tm sen olfa oi 09.27.12 · 2$ $ nih$toolbox$technical$manual$ $ domain:$ sensation$ $ subdomain:$...

!

NIH$Toolbox$

!

!!

!Technical$Manual$

Jerry!Slotkin,!PhD,!Michael!Kallen,!PhD,!James!Griffith,!PhD,!Susan!Magasi,!PhD,!John!Salsman,!PhD,!Cindy!Nowinski,!MD,!PhD,!and!Richard!Gershon,!PhD!

!

September$27,$2012$

2$$

NIH$Toolbox$Technical$Manual$

$

Domain:$

SENSATION$

$

Subdomain:$

OLFACTION$

$

Measure:$

NIH$Toolbox$Odor$Identification$Test$

$

$

$

$

$

3$$

Expert$ContributorsBOLFACTION$$

$

Pamela$Dalton,$PhD$(Monell$Chemical$Senses$Center),$Richard$Doty,$PhD$(University$of$

Pennsylvania),$Robert$Frank,$PhD$(Ohio$University),$Howard$Hoffman,$MA$(National$Institute$on$

Deafness$and$Other$Communication$Disorders,$NIH),$Julie$Mennella,$PhD$(Monell$Chemical$

Senses$Center),$Claire$Murphy,$PhD$(San$Diego$State$University),$Jerry$Slotkin,$PhD$

(Northwestern$University)$

$ $

4$$

Member$Institutes,$Centers,$and$Offices$

$

National$Center$for$Complementary$and$Alternative$Medicine$(NCCAM)$

National$Eye$Institute$(NEI)$

National$Institute$of$Biomedical$Imaging$and$Bioengineering$(NIBIB)$$

Eunice$Kennedy$Shriver$National$Institute$of$Child$Health$and$Human$Development$(NICHD)$$

National$Institute$of$Dental$and$Craniofacial$Research$(NIDCR)$

National$Institute$of$Environmental$Health$Sciences$(NIEHS)$$

National$Institute$of$General$Medical$Sciences$(NIGMS)$

National$Institute$of$Mental$Health$(NIMH)$$

National$Institute$of$Neurological$Disorders$and$Stroke$(NINDS)$$

National$Institute$of$Nursing$Research$(NINR)$$

National$Institute$on$Aging$(NIA)$

National$Institute$on$Alcohol$Abuse$and$Alcoholism$(NIAAA)$

National$Institute$on$Deafness$and$Other$Communication$Disorders$(NIDCD)$

National$Institute$on$Drug$Abuse$(NIDA)$

Office$of$Behavioral$and$Social$Sciences$Research$(OBSSR)$

$

$

$ $

5$$

This$project$is$funded$in$whole$or$in$part$with$Federal$funds$from$the$Blueprint$for$

Neuroscience$Research$and$the$Office$of$Behavioral$and$Social$Sciences$Research,$National$

Institutes$of$Health,$under$Contract$No.$HHSXNX260X2006X00007XC,$with$additional$support$from$

the$National$Children’s$Study,$under$Contract$No.$HHSXNX267X2007X00027XC.$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

$

©$2006X2012$National$Institutes$of$Health$and$Northwestern$University$

6$$

This$Technical$Manual$contains$the$following$informational$sections:$

$

Section$1:$ Introduction$to$NIH$Toolbox$

Section$2:$ Validation$

Section$3:$ Norming$

Section$4:$ NIH$Toolbox$and$the$National$Children’s$

Study$(NCS)$

Section$5:$ Domain$Definition$

Section$6:$ Subdomain$Definition$

Section$7:$ Measure$Description$

Section$8:$ PostBValidation/PostBNorming$Changes$to$

the$Measure$

Section$9:$ The$Measure’s$Scoring$Model$

Section$10:$ Measure$Norms$

7$$

Section$1:$ Introduction$to$NIH$Toolbox$

$

NIH$Toolbox$is$a$multidimensional$set$of$brief$measures$assessing$cognitive,$emotional,$motor,$

