Press Release: Validating Toolbox to help evaluate cognitive processing in people with intellectual disability

UC Davis Health study a “big first step” in standardizing assessments

Researchers at the UC Davis MIND Institute, University of Denver, Northwestern University, Rush University, and University of California Riverside, have updated and validated a series of tests delivered on an iPad to accurately assess cognitive processing in people with intellectual disability. The validation opens new opportunities for more rigorous and sensitive studies in this population, historically difficult to evaluate.

The widely used NIH Toolbox was designed for use in the general population. It had not been applied as a rule to people with intellectual disability. Intellectual disability is characterized by significant limitations in both cognitive functioning and in adaptive behavior such as everyday social and practical skills. The most common genetic causes of intellectual disability are Down syndrome and fragile X syndrome.

The article “Validation of the NIH Toolbox Cognitive Battery in Intellectual Disability,” published February 24 in Neurology©, the medical journal of the American Academy of Neurology, determined that the tests accurately measure cognitive skills in individuals with a mental age of 5 or above. Additional modifications to the test are needed before it can be shown to be equally good at measuring skills in people with lower functioning.

“Our study assessed how the battery is performing in people with intellectual disability. We made some adaptations to the assessment so that it works well in this population,” said Rebecca Shields, the first author on the study and a UC Davis graduate student in human development working in the laboratory of David Hessl. “This is a big first step showing how it works in these individuals. Applying it consistently across this unique population means other researchers and clinicians can use it too.”

Manual developed to aid clinicians in using the test

To guide clinicians and researchers in using the Toolbox with this population, the group also developed and published a manual as a supplement to the NIH Toolbox Administrator’s Manual. The manual documents the researchers’ guidelines specific to assessing individuals with intellectual disabilities, allowing other researchers to administer the test in a standardized way. This project was led by Forrest McKenzie, a member of the Hessl laboratory, and is available in the online article as well as on the NIH Toolbox website.

“People with intellectual disabilities can be very difficult to assess. Many of the existing measures we use to evaluate them have a lot of limitations,” said Hessl, senior author on the study and a professor in the UC Davis Department of Psychiatry and Behavioral Sciences. “Also, different investigators choose a wide variety of different tests for research, making it very hard to compare results in the field. We really hope that the NIH Toolbox cognitive tests can be used more uniformly, as a common metric.”

The lack of standardized tests also has had an impact on clinical trials of potential new treatments, he said.

“When we are trying to determine if people with disabilities are really improving, if their cognitive rate is getting faster or if they are responding to treatment, we face challenges because of measurement limitations,” Hessl said. “This Toolbox really tackles a lot of these limitations. It is well standardized, and objective. And the test is given on an iPad, so the way each person responds to the question should be more consistent and reliable.”

Test measures cognitive skills and executive function in just 30 minutes

The test, which typically takes about 30 minutes, measures a variety of skills, including memory, vocabulary, single-word reading and processing speed. It also measures executive function, such as the ability to shift from one thought to another or to pay attention and inhibit impulses. In the cognitive flexibility test, the individual is asked to match items by shape. But the rules of the game then switch, and they are asked to match the items by color.

The test also measures receptive vocabulary, or how words are understood. For example, the test taker will hear a word and see four pictures then select the picture that matches the word. It also measures memory by presenting a picture story in a sequence then asking the test taker to put the story back together in the same sequence.

A list-sorting task on the test requires the individual to remember the group of items they had seen on the screen and repeat them back in a certain order. A processing speed task evaluates how well the individual can compare different patterns that appear on the screen.

Researchers found that the battery of tests was feasible for a very high percentage of individuals with a mental age of five or higher; individuals in the study did not refuse to participate, were able to respond to the tests as designed and understood what the tests required. The battery also proved to be reliable; the scores were consistent for individuals after re-testing. Hessl said these test properties are especially important in determining the value and utility of the battery, such as determining how useful it may be in detecting changes related to treatment.

Shields said that the team is now learning about how well the test battery picks up cognitive changes over development. They are bringing back the same participants in the study two years later.

Funding for the study came from the NICHD (RO1HD076189), the Health and Human Services Administration of Developmental Disabilities (90DD0596), the MIND Institute Intellectual and Developmental Disabilities Research Center (U54 HD079125) and the National Center for Advancing Translational Sciences, National Institutes of Health, through grant UL1 TR000002.

Other authors on the study include: Andrea Drayton and Stephanie Sansone of UC Davis; Aaron Kaat and Richard Gershon of Northwestern University; Jeanine Coleman and Karen Riley of the University of Denver; Claire Michalak and Elizabeth Berry-Kravis of Rush University Medical Center; and Keith Widaman of the University of California, Riverside.

Feb. 29, 2020

Dr. Sarah Hurtado, HED, was featured in the Denver Post on Friday, Feb. 29, lending her expertise about sexual violence on college campuses. The article reads:

“Sarah Hurtado, a DU assistant professor focused on researching rape culture on college campuses, said society often thinks about rape as a violent act perpetrated by strangers. But particularly on college campuses, most sexual assaults happen between acquaintances.

