Research Results

Here are some of the results from projects to come out of the CID lab, check back for updates as more studies are completed!

Wayfinding and Shortcuts

Take home message:
Children with Down syndrome might require extra practice to learn wayfinding skills.

Completed: Winter 2017
Previous research suggests that young adults with Down syndrome often struggle with learning the layout of a place after through it, or wayfinding. This is an important skill because it allows us to find new routes, take shortcuts, and orient when lost. Zach Himmelberger's , a past graduate student of Dr. Merrill, dissertation study sought to understand how this difficulty emerges over multiple exposures to a new environment. To do this, participants traveled through a virtual environment, then were asked to try to find a shortcut. The game was repeated three times to see how they perform with new exposures.

Zach tested 20 young adults with Down syndrome (many from the registry - thank you all!), 17 typically developing children, and 27 typically developing adults. The findings suggest that the participants with Down syndrome struggled to find a shortcut after each exposure to the environment compared to typical adults. Also, participants with Down syndrome did not improve after initial exposure whereas the typically developing children did.

These findings could be used to create wayfinding programs for people with Down syndrome. Perhaps focusing on specific cognitive strategies or using technology to assist learning could improve wayfinding skills. This, in turn, would hopefully lead to more opportunities for independence for young adults with Down syndrome. From this research, Zach was able to obtain his PhD in Cognitive and Developmental Psychology!
Modeling the Relationships Among Sustained Attention, Short-Term Memory, and Language in Down Syndrome

Take Home Message:
People with Down syndrome may find it hard to process statements that are long and complex, it's helpful to make sure you have his/her attention before speaking.

Completed: Summer 2017
Language can be a challenge for youth with Down syndrome (DS). Gayle's dissertation study sought to determine if reasons for this language difficulty in Down syndrome include sustained attention (the ability to maintain attention over time), and short-term memory (the temporary storage and retrieval of information in memory).

Gayle tested 37 participants (many from the registry - thank you all!) and found that sustained attention to auditory information (e.g., spoken language) predicted language through short-term memory of auditory information. In other words, youth with Down syndrome sustain attention to language, then crucially hold the attended information into short- term memory, to eventually learn language.
These findings hold potential implications for language therapy with youth with Down syndrome. Perhaps addressing auditory sustained attention in language therapy with youth with Down syndrome could improve outcomes, though this idea needs to be tested with additional research. From this research Gayle was able to obtain her PhD in Developmental Psychology!
Physical Activity and Executive Function

Take Home Message:
People with Down syndrome benefit physically and cognitively from physical exercise. An inexpensive pedometer and team sports are some ways to encourage this!

Completed: Summer 2016
For his master’s thesis, Andrew Tungate conducted an innovative pilot study to measure physical activity in youth with Down syndrome (DS). This is a hot up-and-coming topic for research, not only because of all of the known health benefits of physical activity, but also because of possible cognitive benefits. Many registry families participated in this study. Thank you!
Andrew’s study focused on youth with DS ages 5-18. Participants wore a pedometer each day for a week to measure their number of steps, and their parents completed a questionnaire on their son or daughter’s exercise habits.
There were several interesting findings. First, the pedometer measurement was successful with some but not all of the participants. Many of the younger participants did not wear it consistently, either because they didn’t want to or because it fell off of them. Thus, one finding was that using a pedometer to measure daily physical activity may work well with teens with DS, but not so well with younger children with DS.

Another finding was that, for those who did successfully use the pedometer, their average steps per day were below the level expected for their age. This suggests that youth with DS may need more daily physical activity. In contrast to the pedometer measure, the parent report of the child’s exercise habits was successfully completed by all of the parents. However, it was challenging for parents to report the number of minutes per day their child spent in different types of exercise. Parents’ feedback on the questionnaire will be helpful to further refine this measure.

In future studies, we would like to improve the measures of physical activity so that we can look at how they relate to cognition, everyday functioning, and quality of life in youth with DS.
Parenting Children with Down syndrome

Take Home Message:
Kids with Down syndrome seem to respond well to established routines and set rules and follow through with both.

