A case of exceptional reading accuracy in a child with Down syndrome: Underlying skills and the relation to reading comprehension

A pilot study assessing listening comprehension and reading comprehension in children with down syndrome: Construct validity from a multi-method perspective

Obtaining valid assessments of language and literacy skills in children with Down syndrome (DS) presents a challenge as there is a paucity of information about the psychometrics of measures that are commonly used to measure listening and reading comprehension in this population. Evaluating the construct validity of measures that employ different methods is essential to ascertain the optimal method of assessment in individuals with DS and with typical developmental histories (TD). This pilot study aimed to evaluate the construct validity of four parallel measures of listening and reading comprehension. Participants included 19 individuals with DS (M = 17 years, 3 months; SD = 3 years, 6 months) and 19 word-level reading-matched children with TD (M = 7 years, 2 months; SD = 7 months). Participants completed norm-referenced assessments for four parallel measures of listening and reading comprehension. The four measurement methods were: (1) non-verbal response, (2) cloze procedure, (3) passage-level with close-ended questions, and (4) passage-level with open-ended questions. Participants completed additional assessments (e.g., cognition, language, and speech) for descriptive purposes. Construct validity was assessed using the Multitrait-Multimethod Matrix, a correlation matrix arranged to facilitate the assessment and interpretation of construct validity of measures across various formats. For both study groups, we observed strong evidence of construct validity for three out of four measurement methods. Results using the multimethod perspective also indicated that the listening and reading comprehension constructs were not separable. The findings from this pilot study represent a first step toward determining optimal methods of listening and reading comprehension assessment for individuals with DS. Additionally, these results can inform outcome measure selection in future language and literacy research with children with DS.

Intensive computer-based phonics training in the educational setting of children with Down syndrome: An explorative study

Children with Down syndrome (DS) using intensive computer-based phonics (GraphoGame, GG) were studied. The children's independence and improvement in phonological processing, letter knowledge, word decoding, and reading strategies were investigated. Seventeen children (5-16 years) with DS participated in a crossover design through 8 weeks (one period), with three test sessions separated by 4 weeks. Children were randomly assigned to GG intervention or regular schooling (RS). All children completed one period and eight children completed two periods. A majority gradually became independent in managing GG. At the group level, very little benefit was found from working with GG. At the individual level, several children with mild to severe intellectual disabilities showed increased decoding of trained words. After one period of GG and RS, an increase in alphabetically decoded words was found. The finding suggests that when individual challenges are considered, computer-based phonics may be beneficial for children with DS in their educational setting.

Occurrence of Reading Skills in a National Age Cohort of Norwegian Children with Down Syndrome: What Characterizes Those Who Develop Early Reading Skills?

Children with Down syndrome are at risk of reading difficulties. Reading skills are crucial for social and academic development, and thus, understanding the nature of reading in this clinical group is important. This longitudinal study investigated the occurrence of reading skills in a Norwegian national age cohort of 43 children with Down syndrome from the beginning of first grade to third grade. Data were collected to determine which characteristics distinguished those who developed early reading skills from those who did not. The children's decoding skills, phonological awareness, nonverbal mental ability, vocabulary, verbal short-term memory, letter knowledge and rapid automatized naming (RAN) performance were measured annually. The results showed that 18.6% of the children developed early decoding skills by third grade. Prior to onset, children who developed decoding skills had a significantly superior vocabulary and letter knowledge than non-readers after controlling for nonverbal mental abilities. These findings indicate that early specific training that focuses on vocabulary and knowledge of words and letters may be particularly effective in promoting reading onset in children with Down syndrome.

