Differences in the clinical presentation of Trisomy 21 with and without autism.

BACKGROUND: Autism occurs 10 times more often in children with Down syndrome than in the general population, but diagnosing co-occurring autism in Down syndrome with severe intellectual disability is challenging. The objective of this case-control study was to identify characteristics differentiating children with trisomy 21 with and without autism and to determine the extent to which severe cognitive impairment affects the measures of autism symptomatology. METHOD: Twenty children with trisomy 21 and autism (cases) were compared with children with trisomy 21 without autism (controls) matched on chronologic age, race and gender. Communication, cognitive and adaptive behaviour skills were assessed with standardized instruments. Medical history was reviewed and medical records were examined for early head growth. Scores on the diagnostic algorithm of the Autism Diagnostic Interview--Revised (ADI-R) were compared after adjusting for cognitive ability as measured by the Stanford-Binet (Fifth Edition) non-verbal change sensitive score. RESULTS: Cases performed significantly more poorly on all assessments. Mean case-control differences for matched pairs were all significant at P < 0.0001 for receptive and expressive language skills, cognitive skills and adaptive skills. Seven cases had a history of seizures compared with one control(P = 0.01). After adjusting for cognitive ability, the mean scores on the Reciprocal Social Interaction, Communication, and Restricted, Repetitive and Stereotyped Behaviours domains of the ADI-R diagnostic algorithm remained significantly higher in cases compared with controls (P < 0.0001). All participants had decreased head size consistent with Down syndrome, with no case-control differences. CONCLUSION: Children with trisomy 21 and autism have significantly more impaired brain function than children with trisomy 21 without autism. However, the deficits in the core domains of social reciprocity and communication, and the restricted and repetitive interests are not entirely explained by the more severe cognitive impairment. This autism phenotype in children with trisomy 21 which includes an increased risk for seizures may indicate a widespread loss of functional connectivity in the brain.

Utility of an abbreviated version of the stanford-binet intelligence scales (5th ed.) in estimating 'full scale' IQ for young children with autism spectrum disorder.

The fifth edition of the Stanford-Binet Intelligence scales allows 'full scale' IQ (FSIQ) to be estimated using an abridged version of the test-the abbreviated battery IQ (ABIQ). Set within a public early intervention team service, the current cross-sectional study investigated the utility of the ABIQ in estimating FSIQ for 40 children with autism spectrum disorder (ASD) aged 3-5 years. A strong ABIQ-FSIQ association was yielded (r = 0.89; r2 = 0.808) and the ABIQ did not over-estimate mean FSIQ above a clinically-relevant threshold; however, clinically significant over-estimation occurred in 17.5% of individual cases. While the findings provide support for the utility of the ABIQ in estimating FSIQ for young children with ASD, caution relating to the over-estimation of FSIQ is warranted. Careful clinical judgment-ideally based on examination of previous cognitive assessment results (if available), thorough interactional observations, and close multi-disciplinary consultation-is necessary to determine the applicability of the ABIQ to individual cases. Autism Res 2018, 11: 503-508. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: We investigated the utility of a shortened version of the Stanford-Binet Intelligence Scales in estimating IQ for 40 young children with autism spectrum disorder (ASD). The findings provide qualified support for the instrument: acceptably accurate IQ estimation was achieved for most cases; but not so for a sizeable minority (17.5%). Careful clinical judgment is necessary to determine the applicability of the ABIQ to individual cases.

The construct validity of the stanford-binet 5 measures of working memory.

This study examines the validity of the measures of verbal and nonverbal working memory on the Stanford-Binet Fifth Edition (SB5). The validity evidence included Rasch-based, criterion-referenced item mapping, correlations with other clinical measures of memory, and prediction of reading and mathematics scores. The item mapping clearly demonstrates a parallel between increasing item difficulty and a progression of item characteristics that placed increasing demands on verbal and nonverbal working memory. The higher correlations of the SB5 verbal and nonverbal working memory subtests with other measures of verbal and nonverbal memory, respectively, and lower correlations with nonverbal and verbal memory measures, respectively, clearly show convergent and divergent validity. The higher correlations between SB5 verbal working memory and reading skills and between SB5 nonverbal memory and mathematics skills are consistent with past research.

Reporting the size of effects in research studies to facilitate assessment of practical or clinical significance.

"Statistically significant" results may lack practical or clinical significance, and the description of results in reports of research studies is frequently incomplete or misleading in presentation of data necessary to assess such significance (effect sizes). Various common presentations are discussed, and one method of presentation of results is proposed that not only encompasses all the others, but enhances the scope of useful information conveyed in a research report. The results of the Infant Health and Development Program (IHDP) are used to illustrate the method.

