Cognitive, language and motor development in toddlers with Down syndrome: Beyond the floor effect of Italian BSID−III scores

Lina Pezzuti, Rosa Ferri, Elvira Caramuscio, James Dawe, Anna Scala

Accepted July 1, 2023

First published July 16, 2023

https://doi.org/10.26387/bpa.2023.00009

Abstract

Down syndrome is the most common genetic cause of intellectual disability but there are few studies on
the development of toddlers with this syndrome. Considering the importance of early interventions aimed at improving the abilities of this population, the purpose of the present study is to assess the cognitive, language, and motor development of a group of 144 Italian toddlers with Down syndrome aged 12−36 months (individually matched for gender, chronological age, and parental education level with typical development toddlers) through the use of the Bayley Scales of Infant and Toddlers Development−III (BSID−III). The assessment of cognitive, language, and motor development of people with low abilities is far from being easy because it is very frequent to find flat profiles, where strengths are obscured and weaknesses are predominant. So, an alternative method of converting raw scores to weighted scores was used to overcome the floor effect of BSID−III scores. Results showed an increase in cognitive and communicative delay evident as early as the second and third years of age and a developmental profile of toddlers with DS characterized by strengths in expressive and receptive communication skills. Results were discussed in reference to the literature in recent years.

References

  • ABBEDUTO, L., WARREN, S.F. & CONNERS, F.A. (2007). Languagedevelopment in Down syndrome: From the prelinguisticperiod to the acquisition of literacy. Mental Retardation andDevelopmental Disabilities Research Reviews, 13 (3), 247−261.

    doi.org/10.1002/mrdd.20158
  • ALESI, M. & BATTAGLIA, G. (2019). Motor development and Downsyndrome. In International Review of Research in DevelopmentalDisabilities, vol. 56. Academic Press. https:/

    doi.org/10.1016/bs.irrdd.2019.06.007
  • ANDERSON P.J. & BURNETT, A. (2017). Assessing developmentaldelay in early childhood – concerns with the Bayley−IIIscales. The Clinical Neuropsychologist, 31 (2), 371−381,

    doi.org/10.1080/13854046.2016.1216518
  • AOKI, S., YAMAUCHI, Y. & HASHIMOTO, K. (2018).Developmental trend of children with Down’s syndrome: Howdo sex and neonatal conditions influence their developmentalpatterns? Brain and Development, 40 (3), 181−187. https:/

    doi.org/10.1016/j.braindev.2017.10.001
  • BAYLEY, N. (2006). Bayley Scales of Infant and Toddler Development– Third Edition. Harcourt Assessment.

  • BELLO, A., ONOFRIO, D. & CASELLI, M.C. (2014). Nouns andpredicates comprehension and production in children withDown syndrome. Research in Developmental Disabilities, 35 (4),761−775. http://dx.

    doi.org/10.1016/j.ridd.2014.01.023
  • CARDOSO, A.C.D.N., DE CAMPOS, A.C., DOS SANTOS,M.M., SANTOS, D.C.C. & ROCHA, N.A.C.F. (2015). Motorperformance of children with Down syndrome and typicaldevelopment at 2 to 4 and 26 months. Pediatric Physical Therapy,27 (2), 135−141.

    doi.org/10.1097/PEP.0000000000000120
  • CASELLI, M.C., VICARI, S., LONGOBARDI, E., LAMI, L.,PIZZOLI. C. & STELLA, G. (1998). Gestures and words in earlydevelopment of children with Down syndrome. Journal of Speech,Language, and Hearing Research, 41, 1125−1135.

  • CONTESTABILE, A., BENFENATI, F. & GASPARINI, L. (2010).Communication breaks−Down: From neurodevelopmentdefects to cognitive disabilities in Down syndrome. Progressin Neurobiology, 91 (1), 1−22. https:/

    doi.org/10.1016/j.pneurobio.2010.01.003
  • DE LIMA FREIRE, R.C., DE MELO, S.F., HAZIN, I. & LYRA, M.C.(2014). Neurodesarrollo y aspectos relacionales del bebé conSíndrome de Down. Avances en Psicología Latinoamericana, 32(2), 247−259.