Roles of the metacognition and emotional systems in a categorization task for adults with moderate and severe learning disabilities

This research aimed to evaluate the links between metacognitive experiences, emotional coping strategies and categorization in adults with severe and moderate intellectual disabilities. The participants consisted of 32 people between 23 and 70 years old and having severe and moderate intellectual disabilities were recruited in several institutions. Their metacognition and their coping strategies were assessed using questionnaires before and after a complex categorization task. Metacognitive experiences refer to awareness and feelings about a task. The results highlighted a link between the Feeling Of Familiarity (FOF), one of concept of metacognitive experience and categorization performances and between coping strategies and metacognitive experience. There was also a link between coping strategies and metacognitive experiences, more specifically emotional outbursts. Finally, self-criticism appeared to be a good predictor of part of the FOF prior to the task. Self criticism is the ability to people to consider he is partly responsible of a situation. In conclusion, the participants' poor performances could be explained by their inefficient coping strategies and metacognitive experiences. Our results highlight the necessity to coach adults with severe and moderate intellectual disabilities in metacognitive experiences and emotional coping strategies before, and after a cognitive task.

Reading skills in children with mild to borderline intellectual disability: a cross-sectional study on second to eighth graders

BACKGROUND

Students with intellectual disabilities (IDs) have various learning difficulties and are at risk for school failure. Large inter-individual differences are described for reading, but it is unclear how these vary as a function of grade. The aim of this study was to examine various reading fluency, accuracy and comprehension parameters in second-to-eighth-grade Italian children with either borderline intellectual functioning (BIF) or mild ID (MID).

METHODS

We examined 106 children with BIF (67 M and 39 F) and 168 children with MID (107 M and 61 F). The children were in the second to eighth grade and were comparable for chronological age (7 to 14 years). They were administered a battery of tests that assessed fluency and accuracy of word, pseudo-word and text reading, as well as text comprehension. Standardised scores allowed us to compare the performance of the two groups with normative values.

RESULTS

Children with ID obtained generally low scores compared with normative values. Those with MID had greater difficulty than those with BIF. Furthermore, difficulty was greater for speed than for accuracy measures and for words than for pseudo-words. Difficulty (particularly in the case of reading speed) tended to be pronounced at later grades. Marked individual differences were present independently of MID-BIF subgrouping, as well as stimulus category and reading parameter.

CONCLUSIONS

As a group, children with ID showed difficulty in reading acquisition; the effect was greater for children with more severe ID, but large individual differences were observed in children with both BIF and MID. Relatively spared pseudo-word reading skills indicate efficient use of the grapheme-to-phoneme conversion routine. This processing mode may prove more ineffective at higher levels of schooling when even in regular orthographies such as Italian typically developing children rely on lexical activation.

Acquisition of Reading and Intellectual Development Disorder

We propose a review of the literature of the studies investigating reading acquisition in intellectual deficiency (ID), with particular focus on the explanatory factors for reading difficulties. Indeed, we explore the role of intellectual efficiency, perceptual abilities, oral language development, phonological processing and memory. The study of reading acquisition in ID is a challenge because of a high degree of heterogeneity in the results which, together with other variables influencing learning and development. This review has allowed us to understand that there are multiple reasons why individuals with ID have difficulty learning to read. More specifically, there is a link between reading skills and certain cognitive skills, such as perception, oral language, phonological processing and working memory.

Reading Deficits in Intellectual Disability Are still an Open Question: A Narrative Review

BACKGROUND

In children with intellectual disability (ID), the acquisition of reading skills constitutes a basic step towards the possibility of independent living, social inclusion and participation.

METHODS

We carried out a narrative review of the literature on reading fluency and accuracy of individuals with ID resulting from different genetic syndromes (Fragile X, Williams, Velocardiofacial, Prader-Willi, and Down syndrome). Our aim was to define their reading profiles in light of the dual-route reading model. For this purpose, studies that examined both word and non-word reading in children with ID were included in the analysis.

RESULTS

Seventeen studies emerged based on the selection criteria. The results were different depending on the control group used. A deficit in reading non-words emerged in studies that used the reading-level match design but not when standardized scores were used, when controls were age-matched or when a mental age matching was used. Thus, a deficit in reading non-words emerged only in studies that used the reading-level match design. However, severe methodological criticisms were recently raised about the use of this matching design.

CONCLUSIONS

In view of the methodological problems in using grade equivalents, it is premature to draw definite conclusions about the reading profile of children with ID resulting from different genetic syndromes. In any case, the reviewed evidence provides little support for the idea that children with ID have selective difficulty in phonological reading. Thus, the reading profile of children with ID remains an open question that needs to be investigated by means of methodologically sound research.

