Beyond the floor effect on the WISC-IV in individuals with Down syndrome: are there cognitive strengths and weaknesses?

BACKGROUND: Individuals with Down syndrome generally show a floor effect on Wechsler Scales that is manifested by flat profiles and with many or all of the weighted scores on the subtests equal to 1. METHOD: The main aim of the present paper is to use the statistical Hessl method and the extended statistical method of Orsini, Pezzuti and Hulbert with a sample of individuals with Down syndrome (n = 128; 72 boys and 56 girls), to underline the variability of performance on Wechsler Intelligence Scale for Children-Fourth Edition subtests and indices, highlighting any strengths and weaknesses of this population that otherwise appear to be flattened. RESULTS: Based on results using traditional transformation of raw scores into weighted scores, a very high percentage of subtests with weighted score of 1 occurred in the Down syndrome sample, with a floor effect and without any statistically significant difference between four core Wechsler Intelligence Scale for Children-Fourth Edition indices. The results, using traditional transformation, confirm a deep cognitive impairment of those with Down syndrome. Conversely, using the new statistical method, it is immediately apparent that the variability of the scores, both on subtests and indices, is wider with respect to the traditional method. CONCLUSION: Children with Down syndrome show a greater ability in the Verbal Comprehension Index than in the Working Memory Index.

Beyond the floor effect on the Wechsler Intelligence Scale for Children--4th Ed. (WISC-IV): calculating IQ and Indexes of subjects presenting a floored pattern of results.

BACKGROUND: It is now widely known that children with severe intellectual disability show a 'floor effect' on the Wechsler scales. This effect emerges because the practice of transforming raw scores into scaled scores eliminates any variability present in participants with low intellectual ability and because intelligence quotient (IQ) scores are limited insofar as they do not measure scores lower than 40. METHOD: Following Hessl et al.'s results, the present authors propose a method for the computation of the Wechsler Intelligence Scale for Children--4th Ed. (WISC-IV)'s IQ and Indexes in intellectually disabled participants affected by a floored pattern of results. The Italian standardization sample (n = 2200) for the WISC-IV was used. The method presented in this study highlights the limits of the 'floor effect' of the WISC-IV in children with serious intellectual disability who present a profile with weighted scores of 1 in all the subtests despite some variability in the raw scores. RESULTS: Such method eliminates the floor effect of the scale and therefore makes it possible to analyse the strengths and weaknesses of the WISC-IV's Indexes in these participants. CONCLUSIONS: The Authors reflect on clinical utility of this method and on the meaning of raw score of 0 on subtest.

An exploration of adolescent feminine and occupational behavior development.

Women in the United States have become more involved in the dual roles of homemaker and worker. This article traces briefly the development of the feminine role and occupational choice through a review of the literature; and stresses the need for occupational therapists who work with adolescents to be aware of such development. Three theoretical approaches to sex-role development are explored, and developmental aspects of occupational choice are examined. An assessment tool is included, and may be used to help identify areas of developmental lag and thereby aid in treatment planning.

Structure of the Mini-Mental State Examination: a comparison between normal and clinical subjects.

The Mini-Mental State Examination was administered to a sample of 133 Italians ranging from 60 to 80 years of age. From a Principal Components Analysis three factors were retained, being results of both varimax and oblimin rotations. These were labeled (1) Memory, (2) Verbal Comprehension, and (3) Attention. These factors are similar to those obtained with normal elderly Americans, but they are different from the factors based on clinical samples. No age differences in the factor scores were found among the normal elderly subjects when education was considered. In contrast, significant differences were found between a group of 25 demented patients and a matched group randomly extracted from the normal sample.

Self-concept/self-esteem development.

Because the phrases, "has low self-esteem" or "has poor self-concept" are frequently used in describing patients, there is a need for a clearer understanding of the meaning of these terms. This article explores briefly some of the literature on self-concept/self-esteem development through adolescence. How deficits in self-esteem can be recognized and utilized in establishing treatment goals in occupational therapy is addressed.