  • EGGERS, K. & VAN EERDENBRUGH, S. (2018). Speechdisfluencies in children with Down Syndrome. Journal ofcommunication disorders, 71, 72−84. https:/

    doi.org/10.1016/j.jcomdis.2017.11.001
  • FERREIRA−VASQUES, A.T. & LAMÔNICA, D.A.C. (2015). Motor,linguistic, personal and social aspects of children with Downsyndrome. Journal of Applied Oral Science, 23 (4), 424−430.http://dx.

    doi.org/10.1590/1678−775720150102
  • FERRI, R., CARLESCHI, A., MASCELLANI, F., COATTI, L. &STOPPA, E. (2005). Applicazione clinica delle scale Bayleya bambini con sviluppo tipico e atipico. In M.M. Black & K.Matula, La valutazione dello sviluppo infantile. Somministrazionee applicazione delle Scale Bayley. Il Mulino.

  • FERRI, R., ORSINI, A., REA, M., STOPPA, E. & MASCELLANI, F.(2015). Bayley−III: Manuale dell’adattamento italiano. Firenze:Giunti Psychometrics.

  • FRANK, K. & ESBENSEN, A.J. (2015). Fine motor and self‐caremilestones for individuals with Down syndrome using aRetrospective Chart Review. Journal of Intellectual DisabilityResearch, 59 (8), 719−729. http://dx.

    doi.org/10.1111/jir.12176
  • GALEOTE, M., SEBASTIAN, E., CHECA, E., REY, R. & SOTO, P.(2011). The development of vocabulary in Spanish children withDown syndrome: Comprehension, production, and gestures.Journal of Intellectual & Developmental Disability, 36, 184−196.

    doi.org/10.3109/13668250.2011.599317.
  • GODFREY, M. & LEE, N.R. (2018). Memory profiles in Downsyndrome across development: A review of memory abilitiesthrough the lifespan. Journal of Neurodevelopmental Disorders,10 (1), 1−31.

    doi.org/10.1186/s11689−017−9220−y
  • GRIECO, J., PULSIFER, M., SELIGSOHN, K., SKOTKO, B. &SCHWARTZ, A. (2015). Down syndrome: Cognitive andbehavioral functioning across the lifespan. American Journal ofMedical Genetics Part C: Seminars in Medical Genetics, 169 (2),135−149.

    doi.org/10.1002/ajmg.c.31439
  • HAUCK, J.L., FELZER−KIM, I.T. & GWIZDALA, K.L. (2020). Earlymovement matters: Interplay of physical activity and motor skilldevelopment in infants with down syndrome. Adapted PhysicalActivity Quarterly, 37 (2), 160−176. https:/

    doi.org/10.1123/apaq.2019−0012
  • HESSL, D., NGUYEN, D.V., GREEN, C., CHAVEZ, A., TASSONE,F., HAGERMAN, R.J. et al. (2009). A solution to limitations ofcognitive testing in children with intellectual disabilities: the caseof fragile X syndrome. Journal of Neurodevelopment Disorders, 1,33−45.

    doi.org/10.1007/s11689−008−9001−8
  • HYDE, J.S. (2005). The gender similarities hypothesis. AmericanPsychologist, 60 (6), 581.

  • KARMILOFF−SMITH, A., AL−JANABI, T., D’SOUZA, H., GROET,J., MASSAND, E., MOK, K., … & TYBULEWICZ, V. (2016). Theimportance of understanding individual differences in Downsyndrome.F1000Research,5.

    doi.org/10.12688/f1000research.7506.1
  • KIM, H.I., KIM, S.W., KIM, J., JEON, H.R. & JUNG, D.W. (2017).Motor and cognitive developmental profiles in children withDown syndrome. Annals of Rehabilitation Medicine, 41 (1), 97.https:/

    doi.org/10.5535/arm.2017.41.1.97
  • LAGHI, F., FERRI, R., CARAMUSCIO, E., LONIGRO, A., REA,M. & PEZZUTI, L. (2022). The floor effect on the ABAS−II inadolescents with autism spectrum disorder. Journal of Autismand Developmental Disorders, 52 (11), 4975−4985.

