Executive function and intellectual disability: innovations, methods and treatment

Exploration of a somatosensory interactive assessment tool for children with intellectual disabilities

Based on the functional assessment concept and embodied assessment requirements, the present study aimed to design and develop an assessment tool for children with intellectual disabilities with the help of somatosensory interactive (SI) technology. The sample in this study consisted of 73 children with intellectual disabilities and 70 children with typical development. Data were collected through three SI tasks, four traditional executive function tasks, and user experience interviews to analyse the effectiveness of the SI assessment tool. The results showed that the SI assessment tool had good scale validity, discriminant validity, and the ability to identify intellectual disabilities. Children preferred SI tasks and showed higher involvement and more positive emotions. The SI tool with three SI tasks is a more scientific, effective, and advanced tool for assessing children with intellectual disabilities.

Impact of VR-Based Cognitive Training on Working Memory and Inhibitory Control in IDD Young Adults

BACKGROUND

Young people with intellectual developmental disabilities have a persistent delay in the development of executive functions. Virtual reality (VR) is increasingly being used as a cognitive intervention tool, with significant effectiveness demonstrated in different types of populations.

METHODS

This pilot study aims to investigate the impact of a cognitive training program utilizing VR on young adults diagnosed with intellectual developmental disabilities (IDDs). The participants (N = 15) served as their own control group and were assessed three times: weeks 0, 8, and 16, with a rest period (0-8 weeks) and an intervention period (8-16 weeks). The assessments included measures of cognitive function provided by E-Prime® (Version 3).

RESULTS

Overall, an improvement in working memory and inhibitory control was found after the intervention, but not in sustained attention.

CONCLUSIONS

These findings suggest that VR-based cognitive training holds promise as an effective intervention for enhancing cognitive abilities in young adults with intellectual developmental disabilities. This study provides a foundation for future investigations into VR's role in cognitive rehabilitation and its potential to support daily living skills and overall quality of life for individuals with IDDs. Further research is needed to explore the long-term effects and broader applicability of VR interventions.

A personal narrative intervention combined with self-monitoring strategies: Outcomes for Mandarin-speaking adolescents with Down syndrome

BACKGROUND

Personal narratives play an essential role in children's social and academic development. However, children with Down syndrome have ongoing challenges with constructing and communicating personal narratives.

METHODS

Using a single-case multiple-probe across participants design, we examined whether a targeted intervention could improve both micro- and macro-structural aspects of personal narratives from Chinese adolescents with Down syndrome.

RESULTS

All three participants demonstrated high treatment effects in two macrostructural narrative outcomes (i.e., narrative element complexity and narrative coherence) in response to the intervention and moderate to high treatment effects in the microstructural narrative outcomes (i.e., the mean length of utterance in words and the number of different words). However, all participants demonstrated limited improvements in narrative cohesion. These effects were maintained and generalised in a different narrative condition.

CONCLUSIONS

The preliminary findings support the feasibility and effectiveness of the personal narrative intervention incorporated with self-monitoring strategies for adolescents with Down syndrome.

The influence of cognitive load and vision variability on postural balance in adolescents with intellectual disabilities

Introduction

This study aimed to investigate the impact of cognitive load, particularly its escalation during the execution of the same test, under varying vision conditions, on postural balance among adolescents with intellectual disability (ID).

Methods

Twenty adolescents underwent balance assessments under different visual conditions (Open Eyes (OE), Closed Eyes (CE), Flash, Goggles, Visual Stimulation (VS)) and task settings (Single Task (ST), Dual Task (DT) without challenges, and DT with challenges). The cognitive test was assessed using Verbal Fluency (VF).

Results and discussion

Significant effects were found for Task (p < 0.001, ηp2 = 0.85), indicating that CoP values significantly increased (p < 0.05) with the introduction of the DT. Dual Task Cost (DTC) demonstrated significant effects for Vision (p = 0.008, ηp2 = 0.62), with values varying significantly (p < 0.05) among different vision conditions, especially in CE and Flash conditions. Visual Dependency Quotient (VDQ) analyses revealed significant effects of condition (p < 0.001, ηp2 = 0.84), with significant changes observed in CE/OE and Flash/OE conditions (p < 0.05). Significant effects were observed for Cognitive performance in the Challenge condition (p < 0.001, ηp2 = 0.86), with decreased performance with cognitive task challenges, particularly in Flash and Goggles conditions (p < 0.05). In conclusion, cognitive tasks, especially challenging ones, and visual variations significantly impact postural balance in adolescents with ID.

