Personalized reading intervention for children with Down syndrome

The purpose of this replication study was to evaluate the potential efficacy and feasibility of an early reading intervention for children with Down syndrome. The intervention was developed in alignment with the Down syndrome behavioral phenotype. Six children between the ages of seven and ten years participated in a series of multiple-probe across lessons single-case design studies. Results indicate a functional relation between intervention and reading outcomes for four children. Results were mixed for one participant and no functional relation was demonstrated for another. The potential promise of pursuing aptitude-by-treatment interaction research for subgroups of learners with similar characteristics as an effort to personalize intervention is discussed.     

Language and communication development in Down syndrome

Although there is considerable variability, most individuals with Down syndrome have mental retardation and speech and language deficits, particularly in language production and syntax and poor speech intelligibility. This article describes research findings in the language and communication development of individuals with Down syndrome, first briefly describing the physical and cognitive phenotype of Down syndrome, and two communication related domains-hearing and oral motor skills. Next, we describe language development in Down syndrome, focusing on communication behaviors in the prelinguistic period, then the development of language in children and adolescents, and finally language development in adults and the aging period. We describe language development in individuals with Down syndrome across four domains: phonology, semantics, syntax, and pragmatics. Wethen suggest strategies for intervention and directions for research relating to individuals with Down syndrome.     

Rhythmic motor behavior of preambulatory motor impaired,down syndrome and nondisabled children: A comparative analysis

The developmental course of rhythmic motor behavior was followed longitudinally for three groups of preambulatory children — normally developing, Down syndrome, and those with profound motor impairment. The groups differed in chronological age but were comparable with respect to motor age. The motor impaired subjects displayed significantly less rhythmic motor behavior than the nondisabled and Down syndrome groups. In comparing particular subtypes of rhythmic motor behavior, differences were found in both the average number of bouts and duration of subtypes among the groups. Longitudinal analyses of the data over the entire observation period revealed that the rhythmic motor behavior of the children with Down syndrome was more similar to that exhibited by the nondisabled children than was the rhythmic motor behavior of the children with motor impairment. However, there was considerable variability among the groups in several particular subtypes.This research was supported by grants from the National Institute of Child Health and Human Development (HD 17650 and HD 07226).The authors acknowledge the assistance of Robert E. Arendt, Grant Youngquist, Michael Hohn, and Charles Lowitzer in obtaining the observational data and thank the families of the subjects for their enthusiasm and dedication to the project.This study was presented at the 23rd Annual Gatlinburg Conference on Research and Theory in Mental Retardation and Developmental Disabilities, April 21, 1990.     

Randomized controlled trial of an applied behavior analytic intervention for food selectivity in children with autism spectrum disorder

Food selectivity is a common problem for children with autism spectrum disorder (ASD; Schreck, Williams, & Smith, 2004). Behavior‐analytic interventions have the most empirical support for feeding disorders (Sharp, Jaquess, Morton, & Miles, 2011). However, there are no randomized controlled trials that have evaluated its effects with a well‐defined cohort of children with ASD. In the current investigation, we randomly assigned 6 young children with ASD and food selectivity to either an applied behavior analytic intervention or a wait‐list control. We used a crossover randomized controlled trial to evaluate the effects of a multicomponent applied behavior analytic intervention on independent acceptance and mouth clean of 16 novel foods. We subsequently exposed the wait‐list control group to the intervention. We also evaluated the effects of the intervention on individual participants with single‐case designs. The percentage of independent acceptance and mouth clean increased for the applied behavior analytic intervention group, but not for the wait‐list control group until we implemented the intervention.     

