A longitudinal study of narrative development in children and adolescents with Down syndrome

How to Assess Oral Narrative Skills of Children and Adolescents with Intellectual Disabilities: A Systematic Review

Children and adolescents with intellectual disabilities (ID) often encounter difficulties with narrative skills. Yet, there is a lack of research focusing on how to assess these skills in this population. This study offers an overview of the tools used for assessing oral narrative skills in children and adolescents with ID, addressing key questions about common assessment tools, their characteristics, and reported evidence. A systematic review was conducted of the literature published between 2010 and 2023 in the PsycINFO, ERIC, Education, and Psychology databases. An initial 1176 studies were reviewed by abstract, of which 485 were read in full text, leading to the selection and analysis of 22 studies. Most of the identified tools involve analyzing language samples obtained using wordless picture story books. Three common tools are emphasized. Studies have primarily identified inter-rater reliability and test-criterion evidence for validity. The main tools and their characteristics are discussed in depth to aid readers in discerning suitable options for research or practical applications. The importance of reporting diverse sources of evidence for validity and reliability within this population is highlighted.

The effects of incorporating extended conversations into video-based story retelling instruction on oral narrative skills in adolescents with intellectual disability in China

BACKGROUND/AIMS

Oral narrative language is a persistent area of language difficulty for individuals with intellectual disability (ID). This study aims to explore the effectiveness of a comprehensive intervention program that incorporates extended conversations into video-based story retelling instruction with a novel visual support strategy, Story Hand, to develop oral narrative skills in adolescents with ID in China.

METHODS

Using a single-case multiple-probe across participants design, the researchers examined whether the comprehensive intervention program could improve participants' oral narrative skills both microstructurally and macrostructurally.

RESULTS

All three participants demonstrated moderate to high treatment effects in the microstructural narrative outcomes (i.e., the mean length of utterance in morphemes [MLU-M] and the number of different words [NDW]) and one of the macrostructural narrative outcomes (i.e., the complexity of story grammar [SG-complexity]) in response to the comprehensive intervention program, and these acquired effects were maintained at a high level for up to one month. However, all three participants demonstrated limited treatment effects in one of the macrostructural narrative outcomes (i.e., cohesion) in response to the comprehensive intervention program.

CONCLUSIONS/IMPLICATIONS

The comprehensive intervention program that incorporates extended conversations into visually supported video-based story retelling instruction offers an option for teachers to develop oral narrative skills in adolescents with ID. However, the relative effectiveness of the different components of the intervention needs to be further explored.

Narrative and prosodic skills in children and adolescents with Down syndrome and typically developing children

PURPOSE

Children with Down Syndrome (DS) show difficulties in language development, in both basic and complex abilities, as narratives. Less is known about the prosodic competence in DS, but the few available studies highlighted the presence of some deficits. Considering the importance of narratives and prosody in communication, the main aim of this study is to investigate these two competencies in participants with DS.

METHOD

13 children with DS participated (Mean age: 13;04, years; months). Their narrative and prosodic abilities, collected through a storytelling task, were compared with those of two control groups of typically developing (TD) children, one matched for nonverbal mental age (MA, Mean age: 5;03) and the other matched for the mean length of utterance (MLU, Mean age: 5;05). For the narrative competence, we considered both the macrostructural (i.e. quantity of information and story structure) and the microstructural level (i.e. verbal productivity, lexical diversity, syntactic complexity). For the prosodic competence, we took into account acoustic measures linked to intonation (i.e. mean fundamental frequency (f0), pitch range, final speech profile, and speed of speech).

RESULT

The results of the Mann-Whitney test showed that participants with DS produced stories comparable to those of TD children in nearly all the variables considered, except for the syntactic complexity when compared with children of the same MA. Differences between participants with DS and TD children were found in the f0 and the final pitch profile used.

