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Escudero SC, Sepúlveda EM. Pragmatic competence in people with dual diagnosis: down syndrome and autism spectrum disorder. BMC Psychol 2024; 12:74. [PMID: 38360760 PMCID: PMC10870447 DOI: 10.1186/s40359-023-01508-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/23/2023] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Pragmatics is an area that can be affected in a wide variety of disorders. In this sense, Syndromic Autism is defined as a disorder in which a causal link is established between an associated syndrome and Autism Spectrum Disorder (ASD). Likewise, Down Syndrome (DS) is one of the main genetically based syndromes in which ASD is described as one of its possible manifestations. In this direction, people with DS are described as social beings whereas in ASD there seems to be a specific alteration of this domain. METHODS In this study, pragmatic performance was analysed in a sample of 72 participants, where comparisons were made between the scores obtained by children with ASD (n = 24), with DS (n = 24) and with DS + ASD (n = 24). RESULTS The Social Communication Questionnaire (SCQ), the Block Objective and Criterial Language Battery (BLOC-SR) and the Neuropsychology subtest (NEPSY-II) aimed at Theory of Mind (ToM) identified significant differences between the groups. However, two-to-two comparisons reported no significant differences between DS and DS + ASD. CONCLUSIONS Although several studies report differences between the three proposed groups, our data seem to suggest that ASD symptomatology in DS is associated with Intellectual Developmental Disorder (IDD). However, the lack of solid scientific evidence regarding comorbid diagnosis makes further research along these lines indispensable. TRIAL REGISTRATION This study was approved by the Ethics Committee for Social Research at UCLM with reference CEIS-704,511-L8M4.
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Affiliation(s)
- Sara Cortés Escudero
- Department of Psychology, Faculty of Health Sciences, University of Castilla-La-Mancha, Avda Real Fábrica de la Seda s/n, 45600, Talavera de la Reina, Spain
| | - Esther Moraleda Sepúlveda
- Department of Psychology, Faculty of Pychology, University Complutense. Campus de Somosaguas, 28223, Pozuelo de Alarcón. Madrid, Spain.
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2
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Martin GE, Lee M, Bicknell K, Goodkind A, Maltman N, Losh M. A longitudinal investigation of pragmatic language across contexts in autism and related neurodevelopmental conditions. Front Neurol 2023; 14:1155691. [PMID: 37545730 PMCID: PMC10402743 DOI: 10.3389/fneur.2023.1155691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023] Open
Abstract
Background Pragmatic language, or the use of language in social contexts, is a critical skill in daily life, supporting social interactions and the development of meaningful social relationships. Pragmatic language is universally impacted in autism spectrum disorder (ASD) and pragmatic deficits are also common in other neurodevelopmental conditions, particularly those related to ASD, such as fragile X syndrome (FXS). This study used a multi-method, longitudinal approach to characterize potentially unique pragmatic profiles across different neurodevelopmental disabilities, and across contexts that varied in degree of social demand. The utility of computational linguistic analyses, as an efficient tool for capturing pragmatic abilities, was also explored. Methods Pragmatic skills of boys with idiopathic ASD (ASD-O, n = 43), FXS with and without ASD (FXS-ASD, n = 57; FXS-O, n = 14), Down syndrome (DS, n = 22), and typical development (TD, n = 24) were compared using variables obtained from a standardized measure, narrative, and semi-naturalistic conversation at up to three time points. Results Pragmatic language was most significantly impacted among males with ASD-O and FXS-ASD across all three contexts, with more difficulties in the least structured context (conversation), and also some differences based on FXS comorbidity. Patterns of group differences were more nuanced for boys with FXS-O and DS, with context having less of an impact. Clinical groups demonstrated minimal changes in pragmatic skills with age, with some exceptions. Computational language measurement tools showed some utility for measuring pragmatic skills, but were not as successful as traditional methods at capturing differences between clinical groups. Conclusion Overlap and differences between ASD and other forms of neurodevelopmental disability in general, and between idiopathic and syndromic ASD in particular, have important implications for developing precisely tailored assessment and intervention approaches, consistent with a personalized medicine approach to clinical study and care in ASD.
