Psychometric Evaluation of Social Cognition and Behavior Measures in Children and Adolescents with Down Syndrome

Individuals with Down syndrome (DS) are often described as socially engaged; however, challenges with social cognition, expressive language, and social interaction are also common in DS and are prospective outcomes of interest for clinical trials. The current study evaluates the psychometric properties of standardized measurements of social cognition and social behavior for potential use as outcome measures for children and adolescents with DS. Seventy-three youth ages 6 to 17 years old (M = 12.67, SD = 3.16) with DS were assessed on social cognition subtests of a neuropsychological assessment at two time points. Caregivers also completed a parent-report measure of social behavior. Measures were evaluated for feasibility, test-retest reliability, practice effects, convergent validity, and associations with broader developmental domains (i.e., age, cognition, and language). All social cognition and behavior measures met criteria for a portion of the psychometric indices evaluated, yet feasibility limitations were identified for the Developmental Neuropsychological Assessment, Second Edition (NEPSY-II) Affect Recognition subtest, and the NEPSY-II Theory of Mind subtest had problematic floor effects for percentile ranks. The Social Responsiveness Scale, Second Edition (SRS-2; T-scores) had high feasibility, moderate to excellent test-retest reliability, and no practice effects, suggesting this measure could be appropriate for use in clinical trials involving youth with DS.

Automated summary

This study evaluated the psychometric properties of standardized measurements of social cognition and behavior for potential use as outcome measures for children and adolescents with Down syndrome. Results showed that while all measures met criteria for some psychometric indices, there were feasibility limitations and problematic floor effects identified for certain subtests. The Social Responsiveness Scale, Second Edition (SRS-2) was found to be high in feasibility, with moderate to excellent test-retest reliability, and no practice effects, making it a suitable measure for use in clinical trials with youth with DS.