and$sensory$function$from$ages$3X85.$This$suite$of$onXline$and$royaltyXfree$measures$can$be$

administered$to$study$participants$3$to$85$years$of$age$in$two$hours$or$less,$across$diverse$study$

designs$and$settings.$

$

What$is$the$NIH$Toolbox?$

The$NIH$Toolbox$provides$a$standard$set$of$royaltyXfree,$brief,$and$comprehensive$assessment$

tools$that$can$be$used$by$researchers$and$clinicians$in$a$variety$of$settings,$with$a$particular$

emphasis$on$measuring$outcomes$in$longitudinal$epidemiologic$studies$and$prevention$or$

intervention$trials$across$the$lifespan$(ages$3X85).$The$battery$ensures$that$assessment$

methods$and$results$can$be$used$for$comparisons$across$existing$and$future$studies$and$

provides$a$“common$currency”$for$the$study$of$neurological$research$that$promotes$economies$

of$scale$and$enhanced$efficiency$in$measurement.$The$NIH$Toolbox$can$be$used$to$monitor$

neurological$and$behavioral$function$over$time$and$measure$key$constructs$across$

developmental$stages.$This$facilitates$the$study$of$functional$changes$across$the$lifespan,$

including$evaluating$intervention$and$treatment$effectiveness.$

$

$

$

8$$

The$NIH$Toolbox$Batteries$

The$basic$NIH$Toolbox$can$be$administered$within$two$hours$and$divides$tests$into$four$domain$

batteries:$Cognition,$Emotion,$Motor,$and$Sensation.$In$addition,$within$some$domains,$there$

are$supplemental$measures$that$are$available$to$be$administered.$$

$

Selection$of$the$NIH$Toolbox$Domains$and$Subdomains$$

Four$domains$were$selected$for$the$NIH$Toolbox:$Cognition,$Emotion,$Motor,$and$Sensation.$

Subdomain$selection$was$based$upon$literature$reviews,$expert$interviews,$and$multiple$formal$

Requests$for$Information$(RFI)$of$NIHXfunded$researchers.$Initial$literature$and$database$

reviews$and$an$RFI$identified$the$subdomains$for$inclusion$in$the$NIH$Toolbox,$existing$

measures$relevant$to$the$project$goals,$and$criteria$for$instrument$selection.$NIH$Project$Team$

members,$external$content$experts,$and$contract$scientists$met$at$a$followXup$consensus$

meeting$to$discuss$potential$subdomains$along$with$the$criteria$affecting$instrument$selection,$

creation,$and$norming.$Additional$expert$interviews$were$undertaken$to$gather$more$detailed$

information$from$clinical$and$scientific$experts$to$help$further$refine$the$list$of$possible$

subdomains.$A$second$consensus$group$meeting$was$held$and$results$directed$the$decision$for$

the$final$NIH$Toolbox$to$assess$four$core$domain$areas$(cognitive,$emotional,$motor,$and$

sensory$health$and$function).$

$

Selection$of$Measures$for$the$NIH$Toolbox$

More$than$1,400$existing$measures$were$identified$and$evaluated$for$potential$inclusion$in$the$

NIH$Toolbox.$The$selection$criteria$included$a$measure’s$applicability$across$the$life$span,$

9$$

psychometric$soundness,$brevity,$ease$of$use,$applicability$in$diverse$settings$and$with$different$

groups,$and$lack$of$intellectual$property$constraints.$There$was$also$a$preference$for$

instruments$that$were$already$validated$and$normed$for$use$with$individuals$between$3$and$85$

years$old.$Results$of$the$instrument$selection$process$yielded$draft$development$plans$

established$for$the$NIH$Toolbox$measures.$$

$

Early$Childhood$Use$

NIH$Toolbox$measure$development$focused$special$attention$on$assessing$young$children,$to$

ensure$that$all$tests$given$are$developmentally$appropriate$for$ages$3X7.$A$special$team$of$early$

childhood$assessment$consultants$was$engaged$to$provide$testing$guidelines$for$the$very$

