Cognitive profile of young children with Williams syndrome

Does preservice teachers' contact with children with intellectual disabilities during their practicum impact their attitudes and teaching practices? "If you don't have the heart, you can't cope … "

BACKGROUND

This study sought to explore the effects of preservice teachers' contact with children with intellectual disabilities on their attitudes. The study was conducted against the backdrop of the exclusion and discrimination experienced by children with intellectual disabilities in Ghanaian schools.

METHOD

Twenty-two preservice teachers who interned at a special school for children with intellectual disabilities were interviewed before and after their practicums, and the gathered data underwent thematic analysis.

RESULTS

There were changes in the participants' knowledge and willingness to interact and work with children with intellectual disabilities. For instance, before the practicum, the participants held stereotypical understandings of intellectual disabilities. However, after their practicums, their level of discussion of the core characteristics of intellectual disabilities had improved.

CONCLUSION

Based on these findings, this study concludes by recommending that contact with children with intellectual disabilities be included as an integral part of preservice teacher training programmes.

Contrasting neurofunctional correlates of face- and visuospatial-processing in children and adolescents with Williams syndrome: convergent results from four fMRI paradigms

Understanding neurogenetic mechanisms underlying neuropsychiatric disorders such as schizophrenia and autism is complicated by their inherent clinical and genetic heterogeneity. Williams syndrome (WS), a rare neurodevelopmental condition in which both the genetic alteration (hemideletion of ~ twenty-six 7q11.23 genes) and the cognitive/behavioral profile are well-defined, offers an invaluable opportunity to delineate gene-brain-behavior relationships. People with WS are characterized by increased social drive, including particular interest in faces, together with hallmark difficulty in visuospatial processing. Prior work, primarily in adults with WS, has searched for neural correlates of these characteristics, with reports of altered fusiform gyrus function while viewing socioemotional stimuli such as faces, along with hypoactivation of the intraparietal sulcus during visuospatial processing. Here, we investigated neural function in children and adolescents with WS by using four separate fMRI paradigms, two that probe each of these two cognitive/behavioral domains. During the two visuospatial tasks, but not during the two face processing tasks, we found bilateral intraparietal sulcus hypoactivation in WS. In contrast, during both face processing tasks, but not during the visuospatial tasks, we found fusiform hyperactivation. These data not only demonstrate that previous findings in adults with WS are also present in childhood and adolescence, but also provide a clear example that genetic mechanisms can bias neural circuit function, thereby affecting behavioral traits.

Evaluating the challenges and needs of parents caring for children with Williams syndrome: A preliminary study from Poland

BACKGROUND

Although physical, cognitive and behavioural manifestations of Williams syndrome (WS) affect every dimension of caregivers lives, no studies on the parental experiences of caring for a WS child have to date been carried out in Poland.

METHODS

In order to identify the challenges and needs of Polish carers of WS children a survey was conducted with 32 family caregivers who were supported by the Polish Williams Syndrome Association.

RESULTS

While caregivers were mostly challenged by their WS child's behaviours, health problems and mood swings, many parents experienced fatigue, intimacy problems with the partner and deterioration of mental health. They were also burdened by the lack of time for themselves and work restrictions resulting from caregiving responsibilities. Even though parents positively assessed quality of medical care for WS children, still many expressed their dissatisfaction both with the way the healthcare system for WS children works in Poland and complained about the doctors' lack of knowledge about WS, access to specialist care and lack of support from government and social institutions. Although many parents stressed positive impact of rising WS child, more than half experienced role captivity or role overload and felt not being understood by others. They also experienced variety of distressing emotions, including impatience, emotional lability, helplessness, anxiety and depression.

CONCLUSIONS

Although many WS parents stressed the affirmative aspect of raising WS child this research shows that the burden of caring for such a child goes far beyond clinical aspects and seriously affects every aspect of parents' lives, including their mental health, daily lives, family, their professional and social lives. Because apart from the daily challenges related to caring for a WS child, parents' dealings with the healthcare system and support services represent major problems there is a the need for a bio-psychosocial approach to WS that should include not only WS children, but also their caregivers. WHAT THIS PAPER ADDS?: 1. It analyses the challenges and needs of parents caring for children with Williams syndrome; 2. It provides evidence that the impact of caring for WS children goes far beyond clinical aspects and seriously affects every aspect of parents' lives, including their mental health, daily lives, family, their professional and social lives; 3. It also shows that, apart from the daily challenges related to caring for a WS child, parents' dealings with the healthcare system and support services represent major problems. 4. Thereby, it highlights the importance of incorporating a bio-psychosocial approach to WS that should include not only WS children, but also their caregivers.

