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Pinks ME, Van Deusen K, Prince MA, Esbensen AJ, Thurman AJ, Patel LR, Abbeduto L, Walsh MM, Daunhauer LA, Feigles RT, Nguyen V, Fidler DJ. Psychometric evaluation of a working memory assessment measure in young children with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 139:104564. [PMID: 37451184 PMCID: PMC10528903 DOI: 10.1016/j.ridd.2023.104564] [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: 03/09/2023] [Revised: 06/14/2023] [Accepted: 06/24/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Working memory involves the temporary storage and manipulation of information and is frequently an area of challenge for individuals with Down syndrome (DS). Despite the potential benefits of intervention, laboratory assessments of working memory that could capture intervention effects have not undergone rigorous evaluation for use with young children with DS. It is critical to evaluate assessments of working memory in young children with DS to ensure the reliable and accurate measurement of performance. AIM This study evaluated an adapted laboratory measure of working memory for young children with DS 2-8 years old. METHOD A self-ordered pointing task, the Garage Game, was administered to 78 children with DS (mean = 5.17 years; SD = 1.49). Adaptations were made to the task to minimize potential DS phenotype-related language and motor confounds. RESULTS Results indicate that the measure is feasible, scalable, and developmentally sensitive, with minimal floor and practice effects for this population within this chronological and developmental age range. CONCLUSION These findings demonstrate that the Garage Game is promising for use in studies of early working memory and treatment trials that aim to support the development of this critical dimension of executive functioning for children with DS.
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Affiliation(s)
- Miranda E Pinks
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Kaylyn Van Deusen
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Mark A Prince
- Department of Psychology, 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; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Angela John Thurman
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California Davis Health, Sacramento, CA, United States
| | - Lina R Patel
- Department of Psychiatry, University of Colorado-Anschutz Medical Campus, Aurora, CO, United States
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California Davis Health, Sacramento, CA, United States
| | - Madison M Walsh
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Lisa A Daunhauer
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Robyn Tempero Feigles
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California Davis Health, Sacramento, CA, United States
| | - Vivian Nguyen
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California Davis Health, Sacramento, CA, United States
| | - Deborah J Fidler
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States.
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Borji R, Laatar R, Zarrouk N, Sahli S, Rebai H. Cognitive-motor interference during standing stance across different postural and cognitive tasks in individuals with Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 139:104562. [PMID: 37379660 DOI: 10.1016/j.ridd.2023.104562] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 06/10/2023] [Accepted: 06/21/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Individuals with Down syndrome (DS) presented both cognitive and motor impairments that could influence each other. Therefore, exploring cognitive-motor interference during standing stance is relevant in this population. AIMS This study explored the dual task (DT) effects on postural balance during diverse cognitive tasks and sensory manipulations in individuals with DS, compared to those with typical development (TD). METHODS AND PROCEDURES Fifteen adolescents with DS (age = 14.26 ± 1.27 years; height = 1.50 ± 0.02; weight = 46.46 ± 4.03 kg; BMI =20.54 ± 1.51 kg/m2) and thirteen with TD (age = 14.07 ± 1.11 years; height = 1.50 ± 0.05; weight = 44.92 ± 4.15 kg; BMI =19.77 ± 0.94 kg/m2) participated in this study. Postural and cognitive performances for the selective span task (SST) and the verbal fluency (VF) were recorded during single task (ST) and DT conditions. Postural conditions were: firm eyes open (firm-EO), firm eyes closed (firm-EC) and foam-EO. Motor and cognitive DT costs (DTC) were calculated and analyzed across these different cognitive and postural conditions. OUTCOMES AND RESULTS In the DS group, postural performance was significantly (p < 0.001) altered during all DT conditions, compared to the ST situation. Moreover, the motor DTC was significantly (p < 0.001) higher while performing the VF task than the SST. However, in the control group, postural performance was significantly (p < 0.001) impaired only while performing the VF test in the DT-Firm EO condition. For both groups, cognitive performances were significantly (p < 0.05) altered in all DT conditions compared to the ST one. CONCLUSION Adolescents with DS are more prone to DT effects on postural balance than those with TD.
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Affiliation(s)
- Rihab Borji
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia.
| | - Rabeb Laatar
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Nidhal Zarrouk
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Sonia Sahli
- Research Laboratory: Education, Motricité, Sport et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Haithem Rebai
- Laboratory 'Optimisation de la Performance Sportive, Centre National de Médecine et Sciences du Sport (CNMSS)', Tunis, Tunisia
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Schworer EK, Altaye M, Fidler DJ, Beebe DW, Wiley S, Hoffman EK, Esbensen AJ. Evaluating Processing Speed and Reaction Time Outcome Measures in Children and Adolescents with Down Syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5202. [PMID: 36982110 PMCID: PMC10049659 DOI: 10.3390/ijerph20065202] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
Reliable and valid cognitive outcome measures, including examiner-administered and computer-facilitated assessments of processing speed and reaction time, are necessary for future clinical trials that include individuals with Down syndrome (DS). The current study evaluated the score distributions and psychometric properties of four examiner-administered and three computerized processing speed and reaction time measures. Participants included 97 individuals with DS, aged 6 to 17 (M = 12.6, SD = 3.3). Two examiner-administered measures (Differential Ability Scales-II Rapid Naming and Cat/dog Stroop Congruent) met most predetermined psychometric criteria. Other assessments demonstrated good test-retest reliability and had negligible practice effects but lacked adequate feasibility. Recommendations for using processing speed and reaction time assessments in research and suggestions for modifications of measures are discussed.
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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
- Waisman Center, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Mekibib Altaye
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital, Cincinnati, OH 45229, USA
| | - Deborah J. Fidler
- Human Development and Family Studies, Colorado State University, Fort Collins, CO 80523, USA
| | - Dean W. Beebe
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Susan Wiley
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - Emily K. Hoffman
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Anna J. Esbensen
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, 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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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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