Bilingualism and Biliteracy in Down Syndrome: Insights From a Case Study

We present the case study of MB-a bilingual child with Down syndrome (DS) who speaks Russian (first language [L1]) and English (second language [L2]) and has learned to read in two different alphabets with different symbol systems. We demonstrate that, in terms of oral language, MB is as proficient in Russian as English, with a mild advantage for reading in English, her language of formal instruction. MB's L1 abilities were compared with those of 11 Russian-speaking typically developing monolinguals and her L2 abilities to those of 15 English-speaking typically developing monolinguals and six monolingual English-speaking children with DS; each group achieving the same level of word reading ability as MB. We conclude that learning two languages in the presence of a learning difficulty need have no detrimental effect on either a child's language or literacy development.

Reading comprehension in children with Down syndrome

Two studies aimed to investigate the reading comprehension abilities of 14 readers with Down syndrome aged 6 years 8 months to 13 years relative to those of typically developing children matched on word reading ability, and to investigate how these abilities were associated with reading accuracy, listening comprehension, phonological awareness and vocabulary knowledge. Study 1 confirmed significantly poorer passage-reading comprehension than the typically developing group. In an experimental task, readers with Down syndrome understood fewer written sentences than the typical group and, contrary to prediction, received no advantage from printed sentences compared to spoken sentences, despite the lower memory load. Reading comprehension was associated with listening comprehension, word reading and phonological awareness in DS. Vocabulary knowledge was also associated with reading comprehension, mediated by word reading and nonverbal cognitive abilities. Study 2 investigated the longitudinal relationships between reading and language measures in the readers with DS over around 22 months. Time 1 listening comprehension and phonological awareness predicted Time 2 reading comprehension but there was no evidence that reading or reading comprehension predicted Time 2 language scores or phonological awareness, and no evidence that readers had acquired greater depth of vocabulary.

A descriptive study examining phonological awareness and literacy development in children with Down syndrome

OBJECTIVE AND METHOD

This article describes the profiles of a cohort of 77 New Zealand children with Down syndrome (aged between 5 and 14 years) in areas of particular importance to reading development, namely phonological awareness, word level reading and letter knowledge. Assessment of reading accuracy and comprehension of connected text, as well as further phonological awareness knowledge, was measured in 25 of the more advanced readers in this cohort.

RESULTS

The findings showed the expected development with increasing age for letter knowledge, phoneme level awareness and reading tasks. Forty-two percent scored significantly above chance on a phoneme identity task, and most of the participants knew more letter names than letter sounds. Only 17% of the group scored above chance on a rhyme oddity task, and rhyme knowledge was not significantly correlated with age. The majority of the participants could read 1 or more words in isolation and 6.5% demonstrated word level reading at a 7- to 8-year level. Phoneme awareness and letter sound knowledge significantly contributed to word level reading performance. In-depth assessment for the more advanced readers suggested the participants had a comparative strength in reading accuracy compared to reading comprehension and found phonological awareness blending tasks easier than phonological segmentation tasks. Only 1 participant demonstrated strength on a rhyme generation task.

CONCLUSION

Discussion focuses on the implications of better understanding the differing language profiles of children with Down syndrome for enhancement of their educational success.

Consciência fonológica e desenvolvimento da escrita na síndrome de Down: um estudo de caso longitudinal

