Evaluating working memory outcome measures for children with Down syndrome.
E K Schworer, A J Esbensen, D J Fidler and 3 others
PMID 33763953WHAT IT FOUND
For children with Down syndrome, working memory tests are more useful when scored as raw ability scores.
Age-based scores often hit the lowest possible level, and verbal recall tasks were too hard for many children to complete.
Key findings
01Five of seven working memory subtests met the 80% completion benchmark, while DAS-2 Recall of Sequential Order and DAS-2 Recall of Digits Backward did not.
02Raw ability scores were more usable than age-based standard scores: four subtests had acceptable floor effects on raw scores, but no subtests met the acceptable floor-effect benchmark on standard scores.
03The SB-5 Nonverbal Working Memory raw score had the strongest overall psychometric profile, with high feasibility, good test-retest reliability, negligible practice effects and adequate validity.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample was from mid-sized Midwest and Western US cities and was 88.4% Caucasian, 94% non-Hispanic and 58% male, so it may not represent all children with Down syndrome. The study followed children for only two weeks, so it cannot show whether scores stay stable over longer periods or whether they are sensitive to real change after treatment. Some tasks were not clearly working memory measures. DAS-2 Recall of Digits Forward and DAS-2 Recognition of Pictures also involve short-term memory, and 45% progressed to later parts of the SB-5 Nonverbal Working Memory task and 13% reached the more advanced items on the SB-5 Verbal Working Memory task. The adaptive behaviour measure was completed by only 70 participants because a different measure was used for part of the sample. The study did not include very young children or adults with Down syndrome. Eligibility relied partly on parent-reported nonverbal mental age of at least 36 months, so some children may have been outside the chronological age recommended for test administration.
Declared interests
The authors declared no conflicts of interest. The article is labelled as supported by NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not use the age-based scores from these tests to track change after therapy. The paper found that age-based scores often hit the lowest possible level and did not meet reliability or validity criteria, so they may hide real differences.