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Del Hoyo Soriano L, Sterling A, Edgin J, Hamilton DR, Berry-Kravis E, Dimachkie Nunnally A, Thurman AJ, Abbeduto L. Associations Among Sex, Cognitive Ability, and Autism Symptoms in Individuals with Down Syndrome. J Autism Dev Disord 2024; 54:301-311. [PMID: 36315322 PMCID: PMC10184887 DOI: 10.1007/s10803-022-05779-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2022] [Indexed: 11/07/2022]
Abstract
This study explores sex-differences in (a) rates and profiles of autism symptoms as well as in (b) the contribution of intellectual quotient (IQ) to autism symptom presentation in Down syndrome (DS). Participants were 40 males and 38 females with DS, aged 6 to 23 years. Autism symptoms were rated through the Autism Diagnostic Observation Schedule-Second Edition (ADOS-2). Results show no sex differences in the ADOS-2 Calibrated Severity Scores (CSS). However, only females with DS who are classified as DS-Only have higher scores on verbal IQ than those classified as DS + autism. Furthermore, associations between IQ and all CSSs are found for females, but not for males. Findings suggest that verbal cognition may play differential roles for females and males with DS.
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Affiliation(s)
- Laura Del Hoyo Soriano
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, USA.
- Department of Psychiatry and Behavioral Sciences, University of California, Davis Health, Sacramento, CA, USA.
| | - Audra Sterling
- Waisman Center, Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA
| | - Jamie Edgin
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Debra R Hamilton
- Department of Human Genetics, School of Medicine, Emory University, Atlanta, GA, USA
| | - Elizabeth Berry-Kravis
- Departments of Pediatrics, Neurological Sciences and Biochemistry, Rush University Medical Center, Chicago, USA
| | | | - Angela John Thurman
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, Davis Health, Sacramento, CA, USA
| | - Leonard Abbeduto
- MIND Institute, University of California Davis, 2825 50th Street, Sacramento, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, Davis Health, Sacramento, CA, USA
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Abbeduto L, Del Hoyo Soriano L, Berry-Kravis E, Sterling A, Edgin JO, Abdelnur N, Drayton A, Hoffmann A, Hamilton D, Harvey DJ, Thurman AJ. Expressive language sampling and outcome measures for treatment trials in fragile X and down syndromes: composite scores and psychometric properties. Sci Rep 2023; 13:9267. [PMID: 37286643 PMCID: PMC10247708 DOI: 10.1038/s41598-023-36087-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 05/29/2023] [Indexed: 06/09/2023] Open
Abstract
The lack of psychometrically sound outcome measures has been a barrier to evaluating the efficacy of treatments proposed for core symptoms of intellectual disability (ID). Research on Expressive Language Sampling (ELS) procedures suggest it is a promising approach to measuring treatment efficacy. ELS entails collecting samples of a participant's talk in interactions with an examiner that are naturalistic but sufficiently structured to ensure consistency and limit examiner effects on the language produced. In this study, we extended previous research on ELS by analyzing an existing dataset to determine whether psychometrically adequate composite scores reflecting multiple dimensions of language can be derived from ELS procedures administered to 6- to 23-year-olds with fragile X syndrome (n = 80) or Down syndrome (n = 78). Data came from ELS conversation and narration procedures administered twice in a 4-week test-retest interval. We found that several composites emerged from variables indexing syntax, vocabulary, planning processes, speech articulation, and talkativeness, although there were some differences in the composites for the two syndromes. Evidence of strong test-retest reliability and construct validity of two of three composites were obtained for each syndrome. Situations in which the composite scores would be useful in evaluating treatment efficacy are outlined.
