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de Almeida Rodrigues L, de Melo A, de Medeiros N, Camargos AR. Family-professional collaborative intervention via telehealth with an infant with Down syndrome and visual impairment: a case report. Physiother Theory Pract 2024; 40:2458-2467. [PMID: 37540216 DOI: 10.1080/09593985.2023.2244067] [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: 03/30/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND Collaborative interventions, involving partnerships between professionals and families, make it possible to actively engage families in the rehabilitation process. However, no study was found that used a physiotherapy intervention via telehealth for infants with Down syndrome (DS). OBJECTIVE Describe the case report of a family-professional collaborative intervention via telehealth for an infant with Down syndrome and visual impairment during the COVID-19 pandemic. CASE DESCRIPTION A male infant five months old participated in a collaborative intervention for a period of eight weeks. Three goals were set with the family, and a goal-oriented home program, involving visual stimulation strategies, was organized. OUTCOMES Two goals were achieved. The family scored changes in performance and satisfaction with the infant's performance according to the adapted Canadian Occupational Performance Measure. Improvement of motor skills was verified by Alberta Infant Motor Scale and changes in mobility and daily activities performance were measured by the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test. CONCLUSION The use of family-professional collaborative intervention via telehealth during the COVID-19 pandemic shows promising results for achieving the goals established by the family collaboratively with the physical therapists.
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Affiliation(s)
- Lara de Almeida Rodrigues
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Aline de Melo
- Physical Therapy Department, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Náguia de Medeiros
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Resende Camargos
- Graduate Program in Rehabilitation Sciences, School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Peterson JK, Clarke S, Gelb BD, Kasparian NA, Kazazian V, Pieciak K, Pike NA, Setty SP, Uveges MK, Rudd NA. Trisomy 21 and Congenital Heart Disease: Impact on Health and Functional Outcomes From Birth Through Adolescence: A Scientific Statement From the American Heart Association. J Am Heart Assoc 2024; 13:e036214. [PMID: 39263820 DOI: 10.1161/jaha.124.036214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 04/24/2024] [Indexed: 09/13/2024]
Abstract
Due to improvements in recognition and management of their multisystem disease, the long-term survival of infants, children, and adolescents with trisomy 21 and congenital heart disease now matches children with congenital heart disease and no genetic condition in many scenarios. Although this improved survival is a triumph, individuals with trisomy 21 and congenital heart disease have unique and complex care needs in the domains of physical, developmental, and psychosocial health, which affect functional status and quality of life. Pulmonary hypertension and single ventricle heart disease are 2 known cardiovascular conditions that reduce life expectancy in individuals with trisomy 21. Multisystem involvement with respiratory, endocrine, gastrointestinal, hematological, neurological, and sensory systems can interact with cardiovascular health concerns to amplify adverse effects. Neurodevelopmental, psychological, and functional challenges can also affect quality of life. A highly coordinated interdisciplinary care team model, or medical home, can help address these complex and interactive conditions from infancy through the transition to adult care settings. The purpose of this Scientific Statement is to identify ongoing cardiovascular and multisystem, developmental, and psychosocial health concerns for children with trisomy 21 and congenital heart disease from birth through adolescence and to provide a framework for monitoring and management to optimize quality of life and functional status.
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Subu MA, Lubis E, Mustikowati T, Marianna S, Dewi A, Dewi SH, Waluyo I, Sutandi A, Mottershead R, Ahmed FR, Dias JM, Al Yateem N. Listening to the voices of mothers in Indonesia: Qualitative content analysis of experiences in parenting children with down syndrome. J Pediatr Nurs 2024; 77:e8-e15. [PMID: 38458856 DOI: 10.1016/j.pedn.2024.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 03/10/2024]
Abstract
INTRODUCTION Generally, mothers provide the majority of caring for children who have Down syndrome. They pose challenges not only with regard to the acceptability of the child situation but also with regard to the provision of care for children with DS. AIM To explore the experiences of mothers parenting children with DS in Indonesia, to give a better understanding of their needs, which is necessary for the delivery of treatment. METHODS A descriptive qualitative research with content analysis was used. Study participants (15 mothers) were purposively sampled from attendees of a State Special School for students with disabilities. Data was collected via semi-structure interviews and were audio recorded. Participant's statements underwent content analysis, and the principle of trustworthiness was subsequently applied. RESULTS Five main themes describing participants' experiences were identified: (1) parenting experiences - the impacts, (2) special needs, (3) parenting barriers, (4) parenting facilitators, and (5) mothers' expectations. CONCLUSIONS The study findings showed that the mothers viewed their situation in both positive and negative ways. Despite the limited sample size in this exploratory study, the results offer new insights into raising a child with DS in a particular cultural setting. IMPLICATIONS FOR PRACTICE This study offers important information to families and healthcare providers to improve awareness of the disorder and its appropriate management methods. It is important that an exploration of the experiences of mothers will provide healthcare professionals and families with an understanding of the situation. This understanding is essential for the effective management and delivery of treatment.
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Affiliation(s)
- Muhammad Arsyad Subu
- Nursing department, College of Health Sciences University of Sharjah, United Arab Emirates; Faculty of Nursing and Midwifery Universitas Binawan Jakarta, Indonesia.
| | - Erika Lubis
- Faculty of Nursing and Midwifery Universitas Binawan Jakarta, Indonesia.
| | - Tri Mustikowati
- Faculty of Nursing and Midwifery Universitas Binawan Jakarta, Indonesia.
| | - Siswani Marianna
- Faculty of Nursing and Midwifery Universitas Binawan Jakarta, Indonesia.
| | - Aliana Dewi
- Faculty of Nursing and Midwifery Universitas Binawan Jakarta, Indonesia.
| | | | - Imam Waluyo
- Indonesian Manual Manipulative Association, Jakarta, Indonesia
| | - Aan Sutandi
- Faculty of Nursing and Midwifery Universitas Binawan Jakarta, Indonesia.
| | - Richard Mottershead
- Nursing department, College of Health Sciences University of Sharjah, United Arab Emirates.
| | - Fatma Refaat Ahmed
- Nursing department, College of Health Sciences University of Sharjah, United Arab Emirates.
| | - Jacqueline Maria Dias
- Nursing department, College of Health Sciences University of Sharjah, United Arab Emirates.
| | - Nabeel Al Yateem
- Nursing department, College of Health Sciences University of Sharjah, United Arab Emirates.
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Kamińska K, Ciołek M, Krysta K, Krzystanek M. Benefits of Treadmill Training for Patients with Down Syndrome: A Systematic Review. Brain Sci 2023; 13:808. [PMID: 37239280 PMCID: PMC10216428 DOI: 10.3390/brainsci13050808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The objective of this study was to evaluate the effectiveness of various results of treadmill training in children and adults with Down syndrome (DS). METHODS To provide an overview of this effectiveness, we conducted a systematic literature review of studies in which participants with DS from all age groups received treadmill training, alone or combined with physiotherapy. We also looked for comparisons with control groups of patients with DS who did not undergo treadmill training. The search was performed in medical databases: PubMed, PEDro, Science Direct, Scopus, and Web of Science, and included trials published until February 2023. Following PRISMA criteria, the risk of bias assessment was conducted using a tool developed by the Cochrane Collaboration for RCT. The selected studies presented multiple outcomes with differences in methodology; therefore, we were not able to conduct any sort of data synthesis, so we present measures of treatment effect as mean differences and corresponding 95% confidence intervals. RESULTS We selected 25 studies for the analysis with a total number of 687 participants, and identified 25 different outcomes which are presented in a narrative manner. In all outcomes we observed positive results favoring the treadmill training. DISCUSSION Introducing treadmill exercise into typical physiotherapy generates improvement in mental and physical health of people with DS.