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Affiliation(s)
- Gary E. Martin
- Department of Communication Sciences and Disorders, St. John’s University, Staten Island, NY, United States
| | - Michelle Lee
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
- Department of Child and Adolescent Psychiatry, Child Study Center, Hassenfeld Children’s Hospital at NYU Langone, New York, NY, United States
| | - Klinton Bicknell
- Department of Linguistics, Northwestern University, Evanston, IL, United States
- Duolingo, Pittsburgh, PA, United States
| | - Adam Goodkind
- Department of Linguistics, Northwestern University, Evanston, IL, United States
- Department of Communication Studies, Northwestern University, Evanston, IL, United States
| | - Nell Maltman
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Molly Losh
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
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3
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Channell MM, Mattie LJ, Schworer EK, Fidler DJ, Esbensen AJ. Using the Social Skills Improvement System (SSiS) Rating Scales to assess social skills in youth with Down syndrome. Front Psychol 2023; 14:1105520. [PMID: 37082574 PMCID: PMC10110963 DOI: 10.3389/fpsyg.2023.1105520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/02/2023] [Indexed: 04/07/2023] Open
Abstract
Introduction and MethodsThis study provides preliminary data on the Social Skills Improvement System (SSiS) Rating Scales Parent Form to measure social skills in a sample of 124 children and adolescents with Down syndrome (DS) ages 6–17 years.ResultsOverall, participants demonstrated relatively mild symptoms, with the sample’s average standard score falling within 1 standard deviation from the mean of the normative sample for the social skills (M = 92, SD = 15) and problem behaviors (M = 104, SD = 12) domains (normative sample M = 100, SD = 15 for both domains). However, a wide range of scores was observed across the sample for the composite and subscale scores. Differential patterns were also observed by subscale. For some subscales (i.e., Cooperation, Assertion, Responsibility, Engagement, Externalizing, Hyperactivity/Inattention, and Autism Spectrum), a disproportionate number of participants scored in the below average (i.e., lower levels of social skills) or above average (i.e., more symptomatic in problem behaviors or autism spectrum) range relative to the normative sample; for other subscales (i.e., Communication, Empathy, Self-Control, Bullying, and Internalizing), participants’ score distribution aligned more closely to that of the normative sample. SSiS composite scores correlated in the expected directions with standardized measures of autism characteristics, executive function, and expressive language.DiscussionThis study provides some of the first evidence validating the use of the SSiS in youth with DS, filling a gap in standardized measures of social functioning in this population.
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Affiliation(s)
- Marie Moore Channell
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, IL, United States
- *Correspondence: Marie Moore Channell,
| | - Laura J. Mattie
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, IL, United States
| | - Emily K. Schworer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Deborah J. Fidler
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Anna J. Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Univeristy of Cincinnati College of Medicine, Cincinnati, OH, United States
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4
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Foster-Cohen S, Macrae T, Newbury J. Variation in morpho-lexical development within and between diagnoses in children with neurodevelopmental disorders. Front Psychol 2023; 13:968408. [PMID: 36710780 PMCID: PMC9878158 DOI: 10.3389/fpsyg.2022.968408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023] Open
Abstract
While primary diagnosis is only one aspect of the presentation of a child with neurodevelopmental delay/disorder, the degree to which early expressive language reflects diagnostic divisions must be understood in order to reduce the risk of obscuring clinically important differences and similarities across diagnoses. We present original data from the New Zealand MacArthur-Bates Communicative Development Inventory (NZCDI) from 88 English-speaking children aged 2;6 to 5;6 years receiving multidisciplinary intervention within a single family-centered program. The children had one of six pediatrician-assigned genetic or behaviorally determined diagnoses: Down syndrome (DS); motor disorders (cerebral palsy and developmental coordination disorder); global development delay; disorders of relating and communicating (R&C); other genetically defined diagnoses; or language delay due to premature (PREM) birth. Morphological and lexical development were compared within and across diagnostic groups, using both data visualization and mixed-effects modeling. Groups varied in the amount of variation within and between them, but only prematurity reached significance, in interaction with age, as a predictor of morpho-lexical scores. Further analysis of longitudinal data available from a subset of the sample (n = 62) suggested that individual trajectories of vocabulary growth could not be reliably predicted by diagnosis. Moreover, the distribution of word types (nouns, predicates, etc.) only distinguished PREM children with language delay from those with DS and those in the R&C group. There were strong similarities in early morpho-lexical development across these clinical populations, with some differences. These findings align with research and clinical approaches which accommodate individual variation within diagnosis, and broad similarities across diagnostic groups.