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Affiliation(s)
- Leonard Abbeduto
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis Health, 2828 50Th St., Sacramento, CA, 95817, USA.
| | - Laura Del Hoyo Soriano
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis Health, 2828 50Th St., Sacramento, CA, 95817, USA
| | | | - Audra Sterling
- Waisman Center and Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA
| | - Jamie O Edgin
- Department of Psychology, Sonoran UCEDD, UA Family and Community Medicine, University of Arizona, Phoenix, AZ, USA
| | - Nadia Abdelnur
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis Health, 2828 50Th St., Sacramento, CA, 95817, USA
| | - Andrea Drayton
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis Health, 2828 50Th St., Sacramento, CA, 95817, USA
| | - Anne Hoffmann
- Department of Communication Disorders and Sciences, Rush University, Chicago, IL, USA
- Department of Pediatrics, Rush University, Chicago, IL, USA
| | - Debra Hamilton
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Danielle J Harvey
- Department of Public Health Sciences, University of California, Davis, USA
| | - Angela John Thurman
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis Health, 2828 50Th St., Sacramento, CA, 95817, USA
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MacFarlane H, Salem AC, Bedrick S, Dolata JK, Wiedrick J, Lawley GO, Finestack LH, Kover ST, Thurman AJ, Abbeduto L, Fombonne E. Consistency and reliability of automated language measures across expressive language samples in autism. Autism Res 2023; 16:802-816. [PMID: 36722653 PMCID: PMC10123085 DOI: 10.1002/aur.2897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 01/19/2023] [Indexed: 02/02/2023]
Abstract
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with substantial clinical heterogeneity, especially in language and communication ability. There is a need for validated language outcome measures that show sensitivity to true change for this population. We used Natural Language Processing to analyze expressive language transcripts of 64 highly-verbal children and young adults (age: 6-23 years, mean 12.8 years; 78.1% male) with ASD to examine the validity across language sampling context and test-retest reliability of six previously validated Automated Language Measures (ALMs), including Mean Length of Utterance in Morphemes, Number of Distinct Word Roots, C-units per minute, unintelligible proportion, um rate, and repetition proportion. Three expressive language samples were collected at baseline and again 4 weeks later. These samples comprised interview tasks from the Autism Diagnostic Observation Schedule (ADOS-2) Modules 3 and 4, a conversation task, and a narration task. The influence of language sampling context on each ALM was estimated using either generalized linear mixed-effects models or generalized linear models, adjusted for age, sex, and IQ. The 4 weeks test-retest reliability was evaluated using Lin's Concordance Correlation Coefficient (CCC). The three different sampling contexts were associated with significantly (P < 0.001) different distributions for each ALM. With one exception (repetition proportion), ALMs also showed good test-retest reliability (median CCC: 0.73-0.88) when measured within the same context. Taken in conjunction with our previous work establishing their construct validity, this study demonstrates further critical psychometric properties of ALMs and their promising potential as language outcome measures for ASD research.
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Affiliation(s)
- Heather MacFarlane
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - Alexandra C. Salem
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
| | - Steven Bedrick
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon, USA
| | - Jill K. Dolata
- Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
- School of Communication Sciences and Disorders, Pacific University, Forest Grove, Oregon
| | - Jack Wiedrick
- Biostatistics & Design Program, Oregon Health & Science University, Portland, Oregon, USA
| | - Grace O. Lawley
- Computer Science and Electrical Engineering, Oregon Health & Science University, Portland, Oregon, USA
| | - Lizbeth H. Finestack
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sara T. Kover
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington, USA
| | - Angela John Thurman
- MIND Institute, University of California Davis Health, Sacramento, California, USA
- Department of Psychiatry and Behavioral Sciences, University of California Davis Health, Sacramento, California, USA
| | - Leonard Abbeduto
- MIND Institute, University of California Davis Health, Sacramento, California, USA
- Department of Psychiatry and Behavioral Sciences, University of California Davis Health, Sacramento, California, USA
| | - Eric Fombonne
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon, USA
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Soltani A, Schworer EK, Esbensen AJ. Executive functioning and verbal fluency performance in youth with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 131:104358. [PMID: 36209524 PMCID: PMC9701181 DOI: 10.1016/j.ridd.2022.104358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/02/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Executive functioning (EF) is an area of challenge for individuals with Down syndrome (DS) associated with a variety of downstream difficulties. Verbal fluency performance is one potential downstream effect that is commonly assessed in individuals with DS due to the measure's utility as a predictor of dementia. Verbal fluency requires individuals to inhibit irrelevant responses, shift between groupings of related words, and monitor to prevent repetition, all skills related to EF. AIMS This study aimed to determine the association between semantic verbal fluency performance and three EF subdomains (inhibition, shifting, and working memory) in youth with DS after taking into account vocabulary and cognitive ability. METHODS AND PROCEDURES Neuropsychological assessments (verbal and visuospatial), and parent reports of EF, were completed at one time point by 69 youth with DS 6-17 years old and their caregivers. Expressive and receptive vocabulary skills and cognitive ability were also assessed. OUTCOMES AND RESULTS The results revealed that verbal fluency performance was significantly associated with neuropsychological assessments of EF and parent report of inhibition even after controlling for the effects of vocabulary and cognitive ability. CONCLUSIONS AND IMPLICATIONS The findings highlight the underlying importance of EF in verbal fluency tasks in youth with DS.