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Affiliation(s)
- Karolina Kamińska
- Students’ Scientific Association, Department and Clinic of Rehabilitation Psychiatry, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland; (K.K.); (M.C.)
| | - Michał Ciołek
- Students’ Scientific Association, Department and Clinic of Rehabilitation Psychiatry, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland; (K.K.); (M.C.)
| | - Krzysztof Krysta
- Department and Clinic of Rehabilitation Psychiatry, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland;
| | - Marek Krzystanek
- Department and Clinic of Rehabilitation Psychiatry, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, 40-055 Katowice, Poland;
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Declercq C, Pochon R. Emotional Lexicon in Down Syndrome. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2022; 127:278-292. [PMID: 36122328 DOI: 10.1352/1944-7558-127.4.278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 08/03/2021] [Indexed: 06/15/2023]
Abstract
We studied comprehension of emotion versus concrete/abstract words in Down syndrome (DS). Study 1 compared 26 participants with DS and 26 typically developing (TD) children matched on verbal ability. Results showed no difference between groups. Study 2 assessed whether chronological age (CA) and (non)verbal abilities predicted developmental trajectories of comprehension in 36 children with DS and 143 TD children. For the latter, these variables predicted comprehension of all three word types. For the former, receptive vocabulary predicted comprehension of all word types, but CA and nonverbal reasoning only predicted comprehension of concrete words. This suggests that people with DS have no specific emotional lexicon deficit. Supporting their general lexical development would help them access abstract and emotional meanings.
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Affiliation(s)
- Christelle Declercq
- Christelle Declercq and Régis Pochon, C2S Laboratory (Cognition, Health, Society), University of Reims Champagne-Ardenne, Reims, France
| | - Régis Pochon
- Christelle Declercq and Régis Pochon, C2S Laboratory (Cognition, Health, Society), University of Reims Champagne-Ardenne, Reims, France
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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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Recognition of Basic Emotions with and without the Use of Emotional Vocabulary by Adolescents with Down Syndrome. Behav Sci (Basel) 2022; 12:bs12060167. [PMID: 35735377 PMCID: PMC9220526 DOI: 10.3390/bs12060167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/24/2022] [Accepted: 05/26/2022] [Indexed: 11/23/2022] Open
Abstract
Background: Children with Down syndrome (DS) often experience behavioral and emotional issues that complicate their socialization process and may lead to psychopathological disorders. These problems may be related to deficits affecting emotional knowledge, particularly emotional vocabulary. Because emotional vocabulary makes it easier for typically developing children to identify emotions, a deficit affecting it in DS could be problematic. Methods: Twenty-eight adolescents with DS matched with typically developing (TD) children for their score on the Benton Facial Recognition Test were asked to recognize six emotional expressions presented in the form of filmed sequences, based on (1) nonverbal cues such as prosody, and (2) an emotional label. Results: The adolescents with DS recognized the six basic emotional expressions at a level comparable to that of the TD children in both conditions (with and without emotional vocabulary), but the facilitating effect of vocabulary was lower in that group. Conclusions: This study does not show a deficit affecting emotion recognition in DS, but it emphasizes the importance of early acquisition of emotional knowledge in this syndrome. Regular and varied use of internal state words should be encouraged in familial interactions, and education should include specifically adapted social and emotional learning programs.
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Onnivello S, Colaianni S, Pulina F, Locatelli C, Marcolin C, Ramacieri G, Antonaros F, Vione B, Piovesan A, Lanfranchi S. Executive functions and adaptive behaviour in individuals with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:32-49. [PMID: 34750907 PMCID: PMC9299024 DOI: 10.1111/jir.12897] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 08/02/2021] [Accepted: 10/12/2021] [Indexed: 05/31/2023]
Abstract
BACKGROUND Previous research has explored executive functions (EFs) and adaptive behaviour in children and adolescents with Down syndrome (DS), but there is a paucity of research on the relationship between the two in this population. This study aims to shed light on the profile of EFs and adaptive behaviour in DS, exploring the differences by age and investigating the relationship between these two domains. METHOD Parents/caregivers of 100 individuals with DS from 3 to 16 years old participated in the study. The sample was divided into preschoolers (3-6.11 years old) and school-age children (7-16 years old). Parents/caregivers completed either the Preschool Version of the Behaviour Rating Inventory of Executive Function (for children 2-6.11 years old) or the Second Edition of the same Inventory (for individuals 7 + years old). Adaptive behaviour was assessed with the Vineland Adaptive Behaviour Scale - Interview, Second Edition. RESULTS Findings suggest that individuals with DS have overall difficulties, but also patterns of strength and weakness in their EFs and adaptive behaviour. The preschool-age and school-age children's EF profiles differed slightly. While both age groups showed Emotional Control as a relative strength and Working Memory as a weakness, the school-age group revealed further weaknesses in Shift and Plan/Organise. As concerns adaptive behaviour, the profiles were similar in the two age groups, with Socialisation as a strength, and Communication and Daily Living Skills as weaknesses, but with a tendency for preschoolers to obtain intermediate scores for the latter. When the relationship between EFs and adaptive behaviour was explored, Working Memory predicted Communication in the younger group, while in the older group the predictors varied, depending on the adaptive domains: Working Memory was a predictor of Communication, Inhibit of Daily Living Skills, and Inhibit and Shift of Socialisation. CONCLUSION As well as elucidating the EF profiles and adaptive behaviour in individuals with DS by age, this study points to the role of EFs in adaptive functioning, providing important information for targeted interventions.
