SLPCohortResearch in developmental disabilities2022

Executive functioning and verbal fluency performance in youth with Down syndrome.

Amanallah Soltani, Emily K Schworer, Anna J Esbensen

PMID 36209524

WHAT IT FOUND

In 69 children with Down syndrome, verbal fluency scores tracked closely with direct tests of inhibition, shifting, and working memory, even after accounting for vocabulary and IQ.

Parent-reported executive function did not match these scores, so clinicians should rely on performance-based assessments.

Key findings

01Semantic verbal fluency performance was significantly associated with both verbal and visuospatial measures of inhibition, shifting, and working memory, as well as parent-reported inhibition, after controlling for expressive vocabulary and cognitive ability.

02Parent-reported measures of shifting and working memory showed no significant association with verbal fluency performance, unlike the direct neuropsychological assessments.

03Once executive function measures were accounted for, expressive vocabulary and cognitive ability no longer made a significant independent contribution to verbal fluency scores.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The study is cross-sectional, so it cannot determine if executive function problems cause verbal fluency difficulties or if they simply co-occur. The sample size was relatively small (69 participants), and the findings may not generalize to all children with Down syndrome, particularly those with developmental ages under three years or those unable to complete the fluency task. Parent-reported executive function measures did not align with direct performance measures for shifting and working memory, highlighting a disconnect between everyday behavioral observations and standardized testing.

The easy way to misread this

Do not assume that parent reports of executive function difficulties accurately predict a child's verbal fluency performance. The study found that parent-reported shifting and working memory were not associated with fluency scores, while direct tests were.

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