Visuo-spatial knowledge acquisition in individuals with Down syndrome: The role of descriptions and sketch maps

Spatial exploration and navigation in Down syndrome and Williams syndrome

We know little about the ability to explore and navigate large-scale space for people with intellectual disability (ID). In this cross-syndrome study, individuals with Down syndrome (DS), individuals with Williams syndrome (WS) and typically developing children (TD; aged 5-11 years) explored virtual environments with the goal of learning where everything was within the environment (Experiment 1) or to find six stars (Experiment 2). There was little difference between the WS and DS groups when the goal was simply to learn about the environment with no specific destination to be reached (Experiment 1); both groups performed at a level akin to a subset of TD children of a similar level of non-verbal ability. The difference became evident when the goal of the task was to locate targets in the environment (Experiment 2). The DS group showed the weakest performance, performing at or below the level of a subset of TD children at a similar level of non-verbal ability, whilst the WS group performed at the level of the TD subset group. The DS, WS and TD group also demonstrated different patterns of exploration behavior. Exploration behaviour in DS was weak and did not improve across trials. In WS, exploration behavior changed across trials but was atypical (the number of revisits increased with repeated trials). Moreover, transdiagnostic individual difference analysis (Latent Profile Analysis) revealed five profiles of exploration and navigation variables, none of which were uniquely specific to DS or to WS. Only the most extreme profile of very poor navigators was specific to participants with DS and WS. Interestingly, all other profiles contained at least one individual with DS and at least one individual with WS. This highlights the importance of investigating heterogeneity in the performance of individuals with intellectual disability and the usefulness of a data-driven transdiagnostic approach to identifying behavioral profiles.

Visuospatial perspective taking in people with Down syndrome

Visuospatial perspective taking (VPT) refers to the process of mentally representing a viewpoint different from one's own. It is related to mental rotation and theory of mind and helps to support some complex spatial activities such as wayfinding. Despite research advances in spatial cognition, little is known about VPT in people with Down syndrome (DS). Here, we examined VPT in people with DS. A total of 38 individuals with DS (aged 12-25 years old) and nonverbal ability-matched typically developing (TD) children (aged 4-9 years old) participated. They completed two VPT tasks: the classic Piagetian Three Mountains Task and a modified version of the "Dog Task" (Newcombe & Huttenlocher, 1992). For both groups, the Three Mountains Task was more difficult than the Dog Task, implying the impact of task complexity on assessing VPT. However, the overall performance did not differ between the TD and DS groups in either VPT task. Implications of the results were discussed.

The Use of Virtual and Computational Technologies in the Psychomotor and Cognitive Development of Children with Down Syndrome: A Systematic Literature Review

Individuals with Down syndrome (DS) have numerous comorbidities due to trisomy 21. However, virtual reality-based therapy (VRT) has been used nowadays as a learning and visual motor tool in order to facilitate the development and learning process of this group. The aim of this article was to carry out an integrative review of the literature on the use of virtual and computational technologies in the stimulation of children with DS. A search was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) through single key words or their combinations using AND or OR operators: “Down syndrome” AND (“development” OR “cognition” OR “visomotor” OR “digital game” OR “virtual reality”). Eventually, 18 articles were included in our review. The games used in the research were able to stimulate, through the visual field, global motor skills, balance, body scheme and spatial organization, in addition to the learning of mathematical concepts, in order to directly influence the autonomous life activities, language skills, social skills and educational aspects of people with DS. Electronic games contribute to the teaching-learning relationship and stimulate neuropsychomotor and cognitive functions and development in children with DS.

Developmental Trajectories in Spatial Visualization and Mental Rotation in Individuals with Down Syndrome

BACKGROUND

The analysis of developmental trajectories of visuospatial abilities in individuals with Down Syndrome (DS) remains an unexplored field of investigation to examine in depth. The study aimed to fill such a gap by examining changes in two visuospatial abilities: spatial visualization (the ability to manage spatial stimuli) and mental rotation (the ability to rotate spatial stimuli).

METHOD

Eighty-seven participants with DS, aged between 7 and 53 years (forty-seven males and forty females), completed spatial visualization and mental rotation tasks. Changes in these two abilities were analyzed in relation to chronological age and developmental level, the latter derived from Raven's Colored Progressive Matrices.

RESULTS

Chronological age was linearly associated with spatial visualization performance, whereas mental rotation performance increased until 14 years of age and then decreased. Developmental level was linearly associated with increased performance in spatial visualization, the trend in mental rotation was segmented with an increase after 5 years of age. Furthermore, developmental trajectories in mental rotation depended on the rotation degree.

CONCLUSION

Chronological age explains a modest quote of variance. Developmental level better describes changes in spatial visualization and mental rotation of individuals with DS.