Intelligence and lifelong learning. What's new and how can we use it?

The field of intelligence as applied to lifelong learning has some new ideas about what intellectual abilities are and how they can be measured. The field also has come to a realization of what some of the limitations are both of conventional tests and even of new tests that are starting to emerge. What does the future hold for this field? It is in our hands, as a field, to decide.

Analysis of WISC-III, Stanford-Binet:IV, and academic achievement test scores in children with autism.

Nonverbal IQs were greater than verbal IQs for young children (3-7 years of age) on the Stanford-Binet:IV (n = 53). However, WISC-III verbal and nonverbal IQs were similar for older children, 6-15 years of age (n = 63). Stanford-Binet:IV profiles were generally consistent for the low-IQ (< 80) and high-IQ (> or = 80) groups, with high scores on visual matching tests (Bead Memory and Quantitative Reasoning). The low- and high-WISC-III IQ groups both performed well relative to IQ on tests of lexical knowledge (Similarities, Information, and Vocabulary), but not on language comprehension and social reasoning (Comprehension). The low-IQ group did best on visuo-motor subtests (Object Assembly and Block Design), but the high-IQ group did not. The high-IQ group had significantly low scores on the Digit Span, Arithmetic, Coding, VMI, and WIAT Written Expression tests, suggesting attention and writing weaknesses.

Predicting IQ of biologically "at risk" children from age 3 to school entry: sensitivity and specificity of the Stanford-Binet Intelligence Scale IV.

Predictive validity of the Stanford-Binet Intelligence Scale Fourth Edition (S-B IV) from age 3 years to ages 4-5 years was evaluated with biologically "at risk" children without major sensory or motor impairments (n = 236). Using the standard scoring, children with full scale IQ < or = 84 on the Wechsler Preschool and Primary Scale of Intelligence at age 4-5 years were poorly identified (sensitivity 54%) from the composite S-B IV score at age 3. However, sensitivity improved greatly to 78% by including as a predictor the number of subtests the child was actually able to perform at age 3 years. Measures from the Home Screening Questionnaire and ratings of mother-child interaction further improved sensitivity to 83%. The standard method for calculating the composite score on the S-B IV excludes subtests with a raw score of 0, which overestimates cognitive functioning in young biologically high risk children. Accuracy of early identification was improved significantly by considering the number of subtests the child did not perform at age 3 years.

Stability and change over time in cognitive level of children with delays.

Cognitive and family data on 82 children with developmental delays were collected in an 8-year longitudinal study. Child measures included the Gesell and the UCLA Temperament Scale administered at child age 3 and the Stanford Binet, administered at child ages 6 and 11. Family measures included SES, level of maternal education, and factor scores reflecting family accommodation or adaptation at the three time points. Although cognitive scores for the group were stable, use of a random coefficient regression technique documented differences in the decline of cognitive scores over time. Examination of change scores identified increasing, stable, and decreasing patterns of change. There were significant correlations between change in IQ, entering DQ, and Easy and Difficult temperaments.

External validity of the profile variability index for the K-ABC, Stanford-Binet, and WISC-R: another cul de-sac.

Clinicians often attach interpretive significance to high variability among subtest scores in IQ profiles of adults and children. In this study we evaluated the external validity of a relatively new measure of IQ subtest variability, the profile variability index (PVI). Within a sample of referred children, we administered the Kaufman Assessment Battery for Children, the Fourth Edition Stanford-Binet, and the Wechsler Intelligence Scale for Children-Revised. We calculated PVIs for each child from each test and correlated these values with achievement scores and indexes of discrepancy between actual and predicted scholastic achievement. Against these external criteria, PVI information from all three cognitive-ability batteries had essentially nil validity. We discuss implications of these findings for future research in this area.

The impact of receiving the same items on consecutive computer adaptive test administrations.

This study addresses item exposure in a Computerized Adaptive Test (CAT) when the item selection algorithm is permitted to present examinees with questions that they have already been asked in a previous test administration. The results indicate that the combined use of an adaptive algorithm to select items and latent trait theory to estimate person ability provides substantial protection from score contamination. The implications for constraints that prohibit examinees from seeing an item twice are discussed.

Percent of agreement among raters and rater reliability of the copying subtest of the Stanford-Binet Intelligence Scale: Fourth Edition.