  • LEVY, Y. & EILAM, A. (2013). Pathways to language: A naturalisticstudy of children with Williams syndrome and children withDown syndrome. Journal of Child Language, 40 (1), 106−138.

    doi.org/10.1017/S0305000912000475
  • MALAK, R., KOSTIUKOW, A., KRAWCZYK−WASIELEWSKA,A., MOJS, E. & SAMBORSKI, W. (2015). Delays in motordevelopment in children with Down syndrome. Medical ScienceMonitor: International Medical Journal of Experimental andClinical Research, 21, 1904.

    doi.org/10.12659/MSM.893377
  • MASON−APPS, E., STOJANOVIK, V., HOUSTON−PRICE, C.,SEAGER, E. & BUCKLEY, S. (2020). Do infants with Downsyndrome show an early receptive language advantage? Journal ofSpeech, Language, and Hearing Research, 63 (2), 585−598. https:/

    doi.org/10.1044/2019_JSLHR−19−00157
  • MILOJEVICH, H. & LUKOWSKI, A. (2016). Recall memory inchildren with Down syndrome and typically developing peersmatched on developmental age. Journal of Intellectual DisabilityResearch, 60 (1), 89−100.

    doi.org/10.1111/jir.12242
  • NÆSS, K.A.B., LYSTER, S.A.H., HULME, C. & MELBY−LERVÅG,M. (2011). Language and verbal short−term memory skills inchildren with Down syndrome: A meta−analytic review. Researchin Developmental Disabilities, 32 (6), 2225−2234. https:/

    doi.org/10.1016/j.ridd.2011.05.014
  • NARANJO, N.V. & ROBLES−BELLO, M.A. (2020). Dynamicassessment in preschoolers with Down syndrome andnonspecific intellectual disability. Psicología Educativa. Revistade los Psicólogos de la Educación, 26 (2), 101−107. httsp:/

    doi.org/10.5093/psed2020a9
  • NEEDHAM, A.W., NELSON, E.L., SHORT, A.D., DAUNHAUER,L.A. & FIDLER, D.J. (2021). The emergence of fine motor skills inchildren with Down syndrome. International Review of Researchin Developmental Disabilities, vol. 60. Academic Press. https:/

    doi.org/10.1016/bs.irrdd.2021.08.002
  • ORSINI, A., PEZZUTI, L. & HULBERT, S. (2015). Beyond the flooreffect on the Wechsler Intelligence Scale for Children – 4th Ed.(WISC‐IV): Calculating IQ and indexes of subjects presentinga floored pattern of results. Journal of Intellectual DisabilityResearch, 59 (5), 468−473.

    doi.org/10.1111/jir.12150
  • PATTERSON, T., RAPSEY, C.M. & GLUE, P. (2013). Systematicreview of cognitive development across childhood in Downsyndrome: Implications for treatment interventions. Journal ofIntellectual Disability Research, 57 (4), 306−318.

    doi.org/10.1111/j.1365−2788.2012.01536.x
  • PEZZUTI, L., NACINOVICH, R., OGGIANO, S., BOMBA, M.,FERRI, R., LA STELLA, A., … & ORSINI, A. (2018). Beyond thefloor effect on the WISC‐IV in individuals with Down syndrome:Are there cognitive strengths and weaknesses? Journal ofIntellectual Disability Research, 62 (7), 593−603.

    doi.org/10.1111/jir.12499
  • ROBERTS, J.E., PRICE, J. & MALKIN, C. (2007). Language andcommunication development in Down syndrome. MentalRetardation and Developmental Disabilities Research Reviews, 13(1), 26−35. https:/

    doi.org/10.1002/mrdd.20136
  • ROBERTS, L.V. & RICHMOND, J.L. (2015). Preschoolers with Downsyndromedonotyetshowthelearningandmemoryimpairmentsseen in adults with Down syndrome. Developmental Science, 18(3), 404−419. https:/

    doi.org/10.1111/desc.12225
  • ROIZEN, N.J. & PATTERSON, D. (2003). Down’s syndrome.