Parental stress impacts the parent's health and the parent-child relationship, so it's important for parents to find ways to minimize stress.

Completed: Spring 2014
Many of you participated in a research study conducted by one of our graduate students, Dr. Allyson Phillips. The study, Parenting Children with Down Syndrome, examined parenting styles and dimensions in mothers of children with Down syndrome compared to mothers of typically developing children. Effective parenting is vital for a child’s intellectual, physical, social, and emotional development, and not all parenting techniques are equal in terms of their effectiveness in raising a healthy, well-adjusted child. While much work has been conducted on parenting typically developing children, little work has examined parenting children with Down syndrome.

There are three primary parenting styles— authoritative, authoritarian, and permissive. Authoritative parents stress parental control through the use of warm, responsive parenting. They provide their child with explanations, treat their child as an individual, and work to promote their child’s autonomy. Authoritarian parents emphasize parental control by demanding obedience and frequently using harsh and forceful punishment. They provide their children with little warmth, affection, or nurturance. Parents who utilize permissive parenting have no parental control and, while they are warm, they place few demands on their children. They completely accept their children’s desires and actions and require little of their children in terms of household responsibility and obedient behavior. Authoritative parenting has been repeatedly associated with the most positive child outcomes, while authoritarian and permissive parenting are associated with more negative child outcomes.

There are six primary parenting dimensions— warmth, rejection, structure, chaos, autonomy support, and coercion. Warmth is associated with love, affection, caring, enjoyment, appreciation, and emotional support. Rejection is associated with hostility, aversion, harshness, over-reactivity, irritability, critical evaluations, and disapproval. Parents who utilize structure provide a clear explanation of rules and disciplinary action, follow-through when discipline is necessary, and predictable routines and organization within the household and daily life. Chaos is linked to disorganization, environmental confusion, and inconsistency and unpredictability in rules and discipline. Autonomy support promotes independence, supports the child in the exploration of personal preferences and opinions, allows the child to freely express ideas and actions, and encourages the child’s contribution in decisions and problem solving. Finally, coercive parents demand obedience and implement restrictive, over-controlling parenting through the use of harsh punishment. They also attempt to change or control how their child thinks, feels, or behaves and will talk to their child in a derogatory manner (e.g., telling the child that he/she is dumb or stupid). Warmth, structure, and autonomy support are associated with positive child outcomes, while rejection, chaos, and coercion are associated with negative child outcomes.

In the current study, 35 mothers of children with Down syndrome and 47 mothers of typically developing children (age 5-12) participated. The mothers completed nine questionnaires asking about the way in which they parent their child, their child’s cognitive and behavioral abilities, their own well-being, and the expectations and fears they have in relation to their child.
The researchers found that mothers of children with Down syndrome use an authoritative parenting style less and a permissive parenting style more than mothers of typically developing children. Additionally, they found that mothers of children with Down syndrome provided their children with less structure but more chaos than mothers of typically developing children. However, mothers from both groups used similarly high levels of warmth and autonomy support and similarly low levels of rejection and coercion. Further, the differences that they found on parenting styles and dimensions no longer existed when they accounted for differences in parental stress.

Parents of children with Down syndrome experience far greater levels of stress than parents of typically developing children. This increased stress might be due to the children’s increased behavioral problems, increased health-related problems, or decreased cognitive abilities. Parents also experience greater care-giving demands, increased financial burdens, more issues associated with advocacy, limited formal and informal support, and decreased feelings of competency.
The results suggest that mothers of children with Down syndrome are overall using similar parenting methods as mothers of typically developing children. Differences that do exist between the mothers is most likely due to the increased levels of parental stress for mothers of children with Down syndrome. As such, parenting interventions for parents of children with Down syndrome should either be focused on reducing parental stress in an effort to improve parenting techniques or on educating parents on how to utilize positive parenting techniques despite their stressful life circumstances.
Reading Skills in Down syndrome:

Take Home Message:
Reading with children with Down syndrome, focusing on sounding out words and what is happening in the story, is beneficial for reading development.

