50 and older.
  • The research involves telephone interviews with participants from these countries, collecting data on PROMIS scales and sociodemographic factors, while ensuring demographic alignment to improve the representativeness of the sample.
  • Results will reveal how age, gender, and country relate to PROMIS scores, ultimately determining if PROMIS items can be used for valid cross-country comparisons in the specific health domains studied.
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