young,$to$offer$input$on$measure$development,$and$to$review$all$NIH$Toolbox$measures$to$

ensure$they$fit$the$needs$of$young$children.$Advanced$statistical$methods$were$used$to$

emphasize$continuity$of$measurement,$allowing$Toolbox$users$to$confidently$conduct$

longitudinal$measurement$from$age$3$through$the$life$span$while$assessing$the$same$domain$

constructs.$

$

Section$2:$ Validation$

$

Validation$studies$were$conducted$for$all$NIH$Toolbox$Sensation$domain$measures,$to$assure$

that$these$important$tools$for$research$met$rigorous$psychometric$standards.$Studies$were$

10$$

conducted$across$the$entire$age$range$and$were$statistically$compared$against$“gold$standard”$

measures$wherever$available.$$

$

For$specifics$regarding$Sensation$domain$measure$validation,$see:$Coldwell$et$al.,$Gustation$

Assessment$Using$the$NIH$Toolbox,$Neurology,$in$press;$Cook$et$al.,$Pain$Assessment$Using$the$

NIH$Toolbox,$Neurology,$in$press;$Dalton$et$al.,$Olfaction$Assessment$using$the$NIH$Toolbox,$

Neurology,$in$press;$Dunn$et$al.,$Somatosensation$Assessment$Using$the$NIH$Toolbox,$

Neurology,$in$press;$Paz$et$al.,$Development$of$a$VisionXTargeted$HealthXRelated$Quality$of$Life$

Item$Bank,$manuscript1submitted1for1publication;$Rine$et$al.,$Vestibular$Function$Assessment$

Using$the$NIH$Toolbox,$Neurology,1in$press;$Varma$et$al.,$Vision$Assessment$Using$the$NIH$

Toolbox,$Neurology,$in$press;$Zecker$et$al.,$Audition$Assessment$Using$the$NIH$Toolbox,$

Neurology,$in$press.$These$manuscripts$describe$measure$development$studies$undertaken$

(e.g.,$expert$panels$for$content$development$and$validation;$cognitive$interviews;$small$and$

largeXscale$pilot$testing)$and$psychometric$characteristics$(e.g.,$internal$consistency$and$testX

retest$reliability;$convergent$and$divergent$validity).$

$

Section$3:$ Norming$

$

NIH$Toolbox$conducted$a$large$national$standardization$study$in$both$English$and$Spanish$

languages$to$allow$for$normative$comparisons$on$each$assessment.$A$sample$of$4,859$

participants,$ages$3X85$–$representative$of$the$U.S.$population$based$on$gender,$ethnicity,$race,$

11$$

and$socioeconomic$status$–$was$administered$all$of$the$NIH$Toolbox$measures$at$sites$around$

the$country$(n$=$2,917$EnglishXspeaking$children,$ages$3X17;$n$=$496$SpanishXspeaking$children,$

ages$3X7;$n$=$1,038$EnglishXspeaking$adults,$ages$18X85;$n$=$408$SpanishXspeaking$adults,$ages$

18X85).$NIH$Toolbox$normative$scores$are$now$available$for$each$year$of$age$from$3$through$17,$

as$well$as$for$age$ranges$18X29,$30X39,$40X49,$50X59,$60X69,$and$70X85,$allowing$for$targeted$

and$accurate$comparisons$to$the$U.S.$population.$

$

Specifics$regarding$NIH$Toolbox$norming$sampling$methods$(e.g.,$stratification$by$age,$gender,$

and$language$preference;$sampling$a$minimum$of$25X100$individuals$per$targeted$demographic$

and$language$subgroup)$and$norming$analytic$methods$(e.g.,$postXstratification$adjustment$

using$iterative$proportional$fitting,$i.e.,$“raking”)$can$be$found$in$the$following$publication:$

