Associations among co-occurring medical conditions and cognition, language, and behavior in Down syndrome.
Emily K Schworer, Ameena Ahmed, Lori Hogenkamp and 2 others
PMID 35468571WHAT IT FOUND
Children with Down syndrome and gastrointestinal issues showed more social difficulties, maladaptive behaviors, and executive function challenges than those without.
No such differences were found for hearing loss, vision problems, or heart defects. Screen for GI issues when behavior or social skills are a concern.
Key findings
01Participants with GI concerns had significantly higher scores for social difficulties, internalizing and externalizing maladaptive behaviors, and emotional and cognitive regulation challenges compared to those with no GI concerns.
02No significant differences were found in cognition, language, social behavior, maladaptive behaviors, or executive function based on hearing loss, vision problems, or congenital heart defects.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
The study is cross-sectional, so it cannot determine if GI issues cause the behavioral challenges or if they co-occur for another reason. Social, maladaptive, and executive function outcomes were based on parent reports, not direct observation or testing. Medical conditions were identified by caregiver report and confirmed via records, but specific severity or type of GI issue was not detailed. Sample sizes for some conditions, particularly untreated hearing loss, were small. The study excluded children with a developmental level below 3 years and those who did not speak English as their primary language.
The easy way to misread this
Do not assume that GI issues cause these behavioral differences. This is an association found in a cross-sectional study, so the direction of causality is unknown. Also, do not ignore hearing or vision problems; the lack of association here may be because many participants had corrected impairments, or because the outcomes measured were not sensitive enough to detect effects from these specific conditions.