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Affiliation(s)
- S. Onnivello
- Department of Developmental Psychology and SocialisationUniversity of PadovaPadovaItaly
| | - S. Colaianni
- Department of Developmental Psychology and SocialisationUniversity of PadovaPadovaItaly
| | - F. Pulina
- Department of Developmental Psychology and SocialisationUniversity of PadovaPadovaItaly
| | - C. Locatelli
- Neonatology UnitSt. Orsola‐Malpighi PolyclinicBolognaItaly
| | - C. Marcolin
- Department of Developmental Psychology and SocialisationUniversity of PadovaPadovaItaly
| | - G. Ramacieri
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Unit of Histology, Embryology and Applied BiologyUniversity of BolognaBolognaItaly
| | - F. Antonaros
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Unit of Histology, Embryology and Applied BiologyUniversity of BolognaBolognaItaly
| | - B. Vione
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Unit of Histology, Embryology and Applied BiologyUniversity of BolognaBolognaItaly
| | - A. Piovesan
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Unit of Histology, Embryology and Applied BiologyUniversity of BolognaBolognaItaly
| | - S. Lanfranchi
- Department of Developmental Psychology and SocialisationUniversity of PadovaPadovaItaly
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Will EA, Schworer EK, Esbensen AJ. [Formula: see text] The role of distinct executive functions on adaptive behavior in children and adolescents with Down syndrome. Child Neuropsychol 2021; 27:1054-1072. [PMID: 33938385 PMCID: PMC8484022 DOI: 10.1080/09297049.2021.1917531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 04/12/2021] [Indexed: 10/21/2022]
Abstract
Difficulties in executive function are a relatively well-characterized feature of the neuropsychological profile in Down syndrome (DS), yet the impact of these challenges on aspects of daily functioning remain poorly understood. We examined the role of specific executive functions on domains of adaptive behavior in children and adolescents with DS. Participants included 68 children and adolescents with DS between 6-17 years old (mean chronological age = 12.56 years; SD = 3.22) and their caregivers. Parent reported executive function skills were measured using the BRIEF-2 and adaptive behavior was measured using the Vineland Adaptive Behavior Scales-III. Results identified working memory as a significant predictor of Communication, Daily Living, and Socialization skills, and Shifting significantly predicted Daily Living and Socialization. Findings demonstrate the relation between executive functions and adaptive behavior and highlight the effects of working memory on aspects of daily functioning for individuals with DS.
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Affiliation(s)
| | - Emily K Schworer
- Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, 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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10
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One-year effects of bifocal and unifocal glasses on executive functions in children with Down syndrome in a randomized controlled trial. Sci Rep 2021; 11:16893. [PMID: 34413362 PMCID: PMC8377071 DOI: 10.1038/s41598-021-96308-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 08/04/2021] [Indexed: 11/08/2022] Open
Abstract
Appropriate glasses can improve visual functioning of children with Down syndrome (DS), but it is unknown if such interventions influence their cognitive impairments. In a randomized controlled trial with 1-year follow-up. Children with DS (2-16 years) were provided either bifocal glasses (add +2.5 Dioptres; n = 50) or unifocal glasses (n = 52). Executive functions were assessed pre- and post-intervention with the task-based Minnesota Executive Function Scale (MEFS) and with questionnaires, BRIEF-P and BRIEF, parents' and teachers' version. Intervention effects and associations between executive functions, (near) vision and ocular alignment were analysed. Intervention improved MEFS-Total-scores in the bifocal group (p = 0.002; Cohen's d = 0.60) but not in the unifocal group (p = 0.191; Cohen's d = 0.24). Post-intervention, there was no intergroup difference (p = 0.120; Cohen's d = 0.34). Post-intervention, higher MEFS-scores were associated with better visual acuities (crowded near p = 0.025; uncrowded near p = 0.019; distant p = 0.045). Pre-post changes in MEFS-scores correlated significantly with improved ocular alignment (p = 0.040). Exploratory analysis of the questionnaires showed improved teacher-rated BRIEF-scores in both groups (bifocals: p = 0.014, Cohen's d = 1.91; unifocals: p = 0.022, Cohen's d = 1.46), with no intergroup difference (p = 0.594; Cohen's d = 0.23). These results demonstrate positive effects of wearing better-correcting glasses on executive functioning in children with DS, suggesting a link between their visual and executive functioning. However, the relative contributions of distant and near vision need further study.
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Hendrix JA, Amon A, Abbeduto L, Agiovlasitis S, Alsaied T, Anderson HA, Bain LJ, Baumer N, Bhattacharyya A, Bogunovic D, Botteron KN, Capone G, Chandan P, Chase I, Chicoine B, Cieuta-Walti C, DeRuisseau LR, Durand S, Esbensen A, Fortea J, Giménez S, Granholm AC, Hahn LJ, Head E, Hillerstrom H, Jacola LM, Janicki MP, Jasien JM, Kamer AR, Kent RD, Khor B, Lawrence JB, Lemonnier C, Lewanda AF, Mobley W, Moore PE, Nelson LP, Oreskovic NM, Osorio RS, Patterson D, Rasmussen SA, Reeves RH, Roizen N, Santoro S, Sherman SL, Talib N, Tapia IE, Walsh KM, Warren SF, White AN, Wong GW, Yi JS. Opportunities, barriers, and recommendations in down syndrome research. TRANSLATIONAL SCIENCE OF RARE DISEASES 2021; 5:99-129. [PMID: 34268067 PMCID: PMC8279178 DOI: 10.3233/trd-200090] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recent advances in medical care have increased life expectancy and improved the quality of life for people with Down syndrome (DS). These advances are the result of both pre-clinical and clinical research but much about DS is still poorly understood. In 2020, the NIH announced their plan to update their DS research plan and requested input from the scientific and advocacy community. OBJECTIVE The National Down Syndrome Society (NDSS) and the LuMind IDSC Foundation worked together with scientific and medical experts to develop recommendations for the NIH research plan. METHODS NDSS and LuMind IDSC assembled over 50 experts across multiple disciplines and organized them in eleven working groups focused on specific issues for people with DS. RESULTS This review article summarizes the research gaps and recommendations that have the potential to improve the health and quality of life for people with DS within the next decade. CONCLUSIONS This review highlights many of the scientific gaps that exist in DS research. Based on these gaps, a multidisciplinary group of DS experts has made recommendations to advance DS research. This paper may also aid policymakers and the DS community to build a comprehensive national DS research strategy.
