Teaching Individuals with Down Syndrome and Moderate or Severe Intellectual Disability with The Aim of Their Acquiring, Retaining and Recalling Knowledge: An Intervention Programme for Discovering and Understanding The Environment

Christina S Lappa, Constantinos N Mantzikos


Three adults with Down syndrome (DS, hereafter) and moderate or severe intellectual disability were taught the growth stages of wheat (cultivation, tillage, threshing), the products that are derived from it and how this staple human food grain is produced, with the aim of their acquiring knowledge, retaining it and being able to recall it from memory. A quasi-experimental baseline design was implemented. The participants were taught using questions and images, and their answers were examined and re-examined after withdrawing the initial training tools (questions and images) in order to show whether they were able to acquire, retain and recall the knowledge. The intervention programme lasted two months. In order to check the effectiveness of the intervention and the maintenance of the new information, as well as to draw the respective conclusions, evaluations were carried out before the intervention, immediately after it and two weeks after its completion. The results showed that the three participants acquired knowledge about the growth stages of wheat, its products and this staple human food, they retained that knowledge and were able to recall and narrate it in two subsequent probes conducted one and two weeks after the initial probe without the help of questions and images. The results of this intervention show that individuals with DS and moderate or severe intellectual disability can be educated and acquire knowledge, as well as retain and recall it. An additional important finding is that repeated recalling of knowledge promotes long-term retention. 


down syndrome; environmental education; intervention; learning; retention knowledge- recalling from memory

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Abbeduto, L., Pavetto, M., Kesin, E., Weissman, M. D., Karadottir, S., & O’Brien, A. (2001). The linguistic and cognitive profile of Down syndrome: Evidence from a comparison with Fragile X syndrome. Down Syndrome Research and Practice, 7, 9–15. https://doi.org/10.3104/reports.109

Agarwal, P. K., Finley, J. R., Rose, N. S., & Roediger III, H. L. (2017). Benefits from retrieval practice are greater for students with lower working memory capacity. Memory, 25(6), 764–771. https://doi.org/10.1080/09658211.2016.1220579

Agheana, V., & Duță, N. (2015). Achievements of numeracy abilities to children with Down syndrome: Psycho- pedagogical implications. Procedia - Social and Behavioral Sciences, 186, 38–45. https://doi.org/10.1016/j.sbspro.2015.04.068

Almlund, J. T., Kardash, C. A., & Kulhavy, R. W. (1986). Repetitive reading and recall of expository text. Reading Research Quarterly, 21(1), 49–58. https://doi.org/10.2307/747959

Amerikanou, M., Masoura, E., Papageorgiou, B., & Moraitou, D. (2017). Long term effect of retrieval practice on learning demanding educational material. Psychology: the Journal of the Hellenic Psychological Society, 22(2), 32–42 (In Greek).

Anderson, J. S., Nielsen, J. A., Ferguson, M. A., Burback, M. C., Cox, E. T., Dai, L., … Korenberg, J. R. (2013). Abnormal brain synchrony in Down syndrome. Neuro Image: Clinical, 2, 703–715. https://doi.org/10.1016/j.nicl.2013.05.006

Banta Lavenex, P., Bostelmann, M., Brandner, C., Costanzo, F., Fragnière, E., Klencklen, G., … Vicari, S. (2015). Allocentric spatial learning and memory deficits in Down syndrome. Frontiers in Psychology, 6, 1–7. https://doi.org/10.3389/fpsyg.2015.00062

Baroody, A.J. (1996). Self-invented addition strategies by children with mental retardation. American Journal on Mental Retardation, 101(1), 72–89.

