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Thurman AJ, Nunnally AD, Nguyen V, Berry-Kravis E, Sterling A, Edgin J, Hamilton D, Aschkenasy J, Abbeduto L. Short-term and Long-term Stability of the Autism Diagnostic Observation Schedule (ADOS-2) Calibrated Comparison Scores (CCS) and Classification Scores in Youth with Down Syndrome or Fragile X Syndrome with Intellectual Disability. J Autism Dev Disord 2024:10.1007/s10803-024-06535-8. [PMID: 39251531 DOI: 10.1007/s10803-024-06535-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2024] [Indexed: 09/11/2024]
Abstract
Autism diagnosis in individuals with fragile X syndrome (FXS) or Down syndrome (DS) with co-occurring intellectual disability is complex since clinicians often must consider other co-occurring behavioral features. Understanding how best to assess the features of autism in individuals with these conditions is crucial. In this study, we consider the short-term and long-term psychometric consistency of the Autism Diagnostic Observation Schedule-2 (ADOS-2) calibrated comparison scores (CCSs) and ASD classifications in individuals with FXS or DS. 76 individuals with DS (39 males; Mage = 15.27) and 90 individuals with FXS (71 males; Mage = 14.52 years) completed an assessment battery (ADOS-2, abbreviated IQ assessment and semi-structured language sample) at three timepoints (initial visit, short-term stability visit, long-term stability visit). All CCSs were found to have short-and long-term consistency for both groups, with lowest reliability scores for the repetitive behaviors (RRB) CCSs. Decreased reliability of RRB CCSs was found in the DS group than the FXS group. Variable short- and long-term ASD classifications were observed in both groups, with significantly higher variability in the DS group. Across groups, participants with variable classifications had lower ADOS-2 CCSs and higher language scores than those with stable ASD classifications. In the FXS group, those with variable classifications earned higher cognitive scores than did participants with stable ASD classifications. These findings highlight the high incidence of autism symptomatology in individuals with DS or FXS and co-occurring intellectual disability, while elucidating the short- and long-term variability of symptom expression in the context of structured observational tasks such as the ADOS-2.
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Affiliation(s)
- Angela John Thurman
- MIND Institute, University of California, Davis, 2825 50th Street, Room 2335, Sacramento, CA, 95817, USA.
- Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, Sacramento, USA.
| | - Amanda Dimachkie Nunnally
- MIND Institute, University of California, Davis, 2825 50th Street, Room 2335, Sacramento, CA, 95817, USA
- Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, Sacramento, USA
| | - Vivian Nguyen
- MIND Institute, University of California, Davis, 2825 50th Street, Room 2335, Sacramento, CA, 95817, USA
- Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, Sacramento, USA
| | - Elizabeth Berry-Kravis
- Departments of Pediatrics, Neurological Sciences and Anatomy and Cell Biology, Rush University Medical Center, Chicago, USA
| | - Audra Sterling
- Waisman Center and Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, USA
| | - Jamie Edgin
- Department of Psychology, Virginia Tech, Blacksburg, USA
| | - Debra Hamilton
- Department of Human Genetics, Emory University, Atlanta, USA
| | | | - Leonard Abbeduto
- MIND Institute, University of California, Davis, 2825 50th Street, Room 2335, Sacramento, CA, 95817, USA
- Department of Psychiatry and Behavioral Sciences, University of California Davis Medical Center, Sacramento, USA
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Schworer EK, Esbensen AJ, Nguyen V, Bullard L, Fidler DJ, Daunhauer LA, Mervis CB, Becerra AM, Abbeduto L, Thurman AJ. Patterns and predictors of adaptive skills in 2- to 7-year-old children with Down syndrome. J Neurodev Disord 2022; 14:18. [PMID: 35279072 PMCID: PMC8918277 DOI: 10.1186/s11689-022-09430-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 02/23/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There is substantial variability in adaptive skills among individuals with Down syndrome. Few studies, however, have focused on the early developmental period or on the potential sources of variability in adaptive skills. This study characterizes adaptive skills in young children with Down syndrome and investigates child characteristics associated with adaptive skills.
Methods
Participants were 44 children with Down syndrome ranging in age from 2.50 to 7.99 years (M = 4.66 years, SD = 1.46). The Vineland Adaptive Behavior Scales-3 (VABS-3) Comprehensive Interview Form was used to assess adaptive behavior in the three core domains: socialization, daily living, and communication skills. Caregivers also reported on motor skills and autism spectrum disorder symptoms. Child cognitive abilities were assessed.