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Affiliation(s)
| | - Angelika Amon
- Deceased. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA; Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA; MIND Institute, University of California, Davis, CA, USA
| | | | - Tarek Alsaied
- Heart Institute Department of Pediatrics Cincinnati Children’s Hospital Medical Center University of Cincinnati, Cincinnati, OH, USA
| | | | | | - Nicole Baumer
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA; Down Syndrome Program, Developmental Medicine Center, Boston Children’s Hospital, Boston, MA, USA
| | - Anita Bhattacharyya
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Cell and Regenerative Biology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Dusan Bogunovic
- Department of Microbiology, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mt. Sinai, New York, NY; Precision Immunology Institute, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; Mindich Child Health and Development Institute, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Kelly N. Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Priya Chandan
- Department of Neurosurgery, Division of Physical Medicine and Rehabilitation, University of Louisville School of Medicine, Louisville, KY, USA
| | - Isabelle Chase
- Department of Pediatric Dentistry, Boston Children’s Hospital, Boston, MA, USA
| | - Brian Chicoine
- Advocate Medical Group Adult Down Syndrome Center, Park Ridge, IL, USA
| | | | | | | | - Anna Esbensen
- Department of Pediatrics, University of Cincinnati College of Medicine & Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Juan Fortea
- Barcelona Down Medical Center, Fundació Catalana de Síndrome de Down, Barcelona, Spain; Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Center of Biomedical Investigation Network for Neurodegenerative Diseases, Madrid, Spain
| | - Sandra Giménez
- Multidisciplinary Sleep Unit, Respiratory Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ann-Charlotte Granholm
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, USA
- Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Laura J. Hahn
- Department of Speech and Hearing Science, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Elizabeth Head
- Department of Pathology and Laboratory Medicine, UC Irvine School of Medicine, Orange, CA, USA
| | | | - Lisa M. Jacola
- Department of Psychology, St Jude Children’s Research Hospital, Memphis, TN, USA
| | | | - Joan M. Jasien
- Division of Pediatric Neurology, Duke University Health System, Durham, NC, USA
| | - Angela R. Kamer
- Department of Periodontology and Implant Dentistry, New York University, College of Dentistry, New York, NY, USA
| | - Raymond D. Kent
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Bernard Khor
- Benaroy Research Institute at Virginia Mason, Seattle, WA, USA
| | - Jeanne B. Lawrence
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA; Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Amy Feldman Lewanda
- Children s National Rare Disease Institute, Children’s National Health System, Washington, DC., USA
| | - William Mobley
- Department of Neurosciences, University of California, San Diego, CA, USA
| | - Paul E. Moore
- Division of Allergy, Immunology, and Pulmonology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Nicolas M. Oreskovic
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA; Department of Internal Medicine, Massachusetts General Hospital, Boston, Mass
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ricardo S. Osorio
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - David Patterson
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, USA
- Eleanor Roosevelt Institute, University of Denver, Denver, CO, USA; Department of Biological Sciences, University of Denver, Denver, CO, USA; Molecular and Cellular Biophysics Program, University of Denver, Denver, CO, USA
| | - Sonja A. Rasmussen
- Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL; Department of Epidemiology, University of Florida College of Public Health and Health Professions and College of Medicine, Gainesville, FL
| | - Roger H. Reeves
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nancy Roizen
- Department of Pediatrics, UH/Rainbow Babies and Children’s Hospital and Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA
| | - Stephanie Santoro
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Stephanie L. Sherman
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Nasreen Talib
- Division of General Pediatrics, Children’s Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, USA
| | - Ignacio E. Tapia
- Sleep Center, Division of Pulmonary Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kyle M. Walsh
- Division of Neuro-epidemiology, Department of Neurosurgery, Duke University, Durham, NC, USA
| | - Steven F. Warren
- Institute for Life Span Studies, University of Kansas, Lawrence, KS, USA
| | - A. Nicole White
- Research Foundation, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Guang William Wong
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Metabolism and Obesity Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John S. Yi
- Division of Surgical Sciences, Department of Surgery, Duke University Medical Center, Durham, NC, USA
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Differences between children with Down syndrome and typically developing children in adaptive behaviour, executive functions and visual acuity. Sci Rep 2021; 11:7602. [PMID: 33828124 PMCID: PMC8027651 DOI: 10.1038/s41598-021-85037-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 02/18/2021] [Indexed: 11/08/2022] Open
Abstract
In children with Down syndrome (DS) development of visual, motor and cognitive functions is atypical. It is unknown whether the visual impairments in children with DS aggravate their lag in cognitive development. Visual impairment and developmental lags in adaptive behaviour and executive functions were assessed in 104 children with DS, 2–16 years, by comparing their adaptive behaviour, executive functions and visual acuity (distant and near) scores against published age-matched norm scores of typically developing children. Associations between these lags were explored. Mean (± SEM) differences to age-matched norms indicated reduced performance in DS: Vineland Screener questionnaire, − 63 ± 3.8 months; task-based Minnesota Executive Function Scale (MEFS), − 46.09 ± 2.07 points; BRIEF-P questionnaire, 25.29 ± 4.66 points; BRIEF parents’ and teachers’ questionnaire, 17.89 ± 3.92 points and 40.10 ± 3.81 points; distant and near visual acuity, 0.51 ± 0.03 LogMAR and 0.63 ± 0.03 LogMAR (near − 0.11 ± 0.04 LogMAR poorer than distant). Adaptive behaviour (Vineland-S) correlated with the severity of visual impairment (r = − 0.396). Children with DS are severely impaired in adaptive behaviour, executive functions and visual acuities (near visual acuity more severely impaired than distant visual acuity). Larger impairment in adaptive behaviour is found in children with larger visual impairment. This supports the idea that visual acuity plays a role in adaptive development.
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Early Regulatory Skills and Social Communication Development in Infants with Down Syndrome. Brain Sci 2021; 11:brainsci11020208. [PMID: 33572121 PMCID: PMC7915648 DOI: 10.3390/brainsci11020208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 11/30/2022] Open
Abstract
Children with Down syndrome (DS) demonstrate substantial variability in communication and language outcomes. One potential source of variability in this skill area may be early regulatory function. Characterizing the early link between regulatory function and early social communication may benefit infants with DS at risk of difficulties with social communication and language skill acquisition. Forty-three infants with DS were assessed at two time points, six months apart. At Time 1, the average chronological age was 9.0 months (SD = 3.9) and caregivers completed the Infant Behavior Questionnaire-Revised (IBQ-R) to assess regulatory function. Six months later, caregivers rated infant communication at the second visit using the Communication and Symbolic Behavior Scales Infant Toddler Checklist (CSBS-ITC). Infant developmental level was assessed at both visits using the Bayley Scales of Infant and Toddler Development, Third Edition and caregivers reported on developmental history and biomedical comorbidities. Infant regulatory function at Time 1 predicted social communication outcomes at Time 2, six months later. Findings from this study suggest that elevated risk for pronounced communication challenges may be detectable as early as infancy in DS.
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Schworer EK, Fidler DJ, Kaur M, Needham AW, Prince MA, Daunhauer LA. Goal-directed action planning in infants with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:713-724. [PMID: 32666591 DOI: 10.1111/jir.12763] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 06/19/2020] [Accepted: 06/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Down syndrome (DS) is a neurogenetic disorder associated with risk for executive dysfunction, or difficulties with the cognitive processes required for planning volitional, goal-directed behaviour. This study examines the developmental origins of difficulties with goal-directed action planning in infants with DS to inform our understanding of the cognitive phenotype associated with DS and its implications for intervention. METHOD First, the study compared the performance of infants with DS (n = 44, mean chronological age = 7.5 months, SD = 2.3) and typically developing infants (n = 31, mean chronological age = 7.5 months, SD = 2.9) on plan production and planning efficiency during an early planning task. Next, potential sources of variability in planning behaviour (motor performance and sensory processing) within the DS sample were examined. All infants completed an early planning laboratory task and the Bayley Scales of Infant Development-III Cognitive Scale. The motor and sensory skills of infants with DS were assessed by the motor scales of the Bayley Scales of Infant Development-III and the Infant Sensory Profile-2. DS-related biomedical history information was provided by caregivers for the infants with DS. RESULTS Between-group differences in planning were observed on the dimensions of strategy production and completion, such that infants with DS were less efficient in their strategy execution than typically developing infants. In the DS group, motor skills and sensory processing were associated with planning efficiency on all components of the early planning task. CONCLUSIONS Less efficient action planning in infants with DS may disrupt the shaping of goal-directed behaviour, and the identification of early risk factors associated with planning efficiency has important implications for early intervention.