CONCLUSION

Considering the small size of the samples, these preliminary results should be taken with caution. Nonetheless, this study confirms the presence of difficulties in the prosody of speech and in the syntactic competence of children with DS. These difficulties could have consequences on the possibility to communicate efficiently and should be taken into account in rehabilitation programmes.

Comprensión Narrativa: Análisis del Concepto y una Propuesta Metodológica

Resumen El análisis conceptual es un eje metodológico de la investigación científica. Aunque un concepto a menudo sufre cambios como parte de una teoría, el análisis de su operación lógica original es condición previa para comprender estos cambios y evaluar su utilidad. Se analizó el funcionamiento lógico del concepto de comprensión, con fundamento en técnicas de la Filosofía del Lenguaje Ordinario. Son características lógicas importantes del concepto: (1) comprender es un verbo de logro (2) puede haber diferentes grados de logro (3) es un concepto polimórfico y (4) es un concepto disposicional. Son discutidas implicaciones metodológicas y teóricas de este análisis, ejemplificadas con una propuesta para el análisis de la comprensión de textos narrativos.

Spoken fictional narrative and literacy skills of children with Down syndrome

BACKGROUND

Children with Down syndrome (DS) exhibit below average nonverbal intelligence and impaired language skills; however, their spoken narrative production is a relative strength.

AIMS

We examined expressive language skills produced during fictional narrative retells and analyzed the unique contribution of expressive language skills to word-level reading and reading comprehension of children with DS.

METHODS AND PROCEDURES

The microstructure and macrostructure of fifteen, 8- to 18-year-old children with DS's narrative retells were analyzed. Receptive vocabulary, word-level reading, and reading comprehension also were measured.

RESULTS

Narrative microstructure analyses revealed restricted syntactic and semantic diversity. Further analyses of sentence complexity revealed that children with DS predominately produced prepositional phrases and produced more verbs than nouns. Narrative macrostructure analysis revealed participants use of episodic components; however, their stories did not include mental state references. Narrative microstructure contributed unique variance to word-level reading, whereas narrative macrostructure contributed unique variance to word-level reading and reading comprehension. Additionally, strong correlations were found between narrative skills and literacy skills.

CONCLUSIONS AND IMPLICATIONS

Findings from this study support the use of narrative microstructure and macrostructure analyses as a valuable clinical tool to guide assessment and intervention planning for school-aged children with DS.

On the Design of Broad-Based Neuropsychological Test Batteries to Assess the Cognitive Abilities of Individuals with Down Syndrome in the Context of Clinical Trials

Down syndrome (DS) is the most common genetically-defined cause of intellectual disability. Neurodevelopmental deficits displayed by individuals with DS are generally global, however, disproportionate deficits in cognitive processes that depend heavily on the hippocampus and prefrontal cortex are also well documented. Additionally, DS is associated with relative strengths in visual processing and visuospatial short-term memory, and weaknesses in the verbal domain. Although reports of pharmacological rescuing of learning and memory deficits in mouse models of DS abound in the literature, proving the principle that cognitive ability of persons with DS can be boosted through pharmacological means is still an elusive goal. The design of customized batteries of neuropsychological efficacy outcome measures is essential for the successful implementation of clinical trials of potential cognitive enhancing strategies. Here, we review the neurocognitive phenotype of individuals with DS and major broad-based test batteries designed to quantify specific cognitive domains in these individuals, including the one used in a pilot trial of the drug memantine. The main goal is to illustrate the essential considerations in planning trials to enhance cognitive functions in individuals with DS, which should also have implications for the design of similar studies in individuals with other forms of intellectual disability.

Narrative Language and Reading Comprehension in Students With Mild Intellectual Disabilities

Past research shows positive correlations between oral narrative skill and reading comprehension in typically developing students. This study examined the relationship between reading comprehension and narrative language ability of 102 elementary students with mild levels of intellectual disability. Results describe the students' narrative language microstructure and relative strengths and weaknesses in narrative macrostructure. Students' narrative macrostructure accounted for significant variance in reading comprehension beyond what was accounted for by narrative microstructure (i.e., mean length of utterance in morphemes, number of different words, total utterances). This study provides considerations for measuring narrative quality when characterizing the functional language skills of students with mild levels of intellectual disability. Measurement tools that quantify the quality of language provide important information regarding targets of intervention beyond grammar and vocabulary.