Membrino, a junior, remembered staring up at an episode of “The Office” projected on a dorm ceiling while she was sexually assaulted during her freshman year at DU. She was too drunk to consent, but will never forget lying like a ragdoll on her Tinder date’s bed.

Hurtado said alcohol is often a factor in campus sexual assaults.

“I think a lot of times we use someone’s alcohol consumption as a way to blame them or say they should have been more responsible or made better choices, but at the end of the day, there’s only one person responsible, and that’s always the perpetrator,” Hurtado said. “It’s important for people to know that someone can’t consent if they’re inebriated.”

Photo credit: Helen H. Richardson, The Denver Post 

Pictured above: From left: University of Denver students Madeline Membrino, Grace Wankelman and Shannon Saul pose for a portrait outside of the library on the DU campus on Feb. 26, 2020. The trio, who are all survivors of sexual assault, started an Instagram account called wecandubetter where DU students can anonymously share their stories of sexual assault on their college campus.

According to research by the Economic Policy Institute, the teacher shortage “is real, large and growing, and worse than we thought.” If current trends persist, the nationwide shortfall of qualified teachers could reach 200,000 by 2025, up from 110,000 in 2018. In other words, it’s time to take it seriously. Karen Riley, dean of the University of Denver’s Morgridge College of Education, fielded some questions about the shortage from the DU Newsroom.

Dean Riley goes on to answer the following:

  • What is driving the nationwide teacher shortage?
  • Where is the problem most acute?
  • What does a teacher shortage mean for schools and their students?
  • What can school districts do to retain both their young teaching professionals and their experienced teachers?
  • What are the major ramifications for our communities if we don’t address this problem?

March 6, 2020

Dear Morgridge College of Education Community, 

I am pleased to announce that Craig Harrer has been named Director of the Ricks Center for Gifted Children. Since last summer, he has been serving as the Interim Director at Ricks. Craig will now serve as the permanent Director.

As our Interim Director at Ricks, Craig has been focused on community building, gifted learning, and creating internal and external organizational trust at Ricks and the University of Denver (DU). This work has been vital to Ricks and its continued success as a national leader in gifted education. Under Craig’s leadership, we will continue to provide our community – Ricks parents, students and families – an unprecedented educational experience. Something that I have appreciated about Craig and his approach to gifted education is his physical presence in the classroom specifically leading project-based initiatives.

With over 25 years of educational experience in Denver, we are lucky to have Craig as the Director of Ricks. As a native, he grew up blocks away from the DU campus and graduated from Thomas Jefferson High School. Since then, he has taught Kindergarten and grades 2 through 8 in a variety of subjects. As an Administrator, he was Principal of Rishel Middle School before helping to open the Denver Green School, a Pre-K through 8 innovation school in Denver Public Schools. Read more about Craig’s success at the Denver Green School.

Before coming back to Ricks in February 2019, he worked as a high school Assistant Principal and as a School Leadership Consultant. During his doctoral coursework, he worked part-time at Ricks from 2016-2018 and was excited about the opportunity to rejoin the Ricks community. Craig is also a proud Pio and values his deep ties with DU, including being a member of the doctoral cohort in our nationally recognized Educational Leadership and Policy Studies program with a dissertation in shared leadership.

Personally I am so thrilled to have Craig leading the school and look forward to working with him long into the future.

Please join us at a celebratory reception to congratulate Craig on Tuesday, March 10 at 3 p.m., Ricks (2040 South York Street, Denver, CO 80208).

Best,
Dean Karen Riley

Congratulations to Laurier Hampton who was recently selected as one of only three DU students to participate in the fireside chat with Black Lives Matter co-founder Patrisse Cullors, who’s a distinguished keynote speaker at DU’s upcoming Diversity Summit.

Laurier Hampton is a first-year graduate student at the University of Denver in the Morgridge College of Education’s Library and Information Science program, specializing in Archives. Prior to moving to Denver in September of 2019, she lived in Baltimore City her entire life. She was raised in Northeast Baltimore in the 1990s and early 2000s in a supportive home but an underprivileged community. Her family was determined for her to excel in spite of her environment and the lackluster educational institution in Baltimore. Laurier attended Baltimore City’s only all-girl public high school, Western High School. Upon her completion at Western High School, she immediately entered Towson University to study Art and Design and graduated in 2010. During that time, she not only honed her skills as an oil painter and sculptor but she also gained a better understanding of the world outside of her own community.

After obtaining a Bachelor of Science in Art and Design from Towson University, she returned to school to pursue an entirely different path. In 2017 she attended the University of Maryland University College to study History. While conducting research as an undergraduate student, she realized the underrepresentation of ethnic groups in how history is recorded, preserved, managed and taught. This impacted her decision to pursue a graduate degree specializing in Archives. Her hope is to have a positive impact on the biases found in archives and recorded history by providing the perspective of a woman of color.