Imitation and representational development in young children with Down syndrome

Competence in object search and pretend play are argued to reflect young children's representational abilities and appear delayed in children with Down syndrome relative to social and imitative skills. This paper explores the effects on object search and play of this social strength in children with Down syndrome. Three experiments compared performance on traditional tasks with modified tasks designed to assess the role of imitation in object search and pretend play. Children with Down syndrome, relative to typically‐developing children, were able and willing to imitate hiding actions when no object was hidden (Experiment 1). When imitation was prevented in object search, children with Down syndrome searched less effectively than typically‐developing children (Experiment 2). In play, children with Down syndrome expressed more willingness to imitate a counter‐functional action, modelled by the experimenter, despite apparent competence in spontaneous functional play (Experiment 3). These findings indicate that object search and play behaviours of children with Down syndrome rely more heavily on imitation than is the case for typically‐developing children. The implications for the development of children with Down syndrome and models of representational development are discussed.     

Family Stress and Adjustment as Perceived by Parents of Children with Autism or Down Syndrome: Implications for Intervention

ABSTRACT

This study examined stress and adjustment in parents of three groups of families: those with an autistic child, those with a Down syndrome child, and those with only developmentally normal children. A total of 54 families participated, with 18 representing each group. Parents of autistic children generally reported more family stress and adjustment problems than parents of children with Down Syndrome who, in turn, reported more stress and adjustment problems than parents of developmentally normal children. Although parents of disabled children reported more stress associated with caring for their child, they generally showed resilience in adjusting to the presence of a severely disabled family member. Implications for family intervention are discussed.     

Attitudes of Mothers of Children with Down Syndrome Towards Noninvasive Prenatal Testing

Noninvasive prenatal testing (NIPT) allows for highly sensitive detection of Down syndrome early in pregnancy with no risk of miscarriage, therefore potentially increasing the number of pregnancies identified with Down syndrome. This study assesses how mothers of children with Down syndrome perceive NIPT, especially the impact they think it will have on their families and other families with children who have Down syndrome. Seventy-three self-reported mothers of children with Down syndrome responded to an anonymous online survey emailed to, and posted on, message boards of various Down syndrome support groups and networks. Data analysis included chi-square tests and thematic analysis. Fifty-nine percent of respondents indicated they would use NIPT in the future; respondents who had not used prenatal testing in the past were significantly less likely to report interest in using NIPT in the future than those who had prenatal testing previously (p?MOST important factor. They also highlight the need to provide a diagnosis of Down syndrome in a balanced and objective manner.     

Psychiatric and behavioral disorders in persons with Down syndrome

Similar to the state of the broader intellectual disabilities field, many gaps exist in the research and treatment of mental health concerns in people with Down syndrome. This review summarizes key findings on the type and prevalence of behavior and emotional problems in children, adolescents, and adults with Down syndrome. Such findings include relatively low rates of severe problems in children, and well-documented risks of depression and Alzheimer's disease in older adults. The review also considers emerging data on autism, and the paucity of studies on adolescents. Three next steps for research are highlighted, including a need to: (1) connect research on psychiatric status and diagnoses across developmental periods, including adolescence, and to examine such associated processes as sociability, anxiety and attention; (2) unravel complicated biopsycho-social risk and protective factors that serve to increase or diminish psychopathology; and (3) identify evidence-based treatments that both reduce distressful symptoms and enhance well-being in individuals with Down syndrome.     

What Do Parents of Children with Down Syndrome Think about Non-Invasive Prenatal Testing (NIPT)?

This study explores the attitudes of parents of children with Down syndrome towards non-invasive prenatal testing (NIPT) and widening the scope of prenatal screening. Three focus groups (n = 16) and eleven individual interviews with Dutch parents (and two relatives) of children with Down syndrome were conducted. Safety, accuracy and earlier testing were seen as the advantages of NIPT. Some participants were critical about the practice of screening for Down syndrome, but acknowledged that NIPT enables people to know whether the fetus is affected and to prepare without risking miscarriage. Many feared uncritical use of NIPT and more abortions for Down syndrome. Concerns included the consequences for the acceptance of and facilities for children with Down syndrome, resulting in more people deciding to screen. Participants stressed the importance of good counseling and balanced, accurate information about Down syndrome. Testing for more disorders might divert the focus away from Down syndrome, but participants worried about “where to draw the line”. They also feared a loss of diversity in society. Findings show that, while parents acknowledge that NIPT offers a better and safer option to know whether the fetus is affected, they also have concerns about NIPT’s impact on the acceptance and care of children with Down syndrome.     

