Showing papers in "Ajidd-american Journal on Intellectual and Developmental Disabilities in 2009"
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TL;DR: Evidence for the effectiveness of EIBI for some, but not all, preschool children with autism is provided, with some evidence that initial IQ (but not age) was related to progress.
Abstract: Recent reviews highlight limitations in the evidence base for early interventions for children with autism. We conducted a systematic review of controlled studies of early intensive behavioral interventions (EIBI) for young children with autism. Eleven studies met inclusion criteria (including two randomized controlled trials). At group level, EIBI resulted in improved outcomes (primarily measured by IQ) compared to comparison groups. At an individual level, however, there was considerable variability in outcome, with some evidence that initial IQ (but not age) was related to progress. This review provides evidence for the effectiveness of EIBI for some, but not all, preschool children with autism.
495 citations
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TL;DR: These studies provide more evidence of the benefits of deinstitutionalization and community living and continue to indicate variability in results, suggesting that factors other than the basic model of care are important in determining outcomes.
Abstract: Large-scale reviews of research in deinstitutionalization and community living were last conducted about 10 years ago. Here we surveyed research from 1997 to 2007. Articles were included if the researchers based the study on original research, provided information on the participants and methodology, compared residential arrangements for adults with intellectual disability, and were published in English-language peer-reviewed journals. Sixty-eight articles were found. In 7 of 10 domains, the majority of studies show that community-based services are superior to congregate arrangements. These studies provide more evidence of the benefits of deinstitutionalization and community living and continue to indicate variability in results, suggesting that factors other than the basic model of care are important in determining outcomes.
234 citations
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TL;DR: Teachers and parents diverged in their evaluations of the self-determination capacities of youth but agreed that opportunities to engage in self-determined behavior were available both at school and home and problem behaviors were negatively correlated with ratings of students' self- determination capacities and opportunities.
Abstract: We asked teachers and parents to assess the self-determination prospects of 135 youth with severe intellectual and developmental disabilities. Teachers typically reported that youth eviden...
96 citations
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TL;DR: Although the prior group reported a consistent advantage in terms of personal reward and subjective well-being, these diagnostic group differences disappeared when maternal age and child adaptive behavior were controlled, and it was concluded that these variables may help to explain the Down syndrome advantage.
Abstract: The “Down syndrome advantage” is the popular conception that children with Down syndrome are easier to rear than children with other developmental disabilities. We assessed whether mothers...
75 citations
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TL;DR: It was found that age, presence of epilepsy, and presence of paretic conditions were independent risk factors for falling in Japanese adults and the Tinetti balance and gait instrument was successfully administered.
Abstract: Our aim was to identify risk factors for falling and establish a method to assess risk for falls in adults with intellectual disabilities. In a cross-sectional survey of 144 Japanese adults, we found that age, presence of epilepsy, and presence of paretic conditions were independent risk factors. The Tinetti balance and gait instrument was successfully administered to this population and resulted in high diagnostic accuracy (sensitivity 88.9%, specificity 91.9%) for identifying individuals at risk when the cutoff score was set at 25. Participants whose balance and gait deteriorated showed a decrease in the Tinetti score of at least 2 points per year. Thus, the Tinetti instrument may be an effective tool to detect an increased risk of fall in this population.
71 citations
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TL;DR: Student-teacher relationships of 37 children with moderate to borderline intellectual disability and 61 with typical cognitive development were assessed from child ages 6-8 years, and student-teachers relationships predicted subsequent changes in child behavior problems and social skills.
Abstract: Student–teacher relationships of 37 children with moderate to borderline intellectual disability and 61 with typical cognitive development were assessed from child ages 6–8 years. Student–teacher relationship quality was moderately stable for the typical development group, but less so for the intellectual disability group. At each assessment these relationships were poorer for children with intellectual disability. Child behavior problems consistently predicted more conflict, whereas social skills predicted more closeness. Accounting for these child characteristics reduced the status group difference to nonsignificance. Earlier student–teacher relationships predicted subsequent changes in child behavior problems and social skills. Student–teacher relationships in the intellectual disability group were significantly lower for children in regular than special classes by age 8.
