Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
J Intellect Disabil Res. 2022 Jan;66(1-2):195-211. doi: 10.1111/jir.12833. Epub 2021 Mar 25.
There is a critical need for the psychometric evaluation of outcome measures to be used in clinical trials targeting cognition in Down syndrome (DS). This study examines a specific cognitive skill that is of particular importance in DS, working memory, and the psychometric properties of a set of standardised measurements to assess working memory in individuals with DS.
Ninety children and adolescents ages 6 to 18 years old with DS were assessed on a selection of verbal and visuospatial working memory subtests of standardised clinical assessments at two time points to examine feasibility, distributional qualities, test-retest reliability and convergent validity against a priori criteria. Caregivers also completed an adaptive behaviour questionnaire to address working memory subtests' associations with broader developmental functioning.
The Stanford Binet-5 Verbal Working Memory, Differential Ability Scales-2 Recognition of Pictures, Stanford Binet-5 Nonverbal Working Memory and Wechsler Intelligence Scale for Children-5 Picture Span measures met the most psychometric criteria overall across the full age and IQ range of the study. Although Differential Ability Scales-2 Recall of Sequential Order and Differential Ability Scales-2 Recall of Digits Backward met the fewest a priori criteria, follow-up analyses suggested greater feasibility in specific age and IQ ranges.
Several working memory measures appear to be psychometrically sound and appropriate for use in clinical trials for children with DS, especially when focusing on raw scores. However, floor effects on standard scores and feasibility of some measures were problematic. Guidelines for use of the working memory subtests with this population are provided.
针对唐氏综合征（DS）患者认知能力的临床试验需要对结果评估工具进行严格的心理计量学评估。本研究考察了一种特定的认知技能，即工作记忆，以及一组用于评估 DS 个体工作记忆的标准化测量的心理计量学特性。
本研究对 90 名 6 至 18 岁的 DS 儿童和青少年进行了一系列口头和视空间工作记忆子测试的评估，这些测试来自标准临床评估，在两个时间点进行评估，以检验可行性、分布特性、重测信度和与预先设定标准的聚合效度。照顾者还完成了一份适应性行为问卷，以考察工作记忆子测试与更广泛的发育功能之间的关联。
斯坦福-比奈 5 号言语工作记忆、差异能力量表-2 图片识别、斯坦福-比奈 5 号非言语工作记忆和韦氏儿童智力量表-5 图片跨度测试在整个研究的年龄和智商范围内总体上满足了最多的心理计量学标准。尽管差异能力量表-2 序列顺序回忆和差异能力量表-2 数字倒背测试满足的预先设定标准最少，但后续分析表明在特定年龄和智商范围内具有更大的可行性。
一些工作记忆测试在心理计量学上似乎是合理和适当的，可用于 DS 儿童的临床试验，尤其是在关注原始分数时。然而，标准分数上的地板效应和一些测试的可行性是有问题的。本研究为使用这些工作记忆子测试提供了指南。