COVID-19 pandemic among adults with intellectual disabilities: Implementing a social model of disability in crisis and trauma situations

A growing body of evidence has attested to the higher impact of COVID-19 on individuals with intellectual disabilities (IDs) than on members of the general population during the pandemic, mainly showing their higher vulnerability. However, we believe it is important to better understand how their situation interacts with the specific circumstances of the pandemic. In this article we discuss recent findings regarding individuals with IDs through the lens of two theories - the social disability model and the ecological model of trauma and recovery - and propose an integration, namely a social model of disability in crisis and trauma situations. Such a model allows for a wider perspective on understanding the way people living with disabilities (PLWDs) cope in these situations, integrating the individual aspects of coping with the social and environmental ones.

Cognitive flexibility assessment in youth with Down syndrome: Reliability, practice effects, and validity

BACKGROUND

Cognitive flexibility refers to the ability to switch between different mental sets, tasks, or strategies and is challenging for some individuals with Down syndrome (DS). The lack of reliable and valid cognitive flexibility measures for individuals with DS is a major barrier to clinical trials and intervention studies designed to address cognitive challenges specific to DS. To avoid measurement limitations that could confound interpretations of performance in clinical trials in children with DS, it is critical to use phenotype-sensitive and psychometrically sound measures of cognitive flexibility.

AIM

This study aimed to evaluate the psychometric properties of three measures of cognitive flexibility including Rule-Shift, Weigl Sorting, and KiTAP Flexibility in a sample of 97 youth with DS aged 6-17 years old.

METHOD

Data were collected at two time points with a two-week interval. Parents also completed adaptive behavior and cognitive flexibility questionnaires. Child cognitive and language abilities were also assessed.

RESULTS

The Weigl Sorting met the most psychometric criteria, with adequate feasibility (≥ 80 %) and significant correlations with most of the broader developmental domains; however, the levels of test-retest reliability, practice effects, and convergent validity did not meet a priori criteria. Rule-Shift and KiTAP Flexibility measures did not have acceptable feasibility; although sensitivity and specificity analyses revealed that Rule-Shift may be appropriate for a subgroup of the participants.

CONCLUSION

No evaluated measures met all psychometric study criteria and, therefore, additional evaluation of cognitive flexibility measures is needed for use among individuals with DS.

Acute effects of aerobic versus resistance exercises on cognitive function in individuals with intellectual disability

BACKGROUND

This study compared the acute effects of aerobic (AE) and resistance (RE) exercise on reaction time (RT) and working memory (WM) in individuals with intellectual disability.

METHODS

RT tests and Corsi test for WM were performed before and after three intervention sessions: AE, RE, or control session consisting on watching video.

RESULTS

The RT values decreased significantly (p < .001) after both of AE and RE with higher extend after the RE but did not vary following the control session. Corsi scores increased significantly (p < .001) after AE but not after RE or control session.

CONCLUSIONS

These findings suggest that the effects of acute exercise on cognitive function in individuals with intellectual disability depend on the exercise mode as well as the nature of the cognitive task. The RE seems to be more recommended for RT enhancement whereas only the aerobic one could improve WM in these individuals.

Profiles of Caregiver-Reported Executive Function in Children with Down Syndrome

Children with Down syndrome (DS) are at risk for challenges with aspects of executive function (EF). The current study explores whether heterogeneity in EF profiles can be detected within a sample of children with DS. Participants were 69 children with DS, ages 3-10 years (M = 6.23, SD = 1.91). T-scores from a caregiver-report measure of executive function were modeled using latent profile analysis, and auxiliary analyses examined the association between demographic and biomedical factors and probability of profile membership. The two-profile solution was the best fit for the sample, with a profile that involved elevated scores in working memory only ("Working Memory Only" profile; 43% of sample) and a "Multi-Domain" profile that involved elevated scores in planning, inhibition, and working memory (57%). The presence of congenital heart defects was associated with a higher probability of assignment to the Multi-Domain profile. Findings from this study contribute to the characterization of heterogeneous outcomes associated with DS.