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Affiliation(s)
- Susan Foster-Cohen
- Department of Linguistics, University of Canterbury, Christchurch, New Zealand
- New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Christchurch, New Zealand
- Christchurch Early Intervention Trust, The Champion Centre, Christchurch, New Zealand
| | - Toby Macrae
- New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Christchurch, New Zealand
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Jayne Newbury
- New Zealand Institute of Language, Brain and Behaviour, University of Canterbury, Christchurch, New Zealand
- School of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
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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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Bush L, Martin GE, Landau E, Losh M. A Longitudinal Study of Parent-Child Interactions and Language Outcomes in Fragile X Syndrome and Other Neurodevelopmental Disorders. Front Psychiatry 2021; 12:718572. [PMID: 34819882 PMCID: PMC8606641 DOI: 10.3389/fpsyt.2021.718572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/11/2021] [Indexed: 11/23/2022] Open
Abstract
Difficulties with pragmatic language (i.e., language in social contexts, such as conversational ability) are a noted characteristic of the language profiles of both fragile X syndrome (FXS) and autism spectrum disorder (ASD), conditions which show significant phenotypic overlap. Understanding the origins and developmental course of pragmatic language problems in FXS and other developmental conditions associated with language impairment is a critical step for the development of targeted interventions to promote communicative competence across the lifespan. This study examined pragmatic language in the context of parent-child interactions in school-age children with FXS (who did and did not meet ASD criteria on the ADOS; n = 85), idiopathic ASD (n = 32), Down syndrome (DS; n = 38), and typical development (TD; n = 39), and their parents. Parent-child communicative interactions were examined across multiple contexts, across groups, and in relationship to pragmatic language outcomes assessed 2 years later. Results showed both overlapping and divergent patterns across the FXS-ASD and idiopathic ASD child and parent groups, and also highlighted key differences in pragmatic profiles based on situational context, with more pragmatic language difficulties occurring for both ASD groups in less structured interactions. Differences in parental language styles during parent-child interactions were associated with child language outcomes, likely reflecting the complex interplay of discourse style inherent to a parent, with the inevitable influence of child characteristics on parent language as well. Together, findings help delineate the dynamic and multifactorial nature of impaired pragmatic skills among children with FXS and other neurodevelopmental disorders associated with language impairment, with potential implications for the development of targeted interventions for pragmatic communication skills.
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Affiliation(s)
- Lauren Bush
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States.,Department of Psychiatry and Behavioral Sciences, Autism Assessment, Research, Treatment, and Services Center, Rush University Medical Center, Chicago, IL, United States
| | - Gary E Martin
- Department of Communication Sciences and Disorders, St. John's University, Staten Island, NY, United States
| | - Emily Landau
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - Molly Losh
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
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Martzoukou M, Nousia A, Marinis T. Narrative Abilities of Adults' With Down Syndrome as a Window to Their Morphosyntactic, Socio-Cognitive, and Prosodic Abilities. Front Psychol 2020; 11:2060. [PMID: 32982854 PMCID: PMC7479217 DOI: 10.3389/fpsyg.2020.02060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 07/24/2020] [Indexed: 11/14/2022] Open
Abstract
Down syndrome (DS) is the most common developmental disorder characterized by mild to moderate intellectual disability. Several studies have reported poor language and prosodic skills and contradictory results regarding individuals’ with DS socio-cognitive skills, whereas most of them have focused on children with DS. The present study attempts to explore adults’ with DS language, socio-cognitive and prosodic abilities via the use of story-retellings. Twenty adults with DS and two groups of TD children, one matched to their expressive vocabulary (TD-EVT) and the other matched to their non-verbal mental age (TD-RCPM), took part in the present study. Participants listened to a story while viewing a wordless picture PowerPoint presentation on a computer screen, and then, they were instructed to retell the story while viewing the pictures for a second time. Each participant listened to two stories, one with “lively” and one with “flat” prosody. Results revealed that adults’ with DS performance was comparable with the one presented by the TD-RCPM group, whereas the TD-EVT group performed significantly better in almost all variables. Individuals’ with DS re-narrations, however, contained significantly less complement clauses and internal state terms (related or not related to Theory of Mind–ToM) compared to the re-narrations of both control groups. In contrast, the group with DS performed similarly to both control groups in comprehension questions related to main characters’ internal state terms and significantly better compared to the TD-RCPM group in questions related to ToM. In terms of prosody, all three groups performed significantly better on story structure and comprehension questions when prosody was “lively” compared “flat” prosody. DS group’s re-narrations did not contain enough internal state terms, not due to their inability in recognizing them, but due to their poor morphosyntactic abilities, which did not allow them to find the proper means to express the main characters’ internal states. Prosody facilitated participants with DS in the comprehension and re-narration. This suggests that intervention programs based on prosody could support the language skills of adults with DS.