  • The Lancet, 361 (9365), 1281−1289. https:/

    doi.org/10.1016/S0140−6736(03)12987−X
  • TE KAAT−VAN DEN OS, D.J., JONGMANS, M.J., VOLMAN,M.C.J. & LAUTESLAGER, P.E. (2015). Do gestures pave the way?A systematic review of the transitional role of gesture during theacquisition of early lexical and syntactic milestones in youngchildren with Down syndrome. Child Language Teaching andTherapy, 31 (1), 71−84.

    doi.org/10.1177/0265659014537842
  • TE KAAT‐VAN DEN OS, D.T., VOLMAN, C., JONGMANS, M. &LAUTESLAGER, P. (2017). Expressive vocabulary developmentin children with down syndrome: A longitudinal study. Journalof Policy and Practice in Intellectual Disabilities, 14 (4), 311−318.

    doi.org/10.1111/jppi.12212
  • TUDELLA, E., PEREIRA, K., BASSO, R.P. & SAVELSBERGH, G.J.(2011). Description of the motor development of 3−12 monthold infants with Down syndrome: The influence of the posturalbody position. Research in Developmental Disabilities, 32 (5),1514−1520. https:/

    doi.org/10.1016/j.ridd.2011.01.046
  • WESTER OXELGREN, U., MYRELID, Å., ANNERÉN, G.,WESTERLUND, J., GUSTAFSSON, J. & FERNELL, E. (2019).More severe intellectual disability found in teenagers comparedto younger children with Down syndrome. Acta Paediatrica, 108(5), 961−966. https:/

    doi.org/10.1111/apa.14624
  • WITECY, B. & PENKE, M. (2017). Language comprehensionin children, adolescents, and adults with Down syndrome.Research in Developmental Disabilities, 62, 184−196. https:/

    doi.org/10.1016/j.ridd.2017.01.014
  • YANG, Y., CONNERS, F.A. & MERRILL, E.C. (2014). Visuo−spatialability in individuals with Down syndrome: Is it really a strength?Research in Developmental Disabilities, 35 (7), 1473−1500.https:/

    doi.org/10.1016/j.ridd.2014.04.002
  • YODER, P.J. & WARREN, S.F. (2004). Early predictors of languagein children with and without Down syndrome. AmericanJournal on Mental Retardation, 109 (4), 285−300. https://

    <a title="YODER, P.J. & WARREN, S.F. (2004). Early predictors of languagein children with and without Down syndrome. AmericanJournal on Mental Retardation, 109 (4), 285−300. https://" href="http://doi.org/10.1352/0895−8017(2004)1092.0.CO;2″ target=”_Blank”>doi.org/10.1352/0895−8017(2004)1092.0.CO;2
  • YODER, P., WOYNAROSKI, T., FEY, M. & WARREN, S. (2014).Effects of dose frequency of early communication interventionin young children with and without Down syndrome. AmericanJournal on Intellectual and Developmental Disabilities, 119 (1),17−32. https:/

    doi.org/10.1352/1944−7558−119.1.17
  • ZAMPINI, L. & D’ODORICO, L. (2011). Gesture production and language development: A longitudinal study of children with Down syndrome. Gesture, 11 (2), 174−193. https:/

    doi.org/10.1075/gest.11.2.04zam
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Author Surname Author Initial. Title. Publication Title. Year Published;Volume number(Issue number):Pages Used. doi:DOI Number.


Pezzuti Lina . Ferri Rosa . Caramuscio Elvira . Dawe James . Scala Anna . Cognitive, language and motor development in toddlers with Down syndrome: Beyond the floor effect of Italian BSID−III scores. BPA Applied Psychology Bulletin. 2023;297(1):2-19. doi:10.26387/bpa.297.1.

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Author Surname Author Initial. Title. Publication Title. Year Published;Volume number(Issue number):Pages Used. doi:DOI Number.


Pezzuti Lina . Ferri Rosa . Caramuscio Elvira . Dawe James . Scala Anna . Cognitive, language and motor development in toddlers with Down syndrome: Beyond the floor effect of Italian BSID−III scores. BPA Applied Psychology Bulletin. 2023;297(1):2-19. doi:10.26387/bpa.297.1.