Path Learning in Individuals With Down Syndrome: The Challenge of Learning Condition and Cognitive Abilities

Analyzing navigational abilities and related aspects in individuals with Down syndrome (DS) is of considerable interest because of its relevance to everyday life. This study investigates path learning, the conditions favoring it, and the cognitive abilities involved. A group of 30 adults with DS and 32 typically-developing (TD) children matched on receptive vocabulary were shown a 4 × 4 Floor Matrix and asked to repeat increasingly long sequences of steps by walking on the grid. The sequences were presented under two learning conditions, one called Oral instructions (participants received verbal instructions such as “turn right” or “turn left”), the other Observation (participants watched the experimenter's moves). Participants were also assessed on verbal and visuospatial cognitive measures. The results showed a similarly better performance in both groups when the Floor Matrix task was administered in the Observation as opposed to the Oral instructions condition. As for the relation with cognitive abilities, in the Floor Matrix task in the Oral instructions condition, individuals with DS showed an effect of both verbal and visuospatial abilities, which was only positive for verbal ability. The effect of verbal and visuospatial abilities was negligible in the TD group. In the Observation condition, performance was predicted by sequential working memory in both groups. Overall, these results shed light on path learning in individuals with DS, showing that they benefited from the Observation condition, and that the involvement of their cognitive abilities depended on the learning condition.

The Acquisition of Survey Knowledge by Individuals With Down Syndrome

People with Down syndrome often exhibit deficiencies in wayfinding activities, particularly route learning (e.g., Courbois et al., 2013; Davis et al., 2014; Farran et al., 2015). Evidence concerning more sophisticated survey learning has been sparse. In the research reported here, two experiments are reported that evaluated survey learning of youth with DS and typically developing children (TD) matched on mental age. In Experiment 1, participants learned two overlapping routes consisting of three turns each through a virtual environment depicting 9 square city blocks. Following acquisition, they were tested on multiple measures of survey knowledge: finding a shortcut, identifying the direction of landmarks not currently visible from their location in the environment, and recognizing a bird's-eye representation of the overall environment. Under these conditions, which should provide relatively optimal opportunities for survey learning, the participants with DS performed comparably to TD participants matched on non-verbal ability on all of our measures of survey learning. Hence, we concluded that people with DS can acquire some survey knowledge when tasked with learning a small environment and given the opportunity to do so. In Experiment 2, the experimenter navigated participants through a large, relatively complex, virtual environment along a circuitous path, beginning and ending at a target landmark. Then, the participants were placed at a pre-specified location in the environment that they had viewed previously and instructed to navigate to the same target (a door) using the shortest possible path from their current location. They completed the task three times: once after being shown the environment one time, once after three exposures, and once after five exposures. Results indicated that the participants with DS exhibited significantly less skill at identifying the shortcut than did the TD participants, with differences emerging as the number of exposures increased. Participants with DS were also less able to recall landmarks at the end of the experiment. Overall, however, the performance of both groups was relatively poor in both experiments - with the performance of participants with DS being worse as conditions became less optimal. These results were discussed in terms of underlying mechanisms that may account for variations in survey learning as environmental complexity increases.

Path Learning in Individuals With Down Syndrome: The Floor Matrix Task and the Role of Individual Visuo-Spatial Measures

Environment learning is essential in everyday life. In individuals with Down syndrome (DS), this skill has begun to be examined using virtual exploration. Previous studies showed that individuals with DS can learn and remember paths in terms of sequences of turns and straight stretches, albeit with some difficulty, and this learning is supported by their cognitive abilities. This study further investigates environment learning in the DS population, newly examining their ability to learn a path from actual movements, and to learn increasingly long paths, and how their performance relates to their visuo-spatial abilities and everyday spatial activities. A group of 30 individuals with DS and 30 typically-developing (TD) children matched for receptive vocabulary performed a 4 × 4 Floor Matrix task in a grid comprising 16 squares (total area 2.3 × 2.3 meters). The task involved repeating increasingly long sequences of steps by actually moving in the grid. The sequences were presented in two learning conditions, called Observation (when participants watched the experimenter’s moves), or Map (when they were shown a map reproducing the path). Several visuo-spatial measures were also administered. The results showed a clear difference between the two groups’ performance in the individual visuo-spatial measures. In the Floor Matrix task, after controlling for visuo-spatial reasoning ability, both groups benefited to the same degree from the Observation condition vis-à-vis the Map condition, and no group differences emerged. In the group with DS, visuo-spatial abilities were more predictive of performance in the Floor Matrix task in the Observation condition than in the Map condition. The same was true of the TD group, but this difference was much less clear-cut. The visuo-spatial working memory and visualization tasks were the strongest predictors of Floor Matrix task performance. Finally, the group with DS showed a significant relation between Floor Matrix task performance in the Observation condition and everyday spatial activity. These results enlarge on what we know about path learning in individuals with DS and its relation to their visuo-spatial abilities. These findings are discussed within the frame of spatial cognition and the atypical development domain.