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Affiliation(s)
- Maria Martzoukou
- School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Anastasia Nousia
- School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Theodoros Marinis
- Department of Linguistics, University of Konstanz, Konstanz, Germany.,School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
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Systematic Review of Recent Pediatric Down Syndrome Neuropsychology Literature: Considerations for Regression Assessment and Monitoring. J Dev Behav Pediatr 2020; 41:486-495. [PMID: 32251042 DOI: 10.1097/dbp.0000000000000800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To conduct a systematic review of recent pediatric Down syndrome (DS) neuropsychology research that may be useful to clinicians and researchers examining regression in this population. METHODS We reviewed original peer-reviewed articles published between 2013 and 2018 studying neuropsychological profiles in DS. RESULTS Thirty-one articles (of 1231 included in the original search) passed all inclusion criteria, were evaluated for bias, and were included in the analysis. CONCLUSION Findings argued against a single "DS profile" and revealed multiple within-group differences as well as expected and unexpected differences relative to typically developing children and children with other intellectual and developmental disabilities. Areas identified as most germane to regression monitoring included working memory, inhibition, letter and word identification, navigational route learning, motor skills (when strong at baseline), single word receptive/expressive vocabulary, and adaptive function.
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Del Hoyo Soriano L, Thurman AJ, Harvey D, Kover ST, Abbeduto L. Expressive language development in adolescents with Down syndrome and fragile X syndrome: change over time and the role of family-related factors. J Neurodev Disord 2020; 12:18. [PMID: 32593286 PMCID: PMC7321535 DOI: 10.1186/s11689-020-09320-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 06/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is well known that individuals with Down syndrome (DS) or fragile X syndrome (FXS) demonstrate expressive language difficulties beginning early in childhood. It is less clear, however, whether expressive language skills change during the adolescent period in these individuals, and if any of these changes are syndrome specific. Studying this, as well as the role of maternal and family-related factors in expressive language development, may provide the foundation for efficacious interventions for adolescents with DS or FXS. METHODS In this study, we examined expressive language trajectories, assessed through conversation and narration, in 57 adolescent males with intellectual disability (ID) (20 DS and 37 FXS) in relation to the diagnostic group (DS vs. FXS) and family-related factors (maternal IQ, maternal psychological distress, closeness in the mother-child relationship, family income, and maternal and paternal education) after adjusting for chronological age (CA) and nonverbal cognition. RESULTS Changes over repeated annual assessments for males with DS or FXS were observed only during conversation, such as an increase in talkativeness, but a decrease in syntax complexity and lexical diversity. We found a diagnosis-related effect in the change over time in conversational talkativeness favoring those with FXS. Finally, a closer mother-child relationship predicted less decrease over time in lexical diversity during conversation, and participants of mothers who graduated college showed a greater increase in conversational talkativeness over time compared to those of mothers with a high school education. CONCLUSIONS Our results suggest that, during the adolescent period for males with DS or FXS, there is an increase in the amount of talk produced in conversational contexts, but also a decrease in the quality of the language produced. In addition, our results indicate syndrome-specificity for aspects of expressive language development and reinforce the protective role of family-related factors.
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Affiliation(s)
- Laura Del Hoyo Soriano
- The MIND Institute, University of California, Davis, 2825 50th Street, Rm 2101, Sacramento, CA, 95817, USA.