66 citations
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TL;DR: Parents of parents of children with fragile X syndrome described functional skill attainment in eating, dressing, toileting, bathing/hygiene, communication, articulation, and reading to highlight major skill attainments, identify skills that should be the target of specific intervention programs, and suggest variable trajectories to be tested more precisely.
Abstract: Parents of 1,105 male and 283 female children with fragile X syndrome described functional skill attainment in eating, dressing, toileting, bathing/hygiene, communication, articulation, and reading. The majority of adult children had mastered many skills independently. Most adults were verbal, used the toilet, dressed, ate independently, bathed, and used a towel independently. However, some skills were not as well-developed, such as using complex sentences, reading, or speaking at a typical rate. As expected, significant differences were found between males and females. The findings highlight major skill attainments, identify skills that should be the target of specific intervention programs, suggest variable trajectories to be tested more precisely through direct assessments and longitudinally, and provide baseline data for treatment studies.
64 citations
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TL;DR: It was found that healthy behavior was low, with 98.9% of the participants having an unhealthy diet and 68.3%, a lack of exercise, and campaigns to promote health should be focused on education and the introduction of preventive screening programs.
Abstract: The prevalence and correlates of cardiovascular risk factors in older adults with intellectual disability was examined. We conducted a cross-sectional study with 50- to 90-year-old clients (N = 470) of three Dutch intellectual disability care providing organizations and found that healthy behavior was low, with 98.9% of the participants having an unhealthy diet and 68.3%, a lack of exercise. Smoking (13.6%) and alcohol abuse (0.3%) were relatively minor problems. Abdominal overweight (70.4%), diabetes (8.7%), hypertension (36.8%), and hypercholesterolemia (31.8%) were highly prevalent. These profiles have important implications in determining the risk of cardiovascular disease in people with intellectual disability. Campaigns to promote health should be focused on education and the introduction of preventive screening programs.
62 citations
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TL;DR: Sibling relationships characterized by high warmth/closeness, positive affect, and few negative behaviors were predictive of fewer behavior problems for the targets at school, though warmth, conflict, and sibling management had different implications depending on the sibling's gender.
Abstract: We examined sibling relationships for children and adolescents with intellectual disability and assessed implications for their social functioning. Targets (total N = 212) had either intellectual disability, a chronic illness/physical disability, or no disability. Nontarget siblings reported on relationship quality, sibling interactions were observed, and teachers reported on social adjustment. Group comparisons highlighted the asymmetrical hierarchy and low conflict unique to siblings and targets with intellectual disability. Sibling relationships characterized by high warmth/closeness, positive affect, and few negative behaviors were predictive of fewer behavior problems for the targets at school. Both high warmth/ closeness and high conflict predicted greater social competence for the targets with intellectual disability, though warmth, conflict, and sibling management had different implications depending on the sibling's gender.
58 citations
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TL;DR: The depressed group reported a higher frequency and stress impact of stressful social interactions, more negative attribution style, and more avoidant and less active coping strategies did than the nondepressed group.
Abstract: The experience of stressful social interactions, negative causal attributions, and the use of maladaptive coping efforts help maintain depression over time in the general population. We investigated whether a similar experience occurs among adults with mild intellectual disability. We compared the frequency and stress impact of such interactions, identified causal attributions for these interactions, and determined the coping strategies of 47 depressed and 47 nondepressed adults with mild intellectual disability matched on subject characteristics. The depressed group reported a higher frequency and stress impact of stressful social interactions, more negative attribution style, and more avoidant and less active coping strategies did than the nondepressed group. Findings have implications for theory building and development of psychotherapies to treat depression.