The purpose of this study was to investigate the interrater reliability of the visual-motor portion of the Copying subtest of the Stanford-Binet Intelligence Scale: Fourth Edition. Eight raters independently scored 11 protocols completed by children aged 5 through 10 years, using the scoring criteria and guidelines in the manual. The raters marked each of 10 items pass or fail and computed a total raw score for each protocol. Interrater reliability coefficients were obtained for each child's protocol, and the Kappa coefficient was computed for each item. Significant raters' reliability coefficients ranged from .82 to .91, which were low in comparison to test-retest reliability and Kuder-Richardson-20 coefficients for this and other subtests of the Stanford-Binet in the technical manual. Percent agreement among 8 raters also indicated weak reliability. Although the obtained results suggested some interrater reliability coefficients within acceptable levels, questions were raised about the scoring criteria for individual items. Caution is warranted in the use of cognitive measures which include subjective judgement of the examiner in applying scoring criteria.

Comparison of Kaufman's short form of the McCarthy Scales of Children's Abilities and the Stanford-Binet Intelligence Scales--Fourth Edition.

21 kindergarten children completed the Stanford-Binet-IV (Binet-IV) and the McCarthy Scales of Children's Abilities. Kaufman's (1977) estimated General Cognitive Index (GCI) was computed from the entire McCarthy scales. There was only one significant difference among the Binet-IV and estimated GCI scores. Abstract/Visual Reasoning was significantly lower than the Kaufman GCI. Correlations of the five Binet-IV Standard Age Scores and the Kaufman GCI ranged from .29 to .67. The correlation between the GCI and the Kaufman estimated GCI was .91.

Correlations between scores on the Wechsler Intelligence Scale for Children-III and the General Purpose Abbreviated Battery of the Stanford-Binet IV.

Estimations of some relationships among scores on the "General Purpose Abbreviated Battery" of the Stanford-Binet: Fourth Edition and the Wechsler Intelligence Scale for Children-III were based on the responses of 14 boys and 18 girls enrolled in Grades 3, 4, and 5 and who took both tests. Of 13 Pearson correlations between the Binet IV composite score and the Wechsler subtest scores and IQs 12 were statistically significant (rs = .45 to .74). The new Wechsler scale appears to be a valid instrument for the 32 children (8-8 to 11-11) who were tested.

Relationships between scores on Wechsler Preschool and Primary Scale of Intelligence--Revised and Stanford-Binet IV.

The Wechsler Preschool and Primary Scale of Intelligence--Revised and the Stanford Binet-Intelligence Scale: Fourth Edition were given to 51 preschool, kindergarten, first, and second grade students. Twelve of 15 Pearson correlations between Wechsler IQs and composite and area scores of the Stanford-Binet IV were statistically significant. It is apparent that the two tests measure similar, but not identical, concepts.

Assessment of preschoolers at-risk with the WPPSI--R and the Stanford-Binet L-M.

The purpose of this study was to provide data on the validity of using the WPPSI--R with 16 preschoolers who had been referred for psychological assessment. A comparison of the preschoolers' performance on the WPPSI--R and the Stanford-Binet L-M was made. Children ranged in age from 3-0 to 6-0 years, with a mean age of 4-5 yr. The correlations between WPPSI--R and Stanford-Binet L-M scores were strong; WPPSI--R Verbal IQ and Stanford-Binet L-M IQ, r = .85; WPPSI--R Performance IQ and Stanford-Binet L-M IQ, r = .75, and WPPSI--R Full Scale IQ and Stanford-Binet L-M IQ, r = .82. For this very small sample of children whose mean IQ was significantly below average, the WPPSI--R appeared to assess validly their current intellectual functioning. Attention should be given concurrent and predictive validity as well as the efficiency of using the WPPSI--R with other and larger samples of referred children.

An examination of the relationship between autism spectrum disorder, intellectual functioning, and comorbid symptoms in children.

There is a deficiency of research looking at how rates of comorbid psychopathology are effected by autism spectrum disorder (ASD) and intellectual functioning level. The present study aimed to extend the literature in this area by evaluating how ASD and IQ scores are related to ratings on a measure of comorbid symptoms. Twenty-three children with ASD and 87 children without ASD participated in this study. Rates of tantrum behavior, avoidant behavior, worry/depressed, repetitive behavior, under-eating, over-eating, and conduct behavior were examined utilizing the Autism Spectrum Disorders-Comorbidity for Children (ASD-CC). Correlational and multiple regression analyses were then conducted. ASD diagnosis significantly predicted rates of tantrum behavior, avoidant behavior, and repetitive behavior. Children with ASD tended to have higher rates of all three of these comorbid symptoms than children without ASD. Although not statistically significant, there was a negative correlation between IQ and rates of comorbid symptoms, such that children with higher IQ scores tended to have lower rates of comorbid symptoms. The implications of these findings on assessment and intervention are discussed.

Comparison of the Leiter International Performance Scale-Revised and the Stanford-Binet Intelligence Scales, 5th Edition, in children with autism spectrum disorders.

