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Vol. LXIV, No. 22
October 26, 2012

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The NIH ‘Toolbox’ Is Open

Dr. Richard Gershon

Dr. Richard Gershon

A new set of tools to help scientists measure the ways we think, move, feel and sense the world is ready for use in studies assessing neurological and behavioral outcomes.

The NIH Toolbox for Assessment of Neurological and Behavioral Function “will help set a standard for the research enterprise,” Dr. Molly Wagster told 250 scientists attending a recent conference at NIH where the Toolbox was unveiled. Wagster, chief of NIA’s Behavioral and Systems Neuroscience Branch, helped lead the team of 250-plus scientists and staff from 13 ICs and offices and nearly 100 academic institutions that developed the Toolbox.

The principal investigator was Dr. Richard Gershon, associate professor and vice chair for research at Northwestern University’s department of medical social sciences.

“When the idea for this project was first brought forward, we saw the tremendous value in designing a toolbox of standardized measures for neurological and behavioral research,” said NIA director Dr. Richard Hodes. “It is designed to fulfill a unique need for a battery of online and royalty-free measures in this area, a resource especially important for the increasing numbers of large-scale epidemiological studies or clinical trials.”

Six years in the making, the NIH Toolbox seeks to arm investigators with standard sets of instruments to assess cognitive, sensory, motor and emotional function in U.S. study participants between the ages of 3 and 85. It includes 45 brief, royalty-free measures in English and Spanish that measure functions as diverse as language, memory, executive function, vision, smell, pain, strength, movement and psychological well-being. The entire battery can be administered in 2 hours—a shorter time than for many comparable instruments—reducing the burden on both researchers and participants.

“We are really excited about the creation of the NIH Toolbox and will encourage all of our investigators to use it,” said Dr. Story Landis, NINDS director.

Training to administer the NIH Toolbox measures is available for intramural and extramural scientists through a free e-learning module at, a web site that also includes the instruments, training manuals and videos. Northwestern University held 3 days of hands-on training following the conference.

The NIH Toolbox addresses a common issue in scientific research—the difficulty of comparing results of studies using different outcome measures for similar functions, like cognition. “There’s been little uniformity in measures. This hinders our ability to interpret data and to share and integrate study results,” Wagster said. The Toolbox gives researchers a “common currency” for measuring neural and behavioral health and will be particularly useful for large-scale research such as longitudinal studies, epidemiological studies, prevention studies and intervention trials, Wagster said.

NIH scientists noted, too, that they are particularly interested in feedback about the use of these assessments in patient populations. It might be possible to build upon these assessments so they can be used for patients with disorders ranging from schizophrenia to Parkinson’s.

The Toolbox team evaluated more than 1,400 instruments for possible use. In many instances, already-existing instruments were included if they met a number of criteria: available for people over a wide age range; royalty-free; brief and easy to use; psychometrically sound; and applicable in a variety of settings and populations, including people with disabilities, young children and Spanish speakers. Most existing instruments did not meet all the requirements and had to be modified or expanded to meet Toolbox criteria.

Where necessary, novel instruments were created. “If we developed an instrument from scratch, we went out of our way to develop it against whatever was the gold standard in that area,” Gershon said. A rigorous process of field testing and validation was performed in more than 16,000 people. Norming was conducted in almost 4,900 people of different ages, races and economic status.

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