50 citations
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TL;DR: It is suggested that 3 days of pedometer wear is sufficient to predict average weekly steps among ambulatory adults with intellectual disability, which will allow researchers to reduce participant burden and study costs, may guide measurement procedures, and inform missing data protocols.
Abstract: Pedometers are objective, inexpensive, valid, and reliable measures of physical activity. The minimum number of days of pedometer monitoring needed to estimate average weekly step counts w...
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TL;DR: Child solitary and collaborative mother-child play with 21 children with Down syndrome and 33 mental-age-matched typically developing children were compared, showing similar attunement and synchrony.
Abstract: Child solitary and collaborative mother–child play with 21 children with Down syndrome and 33 mental-age-matched typically developing children were compared. In solitary play, children with Down syndrome showed less exploratory but similar symbolic play compared to typically developing children. From solitary to collaborative play, children with Down syndrome increased their exploratory play, attaining the same level as typically developing children. Pretense significantly increased from solitary to collaborative play only in typically developing children. Differences between mothers' play in the two groups mirrored those between their children. Both groups showed similar attunement and synchrony. Mothers contribute to the play development of children with Down syndrome through their own adaptation to their children's limitations and potentialities.
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TL;DR: The likelihood that children would indicate a message was insufficient and that children who verbalized message inadequacy also would effectively communicate the problem varied as a function of type of problem encountered, theory of mind knowledge, receptive vocabulary, and CA.
Abstract: Although children with Williams syndrome have relatively good structural language and concrete vocabulary abilities, they have difficulty with pragmatic aspects of language. To investigate the impact of pragmatic difficulties on listener-role referential communication, we administered a picture placement task designed to measure ability to verbalize message inadequacy to a speaker separated by a barrier. Participants were 57 children with Williams syndrome 6 to 12 years of age. When messages were inadequate, children verbalized that a problem was encountered less than half the time. The likelihood that children would indicate a message was insufficient and that children who verbalized message inadequacy also would effectively communicate the problem varied as a function of type of problem encountered, theory of mind knowledge, receptive vocabulary, and CA.
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TL;DR: Results showed that a complex immune and impairment is present in healthy individuals with Down syndrome in whom interferon gamma, interleukin (IL) IL-10 production, as well as serum IL-7 concentrations and activation markers-bearing T lymphocytes were significantly augmented.
Abstract: Cytokine production, immune activation, T lymphocytes maturation, and serum IL-7 concentration were examined in 24 youngsters with Down syndrome and no acquired diseases (healthy Down syndrome [12 prepubertal, 13 pubertal]) and 42 age- and gender-matched controls (20 prepubertal, 22 pubertal). Results showed that a complex immune and impairment is present in healthy individuals with Down syndrome in whom interferon gamma, interleukin (IL) IL-10 production, as well as serum IL-7 concentrations and activation markers-bearing T lymphocytes were significantly augmented. Additionally, a complex skewing of post-thymic lymphocyte maturation pathways was observed in patients: significant reduction of CD4+ and CD8+ naive (RA+CCR7+) lymphocytes, significant increase of CD4+ and CD8+ central memory (RA-CCR7+), and terminally differentiated (TD) (RA+CCR7-) lymphocytes.
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TL;DR: Investigation of the efficacy of the Supports Intensity Scale showed that SIS scores contributed significantly to a model that predicted greater levels of support need, and data suggest that the SIS measures a different construct than that measured by traditional assessments of personal competence.
Abstract: Data were collected on 274 adults to investigate the efficacy of the Supports Intensity Scale (SIS) as a tool to measure the support needs of individuals with intellectual and related developmental disabilities. Findings showed that SIS scores contributed significantly to a model that predicted greater levels of support need. Moreover, scores from different sections of the SIS made unique contributions to explaining variance associated with a variety of support need proxies. Finally, data suggest that the SIS measures a different construct than that measured by traditional assessments of personal competence. The implications of these findings for decision-making, including decisions affecting the disbursement of state developmental disability funding, are discussed.