Memory coding in individuals with Down syndrome

Previous research has identified a deficit in phonological short-term memory in individuals with Down syndrome.

The present work aimed to analyze how a group of 30 individuals with Down syndrome performed in a picture span task compared with 30 typically developing children of the same mental age. The task involved four conditions (i.e., dissimilar, phonologically similar, visually similar, and long-name items) chosen to analyze the strategy used by individuals with Down syndrome to code visually presented nameable items.

Individuals with Down syndrome performed less well than typically developing children. Both groups showed the visual similarity effect.

Taken together, our results confirm that individuals with Down syndrome have a verbal working memory deficit, even when nameable items are presented visually. Mental age appears to be an important determinant of memory coding stage in individuals with Down syndrome.     

The effects of the child with Down syndrome on maternal stress

This article examines the nature and correlates of stress in mothers of children with Down syndrome. In the first part of our study, we compared 27 mothers of children with Down syndrome with 15 mothers of children with heterogeneous causes of learning difficulty. Using Abidin's (1995) Parenting Stress Index (PSI), mothers in the Down syndrome group reported lower total child‐related stress levels, particularly concerning the degree to which the mother considers the child acceptable and reinforcing. In the second part, we identified predictors of stress in mothers of children and adolescents with Down syndrome (N = 37). Children's behaviour problems related to higher levels of overall and specific domains of child‐related stress, and children who were reported as being more cheerful and outgoing had parents who judged their offspring as more acceptable and reinforcing. Mothers also rated their children as less reinforcing when offspring were older.     

Développement des capacités sociolinguistiques chez des enfants et adolescents porteurs de trisomie 21 et étude de l'environnement sociolinguistique maternel

The aim of our research is to understand the language disturbances in Down syndrome children. Several studies demonstrated substantial differences between sociolanguage behaviours of mothers' Down syndrome children and those of mothers of non retarded children. We propose that these differences can explain DS language disturbances. So, we have compared 12 mother-child dyads (4 Down syndrome children are from 8 to 9 years, 4 are from 12 to 13 years and 4 are from 16 to 17 years). Dyads play in tutorial interaction. Results show language abilities evolution for Down syndrome subjects. Nevertheless, mothers' sociolanguage behaviors do no change.     

TEACHING YOUNG CHILDREN TO USE CONTACT LENSES

Young children with surgically removed lenses and extreme nearsightedness can benefit from contact lenses, but their parents may need instruction to teach their children to accept lenses. In this study, 4 children under the age of 5 years were taught contact lens wear using a shaping procedure. Compliance was rewarded with praise and tangibles, and noncompliance was followed with brief time-out for 3 of the children and restraint for the 4th. Three children showed high compliance during an initial shaping procedure, with a decrease in compliance during initial insertion of the lenses. At 3- to 10-month follow-up, levels of compliance were high. Insertion and removal of lenses were accomplished in substantially less time, with little crying and no need for time-out. All 3 children continue to use the lenses daily, and 2 have shown improved visual acuity. The 4th child, who has Down syndrome, showed low levels of compliance with need for physical restraint throughout. Although his parents reported high compliance when he first went home, fitting difficulties and an infection resulted in plummeting of compliance, and contact lens use was discontinued. This procedure has been used successfully at the same hospital with 11 of 13 other children between the ages of 14 months and 7 years 4 months. Implications for selection of suitable candidates for this intervention and ways to decrease costs are discussed.     

Language phenotypes and intervention planning: bridging research and practice

This paper focuses on the communication and language phenotypes associated with three genetic disorders: Down syndrome, Williams syndrome, and fragile X syndrome. It is argued that there is empirical evidence that these disorders predispose children to specific profiles of strength and weakness in some areas of speech, language, and communication, and that intervention planning for children with each syndrome may take an approach informed by these profiles. Issues related to within-group variability, shared outcomes among syndromes, and the need for empirical validation for syndrome-specific recommendations are discussed.     

