Improving memory span in children with Down syndrome

BACKGROUND: Down syndrome (DS) is characterized by impaired memory span, particularly auditory verbal memory span. Memory span is linked developmentally to several language capabilities, and may be a basic capacity that enables language learning. If children with DS had better memory span, they might benefit more from language intervention. The present study evaluates a home-based parent-implemented intervention designed to improve auditory memory span in children with DS. METHOD: Sixteen children with DS, age 6-14, completed one or two 3-month periods of memory training using overt cumulative rehearsal and auditory-only procedures. Children were divided into two groups. Group 1 completed 3 months of memory training followed by 3 months of visual activities, followed by three more months of memory training. Group 2 had the opposite schedule. Before and after each 3-month period, children came into the laboratory for memory assessment. RESULTS: Children improved in training sessions and a small amount on digit span, the primary proximal outcome assessment measure. Digit span improvement was linked to the memory training, as indicated by control comparisons and correlations. Improvement was correlated with language comprehension and verbal working memory, but not with non-verbal ability, age or home/behavioural variables. No improvement was evident on distal outcome measures (sentence memory and verbal working memory); however, a phonological similarity effect emerged coincidence with memory training, suggesting increased use of phonological codes in memory. CONCLUSIONS: Results suggest that some children with DS can improve their auditory verbal memory span with home-based rehearsal training, at least in limited ways. Children with good language and verbal working memory skills may be the best candidates for this type of training, even though they may show only small improvements. Still, small improvements in a severely impaired function are noteworthy, and justify further investigation.