Assessment & Research

Rapid assessment of cognitive function in down syndrome across intellectual level and dementia status.

Walsh et al. (2015) · Journal of intellectual disability research : JIDR 2015
★ The Verdict

A ten-minute RADD session tells you if an adult with Down syndrome needs a full dementia check.

✓ Read this if BCBAs who serve adults with Down syndrome in day or residential programs.
✗ Skip if Clinicians who only work with young children or typically developing adults.

01Research in Context

01

What this study did

The team tested a 10-minute tool called RADD on adults with Down syndrome.

They wanted to see if it could spot dementia across all IQ levels.

Each adult took RADD and also sat through a full dementia battery so scores could be compared.

02

What they found

RADD matched the long battery almost perfectly.

It rarely missed dementia and rarely called a healthy person sick.

The tool worked for people who could speak and for those who could not.

03

How this fits with other research

Plant et al. (2007) built the first RADD for any severe IDD. The 2015 study keeps the speed but tunes the items for Down-syndrome dementia.

Kahng et al. (1999) showed that caregiver scales like DMR also catch dementia in Down syndrome. RADD gives the same answer in ten minutes without needing a caregiver interview.

Hamama et al. (2021) later upgraded the tool to RADD-2, removing floor effects and adding pictures for clients with even more limits.

04

Why it matters

You now have a ten-minute screen you can run while the client is already at the table. If RADD dips, you can refer for a full work-up and start support plans sooner. No extra staff, no extra time, just faster answers for families who worry about memory loss.

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→ Action — try this Monday

Run RADD during breakfast program; score it on the spot and flag any drop for the nurse.

02At a glance

Intervention
not applicable
Design
other
Sample size
114
Population
down syndrome
Finding
positive
Magnitude
large

03Original abstract

BACKGROUND: Adults with Down syndrome (DS) are at risk of developing dementia and cognitive assessment is a fundamental part of the diagnostic process. Previously, we developed a Rapid Assessment for Developmental Disabilities (RADD), a brief, broadly focused direct test of cognition. In the current report, we assess whether the RADD is sensitive to dementia in DS and the degree to which it compares with other cognitive measures of dementia in this population. METHODS: In a sample of 114 individuals with DS, with dementia diagnosed in 62%, the RADD was compared with the Dementia Questionnaire for Mentally Retarded Persons (DMR), the Bristol Activities of Daily Living Scale, Severe Impairment Battery (SIB), and the Brief Praxis Test (BPT). RESULTS: The RADD showed predicted effects across intellectual disability (ID) levels and dementia status (p < 0.001). Six-month test-retest reliability for the subset of individuals without dementia was high (r(41) = 0.95, p < 0.001). Criterion-referenced validity was demonstrated by correlations between RADD scores and ID levels based upon prior intelligence testing and clinical diagnoses (rs (114) = 0.67, p = 0.001) and with other measures of cognitive skills, such as the BPT, SIB, and DMR-Sum of Cognitive scores (range 0.84 through 0.92). Using receiver operating characteristic curves for groups varying in pre-morbid severity of ID, the RADD exhibited high sensitivity (0.87) and specificity (0.81) in discriminating among individuals with and without dementia, although sensitivity was somewhat lower (0.73) for the subsample of dementia cases diagnosed no more than 2 years prior to their RADD assessment. CONCLUSION: Taken together, findings indicated that the RADD, a relatively brief, easy-to-administer test for cognitive function assessment across ID levels and dementia status, would be a useful component of cognitive assessments for adults with DS, including assessments explicitly focused on dementia.

Journal of intellectual disability research : JIDR, 2015 · doi:10.1111/jir.12200