Exploring the approximate number system in Sotos syndrome: insights from a dot comparison task.
In Sotos syndrome, math problems come from poor inhibition, not a faulty number sense.
01Research in Context
What this study did
Researchers gave adults with Sotos syndrome a dot comparison task. They wanted to know if poor math scores in this group come from a broken 'number sense' or from something else.
The team used congruent and incongruent trials. Incongruent trials make you ignore bigger dots that hold fewer real items. That setup tests inhibitory control, not just knowing 'more or less'.
What they found
People with Sotos chose the bigger number as well as controls on regular trials. Their approximate number system was intact.
They slipped only on incongruent trials. The trouble was stopping themselves from picking the visually larger blob. Inhibition, not numeracy, explained the math gap.
How this fits with other research
Leng et al. (2024) saw the opposite in autistic preschoolers. Those kids really did have weaker magnitude representation. Same task, different syndrome, different locus of difficulty.
Schwenk et al. (2017) meta-analysis backs the split. Kids with broad math disability show small non-symbolic deficits but large symbolic ones. Sotos fits the pattern: core number sense is fine; the bottleneck is higher-order control.
Brankaer et al. (2011) and Margari et al. (2013) echo the story in other IDs. Mild ID and Down syndrome both spare the approximate system while exposing specific hiccups in subitizing or mapping symbols. The Sotos paper extends that line by pointing to inhibition as the new culprit.
Why it matters
If you work with Sotos syndrome, stop drilling dot patterns. Target inhibitory control instead. Embed brief 'stop-and-think' trials inside math lessons. Use small rewards for choosing the correct quantity even when the picture tries to trick them. That tweak directly attacks the cognitive barrier this study uncovered.
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02At a glance
03Original abstract
BACKGROUND: Sotos syndrome is a congenital overgrowth condition associated with intellectual disability and an uneven cognitive profile. Previous research has established that individuals with Sotos syndrome have relatively poor mathematical ability, but domain-specific numeracy skills have not been explored within this population. This study investigated the approximate number system (ANS) in Sotos syndrome. METHOD: A dot comparison task was administered to 20 participants with Sotos syndrome (mean age in years = 18.43, SD = 9.29). Performance was compared to a chronological agematched typically developing control group (n = 25) and a mental age-matched Williams syndrome group (n = 24). RESULTS: The Sotos group did not display an ANS deficit overall when compared to chronological agematched control participants. However, for trials where the size of the individual dots and the envelope area were negatively correlated with the total number of dots (incongruent trials), the Sotos group were less accurate than the typically developing group but more accurate than the Williams syndrome group, suggesting an inhibitory control deficit. Better accuracy on incongruent trials, but not congruent trials, was associated with higher quantitative reasoning ability for participants with Sotos syndrome. CONCLUSION: Overall, the findings suggest that ANS acuity is not impaired in Sotos syndrome but that numerical difficulties may be associated with an inhibitory control deficit for individuals with Sotos syndrome.
Journal of intellectual disability research : JIDR, 2019 · doi:10.1111/jir.12604