Os objetivos deste estudo foram: verificar a existência de avanços em habilidades de consciência fonológica e escrita em uma criança com síndrome de Down, falante do português brasileiro, em um intervalo de tempo de quatro anos e oito meses; identificar quais habilidades de consciência fonológica desenvolveram-se e quais continuaram sendo de difícil resolução; verificar o desempenho do participante em testes de memória de trabalho fonológica e de inteligência verbal e de execução. A criança frequenta escola regular e tinha 7 anos de idade cronológica no início do estudo. A consciência fonológica e a escrita foram avaliadas em três momentos (T1, T2, T3) em um período de 4 anos e 8 meses. Para a avaliação da consciência fonológica foi utilizado o teste Consciência fonológica: instrumento de avaliação sequencial (CONFIAS). No T1 e T2, a escrita foi avaliada de acordo com critérios do mesmo instrumento; no T3, foi utilizado o subteste de escrita do Instrumento de Avaliação Neuropsicológica Breve Infantil (NEUPSILIN-INF). No T1, a memória de trabalho fonológica foi avaliada por meio do span de palavras e, no T3, foi utilizado o subteste de pseudopalavras do NEUPSILIN-INF. Para avaliação da inteligência verbal e de execução (T3), utilizou-se a Escala de Inteligência Wechsler Abreviada (WASI). Foram verificados progressos em habilidades de escrita e consciência fonológica ao longo do estudo. Algumas habilidades de consciência silábica aprimoraram-se, já tarefas que exigem manipulação de constituintes fonêmicos e consciência de rima continuaram de difícil acesso. O participante apresentou um bom desempenho no teste de repetição de palavras reais. O span de palavras reais foi superior ao span de pseudopalavras. O quociente de inteligência geral foi considerado limítrofe. Acredita-se que, neste caso, habilidades linguísticas e cognitivas, como o vocabulário verbal, a memória de trabalho fonológica e a capacidade intelectual, influenciaram o desempenho no teste de consciência fonológica e capacitaram a criança para o aprendizado da língua escrita.

Do students with Down syndrome have a specific learning profile for reading?

The present study assessed achieved reading stages of 190 school-aged children with Down syndrome (DS, age 6-20) in Bavaria, one of the most populated federal states in Germany. Teachers described the reading stages of their students in a questionnaire. The achieved stages of reading according to the developmental model of Frith are compared to a sample of 1419 students with intellectual disability (ID) regardless of etiology, but excluding DS; thereafter parallelized ID-groups were compared. Results of the questionnaire addressed to the students' teachers showed that 20.2% of the students with DS do not read at all, 7.6% read at a logographic stage, 49.4% at an alphabetic and 22.8% at an orthographic level. Alongside these findings among the whole sample, correlations are described concerning age, gender, IQ and sociocultural background. The students with DS are then compared to other students with ID with mixed etiologies. This comparison stresses the emphasis on the alphabetic level amongst students with DS. This emphasis also exists when DS and non-DS students are parallelized in groups of ID, thus showing that students with DS and severe ID are ahead in reading, but those with mild ID are behind. Knowledge about specific literacy attainment of students with DS is vital for planning instruction, for creating learning environments, and for formulating future fields of research. Especially students with DS need specific teaching which takes their impaired verbal short term memory into account, such as learning to read in syllables.

Predicting literacy in children with a high-functioning autism spectrum disorder

The most commonly reported reading profile for children with a high-functioning autism spectrum disorder (HFASD) is one of intact decoding combined with reduced reading comprehension. Whether or not the variables that predict decoding and reading comprehension for children with a HFASD are exactly the same as those identified for a non-ASD population is unknown. Therefore, the ability of cognition, phonological processing, oral language, and vision to predict decoding and reading comprehension was investigated. Regression analysis revealed that cognition, phonological processing, and syntax predicted decoding and reading comprehension for the HFASD and non-ASD groups. One notable difference was that semantics predicted literacy for the non-ASD children but not their HFASD peers.

Learning to read in Williams syndrome and Down syndrome: syndrome-specific precursors and developmental trajectories

BACKGROUND

In typical development, early reading is underpinned by language skills, like vocabulary and phonological awareness (PA), as well as taught skills like letter knowledge. Less is understood about how early reading develops in children with neurodevelopmental disorders who display specific profiles of linguistic strengths and weaknesses, such as Down syndrome (DS) and Williams syndrome (WS).

METHODS

Early reading, letter knowledge, rhyme matching, phoneme matching and receptive vocabulary were assessed in 26 children with DS and 26 children with WS between 4 and 8 years, as well as in two groups of typically developing (TD) children matched on nonverbal mental age (NVMA controls) or reading (RA controls). Reading was also measured 1 year later in DS, WS and RA controls to assess reading growth and its longitudinal predictors.