A review of hospital records was conducted for children evaluated for autism spectrum disorders who completed both the Leiter International Performance Scale-Revised (Leiter-R) and Stanford-Binet Intelligence Scales, 5th Edition (SB5). Participants were between 3 and 12 years of age. Diagnoses were autistic disorder (n  =  26, 55%) and pervasive developmental disorder-not otherwise specified (n  =  21, 45%). Analysis showed that the full sample received significantly higher scores on the Leiter-R than SB5 (mean discrepancy of 20.91 points), specific diagnosis was not a significant factor, and younger children had a larger discrepancy between tests. These analyses strongly suggest that the Leiter-R and the SB5 may not be equivalent measures of intellectual functioning in children with autism spectrum disorders, and that use of one or the other exclusively could lead to misclassification of intellectual capacity.

Gender and geographic differences in the prevalence of intellectual disability in children: analysis of data from the national disability registry of Taiwan.

Intellectual disability (ID) is not uncommon in children, but data at the national level are limited, especially those on geographic differences. On the basis of the Disabled Welfare Law, Taiwan began to certify disabled residents and provide various services in 1980. All the cases are registered, and the registry provides a rare opportunity for studying ID at the national level. Using the data from 2004 to 2010, we calculated the prevalence of ID in children by age, gender, and geographic area and assessed the changes over time. We limited analyses to children at least 3 years of age, because certification before 3 years old is discouraged by the government. We found that from 2004 to 2010, the registered cases between 3 and 17 years old ranged from 20,531 to 23,547, and the prevalence of ID increased constantly from 4.40/1000 to 5.79/1000 (p<0.01), which generally increased every year in all age groups (p<0.01). In each year there were more boy cases than girl cases, and the boy-to-girl ratio generally decreased with age (p<0.01 for chi-square test for trend in all years). The prevalence rate ratio ranged from 1.33 to 1.37 (p<0.01 in all years), and the changes in the rate ratio were small over the years. We observed a higher prevalence in the rural areas over the years, and the prevalence rate ratio ranged from 1.34 to 1.43 (p<0.01 in all years), with an increasing trend over time (p<0.01).

Cognitive and developmental influences in visual-motor integration skills in young children.

Measures of visual-motor integration skills continue to be widely used in psychological assessments with children. However, the construct validity of many visual-motor integration measures remains unclear. In this study, we investigated the relative contributions of maturation and cognitive skills to the development of visual-motor integration skills in young children (N = 856). We used a block regression analysis to determine the contribution of maturation, as indicated by age, followed by broad cognitive factors (Study 1) and subsequently by individual subtests in verbal and nonverbal domains subsumed under each factor (Study 2) in explaining score variance of the Bender Visual-Motor Gestalt Test (2nd ed.; BG-II; Brannigan & Decker, 2003) Copy and Recall scores in children between the ages of 4 and 7 years. Results confirm that maturation accounted for a large proportion of variance in both BG-II Copy and Recall performance, above which Stanford-Binet Intelligence Scale (5th ed.; SB-5; Roid, 2003) Quantitative Reasoning and Fluid Reasoning factors significantly contributed to visual-motor integration performance for the Copy phase, and SB-5 Quantitative Reasoning and Visual-Spatial factors accounted for a significant amount of variance for the Recall phase. Additionally, nonverbal domains were more related to visual-motor performance than verbal domains. Results from this study are interpreted to suggest nonverbal reasoning and visual-spatial attention are important contributing factors to visual-motor integration, as measured by the BG-II. Developmental implications of visual-motor integration skills, nonverbal problem solving, and mathematical competence are discussed.

Executive functioning and the impact of a hearing loss: performance-based measures and the Behavior Rating Inventory of Executive Function (BRIEF).

The impact of deafness on a child's rated executive functioning behaviors and performance capabilities on neurological, cognitive, and achievement domains were examined in a sample of 22 deaf students (ages 5 to 18). The parent and teacher ratings on the Behavior Rating Inventory of Executive Function (BRIEF) showed significant positive correlations (p < .01) on six of the eight clinical scales. There were significant correlations between the BRIEF reports and the students' scores on the Wisconsin Card Sorting Test, the (Children's) Color Trails Test, and the Woodcock-Johnson: Writing Fluency subtest. The Wisconsin Card Sorting Test: Total Errors scale and the Writing Fluency subtest accounted for 70% variance of the parent BRIEF Global Executive Composite and 65% of the variance for the teacher report on this same composite scale. Students with genetic deafness were rated with significantly less challenges with executive functioning (p < .05) on BRIEF scales and performed significantly better on select student measures than students with other causes of deafness.