Neuropsychological Genotype-Phenotype in Patients with Williams Syndrome with Atypical Deletions: A Systematic Review

Williams syndrome (WS) is a neurodevelopmental disorder caused by a microdeletion in the q11.23 region of chromosome 7. Recent case series reports and clinical case studies have suggested that the cognitive, behavioral, emotional, and social profile in WS could depend on the genes involved in the deletion. The objective of this systematic review was to analyze and synthesize the variability of the cognitive and behavioral profile of WS with atypical deletion and its probable relationship with the affected genes. The medical subject headings searched were "Williams syndrome," "genotype," "phenotype," "cognitive profile," and "atypical deletion." The studies included were in English or Spanish, with children and adults, and published between January 2000 and October 2022. Twenty-three studies are reported. The characteristics of the participants, the genes involved, the neuropsychological domains and instruments, and the prevalence of the WS cognitive profile criteria were used for the genotype-phenotype analysis. The genes with a major impact on the cognitive profile of WS were (a) LIMK1 and those belonging to the GTF2I family, the former with a greater influence on visuospatial abilities; (b) GTF2IRD1 and GTF2I, which have an impact on intellectual capacity as well as on visuospatial and social skills; (c) FZD9, BAZ1B, STX1A, and CLIP2, which influence the cognitive profile if other genes are also effected; and (d) GTF2IRD2, which is related to the severity of the effect on visuospatial and social skills, producing a behavioral phenotype like that of the autism spectrum. The review revealed four neuropsychological phenotypes, depending on the genes involved, and established the need for more comprehensive study of the neuropsychological profile of these patients. Based on the results found, we propose a model for the investigation of and clinical approach to the WS neuropsychological phenotype.

Longitudinal Predictors of Word Reading for Children with Williams Syndrome

We examined the cognitive, language, and instructional predictors of early word-reading ability in a sample of children with Williams syndrome longitudinally. At Time 1, sixty-nine 6-7-year-olds (mean age = 6.53 years) completed standardized measures of phonological awareness, visual-spatial perception, vocabulary, and overall intellectual ability. Word-reading instruction type was classified as (systematic) Phonics (n = 35) or Other (n = 34). At Time 2, approximately three years later (mean age = 9.47 years), children completed a standardized assessment of single-word reading ability. Reading ability at Time 2 varied considerably, from inability to read any words to word-reading ability slightly above the level expected for age. The results of a multiple regression indicated that Time 1 word-reading instruction type, phonological awareness, and visual-spatial perception (as assessed by a matching letter-like forms measure) each explained significant unique variance in word reading at Time 2. A systematic phonics approach was associated with significantly better performance than other reading-instruction approaches. Exploratory analyses suggested that the relations between these factors were complex. Considered together, these findings strongly suggest that, in line with the Cumulative Risk and Resilience Model of reading disability, word-reading (dis)ability in Williams syndrome is probabilistic in nature, resulting from the interaction of multiple individual and environmental risk and protective factors. The results also have educational implications: Early word-reading instruction for children with Williams syndrome should combine systematic phonics and phonological awareness training while also incorporating letter discrimination instruction highlighting the visual-spatial differences between similar-appearing letters.

Multisensory Texture Perception in Individuals with Williams Syndrome

The sensory profile of people with Williams syndrome (WS) is characterised by atypical visual and auditory perceptions that affect their daily lives and learning. However, no research has been carried out on the haptic perception, in particular in multisensory (visual and haptic) situations. The aim of this study was to evaluate the communication of texture information from one modality to the other in people with WS. Children and adults with WS were included, as well as typically developing (TD) participants matched on chronological age (TD-CA), and TD children matched on mental age (TD-MA). All participants (N = 69) completed three matching tasks in which they had to compare two fabrics (same or different): visual, haptic and visuo-haptic. When the textures were different, the haptic and visual performances of people with WS were similar to those of TD-MA participants. Moreover, their visuo-haptic performances were lower than those of the two TD groups. These results suggest a delay in the acquisition of multisensory transfer abilities in individuals with WS. A positive link between MA and visual and visuo-haptic abilities only in people with WS suggests that they could benefit from an early intervention to develop their abilities to process and transfer multisensory information.

