Lisa A. Daunhauer, Deborah J. Fidler, Elizabeth Will; School Function in Students With Down Syndrome. Am J Occup Ther 2014;68(2):167-176. doi: 10.5014/ajot.2014.009274.
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People with Down syndrome (DS) are predisposed to specific areas of relative developmental strength and challenge, but it is unclear whether and how this profile affects participation in school and community settings. In this study we characterized the nature of school participation and performance of functional tasks in the school context for 26 elementary students with DS (mean age = 7.86 yr; standard deviation = 1.75). Students participated in assessments of cognitive status and language development. Their teachers completed the School Function Assessment (Coster, Deeney, Haltiwanger, & Haley, 1998) questionnaire and a standardized questionnaire on executive functioning (EF). Students demonstrated a pronounced pattern of assistance- and adaptation-related needs across various domains of school function. The strongest predictor of school function was EF skills, as reported by teachers (adjusted R2 = .47, p = .003). Findings from this study should inform future intervention and school-related planning for elementary school students with DS.
In this study, school-aged children with DS demonstrated that they needed less support and were more successful when performing physical activities in contrast to cognitive–behavioral activities in the school context.
It needs to be emphasized that although this study group needed less support to perform physical activities at school, participants’ performance was still below age expectations as measured by the SFA. The physical activities that were reported to be the most challenging for this group to perform were recreational movement, computer and equipment use, and written work.
The students were reported to demonstrate the greatest challenges in cognitive–behavioral tasks. The group was reported to have the most challenges with the following cognitive–behavioral activities: following social conventions, functional communication, compliance with adult directives and school rules, personal care awareness, task behavior–completion, positive interaction, and safety.
Furthermore, teacher reports of the students’ EF skills better predicted school function outcomes on the SFA than either IQ or language competence. Therefore, EF may play an important role in predicting outcomes in school function and may be an important target for intervention.
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