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Affiliation(s)
- Amanallah Soltani
- Department of Educational Psychology, Kerman Branch, Islamic Azad University, Kerman, Iran
| | - Emily K Schworer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Anna J Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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del Hoyo Soriano L, Villarreal JC, Sterling A, Edgin J, Berry-Kravis E, Hamilton DR, Thurman AJ, Abbeduto L. The association between expressive language skills and adaptive behavior in individuals with Down syndrome. Sci Rep 2022; 12:20014. [PMID: 36411304 PMCID: PMC9678860 DOI: 10.1038/s41598-022-24478-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022] Open
Abstract
The primary goal of this study was to determine whether expressive language skills contribute to adaptive behavior (e.g., socialization and daily living skills) in children, adolescents, and young adults with Down syndrome (DS) whilst controlling for age and nonverbal cognitive ability. Expressive language was assessed using the psychometrically validated Expressive Language Sampling (ELS) conversation and narration procedures. The language produced was transcribed and analyzed to yield measures of expressive vocabulary, syntax, and intelligibility. Socialization and daily living skills of participants with DS were measured with the Vineland Adaptive Behavior Scales, 2nd edition (VABS-2) parent/caregiver rating form. Our results show that the three ELS measures were significantly correlated with multiple measures from the VABS-2 when controlling for age. Several correlations remained significant even when nonverbal cognitive ability was included as a control variable. Our results suggest that expressive language skills contribute to adaptive behavior in children, adolescents, and young adults with DS regardless of age and some of these associations are not explained solely by overall cognitive delays. Further studies including longitudinal data are needed to extend our results.
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Affiliation(s)
- Laura del Hoyo Soriano
- grid.27860.3b0000 0004 1936 9684MIND Institute, University of California Davis, 2825 50Th Street, Sacramento, CA USA ,grid.27860.3b0000 0004 1936 9684Department of Psychiatry and Behavioral Sciences, Davis Health, University of California, Sacramento, CA USA
| | - Jennifer Catalina Villarreal
- grid.27860.3b0000 0004 1936 9684MIND Institute, University of California Davis, 2825 50Th Street, Sacramento, CA USA ,grid.27860.3b0000 0004 1936 9684Department of Psychiatry and Behavioral Sciences, Davis Health, University of California, Sacramento, CA USA
| | - Audra Sterling
- grid.14003.360000 0001 2167 3675Waisman Center and Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI USA
| | - Jamie Edgin
- grid.134563.60000 0001 2168 186XDepartment of Psychology, University of Arizona, Tucson, AZ USA
| | - Elizabeth Berry-Kravis
- grid.240684.c0000 0001 0705 3621Departments of Pediatrics, Neurological Sciences and Biochemistry, Rush University Medical Center, Chicago, IL USA
| | - Debra R. Hamilton
- grid.189967.80000 0001 0941 6502Department of Human Genetics, Emory University School of Medicine, Atlanta, GA USA
| | - Angela John Thurman
- grid.27860.3b0000 0004 1936 9684MIND Institute, University of California Davis, 2825 50Th Street, Sacramento, CA USA ,grid.27860.3b0000 0004 1936 9684Department of Psychiatry and Behavioral Sciences, Davis Health, University of California, Sacramento, CA USA
| | - Leonard Abbeduto
- grid.27860.3b0000 0004 1936 9684MIND Institute, University of California Davis, 2825 50Th Street, Sacramento, CA USA ,grid.27860.3b0000 0004 1936 9684Department of Psychiatry and Behavioral Sciences, Davis Health, University of California, Sacramento, CA USA
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Channell MM, Sandstrom LE, Harvey D. Mental State Language Development in Children With Down Syndrome Versus Typical Development. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:495-510. [PMID: 36306411 DOI: 10.1352/1944-7558-127.6.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 02/08/2022] [Indexed: 06/16/2023]
Abstract
This study compared mental state language (talk about emotions, thoughts, intentions, etc.) used by 6- to 11-year-old children with Down syndrome (DS) to a younger typically developing (TD) comparison group matched by nonverbal cognition. We aimed to determine (1) whether mental state language use is delayed in DS relative to developmental expectations, and (2) if there are differences between groups in the association between mental state language and developmental factors (emotion knowledge, expressive language). Rate of mental state language use was significantly lower in the group with DS, but the number of different mental state terms was not significantly different. Nuanced patterns of similarity and difference emerged between groups regarding the association between mental state language and other developmental factors.
