Cognition & Educational Achievement in the Toronto Adolescent and Youth (TAY) Cohort Study: Rationale, Methods, and Early Data

Background: Cognition and educational achievement in youth are both linked to psychosis risk. One major aim of the Toronto Adolescent and Youth (TAY) Cohort study is to characterize how cognitive and educational achievement trajectories inform the course of psychosis spectrum symptoms (PSS), functioning, and suicidality. Here, we describe the protocol for the cognitive and educational data, and early baseline data. Methods: Cognitive assessment design is aligned with youth population cohort studies, including the NIH Toolbox, Rey Auditory Verbal Learning Test, Wechsler Matrix Reasoning Task, and Little Man Task. Participants complete an educational achievement questionnaire and report cards are requested. Completion rates, descriptive data, and differences across PSS status are reported in the first participants (N=417) aged 11-24 years, recruited between May 4, 2021 and February 2, 2023. Results: 83.7% of the sample completed cognitive testing, 88.2% completed the educational questionnaire, whereas report cards were collected for 40.3%. Modifications to workflows were implemented to improve data collection. Participants meeting criteria for PSS demonstrated lower performance on numerous key cognitive indices compared with those who did not (p<0.05), and also had more academic/educational problems. Conclusions: Following youth longitudinally will enable trajectory mapping and prediction based on cognitive and educational performance in relation to PSS in treatment-seeking youth. Youth with PSS had lower cognitive performance and worse educational outcomes compared to youth without PSS. Results show the feasibility of collecting cognitive and educational outcomes in a cohort of youth seeking treatment related to mental illness and substance use.