Su C-Y, Chen C-C, Wuang Y-P, Lin Y-H, Wu Y-Y
Kaohsiung Medical University, School of Occupational Therapy, Kaohsiung, Taiwan.
J Intellect Disabil Res. 2008 Jan;52(Pt 1):18-28. doi: 10.1111/j.1365-2788.2007.00969.x.
Very little is known about the neuropsychological correlates of adaptive functioning in people with intellectual disabilities (ID). This study examined whether specific cognitive deficits and demographic variables predicted everyday functioning in adults with ID.
People with ID (n = 101; ages 19-41 years; mean education = 11 years; 34% women; 54% competitively employed; 41% with mild ID) completed a comprehensive neuropsychological battery grouped into four cognitive domains: processing speed, verbal memory and comprehension, visual perception/constructive function, and executive function. In addition, parents completed an 89-item rating scale developed to assess a wide range of independent living skills.
Confirmatory factor analysis results confirmed a correlated four-factor model of cognitive function and a unidimensional model of everyday functioning. Furthermore, structural equation modelling results supported the predictive relationship of verbal memory/comprehension and employment status (standardized regression coefficients 0.45, 0.22, P < or = 0.01 for each) to measures of everyday functioning. The two variables together explained 35% of the variance in everyday functioning.
Both general cognitive dysfunction and specific verbal memory and comprehension deficit impair daily functions in people with ID. These findings have implications for predictive models of adaptive functioning, and for cognitive rehabilitation and deficit compensation strategies for this group.
关于智力残疾（ID）患者适应性功能的神经心理学相关因素，人们了解甚少。本研究调查了特定认知缺陷和人口统计学变量是否能预测成年ID患者的日常功能。
ID患者（n = 101；年龄19 - 41岁；平均受教育年限 = 11年；34%为女性；54%有竞争性就业；41%为轻度ID）完成了一组综合神经心理测试，分为四个认知领域：处理速度、言语记忆与理解、视觉感知/建构功能和执行功能。此外，家长完成了一个为评估广泛独立生活技能而编制的89项评定量表。
验证性因素分析结果证实了认知功能的四因素相关模型和日常功能的单维模型。此外，结构方程建模结果支持言语记忆/理解和就业状况与日常功能测量指标之间的预测关系（标准化回归系数分别为0.45、0.22，P≤0.01）。这两个变量共同解释了日常功能中35%的变异。
一般认知功能障碍以及特定的言语记忆和理解缺陷均会损害ID患者的日常功能。这些发现对适应性功能的预测模型以及该群体的认知康复和缺陷补偿策略具有启示意义。