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Affiliation(s)
- Marie Moore Channell
- Marie Moore Channell and Linnea E. Sandstrom, University of Illinois Urbana-Champaign
| | - Linnea E Sandstrom
- Marie Moore Channell and Linnea E. Sandstrom, University of Illinois Urbana-Champaign
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Esbensen AJ, Schworer EK, Fidler DJ, Thurman AJ. Considerations for measuring individual outcomes across contexts in Down syndrome: Implications for research and clinical trials. INTERNATIONAL REVIEW OF RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 62:191-225. [PMID: 36213318 PMCID: PMC9536481 DOI: 10.1016/bs.irrdd.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Individuals with Down syndrome (DS) are increasingly involved in clinical trials that target developmental outcomes, like cognition and behavior. The increased focus on treatment in DS has led to ongoing discussions regarding the selection of outcome measures using syndrome-informed criteria. This discourse is warranted as clinical trials can fail if the outcome measures selected are inappropriate for individuals with DS or do not take into account the behavioral phenotype commonly associated with DS. This review focuses on the challenges present in the measurement of outcomes in DS, with a specific focus on considerations made in evaluating cognitive, language, and behavioral/psychopathology outcomes. This review also provides a summary of recommendations for assessment of outcomes in these domains as well as recommendations for future research. The impact of physical health and assessment psychometrics on the measurement of outcomes is also reviewed.
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Affiliation(s)
- Anna J Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Emily K Schworer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Deborah J Fidler
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - Angela John Thurman
- University of California Davis Health, MIND Institute and Department of Psychiatry and Behavioral Sciences, Sacramento, CA, USA
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Loveall SJ, Channell MM, Mattie LJ, Barkhimer AE. Inclusion of Individuals With Neurodevelopmental Disorders in Norm-Referenced Language Assessments. Front Psychol 2022; 13:929433. [PMID: 36033059 PMCID: PMC9412819 DOI: 10.3389/fpsyg.2022.929433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
Standardized, norm-referenced language assessment tools are used for a variety of purposes, including in education, clinical practice, and research. Unfortunately, norm-referenced language assessment tools can demonstrate floor effects (i.e., a large percentage of individuals scoring at or near the lowest limit of the assessment tool) when used with some groups with neurodevelopmental disorders (NDDs), such as individuals with intellectual disability and neurogenetic syndromes. Without variability at the lower end of these assessment tools, professionals cannot accurately measure language strengths and difficulties within or across individuals. This lack of variability may be tied to poor representation of individuals with NDDs in normative samples. Therefore, the purpose of this study was to identify and examine common standardized, norm-referenced language assessment tools to report the representation of individuals with NDDs in normative samples and the range of standard/index scores provided. A systematic search identified 57 assessment tools that met inclusion criteria. Coding of the assessment manuals identified that most assessment tools included a “disability” or “exceptionality” group in their normative sample. However, the total number of individuals in these groups and the number of individuals with specific NDDs was small. Further, the characteristics of these groups (e.g., demographic information; disability type) were often poorly defined. The floor standard/index scores of most assessment tools were in the 40s or 50s. Only four assessment tools provided a standard score lower than 40. Findings of this study can assist clinicians, educators, and researchers in their selections of norm-referenced assessment tools when working with individuals with NDDs.