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, USA.
| | - Angela John Thurman
- The MIND Institute, University of California, Davis, 2825 50th Street, Rm 2101, Sacramento, CA, 95817, USA
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, USA
| | - Danielle Harvey
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Davis, CA, USA
| | - Sara T Kover
- Department of Speech and Hearing Sciences, University of Washington, Seattle, WA, USA
| | - Leonard Abbeduto
- The MIND Institute, University of California, Davis, 2825 50th Street, Rm 2101, Sacramento, CA, 95817, USA
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, USA
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10
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Udhnani M, Perez M, Clasen LS, Adeyemi E, Lee NR. Relations between Everyday Executive Functioning and Language in Youth with Down Syndrome and Youth with Autism Spectrum Disorder. Dev Neuropsychol 2020; 45:79-93. [PMID: 32063028 PMCID: PMC7549751 DOI: 10.1080/87565641.2019.1706518] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 11/07/2019] [Accepted: 11/19/2019] [Indexed: 01/30/2023]
Abstract
Language and executive functioning are major impairments in many neurodevelopmental disorders, but little is known about the relations between these constructs, particularly using parent-report. Thus, the current research sought to examine relations between executive function and language in two groups - Down syndrome (DS; n=41; Mage = 11.2) and autism spectrum disorder (ASD; n=91; Mage = 7.7). Results were as follows: in DS, executive function predicted pragmatic, but not structural language after covarying for age, sex, and social functioning; in ASD, executive function predicted both. Findings highlight the interrelatedness of language and executive functioning and may have implications for intervention development.
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Affiliation(s)
| | | | - Liv S. Clasen
- Developmental Neurogenomics Unit, National Institute of Mental Health
| | - Elizabeth Adeyemi
- Developmental Neurogenomics Unit, National Institute of Mental Health
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Channell MM. The Social Responsiveness Scale (SRS-2) in school-age children with Down syndrome at low risk for autism spectrum disorder. AUTISM & DEVELOPMENTAL LANGUAGE IMPAIRMENTS 2020; 5:2396941520962406. [PMID: 34179506 PMCID: PMC8232392 DOI: 10.1177/2396941520962406] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND AND AIMS Little is known about how autism spectrum disorder (ASD) symptoms present in individuals with Down syndrome (DS). Some behaviors may be symptomatic of comorbid ASD or more broadly representative of the DS phenotype. A prior research study documented elevated ASD-like symptoms in adolescents and young adults with DS without comorbid ASD, using a common ASD risk screening tool-the Social Responsiveness Scale (SRS). The current study applied a similar approach to younger children with DS using the SRS-2. The primary aim was to document patterns of ASD-like symptoms in children with DS at low risk of comorbid ASD to distinguish the symptoms that may be present across DS in general. METHODS SRS-2 standard scores were analyzed in a sample of 40 children with DS, 6-11 years old, who were considered to be at low risk for ASD based on the Social Communication Questionnaire (SCQ) screener. Other developmental characteristics (i.e., age, nonverbal IQ, expressive language), social skills, and problem behaviors were also examined across the sample. RESULTS SRS-2 scores were significantly elevated in this sample compared to the normative population sample. A pattern of ASD-like symptomatology was observed across SRS-2 subdomains. These findings were similar to the findings of the prior study. However, nuanced differences were observed across the two samples that may represent developmental differences across different ages in this population. CONCLUSIONS Replicating and extending a prior study's findings, certain ASD-like behaviors may occur in individuals with DS who are at low risk for comorbid ASD. IMPLICATIONS Understanding the pattern of ASD-like behaviors that occur in children with DS who are at low risk for comorbid ASD will help clinicians in screening and identification efforts. In particular, it will lead to better specification of the behaviors or symptoms that are not characteristic of the DS phenotype and thus are red flags for comorbid ASD in this population.
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Affiliation(s)
- Marie Moore Channell
- Marie Moore Channell, Department of Speech
and Hearing Science, University of Illinois at Urbana-Champaign, 901 S. Sixth
Street, Champaign, IL 61820, USA.