Developmental trends of communicative skills in children with chromosome 14 aberrations

Children with chromosome 14 aberrations usually show developmental delays, intellectual disability, neurological disorders and behaviour problems. The aim of the present study is to describe the developmental trajectories of the communicative skills of children with chromosome 14 aberrations, considering the possible relationships between the patterns of language development and the children's clinical characteristics (e.g., intellectual disability or autistic traits). Longitudinal data on five children (four with linear deletions and one with ring 14 syndrome) followed for 3 years are presented. Four out of five children showed profound intellectual disability, and three out of five showed autistic traits. A high individual variability was found in both vocal and gestural productions. However, only a modest increase in the children's communicative and symbolic skills was detected over time (e.g., in the quality of preverbal productions).

CONCLUSION

The increase of communicative skills in children with chromosome 14 aberration is very slow. We need to consider the children's characteristics, in terms of type of chromosome aberration, level of intellectual disability and presence/absence of autistic traits, to predict their possible linguistic outcomes and to give a more realistic expectation to their parents. What is known: • The communicative skills of children with chromosome 14 aberrations are usually impaired. • The presence of autistic traits is frequent in these children. What is new: • The increase of communicative skills in children with chromosome 14 aberrations is very slow. • The level of intellectual disability and the presence/absence of autistic traits appeared to have a role in predicting the possible linguistic outcomes in children with chromosome 14 aberrations.

Linguagem narrativa e fluência na síndrome de down: uma revisão

A síndrome de Down é uma condição na qual os indivíduos apresentam comprometimento intelectual e alterações de linguagem oral. A disfluência de fala está presente tanto durante a conversa espontânea como em produções orais de narrativas direcionadas. Este estudo teve como principal objetivo revisar a literatura sobre a disfluência e a narrativa em indivíduos com a síndrome de Down, publicada entre 2002 e 2012, em bases de dados eletrônicos. Foram encontrados 17 artigos e selecionados oito, de acordo com os critérios de inclusão e exclusão. Destes, dois discorriam especificamente sobre a disfluência na síndrome de Down, e seis sobre a narrativa nesta população. A deficiência intelectual é parte do fenótipo dos indivíduos com SD e, em decorrência do comprometimento intelectual, prejuízos na aquisição e no desenvolvimento da linguagem. Estudos específicos, principalmente sobre a fluência/disfluência; e, sobre o desempenho na tarefa da narrativa, ainda são escassos e inconclusivos. A disfluência não aparece na maioria das descrições do fenótipo de linguagem dos indivíduos com esta condição, que mereceria, estudos clínicos adicionais.

Cognition in Down syndrome: a developmental cognitive neuroscience perspective

Down syndrome (DS) is the most common genetic form of intellectual disability. DS results in a characteristic profile of cognitive and neurological dysfunction. The predominant theory of the pattern of neural deficits in this syndrome suggests that DS affects 'late-developing' neural systems, including the function of the prefrontal cortex and hippocampus. In order to evaluate the validity of this theory, in this review, I highlight data addressing the neurological and cognitive phenotype in DS across development. In particular, I address the evidence suggesting that DS may impact late-developing neural systems and end with the conclusion that some cognitive difficulties in DS must result from poor communication between late-developing regions. Analogous to recent theories of cognitive processing in autism, cognitive deficits in DS may be substantially impacted by less efficient interregional communication. Finally, I discuss some ways in which understanding the impact of altered neurodevelopment in DS has the potential to inform our understanding of species-typical trajectories of cognitive development. WIREs Cogn Sci 2013, 4:307-317. doi: 10.1002/wcs.1221 For further resources related to this article, please visit the WIREs website.