Beaumont$et$al.,$Norming$Plans$for$the$NIH$Toolbox,$Neurology,$in$press.$

$

Section$4:$ NIH$Toolbox$and$the$National$Children’s$

Study$(NCS)$

$

In$collaboration$with$NIH$Toolbox$scientists,$NCS$investigators$selected$measures$from$PROMIS$

and$NIH$Toolbox$for$a$Maternal$Health$Profile,$the$Maternal$SelfXReported$Health$Battery.$This$

profile$assesses$Physical$Health$(Physical$function,$Fatigue,$Sleep$disturbance,$SleepXrelated$

impairment),$Mental$Health$(Anger,$Anxiety,$Depression,$Positive$affect,$Perceived$stress,$SelfX

efficacy),$and$Social$Health$(Social$support$and$companionship,$Social$isolation).$The$Maternal$

12$$

SelfXReported$Health$Battery$was$field$tested$in$fall$2011,$using$an$online$sample$of$1000$

women$(200$preXconception,$150$pregnant$women$(50$per$trimester),$and$650$mothers$with$a$

child$between$0X36$months$of$age).$In$addition,$NIH$Toolbox$norming$was$jointly$sponsored$by$

the$NCS$and$included:$3,413$children$in$singleXyear$age$bands$(from$3X17$years);$1,446$adults$in$

seven$age$bands,$including$the$mothers$of$children$also$being$tested;$and$105$pregnant$

women.$The$NIH$Toolbox$sampling$plan$matched$distributions$of$race/ethnicity$and$level$of$

education$for$each$age$band.$

$

Section$5:$ Domain$Definition$

$Domain:$ SENSATION$

Sensation$refers$to$the$biochemical$and$neurologic$process$of$detecting$incoming$nerve$

impulses$as$nervous$system$activity.$Sensory$processes$are$vital$to$one’s$level$of$independence,$

in$relationships$with$others,$in$academic$and$occupational$endeavors,$and$for$activities$of$daily$

living.$Objective$measures$of$Sensation$can$systematically$examine$and$determine$if$

participants$have$intact$sensory$functioning.$There$is$also$fundamental$overlap$of$certain$

sensory$processes$with$cognitive$and$motor$functioning.$Measurement$of$sensory$health$and$

function$is$important$to$epidemiologic$and$longitudinal$studies$whether$or$not$Sensation$is$the$

primary$focus$of$the$study.$Given$the$changes$in$sensory$functioning$across$the$lifespan,$there$

is$value$in$characterizing$ageXrelated$sensory$improvement$and$decline.$The$Sensation$domain$

includes$measures$of:$

$

13$$

AUDITION$$

Measured$by:$

NIH$Toolbox$WordsXinXNoise$Test$

NIH$Toolbox$Hearing$Threshold$Test$(Supplemental$Measure)$

NIH$Toolbox$Hearing$Handicap$Inventory$(Supplemental$Measure)$

$OLFACTION$

Measured$by:$


PAIN$

Measured$by:$

NIH$Toolbox$Pain$Intensity$Survey$

NIH$Toolbox$Pain$Interference$Survey$

$TASTE$

Measured$by:$

NIH$Toolbox$Taste$Intensity$Test$

$

VESTIBULAR!

Measured$by:$

NIH$Toolbox$Dynamic$Visual$Acuity$Test$$

NIH$Toolbox$Standing$Balance$Test$(contained$within$the$NIH$Toolbox$Motor$

battery)$

$

14$$

VISION$

Measured$by:$

NIH$Toolbox$Visual$Acuity$Test$

NIH$Toolbox$VisionXRelated$Quality$of$Life$Survey$(Supplemental$Measure)$

$

SENSATION$Batteries$

The$NIH$Toolbox$Sensation$Battery$for$ages$3X5$includes$Visual$Acuity,$Dynamic$Visual$Acuity,$

and$Odor$Identification$tests.$For$ages$6X11,$the$WordsXinXNoise$Test$is$added$to$the$battery.$