Results
Analyses comparing mean standard score performance across the three VABS-3 core domains demonstrated significant differences between all pairs of domains, resulting in a group-level pattern of socialization > daily living > communication skills. At the individual level, 10 different patterns of relative strength and weakness were identified, with only 18% of participants evidencing significant differences between adaptive skill domain standard scores corresponding to the group-level pattern of significant differences. Child characteristics (cognitive abilities, motor skills, and autism spectrum disorder symptoms) were significantly associated with VABS-3 adaptive domain standard scores.
Conclusion
These findings underscore the importance of individualizing intervention programs focused on improving the adaptive skills of young children with Down syndrome based on consideration of the child’s relative adaptive strengths and weaknesses.
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Krause L, Askew C. Preventing and reducing fear using positive modelling: A systematic review of experimental research with children. Behav Res Ther 2021; 148:103992. [PMID: 34837839 DOI: 10.1016/j.brat.2021.103992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/11/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
Fear of specific stimuli is thought to develop through associative learning mechanisms and research indicates that a form of observational (vicarious) learning known as positive modelling can counter these effects. This systematic review examined and synthesised the experimental positive modelling literature to establish its efficacy for reducing fear. Psych Info, Medline and the Psychology and Behavioural Science Collection databases were systematically searched until August 2021. Of the 1,677 papers identified, 18 experiments across 14 articles met the inclusion criteria. In the majority of these, positive modelling was found to lower fear levels in one or more of three procedures: fear prevention, fear reduction and fear reversal. Procedures inform prevention and treatment initiatives for specific phobias in several ways. The overall efficacy of positive modelling techniques and the ease in which they can be implemented highlight the importance of further research to evaluate their inclusion in prevention and treatment interventions. More research is required to establish the longevity and transferability of positive modelling.
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Affiliation(s)
- Litza Krause
- School of Psychology, University of Surrey, United Kingdom
| | - Chris Askew
- School of Psychology, University of Surrey, United Kingdom.
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Dimachkie Nunnally A, Nguyen V, Anglo C, Sterling A, Edgin J, Sherman S, Berry-Kravis E, del Hoyo Soriano L, Abbeduto L, Thurman AJ. Symptoms of Autism Spectrum Disorder in Individuals with Down Syndrome. Brain Sci 2021; 11:1278. [PMID: 34679343 PMCID: PMC8533848 DOI: 10.3390/brainsci11101278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022] Open
Abstract
There is a growing body of evidence to suggest that individuals with Down syndrome (DS) are diagnosed with autism spectrum disorders (ASD) at a higher rate than individuals in the general population. Nonetheless, little is known regarding the unique presentation of ASD symptoms in DS. The current study aims to explore the prevalence and profiles of ASD symptoms in a sample of individuals with DS (n = 83), aged between 6 and 23 years. Analysis of this sample (MAge = 15.13) revealed that approximately 37% of the sample met the classification cut-off for ASD using the Autism Diagnostic Observation Schedule 2 (ADOS-2) Calibrated Severity Score (CSS), an indicator of the participants' severity of ASD-related symptoms. Item-level analyses revealed that multiple items on Module 2 and Module 3 of the ADOS-2, mostly in the Social Affect (SA) subdomain, differentiated the children with DS who did not meet ASD classification (DS-only) from those who did (DS + ASD). Lastly, comparisons of individuals with DS-only and those with DS + ASD differed significantly on the syntactic complexity of their expressive language. These findings shed light on the unique presentation of ASD symptoms in a sample of individuals with DS and suggest that expressive language abilities may play a pivotal role in the presentation of ASD symptoms in DS.
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Affiliation(s)
- Amanda Dimachkie Nunnally
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95816, USA; (V.N.); (C.A.); (L.d.H.S.); (L.A.); (A.J.T.)
| | - Vivian Nguyen
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95816, USA; (V.N.); (C.A.); (L.d.H.S.); (L.A.); (A.J.T.)
| | - Claudine Anglo
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95816, USA; (V.N.); (C.A.); (L.d.H.S.); (L.A.); (A.J.T.)
| | - Audra Sterling
- Waisman Center and Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI 53706, USA;
| | - Jamie Edgin
- Department of Psychology, University of Arizona, Tucson, AZ 85721, USA;
| | - Stephanie Sherman
- Department of Human Genetics, School of Medicine, Emory University, Atlanta, GA 30322, USA;
| | - Elizabeth Berry-Kravis
- Departments of Pediatrics, Neurological Sciences and Biochemistry, Rush University Medical Center, Chicago, IL 60612, USA;
| | - Laura del Hoyo Soriano
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95816, USA; (V.N.); (C.A.); (L.d.H.S.); (L.A.); (A.J.T.)
| | - Leonard Abbeduto
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95816, USA; (V.N.); (C.A.); (L.d.H.S.); (L.A.); (A.J.T.)