Factorial Validity of the German KABC-II at Ages 7 to 12 in a Clinical Sample: Four Factors Fit Better than Five

Multidimensional intelligence test batteries such as the KABC-II are widely used in clinical practice. Although validity evidence should be provided for all intended uses of a test, data on the factorial validity of the KABC-II mostly relies on the standardization samples and raises some concerns about the adequacy of the factor structure. Confirmatory factor analyses of the KABC-II core subtests were conducted in a sample of 627 children who had been assessed in German Centers for Social Pediatrics. The standard structure of the KABC-II was superior to unidimensional models but, as in previous research, evidenced cross-loadings and a high correlation between Planning/Gf and Simultaneous/Gv. Pattern Reasoning was more closely related to Simultaneous/Gv than to Planning/Gf. A four-factorial structure combining subtests from Planning/Gf and Simultaneous/Gv to form a common factor emerged as a better representation of the data. Story Completion showed a secondary loading on Knowledge/Gc. On average, most subtest variance was accounted for by the general factor. Models with bonus points for fast responses generally fitted worse than those without. Clinicians should be aware that Planning/Gf and Simultaneous/Gv measure both visual and fluid abilities. Scales of the KABC-II should not be interpreted as dimensions independent of the general factor.

In individuals with Williams syndrome, dysregulation of methylation in non-coding regions of neuronal and oligodendrocyte DNA is associated with pathology and cortical development

Williams syndrome (WS) is a neurodevelopmental disorder caused by a heterozygous micro-deletion in the WS critical region (WSCR) and is characterized by hyper-sociability and neurocognitive abnormalities. Nonetheless, whether and to what extent WSCR deletion leads to epigenetic modifications in the brain and induces pathological outcomes remains largely unknown. By examining DNA methylation in frontal cortex, we revealed genome-wide disruption in the methylome of individuals with WS, as compared to typically developed (TD) controls. Surprisingly, differentially methylated sites were predominantly annotated as introns and intergenic loci and were found to be highly enriched around binding sites for transcription factors that regulate neuronal development, plasticity and cognition. Moreover, by utilizing enhancer-promoter interactome data, we confirmed that most of these loci function as active enhancers in the human brain or as target genes of transcriptional networks associated with myelination, oligodendrocyte (OL) differentiation, cognition and social behavior. Cell type-specific methylation analysis revealed aberrant patterns in the methylation of active enhancers in neurons and OLs, and important neuron-glia interactions that might be impaired in individuals with WS. Finally, comparison of methylation profiles from blood samples of individuals with WS and healthy controls, along with other data collected in this study, identified putative targets of endophenotypes associated with WS, which can be used to define brain-risk loci for WS outside the WSCR locus, as well as for other associated pathologies. In conclusion, our study illuminates the brain methylome landscape of individuals with WS and sheds light on how these aberrations might be involved in social behavior and physiological abnormalities. By extension, these results may lead to better diagnostics and more refined therapeutic targets for WS.

Williams syndrome

Williams syndrome (WS) is a relatively rare microdeletion disorder that occurs in as many as 1:7,500 individuals. WS arises due to the mispairing of low-copy DNA repetitive elements at meiosis. The deletion size is similar across most individuals with WS and leads to the loss of one copy of 25-27 genes on chromosome 7q11.23. The resulting unique disorder affects multiple systems, with cardinal features including but not limited to cardiovascular disease (characteristically stenosis of the great arteries and most notably supravalvar aortic stenosis), a distinctive craniofacial appearance, and a specific cognitive and behavioural profile that includes intellectual disability and hypersociability. Genotype-phenotype evidence is strongest for ELN, the gene encoding elastin, which is responsible for the vascular and connective tissue features of WS, and for the transcription factor genes GTF2I and GTF2IRD1, which are known to affect intellectual ability, social functioning and anxiety. Mounting evidence also ascribes phenotypic consequences to the deletion of BAZ1B, LIMK1, STX1A and MLXIPL, but more work is needed to understand the mechanism by which these deletions contribute to clinical outcomes. The age of diagnosis has fallen in regions of the world where technological advances, such as chromosomal microarray, enable clinicians to make the diagnosis of WS without formally suspecting it, allowing earlier intervention by medical and developmental specialists. Phenotypic variability is considerable for all cardinal features of WS but the specific sources of this variability remain unknown. Further investigation to identify the factors responsible for these differences may lead to mechanism-based rather than symptom-based therapies and should therefore be a high research priority.