For$ages$12X17,$the$Taste$Intensity$Test$is$included$with$the$other$four;$and$for$ages$18X85,$the$

two$Pain$surveys$are$added.$There$are$individual$scores$provided$for$each$measure,$as$

described$below,$but$no$composite$scores.$

$

Section$6:$ Subdomain$Definition$

$

Subdomain:$ OLFACTION$

The$human$olfactory$system$allows$us$to$detect$odors,$to$recognize$and$discriminate$odor$

qualities,$and$to$identify$the$sources$of$odors$in$our$world.$Our$sense$of$smell$provides$us$with$

information$about$our$air,$water,$and$food$that$is$critical$to$our$health$and$safety,$nutrition,$

and$psychological$wellXbeing.$$In$addition,$impaired$olfactory$function$is$now$recognized$as$one$

of$the$early$signs$of$several$neurodegenerative$disorders,$including$Alzheimer’s$and$Parkinson’s$

disease.$While$there$are$several$approaches$to$olfactory$measurement,$odor$identification$was$

15$$

chosen$for$Toolbox$because$it$is$an$effective,$brief,$and$inexpensive$method$and$does$not$

require$specialized$equipment$or$training$of$the$examiners.$In$NIH$Toolbox,$Olfaction$is$

measured$by:$$

$


$

Section$7:$ Measure$Description$

$

OLFACTION$Core$Measure$

The$NIH$Toolbox$Odor$Identification$Test$assesses$a$person’s$ability$to$identify$various$odors.$$

Participants$use$scratchXandXsniff$cards$and,$after$scratching$them$one$at$a$time,$are$asked$to$

identify$which$of$four$pictures$on$the$computer$screen$matches$the$odor$they$have$just$

smelled.$Participants$ages$10X85$are$administered$nine$odor$cards,$while$those$ages$3X9$are$

administered$five$odor$cards.$Child$participants$(ages$3X9$years)$are$first$asked$to$identify$the$

eight$pictures$that$are$used$as$answer$choices,$to$ensure$they$can$complete$the$task.$$Having$

identified$the$pictures,$they$are$asked$if$they$have$tasted$or$smelled$the$objects$or$foods$

depicted.$This$test$takes$approximately$four$to$five$minutes$to$administer$and$is$recommended$

for$ages$3X85.$

$

$

16$$

Section$8:$ PostBValidation/PostBNorming$Changes$to$

the$Measure$

$

In$addition$to$those$changes$previously$reported$on$during$the$measure’s$development$and$

validation$phases$(Dalton$et$al.,$Olfaction$Assessment$using$the$NIH$Toolbox,$Neurology,$in$

press),$the$following$changes$have$been$made$to$this$measure:$

$

Item$exclusions:$ One$item$was$excluded$(cinnamon);$the$test’s$version$for$ages$3X9$is$

currently$five$items,$and$the$test’s$version$for$ages$10+$is$currently$nine$

items.$

$

Section$9:$ The$Measure’s$Scoring$Model$

$

Measurement$theory$applied$for$scoring:$

Classical$Test$Theory$(CTT)$

$

CTT$scoring$approach$employed:$

Sum$(the$total$number$of$correct$items)$

$

Measure$length:$

Fixed$(five$items$for$ages$3X9;$nine$items$for$ages$10X85)$

$

Response$data:$

Dichotomous$(correct,$incorrect)$

17$$

$

Scores$computed/available*:$

AgeXAdjusted$Scale$Score$(mean=100,$standard$deviation=15)$

Fully$Adjusted$Scale$Score$(mean=100,$standard$deviation=15)$

Unadjusted$Scale$Score$(mean=100,$standard$deviation=15)$

National$Percentile$Rank$(corresponds$to$the$AgeXAdjusted$Scale$Score)$

$

*Details$on$these$scores$and$their$interpretations$are$available$in$the$NIH$Toolbox$Scoring$and$