Bashash, L., Outhred, L., & Bochner, S. (2003). Counting skills and number concepts of students with moderate intellectual disabilities. International Journal of Disability, Development and Education, 50(3), 325–345. https://doi.org/10.1080/1034912032000120480

Bennett, S. J., Holmes, J., & Buckley, S. (2013). Computerized memory training leads to sustained improvement in visuospatial short-term memory skills in children with Down syndrome. American Journal on Intellectual and Developmental Disabilities, 118(3), 179–192. https://doi.org/10.1352/1944-7558-118.3.179

Borghans, L., Golsteyn, B. H., Heckman, J. J., & Humphries, J. E. (2016). What grades and achievement tests measure. Proceedings of the National Academy of Sciences, 113, 13354–13359. https://doi.org/10.1073/pnas.1601135113

Boudreau, D. M., & Chapman, R. S. (2000). The relationship between event representation and linguistic skill in narratives of children and adolescents with Down syndrome. Journal of Speech, Language, and Hearing Research, 43(5), 1146–1159. https://doi.org/10.1044/jslhr.4305.1146

Chapman, R. S., & Hesketh, L. J. (2000). Behavioral phenotype of individuals with Down syndrome. Mental Retardation and Developmental Disabilities Research Reviews, 6(2), 84–95. https://doi.org/10.1002/1098- 2779(2000)6:2%3C84::aid-mrdd2%3E3.0.co;2-p

Cologon, K. (2013). Debunking myths: Reading development in children with Down syndrome. Australian Journal of Teacher Education, 38(3), 130–151. https://doi.org/10.14221/ajte.2013v38n3.10

Constestabile, A., Benefenat, F., & Gasparini, L. (2010). Communication breaks-Down: From neurodevelopmental defects to cognitive disabilities in Down syndrome. Progress Neurobiology, 91, 1–22. https://doi.org/10.1016/j.pneurobio.2010.01.003

Costa, H. M., Purser, H. R. M., & Passolunghi, M. C. (2015). Improving working memory abilities in individuals with Down syndrome: A treatment case study. Frontiers in Psychology, 6, 13–31. https://dx.doi.org/10.3389/fpsyg.2015.01331

Courbois, Y., Farran, E. K., Lemahieu, A., Blades, M., Mengue-Topio, H., & Sockeel, P. (2013). Wayfinding behaviour in Down syndrome: A study with virtual environments. Research in Developmental Disabilities, 34(5), 1825–1831. https://doi.org/10.1016/j.ridd.2013.02.023

Daunhauer, L. A., Fidler, D. J., Hahn, L., Will, E., Lee, N. R., & Hepburn, S. (2014). Profiles of everyday executive functioning in young children with Down syndrome. American Journal on Intellectual and Developmental Disabilities, 119, 303–318. https://doi.org/10.1352/1944-7558-119.4.303

Davis, E. E., Pitchford, N. J., & Limback, E. (2011). The interrelation between cognitive and motor development in typically developing children aged 4–11 years is underpinned by visual processing and fine manual control. British Journal of Psychology, 102(3), 569–584. https://doi.org/10.1111/j.2044-8295.2011.02018.x

de la Iglesia, C. J. F., Buceta, J. M., & Campos, A. (2005). Prose learning in children and adults with Down syndrome: The use of visual and mental image strategies to improve recall. Journal of Intellectual and Developmental Disability, 30(4), 199–206. https://psycnet.apa.org/doi/10.1080/13668250500349391

Duckworth, A. L., & Yeager, D. S. (2015). Measurement matters: Assessing personal qualities other than cognitive ability for educational purposes. Educational Researcher, 44(4), 237–251. https://doi.org/10.3102/0013189X15584327

Edgin, J. O., Mason, G., Allman, M., Capone, G., DeLeon, I., Maslen, C., … Nadel, L. (2010). Development and validation of the Arizona Cognitive Test Battery for Down syndrome. Journal of Neurodevelopmental Disorders, 2(3), 149–164. https://doi.org/10.1007/s11689-010-9054-3

Edgin, J. O., Spano, G., Kawa, K., & Nadel, L. (2014). Remembering things without context: development matters.Child Development, 85(4), 1491–1502. https://dx.doi.org/10.1111/cdev.12232