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12
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Martin GE, Barstein J, Patel S, Lee M, Henry L, Losh M. Longitudinal analysis of communication repair skills across three neurodevelopmental disabilities. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2020; 55:26-42. [PMID: 31538707 PMCID: PMC10165896 DOI: 10.1111/1460-6984.12500] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 08/05/2019] [Accepted: 08/24/2019] [Indexed: 05/10/2023]
Abstract
BACKGROUND This study is a longitudinal follow-up to prior work examining the important pragmatic skill of communication repair (i.e., the ability to respond effectively to a request for clarification of an unclear message) across three neurodevelopmental disabilities in which language skills are impaired: fragile X syndrome with and without autism spectrum disorder (FXS-ASD; FXS-O), idiopathic ASD (ASD-O), Down syndrome (DS) and controls with typical development (TD). Prior work examining communication repair skills at younger ages indicated impairments in boys with FXS-ASD and ASD-O, with females performing comparably with each other across groups. AIMS To characterize communication repair skills in young individuals with FXS-ASD, FXS-O, ASD-O, DS and TD, across groups and over development. A secondary aim included documenting sex differences in FXS (with and without ASD) and DS. METHODS & PROCEDURES Sixty young individuals with FXS-ASD (49 males, 11 females), 38 with FXS-O (13 males, 25 females), 38 with ASD-O (males only), 42 with DS (21 males, 21 females) and 41 with TD (21 males, 20 females) participated in the study, with a subsample reported on here who were retested at a second time point 2.7 years later on average. Participants completed a structured, picture-based task designed to assess the ability to repair breakdowns in communication. Participants' responses were compared across groups and sexes at the second time point, and interpreted with respect to previously published (Time 1) findings. OUTCOMES & RESULTS Key findings included that, with age, male groups (including those with FXS-ASD and ASD-O, who showed difficulty at Time 1) performed more comparably, decreasing their use of inappropriate responses, in spite of relatively little change observed in general cognitive or structural language abilities in the clinical groups. However, girls with FXS and DS became more non-responsive with age, and differences between boys and girls with FXS-ASD emerged over time as well. CONCLUSIONS & IMPLICATIONS Findings suggest that impairments in a critical pragmatic skill-the ability to repair communication breakdown-show significant change with age across three neurodevelopmental disabilities, with important sex-specific patterns. These developments were often observed in spite of a relative plateau in cognitive and language growth, suggesting that repair skills may be more malleable and therefore an excellent target for intervention. Findings not only inform the nature of pragmatic impairment across groups but also can importantly inform clinical practice, suggesting that clinicians should monitor pragmatic skills such as repairs throughout development and also consider the role of sex in clinical efforts.
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Affiliation(s)
- Gary E. Martin
- Department of Communication Sciences and Disorders, St. John’s University, Staten Island, NY, USA
| | - Jamie Barstein
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - Shivani Patel
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - Michelle Lee
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - Laura Henry
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - Molly Losh
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
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Characteristics Associated with Autism Spectrum Disorder Risk in Individuals with Down Syndrome. J Autism Dev Disord 2019; 49:3543-3556. [DOI: 10.1007/s10803-019-04074-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Abbeduto L, Thurman AJ, McDuffie A, Klusek J, Feigles RT, Ted Brown W, Harvey DJ, Adayev T, LaFauci G, Dobkins C, Roberts JE. ASD Comorbidity in Fragile X Syndrome: Symptom Profile and Predictors of Symptom Severity in Adolescent and Young Adult Males. J Autism Dev Disord 2019; 49:960-977. [PMID: 30382442 DOI: 10.1007/s10803-018-3796-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Many males with FXS meet criteria for ASD. This study was designed to (1) describe ASD symptoms in adolescent and young adult males with FXS (n = 44) and (2) evaluate the contributions to ASD severity of cognitive, language, and psychiatric factors, as well as FMRP (the protein deficient in FXS). A few ASD symptoms on the ADOS-2 were universal in the sample. There was less impairment in restricted and repetitive behaviors (RRB) than in the social affective (SA) domain. The best predictor of overall ASD severity and SA severity was expressive syntactic ability. RRB severity was best predicted by the psychiatric factors. Implications for clinical practice and for understanding the ASD comorbidity in FXS are discussed.
