Hostname: page-component-8448b6f56d-t5pn6 Total loading time: 0 Render date: 2024-04-24T12:54:58.204Z Has data issue: false hasContentIssue false
  • English
  • Français

Validation and Normalization of the Tower of London-Drexel University Test 2nd Edition in an Adult Population with Intellectual Disability

Published online by Cambridge University Press:  20 July 2017

Javier García-Alba ,
Susanna Esteba-Castillo ,
Miguel Ángel Castellanos López ,
Emili Rodríguez Hidalgo ,
Nuria Ribas Vidal ,
Fernando Moldenhauer Díaz  and
Ramón Novell-Alsina
Javier García-Alba*
Affiliation:
Universidad Complutense(Spain)
Susanna Esteba-Castillo
Affiliation:
Parc Hospitalari Martí i Julià(Spain)
Miguel Ángel Castellanos López
Affiliation:
Universidad Complutense(Spain)
Emili Rodríguez Hidalgo
Affiliation:
Parc Hospitalari Martí i Julià(Spain)
Nuria Ribas Vidal
Affiliation:
Parc Hospitalari Martí i Julià(Spain)
Fernando Moldenhauer Díaz
Affiliation:
Hospital Universitario La Princesa(Spain)
Ramón Novell-Alsina
Affiliation:
Parc Hospitalari Martí i Julià(Spain)
*
*Correspondence concerning this article should be addressed to Javier García-Alba. Dpto. de Psicología Evolutiva y de la Educación. Facultad de Educación. Universidad Complutense. C/ Rector Royo Villanova s/n. 28040. Madrid (Spain). E-mail: jgalba@edu.ucm.es
Get access Rights & Permissions [Opens in a new window]

Abstract

Despite how important it is to assess executive functioning in persons with Intellectual Disability (ID), instruments adapted and validated for this population are scarce. This study’s primary goal was to find evidence for the validity of the ID version of the Tower of London (TOLDXtm) test in persons with mild (IDMi) and moderate (IDMo) levels of ID with Down Syndrome (DS). A multicenter study was carried out. Subjects (n = 63, ≥ 39 years old) had DS with mild (n = 39) or moderate ID (n = 24) with no minor neurocognitive disorder or Alzheimer’s disease. Assessment protocol: TOLDXtm for ID, Kaufman Brief Intelligence Test Second Edition (K-BIT II), Cambridge Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities (CAMDEX-DS), Weigl’s Color-Form Sorting Test (WCFST), Barcelona Test for Intellectual Disability (BT-ID), and the Behavior Rating Inventory of Executive Function (BRIEF-P). The internal consistency (IDMi and IDMo), factor structure of the different subscales, and relationship between TOLDXtm subscales and other cognitive measures (BT-ID, WCFST, and BRIEF-P) were analyzed. A normative data table with ID population quartiles is provided. TOLDXtm for ID showed a robust one factor structure and coherentassociations with other, related neuropsychological instruments. Significant differences between IDMi and IDMo on movement-related variables like Correct (Corr; p = .002) and Moves (Mov; p = .042) were observed, along with good internal consistency values, Corr (α = .75), Mov (α = .52). Regarding internal consistency, no between-groups differences were observed (all p-value > 0.05). The TOLDXtm for ID is thus an instrument, supported by good validity evidence, to evaluate problem-solving and planning in ID. It distinguishes between individuals with mild and moderate ID, and is highly associated with other measures of executive functioning.

Keywords

down syndromeexecutive functionsintellectual disabilityTower of Londonvalidity
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 20 , 2017 , E32
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

This study was funded by the Carlos III Health Institute (PI12/02019).