- Department of Psychiatry and Behavioral Sciences, University of California, Davis Health, Sacramento, CA 95817, USA
| | - Angela John Thurman
- MIND Institute, University of California Davis Health, 2825 50th Street, Sacramento, CA 95816, USA; (V.N.); (C.A.); (L.d.H.S.); (L.A.); (A.J.T.)
- Department of Psychiatry and Behavioral Sciences, University of California, Davis Health, Sacramento, CA 95817, USA
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Ha OR, Cashon CH, Holt NA, Mervis CB. Development of rapid word-object associations in relation to expressive vocabulary: Shared commonalities in infants and toddlers with and without Williams syndrome. Dev Sci 2020; 23:e12966. [PMID: 32196857 PMCID: PMC7502509 DOI: 10.1111/desc.12966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 11/14/2019] [Accepted: 03/09/2020] [Indexed: 11/29/2022]
Abstract
Associative word learning, i.e., associating a word with an object, is an important building block of early word learning for TD infants. This study investigated the development of word-object associations by TD infants and infants and toddlers with Williams syndrome (WS), a rare genetic disorder associated with delayed language and cognitive development. The specific reasons for the language delays remain unknown. We investigated whether their early language delay could be related to differences in how word-object associations are formed. Fifty-nine 11- to 14-month-old TD infants and thirty-one 12- to 35-month-olds with WS were tested on a modified version of the "switch" task (Werker, Cohen, Lloyd, Casasola, & Stager, 1998) using phonetically dissimilar words and novel objects. Infants were classified as word learners or novice word learners based on their expressive vocabularies (greater than 10 words vs. 10 words or fewer). We found similar developmental patterns across both populations: Expressive vocabulary size classification was an important index of the development of word-object associations. Moreover, the development of word-object associations evidenced a domain-general progression from independent (processing objects separately from words) to integrated (processing associations between words and objects). As a group, word learners formed word-object associations, but novice word learners did not; instead, they focused primarily on the objects. Findings build on previous research suggesting that although early language acquisition is delayed in infants with WS, infants and toddlers with and without WS share a common developmental pattern and set of mechanisms in early word learning.
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Affiliation(s)
- Oh-Ryeong Ha
- Department of Psychology, University of Missouri-Kansas City
| | - Cara H. Cashon
- Department of Psychological and Brain Sciences, University of Louisville
| | - Nicholas A. Holt
- Department of Psychological and Brain Sciences, University of Louisville
| | - Carolyn B. Mervis
- Department of Psychological and Brain Sciences, University of Louisville
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Autism Spectrum Symptomatology in Children with Williams Syndrome Who Have Phrase Speech or Fluent Language. J Autism Dev Disord 2019; 48:3037-3050. [PMID: 29671106 DOI: 10.1007/s10803-018-3555-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
To characterize autism spectrum-related symptomatology in children with Williams syndrome (WS) with phrase speech or fluent language, the Autism Diagnostic Observation Schedule Module 2 or 3 was administered. The cutoff for autism spectrum was met by 35% (14/40) who completed Module 2 and 30% (18/60) who completed Module 3. Similarities and differences in socio-communicative strengths and weaknesses as a function of language ability were identified. Symptom severity was negatively associated with IQ for participants with phrase speech but not for those with fluent language. The findings suggest an elevated risk of ASD for individuals with WS relative to the general population and contribute to a more nuanced sense of the socio-communicative functioning of children with WS.
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Hahn LJ, Loveall SJ, Savoy MT, Neumann AM, Ikuta T. Joint attention in Down syndrome: A meta-analysis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 78:89-102. [PMID: 29793102 PMCID: PMC5995577 DOI: 10.1016/j.ridd.2018.03.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 03/27/2018] [Accepted: 03/29/2018] [Indexed: 05/16/2023]
Abstract
BACKGROUND Some studies have indicated that joint attention may be a relative strength in Down syndrome (DS), but other studies have not. AIM To conduct a meta-analysis of joint attention in DS to more conclusively determine if this is a relative strength or weakness when compared to children with typical development (TD), developmental disabilities (DD), and autism spectrum disorder (ASD). METHODS AND PROCEDURES Journal articles published before September 13, 2016, were identified by using the search terms "Down syndrome" and "joint attention" or "coordinating attention". Identified studies were reviewed and coded for inclusion criteria, descriptive information, and outcome variables. OUTCOMES AND RESULTS Eleven studies (553 participants) met inclusion criteria. Children with DS showed similar joint attention as TD children and higher joint attention than children with DD and ASD. Meta-regression revealed a significant association between age and joint attention effect sizes in the DS vs. TD contrast. CONCLUSIONS AND IMPLICATIONS Joint attention appears to not be a weakness for children with DS, but may be commensurate with developmental level. Joint attention may be a relative strength in comparison to other skills associated with the DS behavioral phenotype. Early interventions for children with DS may benefit from leveraging joint attention skills.