Fidler, D. J. (2005). The emerging Down syndrome behavioral phenotype in early childhood: Implications for practice. Infants & Young Children, 18(2), 86–103. https://psycnet.apa.org/doi/10.1097/00001163- 200504000-00003

Fidler, D. J. (2006). The emergence of a syndrome-specific personality profile in young children with Down syndrome. Down syndrome Research and Practice, 10(2), 53–60. https://doi.org/10.3104/reprints.305

Fidler, D. J., Hepburn, S., & Rogers, S. (2006). Early learning and adaptive behavior in toddlers with Down syndrome: evidence for an emerging behavioral phenotype? Down Syndrome Research Practices, 9, 37–44. https://doi.org/10.3104/reports.297

Fidler, D. J., & Nadel, L. (2007). Education and children with Down syndrome: neuroscience, development, and intervention. Mental Retardation and Developmental Disabilities, 13(3), 262–271. https://doi.org/10.1002/mrdd.20166

Flouris, G. (1995). The architecture of teaching and the learning process. Athens, Greece: Grigoris Publications (In Greek).

Golley, A. S. (2015). Teaching writing for students with learning disabilities in an inclusive classroom setting: A curriculum development project (Unpublished master’s thesis). The College at Brockport, State University of New York, New York, USA. https://doi.org/

Greek Ministry of Education (2004). Curricula for Students with Severe Mental Retardation. Athens, Greece: Greek Ministry of Education-Pedagogical Institute/Department of Special Education (In Greek).

Gupta, R. K., & Shetty, S. D. (1992). Visual and auditory memory in Down syndrome children. Indian Journal of Disability & Rehabilitation, 6(2), 1–8.

Heckman, J. J., Humphries, J. E., & Kautz, T. (Eds.) (2014). The myth of achievement tests: The GED and the role of character in American life. Chicago, IL: University of Chicago Press. https://doi.org/10.7208/chicago/9780226100128.001.0001

Hodapp, R. M., & Freeman, S. F. N. (2003). Advances in educational strategies for children with Down syndrome.Current Opinion in Psychiatry, 16(5), 511–516. http://dx.doi.org/10.1097/00001504-200309000-00004

Hughes, J. (2006). Developing working memory skills for children with Down syndrome. Down Syndrome News and Update, 6(2), 57–61. https://doi.org/10.3104/reports.44

Iacob, I., & Musuroi, C. (2013). Aspects of adapting the intervention program to the particular learning profile of children’s with Down syndrome. Procedia-Social and Behavioral Sciences, 84, 846 -849. https://doi.org/10.1016/j.sbspro.2013.06.659

Kassotakis, M., & Flouris, G. (2013). Learning and teaching. Contemporary views on learning processes and teaching methodology. Athens, Greece: Grigoris Publications (In Greek).

Kavaliotis, A. (2010). Down syndrome in society and the educational community - detections and management methods. Alexadroupolis, Greece: Pelti Publications (In Greek).

Kay-Raining Bird, E., Chapman, R. S., & Schwartz, S. E. (2004). Fast mapping of words and story recall by individuals with Down syndrome. Journal of Speech, Language, and Hearing Research, 47(6), 1286–1300. https://doi.org/10.1044/1092-4388(2004/097)

Kay-Raining Bird, E., Cleave, P. L., & McConnell. (2000). Reading and phonological awareness in children with Down syndrome: A longitudinal study. American Journal of Speech-Language Pathology, 9(4), 319–330. https://doi.org/10.1044/1058-0360.0904.319

Kay-Raining Bird, E., Gaskell, A., Babineau, M., & MacDonald, S. (2000). Novel word acquisition in children with Down syndrome: Does modality make a difference? Journal of Communication Disorders, 33(3), 241–266. https://doi.org/10.1016/s0021-9924(00)00022-8

Kazdin, A. E. (2011). Single-case research designs. Methods for clinical and applied settings (2nd ed.). New York, NY: Oxford University Press.