Interpretation$Guide.$

$ $

18$$

Section$10:$ Measure$Norms$

$

The$following$Tables$and$Figure$present$NIH$Toolbox$normative$data$associated$with$this$

measure:$

$

Table$1.$ Measure$Raw/Computed$Score,$Unadjusted$Scale$Score,$and$Fully$

Adjusted$Scale$Score$Summary$(N,$Mean,$Standard$Deviation)$by$Age$

Group$(3,$4,$5,$6,$7,$8,$9,$10,$11,$12,$13,$14,$15,$16,$17,$18B29,$30B39,$40B

49,$50B59,$60B69,$70B85,$All)$

$

Table$2.$ Measure$Raw/Computed$Score$Statistics$(N,$Mean,$Standard$Deviation,$

Minimum/Maximum$Observed,$25th/50th/75th$Percentile)$per$Age$

Group$(3,$4,$5,$6,$7,$8,$9,$10,$11,$12,$13,$14,$15,$16,$17,$18B29,$30B39,$40B

49,$50B59,$60B69,$70B85,$All)$

$

Figure$1.$ Measure$Mean$Unadjusted$Scale$Scores$across$All$Age$Groups$(3,$4,$5,$

6,$7,$8,$9,$10,$11,$12,$13,$14,$15,$16,$17,$18B29,$30B39,$40B49,$50B59,$60B69,$

70B85)$

$

Table 1. NIH Toolbox Odor Identification Test by Age

Group

Odor Identification Test (number

correct)