A Randomized Controlled Trial of Group Stepping Stones Triple P: A Mixed‐Disability Trial

Stepping Stones Triple P (SSTP) is a parenting program designed for families of a child with a disability. The current study involved a randomized controlled trial of Group Stepping Stones Triple P (GSSTP) for a mixed‐disability group. Participants were 52 families of children diagnosed with an Autism Spectrum Disorder, Down syndrome, Cerebral Palsy, or an intellectual disability. The results demonstrated significant improvements in parent‐reported child behavior, parenting styles, parental satisfaction, and conflict about parenting. Results among participants were similar despite children's differing impairments. The intervention effect was maintained at 6‐month follow‐up. The results indicate that GSSTP is a promising intervention for a mixed‐disability group. Limitations of the study, along with areas for future research, are also discussed.     

Étude du style interactif maternel et des compétences sociocommunicatives des enfants. Une étude comparative entre enfants porteurs de trisomie et enfants typiques

The goal is to explain Down syndrome social language disturbances. Down's syndrome and non-handicapped children were observed interacting with their mothers. We compared 22 dyads with Down syndrome children and 22 dyads with non-handicapped children. Down's syndrome children were matched on mental age with non-handicapped children (4 to 24 months). Social context, mothers' behaviours and children's social communicative competences were evaluated. Interaction behaviours in the mothers of DS children differ from those of mothers of non-handicapped children. DS communicative competences also are different from those in non-handicapped children. We argue that mothers' behavioural interaction in the dyads with DS children can be an aspect of social communicative disturbances of DS children.     

Déficience mentale,conduites d'autonomisation et résolution de problème en période précoce : analyse factorielle des comportements parent–enfant non déficient et porteur d'une trisomie 21

The empirical studies of tutoring until now were concerned little with the situation of the children carrying an early mental deficiency placed in situation of interactions of assisted training of sensorimotor level. By having recourse to a comparative approach between dyads non-defective parend-child of second year of life and parent-child carrying a Down syndrome of the same age of development, the present study shows that the parental interventions of the two populations are characterized primarily by a request of autonomous operation on behalf of the child. On their side, the children of the two populations take an active share in the resolution of the problem, and this even in the absence of parental intervention. The discussion analyses the influence of Down syndrome characteristics on the task achievement and the influence of the parental strategies.     

Supporting communication in young children with developmental disabilities

The behavior of parents, adult caregivers, and peers comprises the critical features of community support for the development of communication in young children with developmental disabilities. In a bio-ecological model of development, communication development is the result of the interactions of individuals with specific characteristics, in particular contexts over time. From the perspective of this model, foundational findings of intervention research to current views of communication development in children with developmental disabilities are summarized. The contributions of individual child characteristics to child-caregiver interactions that support language development are illustrated based on research with children who have autism, Williams syndrome, Down syndrome, and children who use augmentative communication systems. Parent-child interaction and the quality and quantity of parent talk are discussed as factors in children's language development. The effects of young children's delayed language on their interactions with peers, the contributions of peers to children's language learning and use, and the critical features of classroom settings that support child language development are reviewed. MRDD Research Reviews 7:143-150, 2001.     

Mediating Access to Headsprout<Superscript>®</Superscript> Early Reading for Children with Autism Spectrum Disorders

Many children with autism spectrum disorder (ASD) require instructional programs that simultaneously address academic content, interfering behavior, and potential gaps in prerequisite skills for a given curriculum. This study examined the impact of an intervention package consisting of contingent reinforcement and match-to-sample training on the independent progression of 3 children with ASD through Headsprout^® Early Reading (HER), a behavior analytic online reading program. A multiple probe across participants design was used to examine the effects of the intervention package on participants’ correct interactions per minute and total episodes completed. Transfer of training to oral reading of companion print books was also assessed. All participants demonstrated an increase in correct interactions per minute. Two participants learned to independently complete a HER episode each day and could orally read companion print books. The results suggest individualized behavior analytic programs can support the use of HER as a computer-based reading program for some children with ASD.