Children with Down syndrome often take longer to acquire reading skills, but as we see in this study, most individuals with Down syndrome can learn to read words!

Completed: Fall 2013
Many of you participated in a research study conducted by one of our former graduate students, Dr. Susan Loveall. The study, Reading Skills in Down Syndrome, examined various aspects of reading habits and skills in individuals with Down syndrome and in their family setting. This was a two-part study. Part one was a parent survey that included two different questionnaires. Part two involved the actual testing of reading skills in individuals with Down syndrome. Before reporting the results of the study, I would like to take a minute to define a few reading terms. Reading is a complex skill that is built off of many lower-level skills. The main focus of this study was the ability to read single words (word recognition), which has two important sbuskills, one verbal and one visual. The verbal subskill is known as phonological decoding and is the ability to sound words out. The visual subskill is known as orthographic knowledge and is the ability to read words by recognizing common letter patterns.

For part one of the study, parents of individuals with Down syndrome were invited to complete two questionnaires. The first was a reading questionnaire developed by Dr. Loveall that asked parents to report on their child’s reading abilities, the home literacy environment, their child’s motivation to read and their child’s language, vision and hearing. The home literacy environment is defined as the amount and type of literacy-related activities in the home, such as parent-child shared book reading, number of books in the home, number of trips to the library, and reading done by caregivers. Research with typically developing children has found that rich home literacy environments lead to better language development and reading achievement. The second questionnaire was a measure of executive functioning, a broad term that covers an individual’s ability to plan, pay attention, problem solve and exhibit self-control. Data are still being collected on this study, but some of the results are reported here.

So far, fifty-six parents from the Registry participated in the parent survey. Of the parents with children with Down syndrome over the age of five, 95.9% reported that their child could read single words and 70.8% reported that their child could sound out new or unfamiliar words. Overall 73% of parents reported that they would describe their child as a reader. Taken together, these reports suggest that a majority of individuals with DS have some reading ability. However, while 66.7% of parents reported that their child could read single words very well, only 25% report that their child could sound out new/unfamiliar words very well. Word identification appears to be stronger for individuals with DS, and phonological decoding appears to be impaired relative to word identification. The parent survey reflected rich home literacy environments for individuals with DS. Almost all parents reported that they began reading to their child before their child was one year old. They also reported reading to their child regularly and always having children’s books in the home. The present study also found that the home literacy environment was related to parent reports of the child’s motivation to read suggesting that rich home literacy environments when the child is young may lead to increases in the child’s motivation to read.

The main purpose of part two of the study was to examine word recognition and its verbal and visual subskills in individuals with Down syndrome. Part two of the study looked at individuals with Down syndrome as a group and only included individuals who had some reading skills, so while its findings are true for some people with Down syndrome, they are generalizations. Any individual could have different skills than that of the group reported here. The present study compared individuals with Down syndrome (11 to 21 years) to younger, typically developing children of the same word recognition reading level (5-9 years). Results from the study found that individuals with Down syndrome did not perform as well as the typically developing children on a measure of phonological decoding, but performed similarly on two measures of orthographic knowledge. These results suggest that individuals with Down syndrome may be utilizing stronger visual skills when reading words. However, these results do not minimize the importance of decoding in learning to read. Developing these skills could help individuals with Down syndrome attain even higher levels of reading.

Finally, results from parts 1 and 2 of the study were combined to see how the parent reports related to the measured reading abilities of individuals with Down syndrome. The home literacy environment, as reported by the parent, was related to some of the reading abilities measured in part 2 of the study, namely word recognition and phonological decoding. Richer home literacy environments were also related to vocabulary in the participants with Down syndrome. Though not directly tested, these results imply that rich home literacy environments for individuals with Down syndrome could lead to better reading and language abilities.