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... normally developing peers. This is sometimes attributed to the lethargy caused by being obese; children with DS just do not have the energy to pursue motor tasks as rigorously. The main conclusion Block comes to is that "while a child with DS may exhibit a somewhat normal but delayed course of motor development, there is evidence that such a child has many unique motor problems" (p. 206). Most measures used to assess children with DS are the same ones used to assess normally developing children.
Examples are the Kaufman Assessment Battery for Children, the Bayley Scales of Infant Development, and Gesell Developmental Schedules. Many psychologists question whether these and other tests are valid in assessing children with DS. Miller, Sedey, and Miolo (1995) tested the validity of the MacArthur Communicative Development Inventory (CDI), a test used to measure language production and comprehension. They begin by listing some advantages of parent report instruments, including: access to parents' extensive knowledge about their own child's vocabulary, being cost and time-effective, and fewer limiting factors that may affect a child's performance in a lab setting (e. g. fatigue, lack of familiarity with examiner).
Miller et al also praises the CDI for using a recognition format as opposed to relying on parents' ability to recall vocabulary their child uses. While the CDI offers a good way to assess a child's current lexicon, it is also important for a measure such as this to predict later language skills. Though the CDI has established validity in this sense when used in normally developing and some special populations, it has not yet done so for children with DS. One concern that Miller et al (1995) has is that parents of these children may not have the same reporting style as parents of other types of children. This is because parents of children with DS are informed about their child's disability at or before the birth of the child. This may either cause them to underestimate or overestimate their child's abilities.
Another challenge stems from the large differences between language production, language comprehension and other cognitive skills in children with DS. Miller et al (1995) conducted two experiments to test the reliability and validity of the CDI to assess language production. In both experiments parents of children with DS were asked to fill out the CDI prior to coming to the lab. Parents were able to write in words their children said but were not on the list in this experiment.
This is different from the standard way the CDI is administered. Subjects were then audio and videotaped during a 30 -minute free play session (15 minutes with experimenter, 15 minutes with parent) to measure observed vocabulary. Ten items from the Bayley Scales of Infant Development (BSID) were also used to measure expressive language. Miller et al found that there were significant correlations between the CDI, the observed vocabulary and the BSID. They concluded that the CDI is a valid measure to use in assessing the language development of children DS. The CDI does not seem to have anything wrong with it other than having limitations that other parent reports do, also.
One problem with parent reports is that they are subjective. A parent may hear their child say "mommy" because they want to hear it. In reality, the child may still be babbling and not producing any real words with real meanings. This can especially be a problem when trying to specifically assess children with DS.
Because of the biological problems they have in producing sounds, these children may not be able to say many words. In their study, Miller et al did not use the CDI to test comprehension, a limitation of their study. Finally, there is always a risk that when filling out these kind of questionnaires, parents are trying to make themselves or their children look good to the experimenter by filling out more items than the child truly knows. In 1989, Russell, Rosenbaum, Cadman, Gowland, Hardy, and Jarris found that the Gross Motor Function Measure (GMFM) was a valid measure to use on children who had cerebral palsy. In 1998, Russell, Palisano, Walter, Rosenbaum, Gemus, Gowland, Galuppi, and Lane conducted similar experiments to find if the GMFM was a valid measure to evaluate motor function in children with DS. The GMFM was specifically constructed to use on children with developmental disabilities, which is very unique.
It uses a four-point scale, which comprehensively covers all types of behaviors. Each category has at least 4 and as many as 19 behaviors on which the child is assessed. This presents a wide variety of ways for the child to demonstrate their skills. Russell et al (1998) tested 123 children with DS who were 6 years or younger. Each child was assessed by an intervener, "a service provider who saw the child on an ongoing basis and who was knowledgeable about the child's current motor abilities, but who did not necessarily have specialized training in motor development" (p. 695).
The GMFM requires that only behaviors demonstrated by the child at the time of the assessment be scored. In this experiment, the intervener's were told to ask the primary caregiver about behaviors the child regularly demonstrates but failed to during the assessment. This additional information was marked 'R' and used to calculate the 'reported's core of the child, a combination of the observed and reported behaviors. The children were also assessed using the established Bayley Scales of Infant Development - second edition. Children were assessed using both measures again after 6 months.
At the second meeting, Russell et al administered an additional questionnaire to parents to get more information about the change in the child's gross motor abilities. This questionnaire used a 15 -point Likert scale, ranging from - 7 (a great deal less) to + 7 (a great deal more). Russell et al found good correlations between the GMFM, BSID-II, and parent reports both on current abilities and prediction of change of gross motor function. Russell et al highly suggests using a parent report measure along with the GMFM to get reliable and valid results. The GMFM is a fairly good measure by itself but it should always be accompanied by a parent report. It is unlikely that a child will demonstrate all of their skills in a half hour, especially if a strange person administers the test in a strange place.
It can be difficult to get children to demonstrate tasks that are too easy for them but it cannot always be assumed that children have mastered all of the lower criteria. If they don't complete these tasks it hurts their scores. When assessing children with DS it is important to measure their abilities in many different areas. Since they are developmentally delayed in almost all areas, it is vital to get a global assessment of their progress. The CDI and GMFM are just two of many measures that can be used to assess children with DS. It is also important that other measures are tested for validity in assessing children with DS.
Not all tests will be appropriate and applicable to the special development rate of these children. Since most measures are based on normative development, researchers should continue to test them on children with DS to find out how they apply to this special population or if there is a need for other measures to be constructed. As always, further research is suggested. Words Count: 2, 886. Bibliography: Beeghly, M. , Weiss-Perry, B. , & Cicchetti, D. (1990). Beyond sensor motor functioning: early communicative and play development of children with Down syndrome.
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Russell, D. , Rosenbaum, P. , Cadman, D. , Gowland, C. , Hardy, S. , & Jarris, S. (1989). The gross motor function measure: a means to evaluate the effects of physical therapy. Developmental Medicine and Child Neurology, 31, 341 - 352. Russell, D. , Palisano, R. , Walter, S. , Rosenbaum, P. , Gemus, M. , Gowland, C. , Galuppi, B. , & Lane, M. (1998). Evaluation motor function in children with Down syndrome: validity of the GMFM. Developmental Medicine and Child Neurology, 40, 693 - 701.
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