Development and validation of the visual reasoning test for the NIH Toolbox

Abstract

The Cognition Battery of the NIH Toolbox (NIHTB) is an iPad-based set of brief assessments with documented test score reliability and validity, covering a range of cognitive functions for ages 3-85+. The construct of visual reasoning (VR) was identified as a measurement gap in previous versions of the NIHTB by a contingent of NIH-sponsored researchers. The VR Test was developed de novo to address this gap across the entire age spectrum. Given the intended brevity of NIHTB measures, VR was designed for computer-adaptive test administration. VR items were calibrated on 3,768 participants from the NIHTB Version 3 norming study. To evaluate convergent validity of the derived test score, a subsample of 283 participants was administered the age-appropriate Wechsler Intelligence Scale, including the commonly used Matrix Reasoning subtest to assess VR. A separate subsample of 190 individuals was readministered VR 1-14 days later to evaluate test-retest reliability of VR scores. Results yielded a robust bank of 180 items measuring a wide range on the ability spectrum, with correlations of .45-.55 with Wechsler Matrix Reasoning tests and .48-.65 with Wechsler Full-Scale IQ scores. Test-retest intraclass correlation coefficient for VR scores was .77. The new NIHTB VR Test is a computer-adaptive test that can be used to assess VR from preschool to older adulthood, showing evidence of convergent validity of test scores with those of similar constructs, and test-retest reliability of scores, as well as an overall strong relationship to general cognitive ability. This measure broadens the scope of the NIHTB. (PsycInfo Database Record (c) 2026 APA, all rights reserved).