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Affiliation(s)
- Susan J. Loveall
- Department of Special Education and Communication Disorders, University of Nebraska–Lincoln, Lincoln, NE, United States
- *Correspondence: Susan J. Loveall,
| | - Marie Moore Channell
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Laura J. Mattie
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Alexandria E. Barkhimer
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, United States
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Smeyne CN, Esbensen AJ, Schworer EK, Belizaire S, Hoffman EK, Beebe DW, Wiley S. Evaluating Verbal Fluency Outcome Measures in Children With Down Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:328-344. [PMID: 36122330 PMCID: PMC9487840 DOI: 10.1352/1944-7558-127.4.328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 09/28/2021] [Indexed: 05/26/2023]
Abstract
This study evaluates the psychometric properties of a verbal fluency task for potential use as an outcome measure in future clinical trials involving children with Down syndrome. Eighty-five participants attempted a modified version of the Neuropsychological Assessment of Children, Second Edition Word Generation Task at two time points. In the full sample, the measure fell below a priori reliability and feasibility criteria, though feasibility of the semantic trials were higher than feasibility of the phonemic trials. Performance on the measure correlated with chronological age and IQ scores, and no sex-related effects were found. Additional analyses suggested that the semantic verbal fluency trials might be appropriate for children with Down syndrome 10 years of age and older.
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Affiliation(s)
- Catelyn N. Smeyne
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center
| | - Anna J. Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine
| | - Emily K. Schworer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center
| | - Shequanna Belizaire
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center
| | - Emily K. Hoffman
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center
| | - Dean W. Beebe
- Department of Pediatrics, University of Cincinnati College of Medicine
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center
| | - Susan Wiley
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine
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Hoffmann A, Thurman AJ, Sterling A, Kover ST, Finestack L, Berry-Kravis E, Edgin JO, Drayton A, Fombonne E, Abbeduto L. Analysis of a Repetitive Language Coding System: Comparisons between Fragile X Syndrome, Autism, and Down Syndrome. Brain Sci 2022; 12:575. [PMID: 35624962 PMCID: PMC9139711 DOI: 10.3390/brainsci12050575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/18/2022] [Accepted: 04/25/2022] [Indexed: 02/04/2023] Open
Abstract
Expressive language sampling (ELS) is a frequently used tool for language analysis, as it can be used across widely ranging cognitive and language abilities. ELS can also evaluate pragmatic language, including excessive self-repetition, which is challenging to assess with traditional standardized assessments. This study explored how a well-established ELS protocol can assess three types of linguistic self-repetition in three neurodevelopmental disabilities: fragile X syndrome (FXS), autism spectrum disorder (ASD), and Down syndrome (DS). We examined its ability to differentiate between these disorders, the relationships between repetitive language and other participant characteristics, and initial construct validity. We found that the groups with FXS and ASD differed significantly on each of the three repetitive language measure, and that the group with DS differed from either ASD or FXS on two. Cognitive ability was significantly related to phrase repetition in the group with ASD. When the groups were combined, there was evidence of convergent and divergent validity. This study extends previous research on ELS and supports its use as a means to characterize pragmatic language. It also provides information about the relationships between repetitive language and other phenotypic characteristics.
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Affiliation(s)
- Anne Hoffmann
- Departments of Communication Disorders and Sciences and Pediatrics, Rush University Medical Center, Chicago, IL 60612, USA
| | - Angela John Thurman
- MIND Institute, School of Medicine, University of California Davis Health, Sacramento, CA 95817, USA; (A.J.T.); (A.D.); (L.A.)
