Journal of Intellectual Disability - Diagnosis and Treatment

Mezquita-Hoyos 124-132

Authors: Guadalupe Elizabeth Morales, Ernesto Octavio Lopez, Claudia Castro-Campos, David Jose Charles, Yanko Norberto Mezquita-Hoyos

Background: This paper aimed to explore the ability of people with Down syndrome (PWDS) in recognizing facial emotion by considering automatic cognitive processing levels of face recognition. Method: A sample of PWDS and participants with typical development (PWTD) participated in a set of two affective priming studies. In each study, participants had to categorize an emotional or neutral target face that was preceded by another emotional face. Stimuli presentation for each facial set (one face after another) was conducted by using an stimulus onset asynchrony (SOA) of 300 ms with the inter-stimulus interval (ISI) set at 50 ms. The first affective priming study manipulated emotion congruency between prime and target emotional faces to explore emotion classification abilities and to identify the cognitive mechanisms underlying automatic recognition of some emotional faces. The second study explored the effect that gender of a face has over categorization of facial emotion and difficulty in recognizing negative facial expressions. Results: The results strongly suggest that not all of the PWDS present difficulties in recognizing negative facial emotions. PWDS' performance pattern in categorizing emotion was similar to that of PWTDs if they had to use broad classification categories (e.g., emotion vs. no emotion). However, differences between both samples occurred if PWDS had to use a specific category task (e.g., classification of happiness, sadness, etc.). Conclusions: At least two emotion information processing styles can be identified in PWDS. Methodological and theoretical implications for exploring the emotional capabilities of people with DS are discussed.

94-100

Authors: Shogo Hirata, Hideyuki Okuzumi, Yoshio Kitajima, Tomio Hosobuchi, Mitsuru Kokubun

Purpose: To investigate the relationship between motor and cognitive control in adults with intellectual disabilities (ID), focusing on two aspects, speed and accuracy. Method: Participants were 62 adults with ID aged 20 to 47 years. Their intelligence quotients (IQ) ranged from 13 to 61. Nine of the adults with ID had Down syndrome, and 8 of the adults had autism. We conducted three tasks: seal affixation task, tray-carrying task, and the Matching Familiar Figures Test (MFFT). The seal affixation and tray-carrying tasks are motor tasks we devised that can separately measure the speed and accuracy of motor control. MFFT is a cognitive control task that can be used to evaluate cognitive styles, such as impulsive-reflective. Results: Adults with ID showed high motor accuracy and similar motor speed regardless of their MFFT performance. That is, discrepancies between motor and cognitive control existed in adults with ID. Conclusions: The results of this study indicate that some types of motor control problem may become unclear with growth. A longitudinal investigation focused on the motor skill development of persons with ID is therefore necessary.

112-118

Authors: Meglena Achkova, Harieta Manolova

The authors make a synthesized overview of the evolution of the understanding of autism in historical context and a critical analysis of the development of diagnostic criteria in the spirit of the Diagnostic and Statistical Manual (DSM). Based on personal research and extensive clinical experience they put forward a number of debatable issues and own views about the nature of autistic disorder by outlining the trends and directions for future research. Discussed is the issue of "core" and "additional" symptoms of autism and the need for comparison of categorical and dimensional data when constructing empirical studies for the autistic population. The article contains reflections on the underlying impairment which, according to the authors, is a disturbance in the processing and integration of the incoming information, especially at the level of filtration of significant and insignificant stimuli and their linking into a mental sequence appearing at different levels and with varying degree of severity. Noted is the importance of the detailed assessment of mental functioning for early diagnosis and individualized targeting of the therapeutic efforts. In this regard is emphasized the need to search for a new paradigm in the methodology of future research on autism that would make possible the comparison of interdisciplinary results and identification of connections between the relevant scientific achievements. Thus it will be possible to identify trends that will bring us closer to revealing the etiology, perhaps will have an impact on the criteria for diagnosis and on the overall construction of future therapeutic strategies.

133-143

Authors: Shirley F. Evans, Leigh E. Tenkku, Tay Kennedy, Roger Zoorob, P. Kevin Rudeen

Fetal alcohol spectrum disorders (FASD) occur as a result of prenatal alcohol exposure and are commonly associated with intellectual disability. Maternal alcohol consumption affects fetal development resulting in numerous lifelong physical, mental, and neurobehavioral abnormalities. To promote prevention of prenatal alcohol exposure and intervention to mitigate alcohol’s postnatal effects, the Centers for Disease Control and Prevention (CDC) provides continuing education to healthcare providers through their FASD Regional Training Centers (RTCs). An online survey evaluated healthcare providers’ perceived competency after training. Cover letters with the survey link were electronically mailed to healthcare providers, who received training between 2002 and 2009 from the Midwest and Southeast RTCs. Eighty-two providers who treated women or children responded to the survey (7.5% response rate). Approximately 86% of providers who treated women have identified women ‘at risk’ for alcohol abuse with 90% indicating they would refer to Substance Abuse or Mental Health Services. However, over 25% perceived lack of training and limited time as barriers in treating women of childbearing age for at-risk drinking. Over 90% of providers who treated children reported feeling competent in recognizing FAS and other alcohol-related effects. Yet, only 23% of providers for children reported using FASD diagnostic schema and were more apt to use growth charts (70%) rather than lip philtrum guides (58%) or palpebral fissure length measurements (50%), tools typically used in FAS determination. These results suggest a need for training to focus on methodology that assists providers to easily incorporate screening, diagnostic, and treatment procedures into their daily practice.