Kell, H. J. (2018). Noncognitive proponents’ conflation of “cognitive skills” and “cognition” and its implications. Personality and Individual Differences, 134(1), 25–32. http://doi.org/10.1016/j.paid.2018.05.025

Kogan, C. S., Boutet, I., Cornish, K., Graham, G. E., Berry-Kravis, E., Drouin, A., & Milgram, N. W. (2009). A comparative neuropsychological test battery differentiates cognitive signatures of Fragile X and Down syndrome. Journal of Intellectual Disability Research, 53(2), 125–142. https://doi.org/10.1111/j.1365- 2788.2008.01135.x

Koutou, A., Makri, A., Touloumi, K., Tsamasfyra, E., & Frantzi, A. (n.d.). Education of children with mental retardation. Scientific Journal Articles. Retrieved from: https://cutt.ly/oh81uv6 (In Greek).

Lanfranchi, S., Pulina, F., Carretti, B., & Mammarella, I. C. (2017). Training spatial-simultaneous working memory in individuals with Down syndrome. Research in Developmental Disabilities, 64, 118–129. https://doi.org/10.1016/j.ridd.2017.03.012

Lappa, C., Fr. Anastasiou, I., Mantzikos, C., & Kyparissos, N. (2018). Teaching the Christian Orthodox mystery of baptism to adults with moderate or severe intellectual disability. International Journal of Humanities and Social Science Invention, 7(3), 64–74.

Lappa, C., Kyparissos, N., & Paraskevopoulos, S. (2011). Teaching conversation in small groups of children and adults with moderate and severe mental retardation. European Journal of Behavior Analysis, 12(1), 249– 262. https://doi.org/10.1080/15021149.2011.11434368

Lappa, C., Kyparissos, N., & Paraskevopoulos, S. (2016). Teaching through the environment children and adults with moderate and severe mental retardation. Journal of Research and Method in Education, 6(1), 70–83. https://doi.org/10.9790/7388-06127083

Lappa, C., Mantzikos, C., & Paraskevopoulos, S. (2019). The contribution of environmental education in the education of children with disabilities and/or special educational needs: Views of teachers. Hellenic Journal of Research in Education, 8(1), 1–16. https://doi.org/10.12681/hjre.19473 (In Greek)

Lecas, J-F., Mazaud, A-M., Reibel, E., & Rey, A. (2010). Using visual strategies to support verbal comprehension in an adolescent with Down syndrome. Child Language Teaching and Therapy, 27(1), 84–96. https://doi.org/10.1177%2F0265659010371564

Leggett, J. M. I., Burt, J. S., & Carrol, A. (2019). Retrieval practice can improve classroom review despite low practice test performance. Applied Cognitive Psychology, 33(5), 759–770. https://doi.org/10.1002/acp.3517

Levy Y., & Eilam A. (2013). Pathways to language: A naturalistic study of children with Williams syndrome and children with Down syndrome. Journal of Child Language, 40(1),106–138. https://doi.org/10.1017/s0305000912000475

Lott, I. T., & Dierssen, M. (2010). Cognitive deficits and associated neurological complications in individuals with Down’s syndrome. The Lancet Neurology, 9(6), 623–633. https://doi.org/10.1016/S1474-4422(10)70112-5

Lyle, K. B., & Crawford, N. A. (2011). Retrieving essential material at the end of lectures improves performance on statistics exams. Teaching of Psychology, 38(2), 94–97. https://doi.org/10.1177/0098628311401587

Macchini, F., Leva, E., Torricelli, M., & Valade, A. (2011). Treating acid reflux disease in patients with Down syndrome: pharmacological and physiological approaches. Clinical and Experimental Gastroenterology, 4,19–22. https://dx.doi.org/10.2147/FCEG.S15872

Maltesse, A., Pepi, A., Scifo, L., & Roccella, M. (2014). Referential communication skills in children with Down Syndrome. Minerva Pediatrica, 66(1), 7–16.