RESULTS

Despite poor PA and vocabulary, children with DS displayed good reading and letter knowledge, compared with NVMA controls. Performance of children with WS was equivalent to RA controls and superior to NVMA controls on all tasks. Longitudinal delays emerged in reading in both DS and WS compared with RA controls. Vocabulary was a significant longitudinal predictor of reading growth for all children, but, for both children with DS and WS, and unlike RA controls, letter knowledge and PA were not.

CONCLUSIONS

Children with DS and WS display atypical developmental patterns in the earliest stages of reading, further underlining the importance of cross-syndrome, longitudinal research, which tracks all levels of development in neurodevelopmental disorders. Identifying early syndrome-specific profiles of strengths and weaknesses underlying literacy development is critical for planning intervention programmes.

Reading skills in children with Down syndrome: a meta-analytic review

The authors examine the reading profile in children with Down syndrome by comparing the nonword decoding skills in children with Down syndrome and typically developing children matched for word recognition level. Journal articles published before 04.05.2010 were identified by using the keyword Down* cross-referenced to 'reading', 'literacy', 'decoding', and 'reading comprehension' were selected. A total of eight papers met the criteria for inclusion. Each study was reviewed and coded on both inclusion criteria and coding protocol before the analysis was performed. Children with Down syndrome had equivalent nonword decoding skills to typically developing children matched for word recognition level, but showed deficits on measures of two important underlying skills, vocabulary and phonological awareness. Differences in vocabulary, but not phonological awareness, were predictive of differences in nonword decoding skills. The practical and theoretical implications of these findings are discussed.

Research review: reading comprehension in developmental disorders of language and communication

BACKGROUND

Deficits in reading airment (SLI), Down syndrome (DS) and autism spectrum disorders (ASD).

METHODS

In this review (based on a search of the ISI Web of Knowledge database to 2011), the Simple View of Reading is used as a framework for considering reading comprehension in these groups.

CONCLUSIONS

There is substantial evidence for reading comprehension impairments in SLI and growing evidence that weaknesses in this domain are common in DS and ASD. Further, in these groups reading comprehension is typically more impaired than word recognition. However, there is also evidence that some children and adolescents with DS, ASD and a history of SLI develop reading comprehension and word recognition skills at or above the age appropriate level. This review of the literature indicates that factors including word recognition, oral language, nonverbal ability and working memory may explain reading comprehension difficulties in SLI, DS and ASD. In addition, it highlights methodological issues, implications of poor reading comprehension and fruitful areas for future research.

The role of vocabulary, working memory and inference making ability in reading comprehension in Down syndrome

Thirteen children and young adults with Down syndrome (DS) completed tests of language and reading and their performance was compared to that of three control groups. Reading comprehension was confirmed to be a specific deficit in DS and found to be strongly correlated with underlying language skills. Although reading comprehension was more strongly related to language ability in the DS group, this was shown to be a function of more advanced word recognition rather than a characteristic of DS per se. Individuals with DS were found to have greater difficulty with inferential comprehension questions than expected given their overall comprehension ability and the reading profile associated with DS was found to be similar to that of children known as poor comprehenders. It is recommended that oral language training programs, similar to those that have been shown to improve reading comprehension in poor comprehenders, be trialed with children who have DS.

Effects of targeted reading instruction on phonological awareness and phonic decoding in children with down syndrome

This research evaluated the effectiveness of reading instruction targeting oral reading and phonological awareness for children with Down syndrome (affecting chromosome 21). The participants were 7 children ranging in age from 2 years, 11 months to 10 years, 8 months. Each child acted as his/her own control, with assessments of language, cognition, phonological awareness, word and short-passage comprehension, and oral reading ability conducted on four occasions (initially, preintervention, postintervention and delayed postintervention) over approximately a 12-month period. The intervention was conducted over 10 weekly sessions and involved individual instruction. The postintervention assessment results provided evidence that phonic reading instruction was generally effective in improving reading skills and phonological awareness of children with Down syndrome.