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Affiliation(s)
- E K Schworer
- Human Development & Family Studies, Colorado State University, Fort Collins, CO, USA
| | - D J Fidler
- Human Development & Family Studies, Colorado State University, Fort Collins, CO, USA
| | - M Kaur
- Department of Physical Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - A W Needham
- Department of Psychology & Human Development, Vanderbilt University, Nashville, TN, USA
| | - M A Prince
- Human Development & Family Studies, Colorado State University, Fort Collins, CO, USA
| | - L A Daunhauer
- Human Development & Family Studies, Colorado State University, Fort Collins, CO, USA
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Participation Difficulties in Autism Spectrum Disorders and Intellectual Disabilities: Findings from the 2011 Survey of Pathway to Diagnosis and Services. J Autism Dev Disord 2020; 51:1210-1223. [PMID: 32648148 DOI: 10.1007/s10803-020-04591-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Greater understanding can increase our knowledge and intervention effectiveness for activity participation problems of children with disabilities. We examined participation difficulties of children with autism spectrum disorders (ASD) and intellectual disabilities (ID) in the 2011 Survey of Pathway to Diagnosis and Services. We utilized propensity score matching with inverse probability of treatment weight with questions from parents of 1783 children aged 6-17 years. Friendship was the most difficult area for all children. Children with both ASD and ID experienced the most difficulty in all areas, followed by ASD alone. Reported levels of home life, friendships, classroom and leisure difficulties were moderately correlated for all children. Children who were previously diagnosed, but have no current diagnosis experienced substantial difficulties.
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Tomaszewski B, Hepburn S, Blakeley-Smith A, Rogers SJ. Developmental Trajectories of Adaptive Behavior From Toddlerhood to Middle Childhood in Autism Spectrum Disorder. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2020; 125:155-169. [PMID: 32357104 PMCID: PMC7904212 DOI: 10.1352/1944-7558-125.3.155] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Longitudinal growth modeling was utilized to examine adaptive behavior over eight years across the three time points (i.e., ages 2-10). Seventy-six parents completed the Vineland Adaptive Behavior Scales interviews of adaptive behavior. Child participants completed standardized developmental testing and an executive function task in toddlerhood and the Autism Diagnostic Observation Schedule across all time points. Growth models were specified for communication, daily living skills, and socialization domains of adaptive behavior. Mental age in toddlerhood was a significant predictor of trajectories of communication, daily living skills, and socialization. Executive function and autism severity were significant predictors of socialization. Findings suggest executive function as a potential target for promoting the growth of adaptive behavior skills in addition to autism symptomology.
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Affiliation(s)
- Brianne Tomaszewski
- Brianne Tomaszewski, University of North Carolina at Chapel Hill; Susan Hepburn, Colorado State University; Audrey Blakeley-Smith, University of Colorado; and Sally J. Rogers, University of California Davis
| | - Susan Hepburn
- Brianne Tomaszewski, University of North Carolina at Chapel Hill; Susan Hepburn, Colorado State University; Audrey Blakeley-Smith, University of Colorado; and Sally J. Rogers, University of California Davis
| | - Audrey Blakeley-Smith
- Brianne Tomaszewski, University of North Carolina at Chapel Hill; Susan Hepburn, Colorado State University; Audrey Blakeley-Smith, University of Colorado; and Sally J. Rogers, University of California Davis
| | - Sally J Rogers
- Brianne Tomaszewski, University of North Carolina at Chapel Hill; Susan Hepburn, Colorado State University; Audrey Blakeley-Smith, University of Colorado; and Sally J. Rogers, University of California Davis
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17
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Chen CCJJ, Ringenbach SDR. The effect of acute exercise on the performance of verbal fluency in adolescents and young adults with Down syndrome: a pilot study. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:614-623. [PMID: 30811082 DOI: 10.1111/jir.12603] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 11/22/2018] [Accepted: 01/14/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The high prevalence of cognitive dysfunction is well documented in individuals with Down syndrome. However, only a few studies have focused on the effect of exercise on cognitive performance in this population. In particular, verbal fluency has been shown to be relevant to the early onset of Alzheimer's disease in individuals with Down syndrome. Thus, this study was aimed at investigating the relationship between acute exercise and verbal fluency in this population. METHODS It was a pre-post design. Twenty-eight participants (aged 14-31) were assigned to high-intensity exercise (i.e. 70-85% of predicted maximum heart rate) (N = 8), moderate-intensity exercise (i.e. 50-69% of predicted maximum heart rate) (N = 10) or attentional control (N = 10) groups. Two exercise groups walked on a treadmill using an incremental walking protocol, and the attentional control group watched a video for 20 min. Measures of verbal fluency (i.e. semantic fluency and phonetic fluency) were tested pre-intervention and post-intervention. RESULTS The result showed a quadric trend between semantic fluency and intensity of exercise. The improvement in cognitive performance on semantic fluency test was observed in the moderate-intensity exercise. However, neither a linear trend nor a quadric trend was seen in phonetic fluency. CONCLUSIONS The result showed an inverted-U relationship between exercise intensity and semantic fluency. A larger sample size, testing time and more reliable psychophysiological measures (e.g. VO2 max and neuroimaging technology), should be considered to explore the underlying mechanisms in this population.
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Affiliation(s)
- C-C J J Chen
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - S D R Ringenbach
- School of Health Solutions, Arizona State University, Phoenix, AZ, USA
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Will EA, Daunhauer LA, Fidler DJ, Raitano Lee N, Rosenberg CR, Hepburn SL. Sensory Processing and Maladaptive Behavior: Profiles Within the Down Syndrome Phenotype. Phys Occup Ther Pediatr 2019; 39:461-476. [PMID: 31070074 PMCID: PMC8011957 DOI: 10.1080/01942638.2019.1575320] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Aim: Sensory processing impairments are well characterized in children with neurodevelopmental disorders, particularly autism, and have been associated with maladaptive behaviors. However, little is known regarding sensory processing difficulties within Down syndrome, or how these difficulties may influence maladaptive behavior. This study aims to characterize sensory processing difficulties within the Down syndrome phenotype and determine the influence of processing difficulties on maladaptive behavior. Methods: To explore this issue, we administered the Short Sensory Profile and the Developmental Behavior Checklist to parents or primary caregivers of young children with DS (N = 49; M nonverbal mental age (NVMA) = 30.92 months (SD = 12.30); M chronological age (CA) = 67.04 (SD = 25.13). Results: Results indicated that Low Energy/Weak, Under-responsive/Seeks Sensation, and Auditory Filtering were the areas of greatest sensory regulation difficulty, and that Self-Absorbed behavior and Disruptive/Antisocial behavior were elevated areas of maladaptive behavior. Multivariate regression analyses indicated that Under-responsive/Seeks Sensation was the only sensory regulation domain significantly associated with Self-Absorbed and Disruptive/Antisocial behavior. Conclusion: Findings indicate a consistent pattern of sensory processing impairments and associations with maladaptive behavior in children with DS. Implications for interventions are discussed.