Mara, D., & Mara, E. L. (2011). Characteristics of learning process at children with Down syndrome. Procedia - Social and Behavioral Sciences, 30, 73–78. https://10.1016/j.sbspro.2011.10.015

Martin, G. E., Losh, M., Estigarribia, B., Sideris, J., & Roberts, J. (2013). Longitudinal profiles of expressive vocabulary, syntax and pragmatic language in boys with fragile X syndrome or Down syndrome. International Journal of Language & Communication Disorders, 48(4), 432–43. https://doi.org/10.1111/1460-6984.12019

McDaniel, M. A., Agarwal, P. K., Huelser, B. J., McDermott, K. B., & Roediger III, H. L. (2011). Test-enhanced learning in a middle school science classroom: The effects of quiz frequency and placement. Journal of Educational Psychology, 103(2), 399–414. https://doi.org/10.1037/a0021782

Miles, S., & Chapman, R. S. (2002). Narrative content as described by individuals with Down syndrome and typically developing children. Journal of Speech Language and Hearing Research, 45(1), 175–189. https://doi.org/10.1044/1092-4388(2002/013)

Milojevich, H., & Lukowski, A. (2016). Recall memory in children with Down syndrome and typically developing peers matched on developmental age. Journal of Intellectual Disability Research, 60(1), 89–100. https://doi.org/10.1111/jir.12242

Minotou, C., Mniestris, A., Pantis, J., & Paraskevopoulos, S. (2011). Enabling the disabled through acoustic ecology and environmental education by listening to the ecosystem of the turtle. Educational Research, 2(12), 1759–1764.

Monari Martinez, E., & Pellegrini, K. (2010). Algebra and problem-solving in Down syndrome: a study with 15 teenagers. European Journal of Special Needs Education, 25(1), 13–29. https://doi.org/10.1080/08856250903450814

Moni, K. B., & Jobling, A. (2001). Reading-related literacy learning of young adults with Down syndrome: Findings from a three year teaching and research program. International Journal of Disability, Development and Education, 48(4), 377–394. https://doi.org/10.1080/10349120120094275

Neisser, U. (2014). Cognitive psychology (classic edition). New York, NY: Psychology Press. (Original work published 1967).

Novak, J. (1998). Learning, creating and using knowledge. Mahwah, NJ: Lawrence Erlbaum.

Nye, J., Fluck, M., & Buckley, S. (2001). Counting and cardinal understanding in children with Down syndrome and typically developing children. Down Syndrome Research and Practice, 7(2), 68–78. https://doi.org/10.3104/reports.116

Patterson, T., Rapsey, C. M., & Glue, P. (2013). Systematic review of cognitive development across childhood in Down syndrome: implications for treatment interventions. Journal of Intellectual Disability Research, 57(4), 306–318. https://doi.org/10.1111/jir.12037

Polišenská, K., & Kapalková, S. (2014). Language profiles in children with Down syndrome and children with language impairment: implications for early intervention. Research in Developmental Disabilities, 35(2), 373–82. https://doi.org/10.1016/j.ridd.2013.11.022

Porpodas, K. (2003). Learning and its difficulties. (Cognitive Approach). Patras, Greece: Self-Publishing (In Greek).