References

Ball, S., Holland, A., Treppner, P., Watson, P., & Huppert, F. (2008). Executive dysfunction and its association with personality and behaviour changes in the development of Alzheimer’s disease in adults with Down syndrome and mild to moderate learning disabilities. British Journal of Clinical Psychology, 1, 1–29. https://doi.org/10.1348/014466507X230967 CrossRefGoogle Scholar
Berg, W. K., & Byrd, D. L. (2002). The Tower of London spatial problem-solving task: Enhancing clinical and research implementation. Journal of Clinical and Experimental Neuropsychology, 24, 586–604. https://doi.org/10.1076/jcen.24.5.586.1006 Google Scholar
Cockburn, J. (1995). Performance on the Tower of London test after severe head injury. Journal of the International Neuropsychological Society, 1, 537–544. https://doi.org/10.1017/S1355617700000667 Google Scholar
Culbertson, W. C., Moberg, P. J., Duda, J. E., Stern, M. B., & Weintraub, D. (2004). Assessing the executive function deficits of patients with Parkinson’s disease: Utility of the Tower of London-Drexel. Assessment, 11, 27–39. https://doi.org/10.1177/1073191103258590 CrossRefGoogle ScholarPubMed
Culbertson, W., & Zillmer, E. (2001). The Tower of London-Drexel University. Chicago, IL: Multi-Health Systems.Google Scholar
Davydov, D. M., & Polunina, A. G. (2004). Heroin abusers’ performance on the Tower of London Test relates to the baseline EEG alpha2 mean frequency shifts. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 7, 1143–1152. https://doi.org/10.1016/j.pnpbp.2004.06.006 Google Scholar
Esteba-Castillo, S., Dalmau-Bueno, A., Ribas-Vidal, N., Vilà-Alsina, M., Novell-Alsina, R., & García-Alba, J. (2013). Adaptación y validación del Cambrigde Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities (CAMDEX) en población adulta con discapacidad intelectual [Adaptation and validation of the Cambrigde Examination for Mental Disorders of Older People with Down’s Syndrome and Others with Intellectual Disabilities (CAMDEX) in an adult population with intellectual disability]. Revista de Neurología, 57, 337–346.Google Scholar
Esteba-Castillo, S., & García-Alba, J. (2015). Neuropsicología de la discapacidad intelectual [The neuropsychology of intellectual disability]. In Enseñat, A., Roig, T., & García, A., Neuropsicología pediátrica (pp. 163–188). Madrid, Spain: Síntesis.Google Scholar
Esteba-Castillo, S., Novell, R., Vilá, A., & Ribas, N. (2014). CAMDEX-DS. Prueba de Exploración Cambridge para la Valoración de los Trastornos Mentales en Adultos con Síndrome de Down o con Discapacidad Intelectual [Cambridge Examination for Mental Disorders of Adults with Down’s Syndrome and Others with Intellectual Disabilities]. Madrid, Spain: TEA Ediciones.Google Scholar
Esteba-Castillo, S., Caixas, A., Deus, J., & Peña-Casanova, J. (2015). Neuropsicología del trastorno del desarrollo intelectual con y sin origen genético [The neuropsychology of intellectual disability with and without genetic cause]. (Unpublished Doctoral Dissertation). Universidad Autónoma de Barcelona. Barcelona, Spain.Google Scholar
Feldt, L. S., Woodruff, D. J., & Salih, F. A. (1987). Statistical inference for coefficient alpha. Applied Psychological Measurement, 11(1), 93–103. https://doi.org/10.1177/014662168701100107 CrossRefGoogle Scholar
Gioia, G. A., Isquith, P. K., Guy, S. C., & Kenworthy, L. (2000). Behavior rating inventory of executive function. Child Neuropsychology, 6, 235–238. https://doi.org/10.1076/chin.6.3.235.3152 Google Scholar