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Affiliation(s)
- Elizabeth A Will
- a Department of Psychology, University of South Carolina , Columbia , SC, USA
| | - Lisa A Daunhauer
- b Department of Human Development and Family Studies, Colorado State University , Fort Collins , CO, USA
| | - Deborah J Fidler
- b Department of Human Development and Family Studies, Colorado State University , Fort Collins , CO, USA
| | - Nancy Raitano Lee
- c Department of Psychology, Drexel University , Philadelphia , PA, USA
| | | | - Susan L Hepburn
- b Department of Human Development and Family Studies, Colorado State University , Fort Collins , CO, USA.,d JFK Partners, University of Colorado School of Medicine , Aurora , CO, USA
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Josman N, Meyer S. Conceptualisation and use of executive functions in paediatrics: A scoping review of occupational therapy literature. Aust Occup Ther J 2018; 66:77-90. [DOI: 10.1111/1440-1630.12525] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Naomi Josman
- Department of Occupational Therapy; Faculty of Social Welfare & Health Sciences; University of Haifa; Haifa Israel
| | - Sonya Meyer
- Laboratory of Complex Human Activity and Participation (CHAP); Department Occupational Therapy; Faculty of Social Welfare & Health Sciences; University of Haifa; Haifa Israel
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Esbensen AJ, Hoffman EK, Shaffer R, Chen E, Patel L, Jacola L. Reliability of parent report measures of behaviour in children with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:785-797. [PMID: 30022564 PMCID: PMC6074042 DOI: 10.1111/jir.12533] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 06/07/2018] [Accepted: 06/18/2018] [Indexed: 05/12/2023]
Abstract
BACKGROUND Behavioural problems are common among children with Down syndrome (DS). Tools to detect and evaluate maladaptive behaviours have been developed for typically developing children and have been evaluated for use among children with intellectual and developmental disabilities. However, these measures have not been evaluated for use specifically in children with DS. This psychometric evaluation is important given that some clinically observed behaviours are not addressed in currently available rating scales. The current study evaluates the psychometric properties of the Child Behavior Checklist (CBCL), a commonly used screening tool developed for typically developing children and commonly used with children with intellectual and developmental disabilities. METHODS The study investigated the psychometric properties of the CBCL among school-aged children with DS, including an assessment of the rate of detecting behaviour problems, concerns with distribution, internal consistency, inter-rater reliability and convergent and discriminant validity with the Aberrant Behavior Checklist and Nisonger Child Behavior Rating Form. Caregivers of 88 children with DS aged 6-18 years rated their child's behaviour with the CBCL, Aberrant Behavior Checklist and Nisonger Child Behavior Rating Form. Teachers completed the Teacher Report Form. RESULTS About one-third of children with DS were reported to exhibit behaviours of clinical concern on the total score of the CBCL. Internal consistency for CBCL sub-scales was poor to excellent, and inter-rater reliability was generally acceptable. The sub-scales of the CBCL performed best when evaluating convergent validity, with variable discriminant validity. Normative data conversions controlled for age and gender differences in this sample. CONCLUSIONS The study findings suggest that, among children with DS, some CBCL sub-scales generally performed in a psychometrically sound and theoretically appropriate manner in relation to other measures of behaviour. Caution is warranted when interpreting specific sub-scales (Anxious/Depressed, Somatic Complaints and Thought Problems). The CBCL can continue to be used as a screening measure when evaluating behavioural concerns among children with DS, acknowledging poor discriminant validity and the possibility that key behaviour concerns in DS may not be captured by the CBCL screen.
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Affiliation(s)
- Anna J. Esbensen
- Cincinnati Children’s Hospital Medical Center
- University of Cincinnati School of Medicine
| | | | - Rebecca Shaffer
- Cincinnati Children’s Hospital Medical Center
- University of Cincinnati School of Medicine
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Esbensen AJ, Hoffman EK. Impact of sleep on executive functioning in school-age children with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:569-580. [PMID: 29696706 PMCID: PMC6005178 DOI: 10.1111/jir.12496] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 12/15/2017] [Accepted: 04/01/2018] [Indexed: 05/27/2023]
Abstract
BACKGROUND Sleep problems have an impact on executive functioning in the general population. While children with Down syndrome (DS) are at high risk for sleep problems, the impact of these sleep problems on executive functioning in school-age children with DS is less well documented. Our study examined the relationship between parent-reported and actigraphy-measured sleep duration and sleep quality with parent and teacher reports and neuropsychology assessments of executive functioning among school-age children with DS. METHOD Thirty school-age children with DS wore an actigraph watch for a week at home at night. Their parent completed ratings of the child's sleep during that same week. Children completed a neuropsychology assessment of their inhibitory control, ability to shift and working memory. Their parents and teachers completed rating scales to assess these same constructs of executive functioning. RESULTS Parent reports of restless sleep behaviours on the Children's Sleep Habits Questionnaire (CSHQ), but not actigraph-measured sleep period or efficiency, were predictive of parent reports of concerns with inhibitory control, shifting and working memory, and of teacher reports of inhibitory control. No measure of sleep was predictive of executive functioning as measured by the neuropsychology assessment. CONCLUSION The study findings corroborate the preliminary literature that parent-reported sleep problems are related to executive functioning in school-age children with DS, particularly in the area of inhibitory control across home and school. These findings have implications for understanding contributing factors to academic performance and school behaviour in school-age children with DS.
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Affiliation(s)
- A J Esbensen
- Division of Developmental and Behavioral Pediatric, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati, School of Medicine, Cincinnati, OH, USA
| | - E K Hoffman
- Division of Developmental and Behavioral Pediatric, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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22
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Selanikyo E, Weintraub N, Yalon-Chamovitz S. Effectiveness of the Co-PID for Students With Moderate Intellectual Disability. Am J Occup Ther 2018; 72:7202205090p1-7202205090p10. [PMID: 29426387 DOI: 10.5014/ajot.2018.024109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We aimed to corroborate the effectiveness of the Collaborative Consultation for Participation of Students With Intellectual Disability (Co-PID), intended for enhancing participation in classroom-related activities. METHOD The study took place in two special education schools and included students with moderate intellectual and developmental disabilities ages 7-20 yr. The schools were randomly assigned to intervention (Co-PID; n = 28 students, n = 4 teachers) and control (In-Service [IS]; n = 32 students, n = 7 teachers) groups. Participation was evaluated at pre- and posttest of an 8-mo intervention. RESULTS The Co-PID improved students' ability to choose among provided options. Additionally, the Co-PID group achieved more goals (measured by goal attainment scaling) than the IS group in all participation areas, and their enhanced participation transferred to other school environments (as measured by the School Function Assessment). CONCLUSION The Co-PID was found to be an effective program for enhancing classroom and school participation.