- Department of Psychiatry and Behavioral Sciences, University of California Davis Health, Sacramento, CA 95817, USA
| | - Audra Sterling
- Waisman Center, Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI 53706, USA;
| | - Sara T. Kover
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA 98195, USA;
| | - Lizabeth Finestack
- Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Elizabeth Berry-Kravis
- Departments of Pediatrics, Neurological Sciences, Anatomy and Cell Biology, Rush University Medical Center, Chicago, IL 60612, USA;
| | - Jamie O. Edgin
- Department of Psychology and Sonoran UCEDD, College of Science, The University of Arizona, Tucson, AZ 85721, USA;
| | - Andrea Drayton
- MIND Institute, School of Medicine, University of California Davis Health, Sacramento, CA 95817, USA; (A.J.T.); (A.D.); (L.A.)
- Department of Psychiatry and Behavioral Sciences, University of California Davis Health, Sacramento, CA 95817, USA
| | - Eric Fombonne
- Departments of Psychiatry and Pediatrics, School of Medicine, Oregon Health and Science University, Portland, OR 97239, USA;
| | - Leonard Abbeduto
- MIND Institute, School of Medicine, University of California Davis Health, Sacramento, CA 95817, USA; (A.J.T.); (A.D.); (L.A.)
- Department of Psychiatry and Behavioral Sciences, University of California Davis Health, Sacramento, CA 95817, USA
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del Hoyo Soriano L, Bullard L, Thurman AJ, Alvarez CH, Abbeduto L. Providing a parent-administered outcome measure in a bilingual family of a father and a mother of two adolescents with ASD: brief report. Dev Neurorehabil 2022; 25:140-144. [PMID: 34170787 PMCID: PMC8709875 DOI: 10.1080/17518423.2021.1942281] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 06/01/2021] [Accepted: 06/09/2021] [Indexed: 10/21/2022]
Abstract
There is a need for psychometrically sound outcome measures for treatment studies that have a low burden for families and that are available in multiple languages. We have developed a language assessment in English and Spanish that parents can administer to their children at home via telehealth-delivered procedures. The current case study presents descriptive data on a single family of two parent-child dyads. Both the mother and father from a single family were trained in their primary language (Spanish) on how to administer the Expressive Language Sampling - Narration (ELS-N) in their secondary language (English) to their two English-speaking monolingual sons with ASD through telehealth-delivered procedures. Both parents learned to administer the procedures to a predetermined level of fidelity. Extension to a larger sample of bilingual families is needed for this home-based, parent-administered test; however, the present results suggest feasibility even when the language of training and administration differ.
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Affiliation(s)
- Laura del Hoyo Soriano
- MIND Institute & Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA
| | - Lauren Bullard
- MIND Institute & Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA
| | - Angela John Thurman
- MIND Institute & Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA
| | - Cesar Hoyos Alvarez
- MIND Institute & Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA
- Department of Spanish and Portuguese, University of California Davis, Davis, USA
| | - Leonard Abbeduto
- MIND Institute & Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, USA
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Schworer EK, Belizaire S, Hoffman EK, Esbensen AJ. Semantic Verbal Fluency in Youth with Down Syndrome: Analysis of Conventional and Contextual Cluster Formation. Brain Sci 2021; 12:9. [PMID: 35053754 PMCID: PMC8773708 DOI: 10.3390/brainsci12010009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/15/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022] Open
Abstract
Expressive language delays and executive functioning challenges are common in youth with Down syndrome (DS). Verbal fluency is one method to investigate these constructs. We examined semantic verbal fluency responses to determine patterns in response generation and the psychometric properties of coded cluster formations. Participants were 97 children and adolescents with DS ranging in age from 6 to 19 years old. The semantic verbal fluency task was administered at two time points, two weeks apart. Heterogeneity in performance was observed for responses when coded either with conventional or contextual classifications. Overall, the number of switches in conventional classifications was greater than contextual classifications. This implies that participants did not use traditional (conventional) categories to organize their semantic verbal fluency responses, but may have been using contextual strategies. However, the number of switches and cluster size variables had poor to moderate test-retest reliability, which indicated that participants did not stay consistent with their performance over the two-week testing interval, regardless of the strategies used. Therefore, conventional and contextual clusters and switches as a measure of executive control may not be appropriate for all individuals with DS and additional attention is warranted to determine the utility of response coding in this population.