Pulina, F., Carretti, B., Lanfranchi, S., & Mammarella, I. C. (2015). Improving spatial-simultaneous working memory in Down syndrome: Effect of a training program led by parents instead of an expert. Frontiers in Psychology, 6, 1265. https://doi.org/10.3389/fpsyg.2015.01265

Reed, P., Staytom, L., Stott, S., & Truzoli, R. (2011). Comparison of conditioning impairments in children with Down syndrome, autistic spectrum disorders and mental age-matched controls. Journal of Intellectual Disability Research, 55(10), 988–997. https://doi.org/10.1111/j.1365-2788.2011.01454.x

Roberts, J. E., Price, J., & Malkin, C. (2007). Language and communication development in down syndrome. Mental Retardation and Developmental Disabilities Research Reviews, 13(1), 26–35. https://doi.org/10.1002/mrdd.20136

Roberts, L. V., & Richmond, J. L. (2015). Preschoolers with Down syndrome do not yet show the learning and memory impairments seen in adults with Down syndrome. Developmental Science, 18(3), 404–419. https://doi.org/10.1111/desc.12225

Roberts, L. V., & Richmond, J. L. (2018). Using learning flexibly and remembering after a delay: understanding cognitive dysfunction in adults with Down syndrome. Journal of Intellectual Disability Research, 62(2) 521- 531. https://doi.org/10.1111/jir.12492

Roizen, N. J. (2002). Down syndrome. In M. L. Batshaw, N. J. Roizen, and G. Lotrecchiano (Eds.). Children with disabilities (pp. 361–376). Baltimore, MD: Brookes Publishing.

Rusch, F. R., & Kazdin, A. E. (1981). Toward a methodology of withdrawal designs for the assessment of response maintenance. Journal of Applied Behavior Analysis, 14(2), 131–140. https://doi.org/10.1901/jaba.1981.14- 131

Salvaras, I. (2013). Teaching children with special needs in ordinary school. Athens, Greece: Grigoris Publications (In Greek).

Sommer, C. A., & Henrique-Silva, F. (2008). Trisomy 21 and Down syndrome - A short review. Brazilian Journal of Biology, 68(2), 447–452. https://doi.org/10.1590/s1519-69842008000200031

Starling, D. S. V., Moreira, B. F. T., & Jaeger, A. (2019). Retrieval practice as a learning strategy for individuals with Down syndrome: A preliminary study. Dementia & Neuropsychologia, 13(1), 104–110. https://doi.org/10.1590/1980-57642018dn13-010012

Stasinos, D. (2013). Special education 2020. For an inclusive or total education in the neo-digital school with digital champions. Athens, Greece: Papazisis Publications (In Greek).

Verucci, L., Menghini, D., & Vicari, S. (2006). Reading skills and phonological awareness acquisition in Down syndrome. Journal of Intellectual Disability Research, 50(7), 477–491. https://doi.org/10.1111/j.1365- 2788.2006.00793.x

Vianello, R. (2006). Sindrome di Down. Sviluppo psicologico e integrazione dalla nascita all’età adulta. Bergamo, Italy: Edizioni Junior.

Vygotsky, L. S. (1978). Mind in society: The development of higher psychological processes. Cambridge, MA: Harvard University Press.

West, M. R., Kraft, M. A., Finn, A. S., Martin, R. E., Duckworth, A. L., Gabrieli, C. F., & Gabrieli, J. D. (2016). Promise and paradox: Measuring students’ non-cognitive skills and the impact of schooling. Educational Evaluation and Policy Analysis, 38(1), 148–170. https://doi.org/10.3102%2F0162373715597298

Yussof, R. L., & Paris, T. N. (2011). Reading activities using the scaffolding in MEL-SindD for Down syndrome children. Procedia - Social and Behavioral Sciences, 35, 121–128. https://doi.org/10.1016/j.sbspro.2012.02.070

Yussof, R. L., Wan Mohd Anuuar, W. S., Rias, R. M., Abas, H., & Ariffin, A. (2016). An approach in teaching reading for Down syndrome children. International Journal of Information and Education Technology, 6(11), 909– 912. https://doi.org/ 10.7763/IJIET.2016.V6.815

Zampini, L., Salvi, A., & D’Odorico, L. (2015). Joint attention behaviours and vocabulary development in children with Down syndrome. Journal of Intellectual Disability Research, 59(10), 891–901. https://doi.org/10.1111/jir.12191

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