Parents' reports of young people with Down syndrome talking out loud to themselves

Private speech amount positively predicts memory performance in young adults

This study used a card-matching game that relies on visual-spatial working memory to investigate whether the amount one talks out loud to themselves (referred to as private speech) predicts cognitive performance in young adults (n = 118, mean age = 20.13 years). Each participant's performance was measured in two "Private Speech" trials, in which they were instructed to complete the game efficiently, while using private speech as much as they can. Using multilevel modeling, we found that participants performed significantly better on trials for which they produced more private speech. This relationship was not moderated by baseline competency on the task (measured in a condition where participants were not instructed to use, and rarely ever used, private speech). The study shows that the degree to which adults use private speech - when instructed to do so, is associated with cognitive performance, which may have important implications for educational/instructional settings.

The influence of academic pressure on adolescents’ problem behavior: Chain mediating effects of self-control, parent–child conflict, and subjective well-being

As a negative social issue, teenagers’ problem behavior not only affects individuals’ physical and mental health and social function development but is also not conducive to social harmony and stability. This study mainly discusses the influence of academic pressure on adolescents’ problem behavior, and the potential relationship between these and academic pressure, examining issues such as self-control, parent–child conflict, and subjective well-being. The data were collected from the fifth wave of the China Family Panel Studies (2017–2018). The data of 2,465 teenagers aged 10–15 were analyzed by LISREL8.8 software. The results show that academic pressure positively affects adolescents’ deviant behavior. The mediation model finds that parent–child conflict and self-control play a direct mediating role between academic pressure and adolescents’ behavioral problems. Parent–child conflict, self-control, and subjective well-being have important chain mediation effects between academic pressure and adolescents’ problem behavior. Therefore, in order to reduce the risk of such problems, it is necessary to further strengthen individuals’ ability to maintain self-control, promote or cultivate adolescents’ character strengths, create a harmonious family atmosphere, reduce the probability of parent–child conflict, and increase the subjective well-being of teenagers.

Dementia in Down syndrome: unique insights for Alzheimer disease research

Virtually all adults with Down syndrome (DS) show the neuropathological changes of Alzheimer disease (AD) by the age of 40 years. This association is partially due to overexpression of amyloid precursor protein, encoded by APP, as a result of the location of this gene on chromosome 21. Amyloid-β accumulates in the brain across the lifespan of people with DS, which provides a unique opportunity to understand the temporal progression of AD and the epigenetic factors that contribute to the age of dementia onset. This age dependency in the development of AD in DS can inform research into the presentation of AD in the general population, in whom a longitudinal perspective of the disease is not often available. Comparison of the risk profiles, biomarker profiles and genetic profiles of adults with DS with those of individuals with AD in the general population can help to determine common and distinct pathways as well as mechanisms underlying increased risk of dementia. This Review evaluates the similarities and differences between the pathological cascades and genetics underpinning DS and AD with the aim of providing a platform for common exploration of these disorders.

Reliability of parent report measures of behaviour in children with Down syndrome

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.

Psychiatric disorders in adolescents and young adults with Down syndrome and other intellectual disabilities

BACKGROUND

Relative to other aspects of Down syndrome, remarkably little is known about the psychiatric problems experienced by youth and young adults with this syndrome and if these problems differ from others with intellectual disabilities. Yet adolescence and young adulthood are particularly vulnerable time periods, as they involve multiple life transitions in educational, medical, and other service systems.

METHODS

This study compared the psychiatric diagnoses of 49 adolescent and young adult patients with Down syndrome to 70 patients with other intellectual disabilities (IDs). The groups were similar in age, gender, and level of intellectual impairment. The 119 participants, aged 13 to 29 years (M = 21) were evaluated in one of two specialized psychiatric clinics.

RESULTS

In contrast to previous literature, those with Down syndrome versus other IDs had significantly higher rates of psychosis NOS or depression with psychotic features (43% versus 13%). Unlike the ID group, psychosis was predominantly seen in females with Down syndrome. Marked motoric slowing in performing routine daily activities or in expressive language was manifested in 17% of patients with Down syndrome. No group differences were found in anxiety or depressive disorders, and the ID group had significantly higher rates of bipolar and impulse control disorders.

CONCLUSIONS

These preliminary observations warrant further studies on genetic, neurological, and psychosocial factors that place some young people with Down syndrome or other IDs at high risk for severe psychiatric illness.

The role of self-talk in the awareness of physiological state and physical performance

Different studies have suggested that the majority of self-talk during exercise is either positive or neutral in character. The majority of 'thoughts' during low-intensity exercise have been described as being dissociative conversational chatter. However, with increasing exercise intensity, there is a greater percentage of associative and motivational thoughts, which includes thoughts about feeling and affect, body monitoring, command, instruction and pace monitoring. It has been suggested that self-talk is necessary for creating a time 'wedge' between the activity described by the self-talk, and the self-talk itself. The information redundancy created by this time-wedge allows the capacity for reflection about what is occurring, and self-awareness of the part played by the individual themselves in the activity being performed. Self-talk may be a discussion between a singular 'I' and a singular 'me', or may be a multi-party dialogue. There are anatomical correlates to self-talk, with neural activity in a number of brain areas related to the occurrence of both overt and subvocal self-talk, particularly in Broca's region in the left frontal cortex, and Wernicke's region in the left posterior superior temporal cortex. Whether specific training of self-talk can improve performance is controversial, although recent studies have suggested that task-specific self-talk appears to have a beneficial effect on physical performance. Further studies are required to assess the ability of physical or mental training to modify self-talk in a beneficial and permanent manner, and whether these changes affect an individual's exercise performance and sense of self.

Descriptive functional analysis of behavioral excesses shown by adults with Down syndrome and dementia

OBJECTIVES

The study examined the hypothesis that a functional relationship exists between social environmental events and behavioral excesses in individuals with Down syndrome and dementia.

DESIGN

A case-series design was employed (n = 4) using an direct observation-based descriptive functional assessment procedure.

METHODS

Observations were conducted in the natural environments of four participants over periods ranging from 11 to 15.4 hours. Data were collected on non-verbal and verbal behavioral excesses, appropriate engagement and verbal interaction with others. Social environmental events observed including both staff and peer behavior.

RESULTS

Analysis of co-occurrence for behavioral excesses and social environmental events indicated significant relationships for some behaviours consistent with operant reinforcement processes. Sequential analysis showed that changes in the probability of social contact occurred in the period directly preceding and following verbal behaviors.

CONCLUSIONS

Results support the hypothesis that, consistent with literature for older adults with dementia in the general population, some behavioral excesses were functional in nature and not randomly occurring events. No relationship was found between appropriate engagement and staff contact. Evidence of the functional nature of target behavioral excesses indicates that behavioral interventions have potential for this client group.

Health maintenance throughout the life span for individuals with Down syndrome

PURPOSE

To describe the routine health maintenance needs of individuals with Down syndrome who have specialized health needs associated with the multi-system impact of the diagnosis.

DATA SOURCES

Review of scientific literature including peer-reviewed articles, books, and online resources.

CONCLUSION

In addition to the routine health maintenance needs of all persons, those with Down syndrome have specialized needs. Failure to address these specific health maintenance concerns may lead to misdiagnoses and failure to reach the highest level of function possible.

IMPLICATIONS FOR PRACTICE

Patients with Down syndrome who have legitimate, treatable diagnoses may be misdiagnosed as having behavior problems or dementia. Failure to identify abnormalities such as cardiac problems or sleep apnea may shorten life and interfere with ability to live life to the fullest.