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TL;DR: Relations among externalizing behavior, therapeutic context (community care vs. residential care), and social problem-solving by children with mild intellectual disabilities or borderline intelligence were examined and indicate a discrepancy between appropriate problem-Solving skills and behavior in daily life.
Abstract: Relations among externalizing behavior, therapeutic context (community care vs. residential care), and social problem-solving by children with mild intellectual disabilities or borderline intelligence were examined. Participants were 186 children (12 to 14 years of age) who responded to a video-based social problem-solving task. Of these, 130 received residential care and the majority suffered from severe externalizing behavior problems. The results indicated that externalizing behavior was related to encoding, generation of aggressive responses, and negative evaluation of assertive responses. Therapeutic context was related to encoding, positive evaluation of assertive responses, and negative evaluation of aggressive responses. Results indicate a discrepancy between appropriate problem-solving skills and behavior in daily life. Implications for interventions are discussed.
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TL;DR: This work used experimental and descriptive functional analyses and lag sequential analyses to examine the functional and temporal relationship among the self-injurious (SIB), potentially injurious, repetitive, challenging, and pragmatic communicative behaviors of 6 children with intellectual disabilities.
Abstract: We used experimental and descriptive functional analyses and lag sequential analyses to examine the functional and temporal relationship among the self-injurious (SIB), potentially injurio...
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TL;DR: Caregivers reported on sleep in a convenience sample of 90 children with fragile X syndrome utilizing a standardized assessment tool, the Children's Sleep Habits Questionnaire (CSHQ), and a 14-day sleep diary, which indicated high rates of several sleep problems.
Abstract: Caregivers reported on sleep in a convenience sample of 90 children with fragile X syndrome utilizing a standardized assessment tool, the Children's Sleep Habits Questionnaire (CSHQ), and a 14-day sleep diary. CSHQ data indicated that 47% of participants had sleep problems at a level that suggested referral and further evaluation. Sleep diary data indicated high rates of several sleep problems. These problems did not appear to follow a typical developmental trajectory and were not related to gender or demographic variables. Nineteen percent of the sample was currently receiving medication to improve sleep; however, there were no significant differences between those receiving medications and those not receiving medications.
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TL;DR: Overall, the Rosenberg Self-Esteem Scale showed only moderate temporal and moderate internal reliability and poor aspects of criterion validity, and should be redesigned and simplified in order to increase its initial face validity in intellectual disability samples.
Abstract: The Rosenberg Self-Esteem Scale (RSES) continues to be used to purportedly measure self-esteem of people with intellectual disabilities, despite the lack of sound evidence concerning its validity and reliability when employed with this population The psychometric foundations of the RSES were analyzed here with a sample of 219 participants with intellectual disabilities The factor analytic methods employed revealed two factors (Self-Worth and Self-Criticism) and more specific problems with RSES Items 5 and 8 Overall, this scale showed only moderate temporal and moderate internal reliability and poor aspects of criterion validity Results are discussed with reference to either developing a new measure of self-esteem or redesigning and simplifying the RSES in order to increase its initial face validity in intellectual disability samples
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TL;DR: In this sample, autistic behavior was associated with poorer developmental outcomes, primarily due to interactions of age with autistic behavior, even though autism behavior, measured continuously, was relatively mild.
Abstract: To describe the early phenotype of girls with full mutation fragile X, we used 54 observations of 15 girls between the ages of 6 months and 9 years to examine developmental trajectories as measured by the Battelle Development Inventory. In this sample, autistic behavior was associated with poorer developmental outcomes, primarily due to interactions of age with autistic behavior, even though autistic behavior, measured continuously, was relatively mild. Although this small sample, ascertained primarily through male relatives with fragile X syndrome, limits generalizability, considerable variability in developmental outcome in young girls was documented. In addition, findings support previous research suggesting that even mild autistic behaviors in girls can be associated with developmental outcomes.