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Affiliation(s)
- Efrat Selanikyo
- Efrat Selanikyo, PhD, is Lecturer, Department of Occupational Therapy, Faculty of Health Professions, Ono Academic College, Kiryat Ono, Israel
| | - Naomi Weintraub
- Naomi Weintraub, PhD, is Head, Neurodevelopmental and Writing Research Laboratory, Hadassah School of Occupational Therapy, Hebrew University, Jerusalem, Israel
| | - Shira Yalon-Chamovitz
- Shira Yalon-Chamovitz, PhD, OTR, is Dean of Students, Ono Academic College, Kiryat Ono, Israel;
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Tomaszewski B, Fidler D, Talapatra D, Riley K. Adaptive behaviour, executive function and employment in adults with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:41-52. [PMID: 29214700 DOI: 10.1111/jir.12450] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 09/28/2017] [Accepted: 10/24/2017] [Indexed: 05/26/2023]
Abstract
BACKGROUND Individuals with Down syndrome (DS) demonstrate difficulties with aspects of executive function (EF) and adaptive behaviour across the lifespan. There is a current lack of information regarding how these difficulties relate to employment outcomes in adulthood. This study evaluated the adaptive behaviour and EF profiles of individuals with DS during early adulthood and the association between these areas of functioning and employment status. METHODS Parents or caregivers of primarily young adults with DS (n = 31; mean chronological age = 25.9 years; SD = 5.92) completed the Vineland Adaptive Behavior Scales - Second Edition the Behavior Rating Inventory of Executive Function - Adult version and a demographic questionnaire that requested information regarding adult employment status. RESULTS Findings indicated a distinct pattern of relative strengths and challenges in adaptive behaviour and EF. In addition, the EF sub-domain of working memory was a significant predictor of employment status. CONCLUSIONS Specific aspects of the DS cognitive profile may have an important influence on employment status in primarily young adults with DS. Implications for interventions are discussed.
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Affiliation(s)
- B Tomaszewski
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - D Fidler
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - D Talapatra
- Morgridge College of Education, University of Denver, Denver, CO, USA
| | - K Riley
- Morgridge College of Education, University of Denver, Denver, CO, USA
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Daunhauer LA, Gerlach-McDonald B, Will E, Fidler DJ. Performance and Ratings Based Measures of Executive Function in School-Aged Children with Down Syndrome. Dev Neuropsychol 2017; 42:351-368. [DOI: 10.1080/87565641.2017.1360303] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Lisa A. Daunhauer
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado
| | - Brianne Gerlach-McDonald
- Frank Porter Graham Child Development Institute, University of North Carolina, Chapel Hill, North Carolina
| | - Elizabeth Will
- Department of Psychology, University of South Carolina, Columbia, South Carolina
| | - Deborah J. Fidler
- Human Development and Family Studies, Colorado State University, Fort Collins, Colorado
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25
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Patton S, Hutton E. Exploring the participation of children with Down Syndrome in Handwriting Without Tears. JOURNAL OF OCCUPATIONAL THERAPY, SCHOOLS, & EARLY INTERVENTION 2017. [DOI: 10.1080/19411243.2017.1292485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Will E, Fidler DJ, Daunhauer L, Gerlach-McDonald B. Executive function and academic achievement in primary - grade students with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:181-195. [PMID: 27561217 DOI: 10.1111/jir.12313] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 06/08/2016] [Accepted: 06/22/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Executive function (EF) plays a critical role in academic outcomes in typically developing children, but the contribution of EF to academic performance in Down syndrome (DS) is less well understood. This study evaluated differences in early academic foundations between primary school aged children with DS and non-verbal mental-age matched typically developing (TD) children. Additionally, the contribution of EF domains to academic outcomes was evaluated in each group. METHOD Participants with DS (n = 29) and mental-age matched TD participants (n = 23) were administered the Woodcock Johnson- III NU Tests of Academic Achievement, as well as a laboratory-based EF battery, including measures of working memory, shifting, inhibition and object-planning. RESULTS Findings indicated a difference in early academic foundations profile between children with DS and mental-age matched TD children. Patterns of EF contributions towards academic outcomes were also observed across groups. CONCLUSIONS Aspects of EF are critical to academic achievement in DS but differentially so relative to typical development. Implications for educational instruction are discussed.
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Affiliation(s)
- E Will
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - D J Fidler
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - L Daunhauer
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
| | - B Gerlach-McDonald
- Human Development and Family Studies, Colorado State University, Fort Collins, CO, USA
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Will EA, Gerlach-McDonald B, Fidler DJ, Daunhauer LA. Impact of maladaptive behavior on school function in Down syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 59:328-337. [PMID: 27668400 DOI: 10.1016/j.ridd.2016.08.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 08/29/2016] [Accepted: 08/31/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND/AIMS Individuals with Down syndrome (DS) are at an increased risk for certain maladaptive behaviors. This study characterized maladaptive behavior in school-aged children with DS and examined the extent to which maladaptive behaviors are associated with school function. METHODS AND PROCEDURES Participants were 24 students with DS [mean nonverbal mental age (NVMA)=43.83months; mean chronological age (CA)=77.58months] who completed the Leiter Scales of Performance- Revised (Leiter-R; Roid & Miller, 1997). Their teachers completed the Behavior Assessment Scales for Children Version 2 (Reynolds & Kamphaus, 2004), and the School Function Assessment (Coster et al., 1998), measures of maladaptive and adaptive behavior as observed in the school setting. RESULTS Findings reveal a maladaptive behavior profile of elevated areas including Aggression, Attention Problems, and Somatization. When examining the association between maladaptive behavior and school function, multivariate regression results indicated a significant association between Aggression and Compliance, and Attention Problems and Task Completion. CONCLUSIONS AND IMPLICATIONS Results underscore the importance of developing training for educators regarding the potential impact of maladaptive behavior on school function for students with Down syndrome.
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Affiliation(s)
- Elizabeth A Will
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, 80523-1570, United States.
| | - Brianne Gerlach-McDonald
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, 80523-1570, United States
| | - Deborah J Fidler
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, 80523-1570, United States
| | - Lisa A Daunhauer
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, 80523-1570, United States
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Amadó A, Serrat E, Vallès-Majoral E. The Role of Executive Functions in Social Cognition among Children with Down Syndrome: Relationship Patterns. Front Psychol 2016; 7:1363. [PMID: 27679588 PMCID: PMC5020061 DOI: 10.3389/fpsyg.2016.01363] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 08/26/2016] [Indexed: 11/13/2022] Open
Abstract
Many studies show a link between social cognition, a set of cognitive and emotional abilities applied to social situations, and executive functions in typical developing children. Children with Down syndrome (DS) show deficits both in social cognition and in some subcomponents of executive functions. However this link has barely been studied in this population. The aim of this study is to investigate the links between social cognition and executive functions among children with DS. We administered a battery of social cognition and executive function tasks (six theory of mind tasks, a test of emotion comprehension, and three executive function tasks) to a group of 30 participants with DS between 4 and 12 years of age. The same tasks were administered to a chronological-age control group and to a control group with the same linguistic development level. Results showed that apart from deficits in social cognition and executive function abilities, children with DS displayed a slight improvement with increasing chronological age and language development in those abilities. Correlational analysis suggested that working memory was the only component that remained constant in the relation patterns of the three groups of participants, being the relation patterns similar among participants with DS and the language development control group. A multiple linear regression showed that working memory explained above 50% of the variability of social cognition in DS participants and in language development control group, whereas in the chronological-age control group this component only explained 31% of the variability. These findings, and specifically the link between working memory and social cognition, are discussed on the basis of their theoretical and practical implications for children with DS. We discuss the possibility to use a working memory training to improve social cognition in this population.