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Affiliation(s)
- Leonard Abbeduto
- University of California, Davis, USA. .,UC Davis MIND Institute, 2825 50th St, Sacramento, CA, 95817, USA.
| | | | | | | | | | - W Ted Brown
- New York State Institute for Basic Research in Developmental Disabilities, New York, USA
| | | | - Tatyana Adayev
- New York State Institute for Basic Research in Developmental Disabilities, New York, USA
| | - Giuseppe LaFauci
- New York State Institute for Basic Research in Developmental Disabilities, New York, USA
| | - Carl Dobkins
- New York State Institute for Basic Research in Developmental Disabilities, New York, USA
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15
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Martin GE, Bush L, Klusek J, Patel S, Losh M. A Multimethod Analysis of Pragmatic Skills in Children and Adolescents With Fragile X Syndrome, Autism Spectrum Disorder, and Down Syndrome. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:3023-3037. [PMID: 30418476 PMCID: PMC6440309 DOI: 10.1044/2018_jslhr-l-18-0008] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/26/2018] [Accepted: 07/16/2018] [Indexed: 05/19/2023]
Abstract
PURPOSE Pragmatic language skills are often impaired above and beyond general language delays in individuals with neurodevelopmental disabilities. This study used a multimethod approach to language sample analysis to characterize syndrome- and sex-specific profiles across different neurodevelopmental disabilities and to examine the congruency of 2 analysis techniques. METHOD Pragmatic skills of young males and females with fragile X syndrome with autism spectrum disorder (FXS-ASD, n = 61) and without autism spectrum disorder (FXS-O, n = 40), Down syndrome (DS, n = 42), and typical development (TD, n = 37) and males with idiopathic autism spectrum disorder only (ASD-O, n = 29) were compared using variables obtained from a detailed hand-coding system contrasted with similar variables obtained automatically from the language analysis program Systematic Analysis of Language Transcripts (SALT). RESULTS Noncontingent language and perseveration were characteristic of the pragmatic profiles of boys and girls with FXS-ASD and boys with ASD-O. Boys with ASD-O also initiated turns less often and were more nonresponsive than other groups, and girls with FXS-ASD were more nonresponsive than their male counterparts. Hand-coding and SALT methods were largely convergent with some exceptions. CONCLUSION Results suggest both similarities and differences in the pragmatic profiles observed across different neurodevelopmental disabilities, including idiopathic and FXS-associated cases of ASD, as well as an important sex difference in FXS-ASD. These findings and congruency between the 2 language sample analysis techniques together have important implications for assessment and intervention efforts.
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Affiliation(s)
- Gary E. Martin
- Department of Communication Sciences and Disorders, St. John's University, Staten Island, NY
| | - Lauren Bush
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Jessica Klusek
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia
| | - Shivani Patel
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Molly Losh
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
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Del Hoyo Soriano L, Thurman AJ, Abbeduto L. Specificity: A Phenotypic Comparison of Communication-Relevant Domains Between Youth With Down Syndrome and Fragile X Syndrome. Front Genet 2018; 9:424. [PMID: 30327664 PMCID: PMC6174242 DOI: 10.3389/fgene.2018.00424] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 09/10/2018] [Indexed: 01/25/2023] Open
Abstract
Despite the shared presence of an intellectual disability (ID), there is a growing literature documenting important phenotypic differences between Down syndrome (DS) and fragile X syndrome (FXS). These conclusions, however, are based on a synthesis across studies, each of which typically includes only measures of a limited number of constructs, and with differing participant characteristics. Firmer conclusions regarding specific phenotypes require a single comprehensive multi-domain assessment of participants with the syndrome groups being well matched on chronological age (CA) and cognitive functioning. The current study was designed to fill this gap by assessing several important cognitive and behavioral domains relevant to communication, such as: structural language skills, false belief understanding, as well as pragmatics and behavioral difficulties, in 30 adolescents of both sexes with DS and 39 males with FXS, matched on CA and nonverbal (NV) cognition. After statistically controlling for NV cognition, we did not find significant syndrome differences in expressive and receptive structural language or false belief understanding. In contrast, participants with DS displayed less stereotyped language and fewer behavioral difficulties compared to males with FXS. Within-syndrome associations among the targeted domains are described. Finally, females with DS were less impaired than males with DS in almost all structural language domains, whereas no significant sex-related differences were observed in NV cognition, false belief understanding, pragmatics, or behavior. Clinical and methodological implications of the findings are discussed.
