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NIH Toolbox Flanker Inhibitory Control and Attention Test
Please visit this website for more information about the instrument: NIH Toolbox Flanker Inhibitory Control and Attention Test
Information regarding iPad administration: NIH Toolbox and PROMIS iPad App
Information regarding cost: Pricing for Tools
NeuroRehab Supplemental - Highly Recommended
Recommendations for Use: Indicated for studies requiring a measure for attention/working memory.
Short Description of Instrument
The Flanker Inhibitory Control and Attention Test is part of the NIH Toolbox Cognitive Battery.
The NIH Toolbox Cognitive Battery contains 7 new, validated measures designed to assess unique domains of cognitive functioning (Episodic Memory, Reading, Vocabulary, Processing Speed, Working Memory, Executive Function, and Attention).
The test is administered on an iPad with the assistance of an examiner (e.g., research assistant, technician). The examiner will read instructions and administer measures. The iPad will record responses and compute normative scores based on age and other demographic categories. Administration time for the Flanker Inhibitory Control and Attention Test is approximately 3 minutes.
The National Institutes of Health Toolbox is part of the NIH Blueprint initiative. It seeks to assemble brief, comprehensive assessment tools that will be useful in a variety of settings with an emphasis on measuring outcomes in epidemiologic studies and clinical trials over time and across the lifespan.
NIH Toolbox Overview:
The goal is to help improve communication within and between fields of biomedical research and advance knowledge by using common data elements. The battery  examines various cognitive (episodic memory, language, processing speed, working memory, executive functions, attention), emotional (negative affect, positive affect [psychological well-being], stress and coping, social relationships [social satisfaction]), sensory (vestibular, audition, olfaction, taste, vision) and motor functions (dexterity, strength, locomotion, endurance, balance).
Other Important Notes:
The NIH Toolbox Cognition Battery is designed to measure the various domains in ages 3 through 85. All measures are available and normed in both English and Spanish.
Scoring and Psychometric Properties
Scoring: Scoring is calculated by NIH Toolbox.
Psychometric Properties: The NIH Toolbox Cognitive battery has gone through extensive work to identify and pre-test the constructs to be measured. All measures were validated and normed on a very large, nationally representative s:ample. Information on validation, norming, and measure development, as well as publications on the NIH Toolbox, are available on the NIH Toolbox Website. Flanker task has demonstrated convergent validity with D-KEFS Color Word Inhibition Test and divergent validity with PPVT-4.
Strengths: Part of NIH Toolbox project, comprehensive norms, developed and tested for numerous clinical populations and age groups relevant to rehabilitation. Flanker test is well-recognized for the assessment of complex attention and inhibition.
Weaknesses: Requires full NIH Toolbox purchase to use subtest with limited research on its use in clinical populations to date.
NIH Toolbox Executive Summary. NIH Toolbox Website (accessed October 20, 2016). Principal Investigator: Richard Gershon PhD e-mail:
Beaumont JL, Havlik R, Cook KF, Hays RD, Wallner-Allen K, Korper SP, Lai J, Nord C, Zill N, Choi S, Yost KJ, Ustsinovich V, Brouwers P, Hoffman HJ, Gershon R. Norming plans for the NIH Toolbox. Neurology. 2013;80(11 Suppl 3):S87-S92.
Carlozzi NE, Goodnight S, Casaletto KB, Goldsmith A, Heaton RK, Wong AWK, Baum CM, Gershon R, Heinemann AW, Tulsky DS. Validation of the NIH Toolbox in Individuals with Neurologic Disorders. Arch Clin Neuropsychol. 2017 Aug 1;32(5):555-573.
Casaletto KB, Umlauf A, Marquine M, Beaumont JL, Mungas D, Gershon R, Slotkin J, Akshoomoff N, Heaton RK. Demographically Corrected Normative Standards for the Spanish Language Version of the NIH Toolbox Cognition Battery. J Int Neuropsychol Soc. 2016 Mar;22(3):364-374.
Casaletto KB, Umlauf A, Beaumont J, Gershon R, Slotkin J, Akshoomoff N, Heaton RK. Demographically Corrected Normative Standards for the English Version of the NIH Toolbox Cognition Battery. J Int Neuropsychol Soc. 2015 May;21(5):378-391.
Gershon RC, Cella D, Fox NA, Havlik RJ, Hendrie HC, Wagster MV. Assessment of neurological and behavioural function: the NIH Toolbox. Lancet Neurol. 2010;9(2):138-139.
Nitsch KP, Casaletto KB, Carlozzi NE, Tulsky DS, Heinemann AW, Heaton RK. Uncorrected versus demographically-corrected scores on the NIH Toolbox Cognition Battery in persons with traumatic brain injury and stroke. Rehabil Psychol. 2017 Nov;62(4):485-495.
Quatrano LA, Cruz TH. Future of outcomes measurement: impact on research in medical rehabilitation and neurologic populations. Arch Phys Med Rehabil. 2011;92(10 Suppl):S7-S11.
Tulsky DS, Heinemann AW. The clinical utility and construct validity of the NIH Toolbox Cognition Battery (NIHTB-CB) in individuals with disabilities. Rehabil Psychol. 2017;62(4):409-412.
Weintraub S, Dikmen SS, Heaton RK, Tulsky DS, Zelazo PD, Slotkin J, Carlozzi NE, Bauer PJ, Wallner-Allen K, Fox N, Havlik R, Beaumont JL, Mungas D, Manly JJ, Moy C, Conway K, Edwards E, Nowinski CJ, Gershon R. The cognition battery of the NIH toolbox for assessment of neurological and behavioral function: validation in an adult sample. J Int Neuropsychol Soc. 2014;20(6):567-578.
Zelazo PD, Anderson JE, Richler J, Wallner-Allen K, Beaumont JL, Weintraub S. II. NIH Toolbox Cognition Battery (CB): measuring executive function and attention. Monogr Soc Res Child Dev. 2013 Aug;78(4):16-33.
Document last updated January 2022