Eye-movement patterns of readers with down syndrome during sentence-processing: an exploratory study

Eye movements were examined to determine how readers with Down syndrome process sentences online. Participants were 9 individuals with Down syndrome ranging in reading level from Grades 1 to 3 and a reading-level-matched control group. For syntactically simple sentences, the pattern of reading times was similar for the two groups, with longer reading times found at sentence end. This "wrap-up" effect was also found in the first reading of more complex sentences for the control group, whereas it only emerged later for the readers with Down syndrome. Our results provide evidence that eye movements can be used to investigate reading in individuals with Down syndrome and underline the need for future studies.

Children who read words accurately despite language impairment: who are they and how do they do it?

Some children learn to read accurately despite language impairments (LI). Nine- to 10-year-olds were categorized as having LI only (n = 35), dyslexia (DX) only (n = 73), LI + DX (n = 54), or as typically developing (TD; n = 176). The LI-only group had mild to moderate deficits in reading comprehension. They were similar to the LI + DX group on most language measures, but rapid serial naming was superior to the LI + DX group and comparable to the TD. For a subset of children seen at 4 and 6 years, early phonological skills were equally poor in those later classified as LI or LI + DX. Poor language need not hinder acquisition of decoding, so long as rapid serial naming is intact; reading comprehension, however, is constrained by LI.

Somatostatin receptor subtypes 2 and 5 are associated with better survival in well-differentiated endocrine carcinomas

The majority of gastroenteropancreatic well-differentiated endocrine carcinomas (WDEC) express somatostatin receptors (SSTR). To correlate the expression of SSTR subtypes by reverse transcriptase-polymerase chain reaction (RT-PCR) with clinicopathological features and survival in a group of WDEC patients, 42 WDEC tissue specimens from 33 patients were analysed. All patients were treated with somatostatin analogues and had a median follow-up period of 45 months (range 6-196). Neither SSTR2 and SSTR5 expression nor Ki-67 level alone correlated with survival. A significantly better survival rate was observed in patients with tumours expressing SSTR2, SSTR5 and Ki-67 <2%, compared to those with SSTR2- and SSTR5-negative tumours and Ki-67 >or=2% (p < 0.038), with 5-year survival rates of 91 vs. 43%, respectively. Expression of SSTR2 and SSTR5 appears to play a positive prognostic role, possibly correlated with the high affinity that the available somatostatin analogues display for these 2 specific SSTR subtypes.

Socio-cognitive understanding: a strength or weakness in Down's syndrome?

BACKGROUND

Social understanding is often thought to be relatively 'protected' in children with Down's syndrome (DS) and to underlie the outgoing personality characteristically attributed to them. This paper draws together findings from our studies of behaviours during object concept testing, generally considered a theoretically 'pure' measure of early cognitive ability, and from more recent work focusing on two key socio-cognitive skills: recognising facial expressions of emotion and collaborative learning. Age range of children studied was 4 months to 18 years.

METHODS

Using standardised hiding tasks, object concept ability was assessed cross-sectionally and longitudinally in children with DS and in age- or stage-matched typically developing (TD) children. Stability of cognitive advances was assessed and similarities/differences in developmental pathways explored. In the emotion recognition studies, the ability to distinguish six primary emotions was measured, with performance compared with that of developmentally-matched TD children and age-matched children with intellectual disabilities of similar severity but differing aetiology [non-specific intellectual disability (NSID) or fragile X syndrome (FXS)]. In the collaborative learning study, the impact on sorting skills of working with a peer on a conceptually related task was measured, with outcomes compared in DS, NSID and TD child pairings.

RESULTS

Evidence of counterproductive, socially-based strategies being inappropriately applied by children with DS in learning contexts was found in both the object concept and collaborative learning studies, along with inefficient use of current cognitive and linguistic abilities. Emotion recognition weaknesses were also identified, although deficits were relative rather than absolute and individual variability was marked.

CONCLUSIONS

In line with emerging evidence from other research teams, findings suggest possible difficulties in some core aspects of interpersonal functioning in DS, with both qualitative and quantitative differences in how social cognition develops and is applied in learning contexts. Implications for development and for behavioural phenotype theory are briefly discussed.