Gioia, G. A., Isquith, P. K., Guy, S. C., & Kenworthy, L. (2016, October). Behavior Rating Inventory of Executive Funtion (BRIEF). North Florida, FL: PARINC. Retrieved from http://www4.parinc.com/Products/Product.aspx?ProductID=BRIEF Google Scholar
Goldstein, K., & Scheerer, M. (1941). Abstract and concrete behavior an experimental study with special tests. Psychological Monographs, 53, i–151. https://doi.org/10.1037/h0093487 Google Scholar
Hartman, E., Wouwen, S., Scherder, E., & Visscher, C. (2010). On the relationship between motor performance and executive functioning in children with intellectual disabilities. Journal of Intellectual Disability Research, 54, 468–477. https://doi.org/10.1111/j.1365-2788.2010.01284.x Google Scholar
Hobson, P., Meara, J., & Taylor, C. (2007). The Weigl Colour-Form Sorting Test: A quick and easily administered bedside screen for dementia and executive dysfunction. International Journal of Geriatric Psychiatry, 22, 909–915. https://doi.org/10.1002/gps.1765 Google Scholar
Jacobs, R., & Anderson, V. (2002). Planning and problem solving skills following focal frontal brain lesions in childhood: Analysis using the Tower of London. Child Neuropsychology, 8, 93–106. https://doi.org/10.1076/chin.8.2.93.8726 Google Scholar
Kaufman, A., & Kaufman, N. (2004). Kaufman Brief Intelligence Test, Second Edition (KBIT-2). Bloomington, MN: Pearson.Google Scholar
Kotovsky, K., Hayes, J. R., & Simon, H. A. (1985). Why are some problems hard? Evidence from Tower of Hanoi. Cognitive Psychology, 17, 248–294. https://doi.org/10.1016/0010-0285(85)90009-X CrossRefGoogle Scholar
Masson, J. D., Dagnan, D., & Evans, J. (2010). Adaptation and validation of the Tower of London test of planning and problem solving in people with intellectual disability. Journal of Intellectual Disability Research, 54, 457–467. https://doi.org/10.1111/j.1365-2788.2010.01280.x Google Scholar
Medina-Gómez, M. B., & García-Alonso, I. (2010). Evaluación de la conducta adaptativa de las personas con discapacidad intelectual. Valoración y usos de la escala ABS-RC:2 [Assessment of adaptive behavior in people with intellectual disability. Evaluation and uses of the ABS-RC2 scale]. (Unpublished doctoral dissertation). University of Burgos, Burgos, Spain.Google Scholar
Moore, C. J., Daly, E. M., Schmitz, N., Tassone, F., Tysoe, C., Hagerman, R. J., … Murphy, D. G. M. (2004). A neuropsychological investigation of male premutation carriers of fragile X syndrome. Neuropsychologia, 42, 1934–1947. https://doi.org/10.1016/j.neuropsychologia.2004.05.002 Google Scholar
Nieuwenhuis-Mark, R. E. (2009). Diagnosing Alzheimer’s dementia in Down syndrome: Problems and possible solutions. Research in Developmental Disabilities, 30, 827–838. https://doi.org/10.1016/j.ridd.2009.01.010 CrossRefGoogle ScholarPubMed
Nihira, K., Leland, H., & Lambert, N. (1993). Adaptive Behavior Scale: Residential and Community (ABS-RC:2). Austin, TX: Pro-ed.Google Scholar
Owen, A. M., Downes, J. J., Sahakian, B. J., Polkey, C. E., & Robbins, T. W. (1990). Planning and spatial working memory following frontal lobe lesions in man. Neuropsychologia, 28, 1021–1034. https://doi.org/10.1016/0028-3932(90)90137-D Google Scholar
Paula, J. J., Neves, F., Levy, A., Nassif, E., & Malloy-Diniz, L. (2012). Assessing planning skills and executive functions in the elderly: Preliminary normative data for the Tower of London Test. Archivos de Neuro-Psiquiatria, 70, 828–829. https://doi.org/10.1590/S0004-282X2012001000015 Google Scholar