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Affiliation(s)
- Laura Del Hoyo Soriano
- MIND Institute, University of California, Davis, Sacramento, CA, United States.,Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Angela John Thurman
- MIND Institute, University of California, Davis, Sacramento, CA, United States.,Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
| | - Leonard Abbeduto
- MIND Institute, University of California, Davis, Sacramento, CA, United States.,Department of Psychiatry and Behavioral Sciences, University of California, Davis, Sacramento, CA, United States
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Barstein J, Martin GE, Lee M, Losh M. A Duck Wearing Boots?! Pragmatic Language Strategies for Repairing Communication Breakdowns Across Genetically Based Neurodevelopmental Disabilities. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1440-1454. [PMID: 29800075 PMCID: PMC6195092 DOI: 10.1044/2018_jslhr-l-17-0064] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 02/28/2018] [Indexed: 05/12/2023]
Abstract
PURPOSE The ability to repair breakdowns in communication is an important pragmatic language skill that helps to maintain clear and meaningful interactions. Examining this ability in genetically based neurodevelopmental disabilities in which pragmatics are affected can provide important information about the precise pragmatic skills impacted across different populations and also help to identify core mechanisms underlying pragmatic impairment that may inform tailored interventions. METHOD Individuals with idiopathic autism spectrum disorder (ASD-O; n = 40), fragile X syndrome with comorbid autism spectrum disorder (FXS-ASD; n = 62), FXS without ASD (FXS-O; n = 38), Down syndrome (DS; n = 43), and typical development (TD; n = 42) completed a picture description task in which an examiner prompted for clarification repeatedly to elicit communication repair attempts. Participants' response strategies were compared across diagnostic groups and by sex and examined in relationship to different cognitive abilities. RESULTS Relatively few group differences were observed in responses to requests for clarification overall. Males with ASD-O responded less to clarification requests than males with FXS-ASD and FXS-O, and males with FXS-ASD responded more inappropriately than males with ASD-O and DS. All male groups became less responsive to prompts for communication repair across the series of requests. Males with TD and FXS-ASD used less effective strategies than females. CONCLUSION All groups showed some proficiency in repairing communication breakdowns, although individuals with ASD-O and FXS-ASD demonstrated some key areas of difficulty, highlighting the importance of considering ASD symptomatology in assessment and treatment of males with FXS. Findings also suggest that, across groups, multiple requests for clarification may lead to disengagement from the interaction. Finally, correlated skills observed across groups could implicate different underlying skills related to communication repair abilities across groups.
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Affiliation(s)
- Jamie Barstein
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Gary E. Martin
- Department of Communication Sciences and Disorders, St. John's University, Staten Island, NY
| | - Michelle Lee
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
| | - Molly Losh
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL
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Ashby SA, Channell MM, Abbeduto L. Inferential language use by youth with Down syndrome during narration. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 71:98-108. [PMID: 29032290 PMCID: PMC5675781 DOI: 10.1016/j.ridd.2017.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 08/22/2017] [Accepted: 10/03/2017] [Indexed: 05/23/2023]
Abstract
We examined inferential language use by youth with Down syndrome (DS) in the context of narrative storytelling relative to younger typically developing (TD) children and same-aged peers with fragile X syndrome (FXS) matched on nonverbal cognitive ability level. Participants' narratives were coded for the use of different types of inferential language. Participants with DS used proportionately less inferential language overall relative to their counterparts with TD or FXS, although mean length of utterance accounted for group differences observed for the DS-TD group comparison only. Patterns of inferential language use varied across inferential subtypes and across participant groups, with mean length of utterance playing a significant role in group differences. These findings suggest potential syndrome specificity to the DS phenotype regarding impairments in inferential language use that can be partially explained by level of expressive syntactic ability and should be considered in future research. Clinical interventions within the DS population, therefore, should target to some extent the use of inferential language and complex sentence structure.
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Affiliation(s)
- Shealyn A Ashby
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, 901 S. Sixth Street, Champaign, IL, 61820, USA.
| | - Marie Moore Channell
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, 901 S. Sixth Street, Champaign, IL, 61820, USA.
| | - Leonard Abbeduto
- MIND Institute, University of California, Davis, 2825 50th Street, Sacramento, CA, 95817, USA.
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