Odor Identification Unadjusted Scale

Score

Odor Identification Fully Adjusted Scale

Score

N Mean SD N Mean SD N Mean SD

Age Group

201 2.29 0.76 201 77.32 5.12 183 100.06 10.69 3

4 239 2.90 0.70 239 81.37 4.54 222 99.74 9.09

5 221 3.25 0.64 221 83.74 4.03 198 99.45 8.57

6 216 3.62 0.61 216 85.92 3.70 194 98.89 7.53

7 255 3.67 0.56 255 86.23 3.36 230 98.90 6.99

8 211 3.87 0.62 211 87.32 3.74 202 98.68 7.20

9 218 4.09 0.51 218 88.65 2.85 204 98.08 5.95

10 229 7.14 0.75 229 104.67 5.26 213 99.85 9.01

11 212 7.23 0.70 212 105.13 5.18 201 99.57 8.61

12 216 7.66 0.74 216 108.59 5.69 206 99.47 7.75

13 217 7.64 0.66 217 108.24 5.23 209 99.30 7.56

14 227 7.69 0.68 227 108.97 5.49 219 99.34 7.62

15 223 7.58 0.67 223 107.82 5.39 217 99.41 8.06

16 211 7.77 0.66 211 109.38 5.60 201 99.07 7.79

17 219 7.83 0.71 219 109.94 5.65 210 98.55 7.16

18 - 29 265 8.00 1.66 265 110.96 15.57 256 98.28 19.16

30 - 39 307 7.93 1.87 307 111.12 15.20 291 98.93 19.22

40 - 49 256 7.90 2.05 256 110.94 17.04 240 98.53 21.65

50 - 59 192 7.68 2.25 192 108.53 18.35 174 98.97 25.95

60 - 69 158 7.26 2.60 158 106.08 18.84 147 100.41 31.11

70 - 85 239 6.53 2.07 239 101.07 12.51 209 101.03 25.59

All 4732 7.25 1.84 4732 106.45 12.47 4426 99.12 14.33

Table 2. NIH Toolbox Odor Identification Test (number

correct) – Age 3

English Spanish Total

All Males Females Total Males Females Total Males Females

N 55 49 104 48 49 97 103 98 201

Mean 2.23 2.42 2.30 2.11 2.43 2.23 2.20 2.42 2.29

Standard Deviation 0.99 0.85 0.93 0.59 0.43 0.52 0.83 0.67 0.76

Minimum Observed 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00

25th Percentile 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00 1.00

50th Percentile (Median) 2.00 2.00 2.00 2.00 3.00 2.00 2.00 2.00 2.00

75th Percentile 3.00 3.00 3.00 3.00 3.00 3.00 3.00 3.00 3.00

Maximum Observed 5.00 5.00 5.00 5.00 5.00 5.00 5.00 5.00 5.00


correct) – Age 4



N 64 68 132 50 57 107 114 125 239

Mean 3.03 2.92 2.99 2.34 2.70 2.49 2.91 2.88 2.90



25th Percentile 2.00 2.00 2.00 2.00 2.00 2.00 2.00 2.00 2.00


75th Percentile 4.00 4.00 4.00 3.00 4.00 3.00 4.00 4.00 4.00



correct) – Age 5



N 64 66 130 43 48 91 107 114 221

Mean 3.33 3.07 3.23 3.36 3.43 3.39 3.33 3.14 3.25



25th Percentile 3.00 2.00 3.00 2.00 3.00 3.00 3.00 2.00 3.00


75th Percentile 4.00 4.00 4.00 4.00 4.00 4.00 4.00 4.00 4.00



correct) – Age 6



N 61 61 122 41 53 94 102 114 216

Mean 3.63 3.60 3.62 3.63 3.60 3.62 3.63 3.60 3.62



25th Percentile 3.00 3.00 3.00 3.00 3.00 3.00 3.00 3.00 3.00


75th Percentile 4.00 5.00 4.00 5.00 4.00 4.00 4.00 5.00 4.00



correct) – Age 7



N 84 77 161 46 48 94 130 125 255

Mean 3.73 3.64 3.70 3.57 3.46 3.52 3.71 3.61 3.67



25th Percentile 3.00 3.00 3.00 3.00 2.00 3.00 3.00 3.00 3.00


75th Percentile 5.00 5.00 5.00 4.00 4.00 4.00 5.00 5.00 5.00



correct) – Age 8



N 108 103 211 0 0 0 108 103 211

Mean 3.71 4.11 3.87 3.71 4.11 3.87

Standard Deviation 0.70 0.51 0.62 0.70 0.51 0.62

Minimum Observed 0.00 0.00 0.00 0.00 0.00 0.00

25th Percentile 3.00 4.00 3.00 3.00 4.00 3.00

50th Percentile (Median) 4.00 4.00 4.00 4.00 4.00 4.00

75th Percentile 5.00 5.00 5.00 5.00 5.00 5.00

Maximum Observed 5.00 5.00 5.00 5.00 5.00 5.00


correct) – Age 9



N 109 109 218 0 0 0 109 109 218

Mean 4.03 4.20 4.09 4.03 4.20 4.09



25th Percentile 3.00 4.00 3.00 3.00 4.00 3.00


75th Percentile 5.00 5.00 5.00 5.00 5.00 5.00



correct) – Age 10



N 115 114 229 0 0 0 115 114 229

Mean 7.12 7.16 7.14 7.12 7.16 7.14