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TL;DR: For many key measures, particularly involvement in play, linkages to other settings, and control of play, children with Down syndrome have less well-developed peer networks even in comparison to a mental age matched group of typically developing children.
Abstract: Numerous dimensions of the peer social networks of children with Down syndrome were examined within a developmental framework. Results revealed that for many key measures, particularly involvement in play, linkages to other settings, and control of play, children with Down syndrome have less well-developed peer networks even in comparison to a mental age matched group of typically developing children. This suggests both an absence of any social advantage in the peer context for children with Down syndrome and the existence of unusual difficulties that may be traced to underlying problems in peer-related social competence. The need for future observational studies of peer interactions for this group of children was emphasized.
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TL;DR: FMRI activation patterns during passive story listening in 9 young adults with Down syndrome and 9 approximately age-matched, typically developing controls showed almost no difference in activation patterns between the language (forward speech) and nonlanguage (backward speech) conditions.
Abstract: Down syndrome is characterized by disproportionately severe impairments of speech and language, yet little is known about the neural underpinnings of these deficits. We compared fMRI activation patterns during passive story listening in 9 young adults with Down syndrome and 9 approximately age-matched, typically developing controls. The typically developing group exhibited greater activation than did the Down syndrome group in classical receptive language areas (superior and middle temporal gyri) for forward . backward speech; the Down syndrome group exhibited greater activation in cingulate gyrus, superior and inferior parietal lobules, and precuneus for both forward speech . rest and backward speech . rest. The Down syndrome group showed almost no difference in activation patterns between the language (forward speech) and nonlanguage (backward speech) conditions.
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TL;DR: Gender difference patterns found for individuals with intellectual disabilities were similar to those of persons without intellectual disabilities, with the exception of eating disorder and psychotic disorder diagnoses.
Abstract: There are few published studies on the relationship between gender and psychiatric disorders in individuals with intellectual disabilities. Adults (N = 1,971) with and without intellectual disabilities who received inpatient services for psychiatric diagnosis and clinical issues were examined. Among individuals with intellectual disabilities, women were more likely to have a diagnosis of mood disorder and sexual abuse history; men were more likely to have a substance abuse diagnosis, legal issues, and past destructive behavior. Gender difference patterns found for individuals with intellectual disabilities were similar to those of persons without intellectual disabilities, with the exception of eating disorder and psychotic disorder diagnoses. Gender issues should receive greater attention in intellectual disabilities inpatient care.
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TL;DR: Predictors varied for men and women, but in general greater midlife occupational attainment was predicted by continuation of education beyond high school, having role models for achievement, and social participation earlier in adulthood.
Abstract: The life course of individuals with mild intellectual deficits and the factors that account for heterogeneity in their midlife outcomes were examined. Past research has shown that such individuals are at risk for poor occupational attainment in adulthood and more compromised psychological functioning, including increased depression. Although predictors varied for men and women, in general greater midlife occupational attainment was predicted by continuation of education beyond high school, having role models for achievement, and social participation earlier in adulthood. Midlife psychological functioning was predicted by having role models of achievement, having discussed plans for the future with parents and teachers, and achievement of aspirations set in high school. Implications for contemporary models of transition planning are discussed.
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TL;DR: In this paper, the authors determined frequency and severity of various stressful social interactions, identified the social partners in these interactions, and examined the specific interpersonal skill difficulties of 114 adults with mild intellectual disability.
Abstract: Adults with intellectual disability are vulnerable to stressful social interactions. We determined frequency and severity of various stressful social interactions, identified the social partners in these interactions, and examined the specific interpersonal skill difficulties of 114 adults with mild intellectual disability. Participants' characteristic risk factors for stressful social interactions were also identified. Minor and unintentional negative actions of others had high frequency but low severity of stress. Serious and intentional negative actions of others had a low frequency but high severity of stress. Stressful social interactions with other people who have intellectual disability occurred frequently and had a high severity. Difficulty controlling aggression predicted stressful social interactions. Findings are beneficial to developers of interventions to decrease stressful social interactions.