Accessible and inclusive transportation for youth with disabilities: exploring innovative solutions

Background: Although access to reliable transportation is an essential component of quality of life, young people with disabilities encounter many transportation-related obstacles.Objective: To explore solutions to the challenges that youth with disabilities encounter in accessing and navigating transportation.Methods: A nominal group technique was used in two consultation workshops (one involving rehabilitation clinicians and accessible transportation stakeholders; and one with youth with disabilities and parents). Fifteen participants across two workshops took part and prioritized their solutions and we used a comparative analysis within and between groups to explore overarching themes.Results: The workshops resulted in 122 solutions (76 from youth/parents; 46 from stakeholders). Although there was considerable overlap within the ideas generated between the groups, they each prioritized them differently. The following themes emerged across the two group's prioritized solutions: training, funding, enhancing access, and improved efficiency.Conclusions: Our findings highlight that youth with disabilities, parents and key stakeholders offered many practical solutions for enhancing accessible transportation for youth with disabilities.Implications for RehabilitationClinicians and educators should explore different apps and transportation training programs that could help support youth with disabilities to enhance their independence and participation in the communityClinicians and educators should be involved in the development of disability awareness training programs for public transit and school bus drivers to enhance youth's inclusion and participation in society.Clinicians, educators, youth and parents should continue to advocate for inclusive, accessible, affordable and efficient transportation for people with disabilities.

Pedestrian navigation and public transit training interventions for youth with disabilities: a systematic review

Purpose: Being able to travel independently, whether as a pedestrian or by taking public transportation, is a critical element to maintaining quality of life and participation in the community. The objective of this systematic review is to understand the best practices and effective components of pedestrian and public transit training interventions for youth with disabilities. Method: Systematic searches of seven international databases identified 29 studies meeting our inclusion criteria. We analyzed these studies based on participant characteristics, methods, results, and quality of evidence. Results: Among the 29 studies, 857 participants (aged 5-39, mean 18.3 years) were represented across 10 countries. Although the intervention outcomes varied across the studies, 24 of them reported an improvement in at least one of the following: pedestrian and general navigation skills, pedestrian safety, landmark recognition, route knowledge, and public transportation skills. Conclusions: Our findings highlight that pedestrian and public transit interventions have the potential to improve the participation and quality of life of children and youth with disabilities. More rigorous, theoretically informed interventions, using standardized measures are needed to enhance pedestrian and transit training skills among youth with disabilities. Implications for rehabilitation Travel training interventions have the potential to effectively support youth with disabilities in learning pedestrian and public transportation navigation skills. Clinicians and educators should encourage youth with disabilities to participate in travel training programs enhance their independence skills and participation in the community. Clinicians, educators, and program managers can help to build relevant content for travel training programs and connect youth to programs.

Mental rotation ability and everyday-life spatial activities in individuals with Down syndrome

Although certain visuospatial abilities, such as mental rotation, are crucially important in everyday activities, they have been little explored in individuals with Down syndrome (DS). This study investigates: i) mental rotation ability in individuals with DS; and ii) its relation to cognitive abilities and to everyday spatial activities. Forty-eight individuals with DS and 48 typically-developing (TD) children, matched on measures of vocabulary and fluid intelligence, were compared on their performance in a rotation task that involved detecting which of two figures would fit into a hole if rotated (five angles of rotation were considered: 0°, 45°, 90°, 135°, 180°). Participants were also assessed on their visuospatial and verbal cognitive abilities, and on their parents and/or educators reports regarding their everyday spatial activities. Results showed that: (i) individuals with DS were less accurate in mental rotation than TD children, with larger differences between the groups for smaller angles of rotation; individuals with DS could not mentally rotate through 180°, while TD children could; (ii) mental rotation ability was related to fluid intelligence and to spatial activities (though other cognitive abilities are also involved in the latter) to a similar degree in the DS group and the matched TD children. These results are discussed with regard to the atypical development domain and spatial cognition models.

Environment learning from virtual exploration in individuals with down syndrome: the role of perspective and sketch maps

BACKGROUND

Spatial knowledge about an environment is an important determinant of ability to move effectively within it and of personal autonomy. Individuals with Down's syndrome (DS) have difficulty managing configural visuospatial information.

METHOD

Twenty-nine individuals with DS and 29 typically developing (TD) children, matched for mental age, learned about environments through virtual exploration using a route or survey view. A sketch map of the environment was or was not presented before exploration. Then the acquisition of configural knowledge (landmark locations) and route retracing were tested.

RESULTS

Individuals with DS were able to acquire configural knowledge through virtual exploration in all presentation conditions, and generally performed no worse than matched TD children. However, they were not able to benefit from the conditions that facilitated acquisition of configural knowledge in TD children, that is, seeing a sketch map before exploring and exploring in survey (rather than route) view. As regards route retracing, individuals with DS paused more often than controls and tended to travel longer paths, which made them slower overall.

CONCLUSIONS

DS reduces children's ability to benefit from additional survey information and may be related to difficulty in elaborating configural/simultaneous information.