Her past and present work is closely connected to helping people and empowering communities, be it through contributions to a healthy and equitable work environment in her position as a move coordinator for a large international moving company; as a volunteer assistant librarian at Guilford Elementary Middle School for underprivileged children in Baltimore, as a volunteer at the Colorado State Archives and Public Records; or as a volunteer at the non-profit art gallery and community art center Baltimore Clayworks, which introduced ceramic arts to underprivileged children.

Laurier brings her interdisciplinary vision, acute sense of social justice, rich life experience, and artistic talent to our continuously evolving and contentious field. For Laurier, an emerging leader with outstanding potential, diversity, equity, and inclusion constitute a major drive of her scholarly, professional, and volunteer activities. They also serve as a lens through which Laurier sees the world and analyzes the human condition. Some of Laurier’s professional aspirations are anti-oppression in archival practices, community archives, and social justice in archival representation and memory preservation. She is an incredible scholar and an outspoken advocate for equity and social justice.

A member of our MCE community, Dr. Elaine Belansky, executive director for the Center for Rural Health and Education (CRSHE), was featured on The Denver Channel over the holiday break. Before the holiday, two rural school districts in Colorado had to shut down due to a fast-spreading norovirus. Dr. Belanksy told Channel 7 why this norovirus can have a larger impact on rural schools in comparison to their urban counterparts. Read the full story on Channel 7.

On Tuesday, Oct. 8, Andi Pusavat, PhD was joined by Trisha Raque-Bogdan, PhD for a livestream with 9Health. The livestream focused on the affect cancer diagnosis and treatment have on the mental wellbeing of patients and survivors.

Watch the recorded livestream video below or on Facebook.

Additionally, Dr. Andi Pusavat was invited to the 9News station on Thursday morning to share more information about mental health/stress screenings that will be available at upcoming 9Health Fair events. Along with the mental health screenings people can do in person at 9Health Fairs, free online, anonymous mental health screenings are available at 9healthfair.org/etools/.

You can watch Dr. Pusavat’s full interview with 9Health here.

Dr. Pusavat recently became a board member on 9Health’s Medical Advisory Committee (MAC), which is comprised of Colorado’s top healthcare providers and allied healthcare professionals. These notable and experienced individuals provide high-quality and evidence-based health screenings to our Greater Colorado community. The MAC is responsible for creating, reviewing and approving all medical screening protocols and interactive educational center requests. Through quarterly evaluation and follow-up of statistical data and screenings results, the MAC ensures all health screenings meet 9Health’s strict criteria.

Congratulations to Dr. Lolita Tabron who was named the 2019 recipient of the Jack A. Culbertson Award, presented by the University Council for Educational Administration (UCEA), a leading professional organization of higher education institutions focused on advancing the preparation of educational leaders. Dr. Tabron is an assistant professor in the Morgridge College of Education’s Educational Leadership and Policy Studies program.

The Culbertson Award is given to a professor in the first six years of his or her career. As the UCEA noted in a press release announcing the award, Tabron is “a scholar, teacher and mentor whose early career contributions are already having a multiplier effect by impacting the lives of educational leadership scholars. Her passion and actions for social justice and equity contribute greatly to her ability to ignite confidence and learning from her students.”

The award will be presented at the UCEA Annual Conference Luncheon in New Orleans on Thursday, Nov. 21.

To read the full announcement, please visit the UCEA site.

PUEBLO, CO – On Monday, September 9, experts from the University of Denver (DU) Morgridge College of Education (MCE) Center for Rural School Health & Education (CRSHE) went to Pueblo to work with rural wellness coordinators to shared district-level comprehensive health and wellness plans and prepared for the implementation process. The event, held at Pueblo Community College, signified a milestone in CRSHE’s commitment to rural communities.

CRSHE is a research and education institute housed within MCE. Its vision is happy, healthy children and families living in vibrant rural communities. CRSHE partners with rural schools and communities to improve health and education outcomes through four focus areas: comprehensive health and wellness planning and implementation in schools; social-emotional health for students, teachers, and service providers; workforce development for professionals working with children and families; and economic development.

“This event brought together wellness coordinators from 21 districts across southeastern Colorado and the San Luis Valley to celebrate their completion of 5-year comprehensive health and wellness plans,” said Shannon Allen, PhD, Director of Community Services and Resources with CRSHE. Allen is the project manager for the project, designed to help coordinators identify areas of need in their district and work to create evidence-based solutions.

“The top student health problems that districts are focusing on include poor mental health; alcohol, tobacco, and other drug use; physical inactivity; bullying and violence; nutrition; and sexual health and healthy relationships,” she said. “Over the next 5-years, districts in these regions will be working on strategically improving student health by implementing evidence-based policies and programs in their districts.”


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