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Abstract：
BACKGROUND: Intellectual and developmental disabilities (IDDs) are associated with both cognitive challenges and difficulties in conceptual, social, and practical areas of living, commonly referred to as adaptive behavior (DSM-5). Although cross-sectional associations between intelligence or cognition and adaptive behavior have been reported in IDD populations, no study to date has examined whether developmental changes in cognition contribute to or track with changes in adaptive behavior. The present study sought to examine associations of longitudinal developmental change in domains of cognition (NIH Toolbox Cognition Battery, NIHTB-CB) and adaptive behavior domains (Vineland Adaptive Behavior Scales-3; VABS-3) including Socialization, Communication, and Daily Living Skills (DLS) over a two year period in a large sample of children, adolescents and young adults with IDD.
METHODS: Three groups were recruited, including those with fragile X syndrome, Down syndrome, and other/idiopathic intellectual disability. Eligible participants (n = 263) included those who were between 6 and 26 years (mage = 15.52, sd = 5.17) at Visit 1, and who had a diagnosis of, or suspected intellectual disability (ID), including borderline ID, with a mental age of at least 3.0 years. Participants were given cognitive and adaptive behavior assessments at two time points over a two year period (m = 2.45 years, range = 1.27 to 5.56 years). In order to examine the association of developmental change between cognitive and adaptive behavior domains, bivariate latent change score (BLCS) models were fit to compare change in the three cognitive domains measured by the NIHTB-CB (Fluid Cognition, Crystallized Cognition, Total Cognition) and the three adaptive behavior domains measured by the VABS-3 (Communication, DLS, and Socialization).
RESULTS: Over a two year period, change in cognition (both Crystallized and Total Composites) was significantly and positively associated with change in daily living skills. Also, baseline cognition level predicted growth in adaptive behavior, however baseline adaptive behavior did not predict growth in cognition in any model.
CONCLUSIONS: The present study demonstrated that developmental changes in cognition and adaptive behavior are associated in children and young adults with IDD, indicating the potential for cross-domain effects of intervention. Notably, improvements in DLS emerged as a primary area of adaptive behavior that positively related to improvements in cognition. This work provides evidence for the clinical, \"real life\" meaningfulness of changes in cognition detected by the NIHTB-CB in IDD, and provides empirical support for the NIHTB-CB as a fit-for-purpose performance-based outcome measure for this population.
METHODS: Three groups were recruited, including those with fragile X syndrome, Down syndrome, and other/idiopathic intellectual disability. Eligible participants (n = 263) included those who were between 6 and 26 years (mage = 15.52, sd = 5.17) at Visit 1, and who had a diagnosis of, or suspected intellectual disability (ID), including borderline ID, with a mental age of at least 3.0 years. Participants were given cognitive and adaptive behavior assessments at two time points over a two year period (m = 2.45 years, range = 1.27 to 5.56 years). In order to examine the association of developmental change between cognitive and adaptive behavior domains, bivariate latent change score (BLCS) models were fit to compare change in the three cognitive domains measured by the NIHTB-CB (Fluid Cognition, Crystallized Cognition, Total Cognition) and the three adaptive behavior domains measured by the VABS-3 (Communication, DLS, and Socialization).
RESULTS: Over a two year period, change in cognition (both Crystallized and Total Composites) was significantly and positively associated with change in daily living skills. Also, baseline cognition level predicted growth in adaptive behavior, however baseline adaptive behavior did not predict growth in cognition in any model.
CONCLUSIONS: The present study demonstrated that developmental changes in cognition and adaptive behavior are associated in children and young adults with IDD, indicating the potential for cross-domain effects of intervention. Notably, improvements in DLS emerged as a primary area of adaptive behavior that positively related to improvements in cognition. This work provides evidence for the clinical, \"real life\" meaningfulness of changes in cognition detected by the NIHTB-CB in IDD, and provides empirical support for the NIHTB-CB as a fit-for-purpose performance-based outcome measure for this population.
摘要：
背景：智力和发育障碍（IDD）与认知挑战和概念困难有关，社会,和实际的生活领域，通常称为自适应行为(DSM-5)。尽管在IDD人群中已经报道了智力或认知与适应性行为之间的横断面关联，迄今为止，还没有研究研究认知的发展变化是否有助于或追踪适应行为的变化。本研究试图检查认知领域纵向发展变化的关联(NIH工具箱认知电池，NIHTB-CB)和自适应行为领域(Vineland自适应行为量表-3；VABS-3)，包括社会化，Communication,和日常生活技能（DLS）在一个大样本的儿童，青少年和年轻人患有IDD。
方法：招募三组，包括患有脆性X综合征的患者,唐氏综合症,和其他/特发性智力障碍。符合条件的参与者（n=263）包括在第1次访问时年龄在6至26岁之间（mage=15.52，sd=5.17）的参与者，或怀疑智力残疾(ID)，包括边界线ID，精神年龄至少为3.0岁。参与者在两年内的两个时间点接受认知和适应行为评估（m=2.45年，范围=1.27至5.56年）。为了检查认知和适应行为领域之间的发展变化的关联，双变量潜在变化评分(BLCS)模型适合于比较NIHTB-CB(流体认知，结晶认知,总认知)和VABS-3测量的三个自适应行为域(通信，DLS,和社会化)。
结果：在两年的时间里，认知（结晶和总复合材料）的变化与日常生活技能的变化显着正相关。此外，基线认知水平预测适应性行为的增长，然而,在任何模型中,基线适应性行为都不能预测认知的增长.
结论：本研究表明，认知和适应行为的发展变化与儿童和年轻人患有IDD有关，表明干预的跨领域效应的潜力。值得注意的是,DLS的改善是适应性行为的主要领域，与认知改善呈正相关。这项工作为临床提供了证据,NIHTB-CB在IDD中检测到的认知变化的“现实生活”意义，并为NIHTB-CB作为适合该人群的基于绩效的结果度量提供了经验支持。
方法：招募三组，包括患有脆性X综合征的患者,唐氏综合症,和其他/特发性智力障碍。符合条件的参与者（n=263）包括在第1次访问时年龄在6至26岁之间（mage=15.52，sd=5.17）的参与者，或怀疑智力残疾(ID)，包括边界线ID，精神年龄至少为3.0岁。参与者在两年内的两个时间点接受认知和适应行为评估（m=2.45年，范围=1.27至5.56年）。为了检查认知和适应行为领域之间的发展变化的关联，双变量潜在变化评分(BLCS)模型适合于比较NIHTB-CB(流体认知，结晶认知,总认知)和VABS-3测量的三个自适应行为域(通信，DLS,和社会化)。
结果：在两年的时间里，认知（结晶和总复合材料）的变化与日常生活技能的变化显着正相关。此外，基线认知水平预测适应性行为的增长，然而,在任何模型中,基线适应性行为都不能预测认知的增长.
结论：本研究表明，认知和适应行为的发展变化与儿童和年轻人患有IDD有关，表明干预的跨领域效应的潜力。值得注意的是,DLS的改善是适应性行为的主要领域，与认知改善呈正相关。这项工作为临床提供了证据,NIHTB-CB在IDD中检测到的认知变化的“现实生活”意义，并为NIHTB-CB作为适合该人群的基于绩效的结果度量提供了经验支持。