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Affiliation(s)
- Anna Amadó
- Department of Psychology, University of Girona Girona, Spain
| | - Elisabet Serrat
- Department of Psychology, University of Girona Girona, Spain
| | - Eduard Vallès-Majoral
- Department of Psychology, University of GironaGirona, Spain; Servei Neuropsicopedagògic ArlotGirona, Spain
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Kay-Raining Bird E, Genesee F, Verhoeven L. Bilingualism in children with developmental disorders: A narrative review. JOURNAL OF COMMUNICATION DISORDERS 2016; 63:1-14. [PMID: 27461977 DOI: 10.1016/j.jcomdis.2016.07.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 05/20/2016] [Accepted: 07/11/2016] [Indexed: 06/06/2023]
Abstract
Children with developmental disabilities (DD) often need and sometimes opt to become bilingual. The context for bilingual acquisition varies considerably and can impact outcomes. In this first article of the special issue, we review research on the timing and amount of bilingual exposure and outcomes of either direct language intervention or educational placements in three groups of children with DD: Specific Language Impairment (SLI), Autism Spectrum Disorders (ASD), and Down syndrome (DS). Children with SLI have been studied more than the other two groups. Findings showed that, on the one hand, the communication skills of simultaneous bilinguals and matched monolinguals with DD were similar for all groups when the stronger language or both languages of the bilingual children were considered. On the other hand, similar to typically developing children, sequential bilinguals and matched monolinguals with SLI (other groups not studied) differed on some but not all second language (L2) measures; even after an extended period of exposure, differences in L2 outcomes were not completely resolved. There is emerging evidence that the typological similarity of the languages being learned influences L2 development in sequential bilinguals, at least in children with SLI. Increasing the frequency of exposure seems to be more related to development of the weaker language in bilinguals with DD than their stronger language. Language intervention studies show the efficacy of interventions but provide little evidence for transfer across languages. In addition, only one (unpublished) study has compared the language and academic outcomes of children with DD in different language education programs. Research on bilingual children with DD in different educational settings/programs is limited, probably as a result of restricted inclusion of these children in some educational settings. We argue for the implementation of full inclusion policies that provide increased access to dual language programs for children with DD and access to a complete range of support services.
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Lamônica DAC, Ferreira-Vasques AT. Habilidades comunicativas e lexicais de crianças com Síndrome de Down: reflexões para inclusão escolar. REVISTA CEFAC 2015. [DOI: 10.1590/1982-021620151756015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo: OBJETIVO: verificar o desempenho comunicativo e lexical expressivo de crianças com Síndrome de Down e refletir sobre como a compreensão de fatores interferentes no processo de aprendizagem pode contribuir para uma melhor adaptação dessas crianças no ambiente escolar. MÉTODOS: a amostra proposta foi de 60 crianças, porém, após análise dos critérios de inclusão, participaram 20 crianças, 10 com Síndrome de Down e 10 com neurodesenvolvimento típico, de idade entre 36 a 62 meses, pareadas quanto ao gênero, idade cronológica e nível socioeconômico. Procedimentos: entrevista com familiares, Observação do Comportamento Comunicativo e Teste de Linguagem Infantil ABFW-Vocabulário Parte B. A análise dos dados foi realizada por meio de estatística descritiva e aplicação do Teste "t" Student (p≤ 0,05). RESULTADOS: indicaram diferença estatisticamente significante para produção de palavras e frases, narrativa, tempo de atenção, designação verbal usual e não designação. Para processos de substituição a análise estatística não acusou diferença estatisticamente significante. Apenas para profissões e locais, nesta categoria, houve diferença estatisticamente significante entre os grupos. Como são avaliados nove campos conceituais, este dado não interferiu na análise estatística da somatória dos valores de todos os campos. CONCLUSÃO: o desempenho comunicativo e lexical expressivo de crianças com Síndrome de Down é inferior quando comparado com crianças com neurodesenvolvimento típico. A escola tem importante papel em proporcionar um ambiente estimulador, por meio de práticas pedagógicas adequadas às necessidades de aprendizagem destas crianças.
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Rodríguez-Núñez A, Regueiro-García A, Jorge-Soto C, Cañas-González J, Leboráns-Iglesias P, García-Crespo O, Barcala-Furelos R. Quality of chest compressions by Down syndrome people: a pilot trial. Resuscitation 2015; 89:119-22. [PMID: 25637696 DOI: 10.1016/j.resuscitation.2015.01.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Revised: 01/17/2015] [Accepted: 01/21/2015] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Immediate bystander cardiopulmonary resuscitation (CPR) is essential for survival after out-of-hospital cardiac arrest. Down syndrome (DS) citizens have improved their active engagement in society. The objective of this pilot trial was to investigate if they are able to perform quality chest compression-only CPR after a brief training. METHODS Nineteen DS young people (15-30 year old) and 20 University level subjects (18-29 year old) were trained by means of a short video and a brief hands-on session on manikins, to perform chest compression-only CPR. All participants were naïve in CPR. Chest compression (CC) quality (percentage of correct CC, CC rate and depth and chest complete release) was measured during a 2min test. CPR quality goal was according to 2010 European Resuscitation Council guidelines. RESULTS DS people had similar weight, lower height and a higher BMI than controls. They were able to deliver chest compression-only CPR but with higher mean CC rate (140±30 vs 123±12CC/min, p=0.03), less mean CC depth (35.4±10.3 vs 47.2±9.6mm, p=0.03) and lower % of full correct CC (13±18 vs 39±37, p=0.02) than controls. Differences were maintained when first and second minute of test were compared. CONCLUSIONS After a short instruction based on a brief video and hands-on session DS people were able to deliver CC but with poor quality.
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Affiliation(s)
- Antonio Rodríguez-Núñez
- Pediatric Area, Pediatric Emergency and Critical Care Division, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain; School of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain; Institute of Investigation of Santiago (IDIS), Santiago de Compostela, Spain; Research Network on Maternal and Child Health and Development II (Red SAMID II), Spanish Health Institute Carlos III, Madrid, Spain.
| | - Alexandra Regueiro-García
- Pediatric Area, Pediatric Emergency and Critical Care Division, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Cristina Jorge-Soto
- School of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Janali Cañas-González
- Education and Sports Sciences University School, University of Vigo, Pontevedra, Spain
| | - Pilar Leboráns-Iglesias
- Pediatric Area, Pediatric Emergency and Critical Care Division, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain; Down Compostela Foundation, Santiago de Compostela, Spain
| | | | - Roberto Barcala-Furelos
- School of Nursing, University of Santiago de Compostela, Santiago de Compostela, Spain; Education and Sports Sciences University School, University of Vigo, Pontevedra, Spain
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Abstract
The outgoing editor-in-chief outlines the advances made during her 6-yr tenure and provides recommendations for AJOT’s future
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Affiliation(s)
- Sharon A Gutman
- Sharon A. Gutman, PhD, OTR, FAOTA, is former Editor-in-Chief, American Journal of Occupational Therapy, and Associate Professor, Programs in Occupational Therapy Research, Columbia University, New York, NY 10032;
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