Evaluating working memory outcome measures for children with Down syndrome
Open accessAbstract
Background: There is a critical need for the psychometric evaluation of outcome measures to be used in clinical trials targeting cognition in Down syndrome (DS). This study examines a specific cognitive skill that is of particular importance in DS, working memory, and the psychometric properties of a set of standardised measurements to assess working memory in individuals with DS. Methods: Ninety children and adolescents ages 6 to 18 years old with DS were assessed on a selection of verbal and visuospatial working memory subtests of standardised clinical assessments at two time points to examine feasibility, distributional qualities, test–retest reliability and convergent validity against a priori criteria. Caregivers also completed an adaptive behaviour questionnaire to address working memory subtests' associations with broader developmental functioning. Results: The Stanford Binet‐5 Verbal Working Memory, Differential Ability Scales‐2 Recognition of Pictures, Stanford Binet‐5 Nonverbal Working Memory and Wechsler Intelligence Scale for Children‐5 Picture Span measures met the most psychometric criteria overall across the full age and IQ range of the study. Although Differential Ability Scales‐2 Recall of Sequential Order and Differential Ability Scales‐2 Recall of Digits Backward met the fewest a priori criteria, follow‐up analyses suggested greater feasibility in specific age and IQ ranges. Conclusions: Several working memory measures appear to be psychometrically sound and appropriate for use in clinical trials for children with DS, especially when focusing on raw scores. However, floor effects on standard scores and feasibility of some measures were problematic. Guidelines for use of the working memory subtests with this population are provided.
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Test-retest reliability was assessed using intraclass correlation coefficients with a priori descriptive categories of poor (<0.50), moderate (0.50−0.74), good (0.75−0.90), or excellent (>0.90), and good or excellent classifications were deemed suitable.
“Test-retest reliability was assessed using intraclass correlation coefficients (ICC). Descriptive categories for ICCs are poor (<0.50), moderate (0.50−0.74), good (0.75−0.90), or excellent (>0.90) [33,40], and a priori good or excellent classifications were deemed suitable.”
From Psychometric Evaluation of Social Cognition and Behavior Measures in Children and Adolescents with Down Syndrome (2021) · cites this paper as [33]
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“These analyses were completed for any measure that did not meet study feasibility criteria, and suggestions for age and cognitive ability of participants for future administration were established (as per [33]).”
BackgroundMethodResultInfluentialSelf-citation
- Authors
- Schworer, E. K., Esbensen, A. J., Fidler, D. J., Beebe, D. W., Carle, A., & Wiley, S.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- Colorado State University (US)
- Venue
- Journal of Intellectual Disability Research
- Publisher
- Wiley
- Published
- 2021-03-25
- Volume
- 66
- Issue
- 1-2
- Pages
- 195-211
- ISSN
- 0964-2633 (ISSN-L)
- 1365-2788
- PMC
- PMC8463631
- OpenAlex
- W3135930466
- Cited by
- 26
- References
- 57
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 3 · 2023: 8 · 2022: 4 · 2021: 4
- FWCI
- 4.11
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Intellectual Disability Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01 HD093754)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- Down syndrome, working memory, psychometric properties, outcome measures, test-retest reliability, convergent validity, children and adolescents, floor effect, adaptive behavior, clinical trial outcome measures
- MeSH terms
- Adolescent, Child, Down Syndrome, Humans, Memory, Short-Term, Wechsler Scales, Reproducibility of Results, Outcome Assessment, Health Care
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