25th Percentile 6.00 7.00 7.00 6.00 7.00 7.00


75th Percentile 8.00 8.00 8.00 8.00 8.00 8.00



correct) – Age 11



N 107 105 212 0 0 0 107 105 212

Mean 7.08 7.44 7.23 7.08 7.44 7.23



25th Percentile 6.00 7.00 7.00 6.00 7.00 7.00


75th Percentile 8.00 8.00 8.00 8.00 8.00 8.00



correct) – Age 12



N 102 114 216 0 0 0 102 114 216

Mean 7.54 7.82 7.66 7.54 7.82 7.66



25th Percentile 7.00 7.00 7.00 7.00 7.00 7.00


75th Percentile 8.00 9.00 9.00 8.00 9.00 9.00



correct) – Age 13



N 117 100 217 0 0 0 117 100 217

Mean 7.47 7.95 7.64 7.47 7.95 7.64



25th Percentile 7.00 7.00 7.00 7.00 7.00 7.00


75th Percentile 8.00 9.00 8.00 8.00 9.00 8.00



correct) – Age 14



N 110 117 227 0 0 0 110 117 227

Mean 7.53 7.93 7.69 7.53 7.93 7.69



25th Percentile 7.00 7.00 7.00 7.00 7.00 7.00


75th Percentile 8.00 9.00 9.00 8.00 9.00 9.00



correct) – Age 15



N 110 113 223 0 0 0 110 113 223

Mean 7.37 7.88 7.58 7.37 7.88 7.58



25th Percentile 7.00 7.00 7.00 7.00 7.00 7.00


75th Percentile 8.00 9.00 8.00 8.00 9.00 8.00



correct) – Age 16



N 104 107 211 0 0 0 104 107 211

Mean 7.75 7.79 7.77 7.75 7.79 7.77



25th Percentile 7.00 7.00 7.00 7.00 7.00 7.00


75th Percentile 9.00 9.00 9.00 9.00 9.00 9.00



correct) – Age 17



N 107 112 219 0 0 0 107 112 219

Mean 7.85 7.81 7.83 7.85 7.81 7.83



25th Percentile 7.00 7.00 7.00 7.00 7.00 7.00


75th Percentile 9.00 9.00 9.00 9.00 9.00 9.00



correct) – Age 18-29



N 60 112 172 22 71 93 82 183 265

Mean 8.02 8.08 8.05 7.63 7.76 7.72 7.98 8.02 8.00



25th Percentile 8.00 8.00 8.00 7.00 7.00 7.00 8.00 8.00 8.00


75th Percentile 9.00 9.00 9.00 8.00 9.00 9.00 9.00 9.00 9.00






N 55 156 211 21 75 96 76 231 307

Mean 7.88 8.07 8.01 6.82 7.52 7.30 7.77 8.01 7.93



25th Percentile 8.00 8.00 8.00 6.00 7.00 7.00 7.00 7.00 7.00


75th Percentile 9.00 9.00 9.00 8.00 9.00 8.00 9.00 9.00 9.00






N 62 121 183 30 43 73 92 164 256

Mean 7.87 8.04 7.97 6.94 7.68 7.29 7.75 8.01 7.90



25th Percentile 7.00 8.00 7.00 6.00 7.00 6.00 7.00 7.00 7.00


75th Percentile 9.00 9.00 9.00 8.00 8.00 8.00 9.00 9.00 9.00






N 58 83 141 25 26 51 83 109 192

Mean 7.84 7.65 7.75 6.84 7.31 7.03 7.74 7.62 7.68



25th Percentile 7.00 7.00 7.00 6.00 7.00 6.00 7.00 7.00 7.00


75th Percentile 9.00 9.00 9.00 8.00 8.00 8.00 8.00 9.00 9.00






N 46 70 116 18 24 42 64 94 158

Mean 7.22 7.46 7.34 6.07 6.93 6.46 7.11 7.42 7.26



25th Percentile 6.00 7.00 7.00 5.00 6.00 6.00 6.00 7.00 6.00


75th Percentile 8.00 9.00 9.00 8.00 8.00 8.00 8.00 9.00 8.00






N 97 98 195 25 19 44 122 117 239

Mean 6.32 6.82 6.52 6.85 6.23 6.63 6.35 6.79 6.53



25th Percentile 5.00 6.00 5.00 6.00 5.00 6.00 5.00 6.00 5.00


75th Percentile 8.00 8.00 8.00 8.00 7.00 8.00 8.00 8.00 8.00


Table 2. NIH Toolbox Odor Identification Test (number correct) – NCS Sample of

Mothers English Spanish All

N 80 35 115

Mean 8.14 7.74 8.02

Standard Deviation 1.03 1.12 1.07

Minimum Observed 3.00 5.00 3.00

25th Percentile 8.00 7.00 7.00

50th Percentile (Median) 8.00 8.00 8.00


Maximum Observed 9.00 9.00 9.00

Table 2. NIH Toolbox Odor Identification Test (number correct) – NCS Sample of

Pregnant Women English Spanish All

N 81 44 125

Mean 7.80 7.61 7.74

Standard Deviation 1.19 1.43 1.28

Minimum Observed 3.00 3.00 3.00


50th Percentile (Median) 8.00 8.00 8.00


Maximum Observed 9.00 9.00 9.00

Figure 1 Least Squares Means

tm sen olfa oi 09.27.12 · 2$ $ nih$toolbox$technical$manual$ $ domain:$ sensation$ $ subdomain:$...

Documents