School Learning in 8 Year Old Down Syndrome Children Treated or Not with Drugs

Renato Cocchi M.D., Ph.D. (Sociology) Italian Journal of Intellective Impairment 5 (2): 143-8 (1992) Presented in Italian during the IV Convegno Il disturbo cognitivo in eta' scolare: Il ritardo mentale, S. Costanzo, September 1992 Paper presented during the 6th World Down Syndrome Congress, Madrid October 1997

Reprinted with the permission of Renato Cocchi Via A. Rabbeno, 3 42100 Reggio Emilia, Italy +39 0522 320 716 Mobile +39 348 5145 520 URL: http://www.stress-cocchi.net

Summary

School learning in 8 years old children of two group (Experimental Group: 40 Ss, 23 F and 17 M; 36 pure trisomy 21, 3 translocations and 1 mosaicism; at least 5 years of individualised drug therapy. Control Group: 24 Ss, 13 F and 11 M; 21 pure trisomy 21, 2 translocations and 1 mosaicism; no drug treatment) was compared. Classroom behaviour, reading (syllables, plain words, sentences), writing (copy, dictation, invention from a visual model, free invention) and arithmetic (digit sequence, addiction and subtraction up to 20 were evaluated according to a 5 point scale.
Drug treated Ss presented significant improvements in all the investigated fields but classroom behaviour showed only a very strong trend (.053) towards amelioration.
Since both groups differ from the general population as for gender and chromosomal anomalies distribution, the generalisation of these very promising results warrants some caution.

Key words: Down syndrome; school learning; drug therapy.

Since 1979 I have been occupied with the use of the drug therapy in Downs Syndrome. Among the various areas this therapy has demonstrated to have effect there are a definite improvement in attention, concentration, long-term memory and speech. This means an improvement in the pre-requisites indispensable for school learning.

Owing the difficulty to make an investigation in this field, a valuation of the capacity of school learning has never been done before. In this study, from 502 cases personally visited and checked (seen between January 1979 and September 1992) a survey was carried out to compare school learning in 8 years Down children coming for a first visit at that age (control group) with school learning of same age children treated with drugs for at least 5 years (experimental group).

Materials and methods

The records pertaining to an unselected consecutive series of 502 Down's children visited between January 1979 and the end of September 1992 were re-examined, and those who had had a diagnosis of childhood psychosis were first excluded.

From the remaining were extracted the records of those who came for their first visit between the ages of 7 years 7 months and 8 years 6 months and also the records of the children who had a check at the same age period, after undergoing an individualised drug treatment for at least 5 years.

Data were gathered from all of these regarding sex, chromosomal diagnosis and the age (year and months) at the first visit (Control Group) or at check visit in the same age period (Experimental Group).

Also data were gathered regarding classroom behaviour and reading (isolated syllables, plain words, sentences) writing (copying, dictation, invention on sight models, real or picture or photo, free invention) and elementary arithmetic (sequence of numbers more than 20, addition and subtraction up to at least 20, with 1 or 2 digits).

These data were reported by parents and often controlled in exercise books shown during the visit of control or by school reports at the end of the year.

All of these fields were investigated and evaluated by using a 5 points scale from 0 (negative behaviour or zero learning) to 4 (behaviour and learning normal).

The statistic comparison between the 2 groups was done by the test of Mann-Whitney.

Results

It was possible to collect the charts of two groups of Down subjects, an Experimental Group (EDG) with 40 children and a Control Group (CDG) with 24 children.

Comparing the results of the two groups, according to the field investigated, the results obtained from the experimental group reached a significant statistic level, sometimes a very high level, in all the learning fields of this study.

Although the experimental group obtained higher rates, the difference in classroom behaviour has only a high tendency to a major suitability, without attaining for a while the minimum conventional significant level.

Discussion

With view to the 2 groups, I have to say that the ratio M/F is reversed, as compared to the general population of Down subjects where boys are about one third more than girls. The distribution of chromosomal anomalies, although not very different from the Italian and international rates, cannot be assumed as representative, especially as for CDG, because the exiguity of the samples has probably not expressed true rates for mosaicisms or translocations.

Though important as for the generalisation of the results, these differences have less importance as for our research, the aim of which was, for now, to discover, if any, an improvement in school learning between the 2 casual groups, one of them treated by drug for a long period. The two samples are very similar in their distribution of the sexes, of the chromosomal anomalies and the age in which they were taken.

The result of the drug therapy on school learning at the age of 8 was certainly different in the two groups, being definitely better in the experimental group, in which the components had at least 5 years drug treatment. Regarding the actual treatment, the therapy is individualised, that means that it could be different from child to child.

The therapies were not reported here case by case, but the rationale and a large idea of it could be deduced from other papers (Cocchi, 1987a; Cocchi, 1987b; Cocchi, 1988; Lamma and Cocchi, 1988; Cocchi, 1989; Cocchi, 1990; Cocchi, 1991; Cocchi, 1992).

The classroom behaviour is much more adequate in the experimental group, where in the control group there are more hyperkinetic children, with a marked attention deficit.

With regards to school learning it is evident that drug therapy is not able to resolve every situation of poor learning, but in the group of children treated there was only one case of zero learning, and those with little learning were definitely few.

The sequence by which the various abilities were drawn up presents decreasing scores attained by each child of both groups.

The best results were in reading syllables, in copy writing and in memorising number sequences. Being that learning occurs first also in normal children, it is probable that the process of promotion or stimulation in the capacity of learning becomes developed in the same way, a fact that in Down children, was already noted in England by Buckley et al., in 1986.

It is not possible for me to make a comparison with other research as I have not found anything similar in literature, either in treatment or standard valuation in school learning. I retain that an tailored drug therapy that tends to favour learning should be valued in long term and based on precise indicators, clear and comprehensible.

The presentation of this research during a refreshment course for school teachers (San Costanzo, September 1992) confirmed that the choice of the parameters investigated in this study was the same the school teachers use in evaluating learning.

Conclusions

The comparative examination of the results of a drug therapy individualised for school learning for a group of Downs aged 8 (elementary level 2-3) with a group of Downs subjects aged 8 and not treated (same school level) has shown that the group treated with drugs for at least 5 years have attained average higher scores. In 10 out of 11 investigated fields significant differences were reached.

The results again confirmed the intuition that a therapy prevalently anti-stress in Down's Syndrome (Cocchi, 1987a) is a wide spectrum therapy which can gain improvements also in intellectual performances.

Nevertheless different characteristics between the two samples and the general population of Downs subjects, with regard to gender and chromosomal anomalies distribution suggest that caution must be taken as for the generalisation of these results.

References

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