Peña-Casanova, J., Quiñones-Ubeda, S., Gramunt-Fombuena, N., Quintana, M., Aguilar, M., Molinuevo, J. L., … Blesa, R. (2009). Spanish multicenter normative studies (NEURONORMA Project): Norms for the Stroop color-word interference test and the Tower of London-Drexel. Archives of Clinical Neuropsychology, 24, 413–429.Google Scholar
Rainville, C., Amieva, H., Lafont, S., Dartigues, J. F., Orgogozo, J. M., & Fabrigoule, C. (2002). Executive function deficits in patients with dementia of the Alzheimer’s type: A study with a Tower of London task. Archives of Clinical Neuropsychology, 17, 513–530. https://doi.org/10.1093/arclin/17.6.513 Google Scholar
Robinson, S., Goddard, L., Dritschel, B., Wisley, M., & Howlin, P. (2009). Executive functions in children with autism spectrum disorders. Brain and Cognition, 71, 362–368. https://doi.org/10.1016/j.bandc.2009.06.007 Google Scholar
Rognoni, T., Casals-Coll, M., Sánchez-Benavides, G., Quintana, M., Manero, R., Calvo, L., … Peña-Casanova, J. (2013). Spanish normative studies in young adults (NEURONORMA young adults project): Norms for Stroop Color-Word Interference and Tower of London-Drexel University tests. Neurologia, 28, 73–80. https://doi.org/10.1016/j.nrleng.2012.02.004 CrossRefGoogle Scholar
Shallice, T. (1982). Specific impairments of planning. Philosophical Transaction of the Royal Society, 298, 199–209. https://doi.org/10.1098/rstb.1982.0082 Google Scholar
Strauss, H., & Lewin, I. (1982). An empirical study of the Weigl-Goldstein-Scheerer color-form test according to a developmental frame of reference. Journal of Clinical Psychology, 38, 367–375. https://doi.org/10.1002/1097-4679(198204)38:2<367::aid-jclp2270380226>3.0.co;2–9 Google Scholar
Teipel, S. J., Alexander, G. E., Schapiro, M. B., Möller, H. J., Rapoport, S. I., & Hampel, H. (2004). Age-related cortical grey matter reductions in non-demented Down’s syndrome adults determined by MRI with voxel-based morphometry. Brain, 127, 811–824. https://doi.org/10.1093/brain/awh101 Google Scholar
Tirapu, J., García, A., Luna, P., & Periañez, J. (2012). Evaluación de las funciones ejecutivas [Executive functions assessment]. In Tirapu, J., García, A., Rios, M., & Árdila, A. (Eds.), Neuropsicología de la corteza prefrontal y las funciones ejecutivas (pp. 197–216). Barcelona, Spain: Viguera.Google Scholar
Tirapu-Ustárroz, J., Muñoz-Céspedes, J., Pelegrín-Valero, C., & Albéniz-Ferreras, A. (2005). A proposal for a protocol for use in the evaluation of the executive functions. Revista de Neurología, 41, 177–186.Google Scholar
Unterrainer, J. M., Rahm, B., Leonhart, R., Ruff, C. C., & Halsband, U. (2003). The Tower of London: The impact of instructions, cueing, and learning on planning abilities. Cognitive Brain Research, 17, 675–683. https://doi.org/10.1016/S0926-6410(03)00191-5 Google Scholar
Walley, R. M., & Donaldson, M. D. C. (2005). An investigation of executive function abilities in adults with Prader-Willi syndrome. Journal of Intellectual Disability Research, 49, 613–625. https://doi.org/10.1111/j.1365-2788.2005.00717.x Google Scholar
Zhu, Y., Liu, X., Wang, H., Jiang, T., Fang, Y., Hu, H., … Zhang, K. (2010). Reduced prefrontal activation during Tower of London in first-episode schizophrenia: A multi-channel near-infrared spectroscopy study. Neuroscience Letters, 478, 136–140. https://doi.org/10.1016/j.neulet.2010.05.003 Google Scholar
Zigman, W. B., & Lott, I. T. (2007). Alzheimer’s disease in Down syndrome: Neurobiology and risk. Mental Retardation and Developmental Disabilities Research Review, 13, 237–246. https://doi.org/10.1002/mrdd.20163 Google Scholar
Supplementary material: File

García-Alba supplementary material

Appendix A-I

Download García-Alba supplementary material(File)
File 63.3 KB