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Affiliation(s)
- Emily K. Schworer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (S.B.); (E.K.H.); (A.J.E.)
| | - Shequanna Belizaire
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (S.B.); (E.K.H.); (A.J.E.)
| | - Emily K. Hoffman
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (S.B.); (E.K.H.); (A.J.E.)
| | - Anna J. Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (S.B.); (E.K.H.); (A.J.E.)
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
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del Hoyo Soriano L, Bullard L, Hoyos Alvarez C, Thurman AJ, Abbeduto L. Using telehealth-delivered procedures to collect a parent-implemented expressive language sampling narrative task in monolingual and bilingual families with Autism Spectrum Disorder: A pilot study. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:716550. [PMID: 35036992 PMCID: PMC8758070 DOI: 10.3389/fresc.2021.716550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022]
Abstract
Language impairments are frequent, severe, and of prognostic value in autism spectrum disorder (ASD). Unfortunately, the evaluation of the efficacy of treatments targeting the language skills of those with ASD continues to be hindered by a lack of psychometrically sound outcome measures. Expressive Language Sampling (ELS) procedures offer a promising alternative to norm-referenced standardized tests for assessing expressive language in treatment studies. Until now, however, research on the validity and utility of ELS as outcome measures has been limited to administrations by a trained professional in a clinic setting and to use with English-speaking families. These limitations are a barrier for many families accessing the benefits of participation in treatment studies. The current study examines the feasibility of teaching native English-speaking parents (NESP) and native Spanish-speaking parents (NSSP) how to administer the ELS narrative task (ELS-N) to their sons and daughters with ASD (between ages 6 and 21) at home through telehealth-delivered procedures. The parent training was provided in the primary language of the participating parent (i.e., 11 NSSP and 11 NESP) and administered by the parent to the youth in the language that the parent reported to use to communicate with the youth at home (i.e., 9 Spanish and 13 English). Families were able to choose between using their own technology or be provided with the technology needed for participation. Of the 19 parents who completed the training, 16 learned to administer the ELS-N procedures. In addition, strong test-retest reliability and no practice effects over the 4-week interval were observed for ELS-N derived youth outcome measures (i.e., talkativeness, vocabulary, syntax, dysfluency, and intelligibility) for both NSSP and NESP. Results from this pilot study suggest that the home-based parent-implemented ELS-N procedures can be learned and administered at acceptable levels of fidelity by parents, with good test-retest reliability and limited practice effects observed in terms of outcome measures for youth with ASD. Implications for treatment studies and future directions are discussed.
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Affiliation(s)
- Laura del Hoyo Soriano
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Lauren Bullard
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Cesar Hoyos Alvarez
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, CA, United States
- Department of Spanish and Portuguese, University of California, Davis, Davis, CA, United States
| | - Angela John Thurman
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, CA, United States
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California, Davis, Sacramento, CA, United States
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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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Concurrent Associations between Expressive Language Ability and Independence in Adolescents and Adults with Fragile X Syndrome. Brain Sci 2021; 11:brainsci11091179. [PMID: 34573200 PMCID: PMC8465941 DOI: 10.3390/brainsci11091179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Few individuals with fragile X syndrome (FXS) successfully meet adult normative expectations in education, employment, peer relations, and habitation, although there is within-syndrome variability in this regard. The primary goal of this study was to determine whether expressive language skills contribute to the capacity for independent functioning in adulthood even after controlling for nonverbal cognitive ability. METHODS Participants were 18- to 23-year-olds with FXS. Expressive language was assessed using the psychometrically validated Expressive Language Sampling (ELS) conversation and narration procedures. The language produced was transcribed and analyzed to yield measures of expressive vocabulary, syntax, and intelligibility. Parents concurrently completed questionnaires on the independent functioning of the participants with FXS. RESULTS All three ELS measures were significantly corelated with multiple measures of independence. The magnitudes of the correlations were reduced when nonverbal IQ was controlled through partial correlation. Nonetheless, many of the partial correlations were medium to large and several were statistically significant. CONCLUSIONS Expressive language skills appear to contribute uniquely to the capacity for independence, although longitudinal data are needed to evaluate the possibility of a bidirectional relationship between these domains. Thus, language intervention may be a prerequisite for preparing youth with FXS for an independent adult life.
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