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Affiliation(s)
- Laura J Hahn
- University of Illinois at Urbana-Champaign, Department of Speech & Hearing Science, 901 South Sixth St. MC-482, Champaign, IL, 61820, United States.
| | - Susan J Loveall
- University of Mississippi, Department of Communication Sciences & Disorders, 100 George Hall, P.O. Box 1848, University, MS, 386 77, United States.
| | - Madison T Savoy
- University of Mississippi, Department of Communication Sciences & Disorders, 100 George Hall, P.O. Box 1848, University, MS, 386 77, United States.
| | - Allie M Neumann
- University of Illinois at Urbana-Champaign, Department of Speech & Hearing Science, 901 South Sixth St. MC-482, Champaign, IL, 61820, United States.
| | - Toshikazu Ikuta
- University of Mississippi, Department of Communication Sciences & Disorders, 100 George Hall, P.O. Box 1848, University, MS, 386 77, United States.
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Cebula KR, Wishart JG, Willis DS, Pitcairn TK. Emotion Recognition in Children With Down Syndrome: Influence of Emotion Label and Expression Intensity. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2017; 122:138-155. [PMID: 28257244 DOI: 10.1352/1944-7558-122.2.138] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Some children with Down syndrome may experience difficulties in recognizing facial emotions, particularly fear, but it is not clear why, nor how such skills can best be facilitated. Using a photo-matching task, emotion recognition was tested in children with Down syndrome, children with nonspecific intellectual disability and cognitively matched, typically developing children (all groups N = 21) under four conditions: veridical vs. exaggerated emotions and emotion-labelling vs. generic task instructions. In all groups, exaggerating emotions facilitated recognition accuracy and speed, with emotion labelling facilitating recognition accuracy. Overall accuracy and speed did not differ in the children with Down syndrome, although recognition of fear was poorer than in the typically developing children and unrelated to emotion label use. Implications for interventions are considered.
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Affiliation(s)
- Katie R Cebula
- Katie R. Cebula, University of Edinburgh, School of Education
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Lamônica DAC, Ferreira-Vasques AT. Habilidades comunicativas e lexicais de crianças com Síndrome de Down: reflexões para inclusão escolar. REVISTA CEFAC 2015. [DOI: 10.1590/1982-021620151756015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo: OBJETIVO: verificar o desempenho comunicativo e lexical expressivo de crianças com Síndrome de Down e refletir sobre como a compreensão de fatores interferentes no processo de aprendizagem pode contribuir para uma melhor adaptação dessas crianças no ambiente escolar. MÉTODOS: a amostra proposta foi de 60 crianças, porém, após análise dos critérios de inclusão, participaram 20 crianças, 10 com Síndrome de Down e 10 com neurodesenvolvimento típico, de idade entre 36 a 62 meses, pareadas quanto ao gênero, idade cronológica e nível socioeconômico. Procedimentos: entrevista com familiares, Observação do Comportamento Comunicativo e Teste de Linguagem Infantil ABFW-Vocabulário Parte B. A análise dos dados foi realizada por meio de estatística descritiva e aplicação do Teste "t" Student (p≤ 0,05). RESULTADOS: indicaram diferença estatisticamente significante para produção de palavras e frases, narrativa, tempo de atenção, designação verbal usual e não designação. Para processos de substituição a análise estatística não acusou diferença estatisticamente significante. Apenas para profissões e locais, nesta categoria, houve diferença estatisticamente significante entre os grupos. Como são avaliados nove campos conceituais, este dado não interferiu na análise estatística da somatória dos valores de todos os campos. CONCLUSÃO: o desempenho comunicativo e lexical expressivo de crianças com Síndrome de Down é inferior quando comparado com crianças com neurodesenvolvimento típico. A escola tem importante papel em proporcionar um ambiente estimulador, por meio de práticas pedagógicas adequadas às necessidades de aprendizagem destas crianças.
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