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TL;DR: Directors of residential agencies for persons with intellectual disability in one U.S. state completed a self-administered, mailed survey to assess relative importance of information sources and decision factors in proxy healthcare decision-making.
Abstract: Directors of residential agencies for persons with intellectual disability in one U.S. state completed a self-administered, mailed survey to assess relative importance of information sources and decision factors in proxy healthcare decision-making. The most important sources were physician recommendations and input from the person; family input, care staff recommendations, and medical records were less valued. The person's wishes and best interests and recommendations of medical experts were the most important decision factors. Less important were benefits and risks of the intervention, family wishes, and health status; little emphasis was accorded to religious affiliation and extra cost to agency. More research is needed on how best to elicit the wishes and determine what constitutes the "best interests" of these vulnerable individuals.
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TL;DR: Results show that adaptive behaviors and support needs were meaningfully related to the number and severity of additional disabilities present, whereas this was not so for challenging behaviors.
Abstract: Numerous researchers have reported a high incidence of additional disabilities coexisting with intellectual disabilities. Although an intuitive link can be made between the existence of multiple disabilities and greater need for support, little has been reported about this relationship. Using measures of adaptive functioning and support needs, we examined the extent to which adaptive and challenging behaviors and consequent support needs (including medical) were impacted by the presence and severity of additional disabilities for individuals with intellectual disabilities. Results show that adaptive behaviors and support needs were meaningfully related to the number and severity of additional disabilities present, whereas this was not so for challenging behaviors. Findings are discussed in terms of contemporary models of disability and functioning.
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TL;DR: The findings show that the SIS-F is a good measure of intensity of support needs of individuals with developmental disabilities.
Abstract: The Supports Intensity Scale (SIS) was translated into French. The French version was then validated using a sample of 245 persons with intellectual disabilities between the ages of 16 and 75 years. The internal consistency was excellent (.98). Correlations with age and levels of intellectual disabilities were evidence of good construct validity. These psychometric results replicate the psychometric characteristics reported on the original SIS version. Our findings show that the SIS-F is a good measure of intensity of support needs of individuals with developmental disabilities.
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TL;DR: A common variant in the MAOA gene may be associated with problem behavior in adults with intellectual/developmental disabilities.
Abstract: A functional polymorphism in the promoter of the gene encoding monoamine oxidase A has been associated with problem behavior in various populations. We examined the association of MAOA alleles in adult males with intellectual/developmental disabilities with and without established histories of problem behavior. These data were compared with a gender, ethnicity, and age-matched contrast sample. About 43% (15/35) of adults with intellectual/developmental disabilities and problem behavior possessed the low-efficiency version of the MAOA gene. In comparison, 20% (7/35) of adults with intellectual/developmental disabilities and no problem behavior and 20% (7/35) of the contrast group had the short-allele MAOA polymorphism. Therefore, a common variant in the MAOA gene may be associated with problem behavior in adults with intellectual/developmental disabilities.
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TL;DR: Mechanisms of motor control are similar in Down syndrome and typically developing groups, and differences primarily related to scaling are concluded.
Abstract: Speed–accuracy trade-offs in persons with Down syndrome and typically developing controls were tested with a Fitts' task. Movement time scaled linearly with index of difficulty in both groups, and there were no accuracy differences. Persons with Down syndrome were slower than typically developing individuals. Regression analysis on movement time and index of difficulty showed a nearly two-fold higher regression coefficient and a nearly three-fold larger intercept value in the Down syndrome group. The dwell time on a target was much longer for Down syndrome persons but scaled with index of difficulty in about the same percentage for participants in both groups. Because of differences primarily related to scaling, we conclude that mechanisms of motor control are similar in Down syndrome and typically developing groups.