Cognitive flexibility assessment in youth with Down syndrome: Reliability, practice effects, and validity.
Emily K Schworer, Amanallah Soltani, Mekibib Altaye and 2 others
PMID 36603310WHAT IT FOUND
The Weigl Sorting task was the only one of three cognitive flexibility tests feasible for youth with Down syndrome, though it showed practice effects and moderate reliability.
The Rule-Shift test worked only for those with higher IQs, and the computerized KiTAP Flexibility test was unusable for nearly all participants.
Key findings
01The Weigl Sorting task met feasibility criteria (≥80% completion), whereas the Rule-Shift task had unacceptable feasibility (59.8%) and the KiTAP Flexibility subtest had very poor feasibility (3.1%).
02Test-retest reliability for both the Rule-Shift (ICC 0.69) and Weigl Sorting (ICC 0.71) tasks was moderate but did not meet the study's acceptable threshold of ≥0.75.
03The Weigl Sorting task showed significant practice effects (p < 0.01, Cohen’s d > 0.20), while the Rule-Shift task showed potential but not statistically significant practice effects (p = 0.06).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study used raw scores rather than standard scores, limiting interpretation relative to norms. Results cannot be generalized to adults or very young children with Down syndrome. The sample was limited in representation from Black and Hispanic participants. Down syndrome diagnosis was confirmed by report or chart review, not karyotyping.
The easy way to misread this
Do not assume the Weigl Sorting task is a psychometrically sound outcome measure for clinical trials simply because it is feasible. It failed to meet reliability and validity criteria, and its scores improved significantly between test and retest due to practice effects.