Implementing A Naturalistic Recast Approach In Adults With Down Syndrome Disintegrative Disorder

"Researchers have reported unexplained regression in young adults with Down Syndrome (DS). This regression has been termed Down Syndrome disintegrative disorder (DSDD) (Worley et al., 2015), catatonia not otherwise specified (Ghaziuddin et al., 2015; Lyons et al., 2020; Miles et al., 2019), early-onset parkinsonism (Palat et al., 2018), new-onset autistic regression, dementia, and insomnia (Worley et al., 2015). The demographic profile of Down Syndrome disintegrative disorder (DSDD) includes a post-pubertal onset, a female to male ratio of 2:1, and a mean age of regression of 17.5 years (Rosso et al., 2019). These individuals exhibit seven times as many depressive symptoms and experience six times as many life stressors, such as a change in school or death of a family member (Santoro et al., 2020). Symptoms typically associated with DSDD include impaired cognition, or cognitive decline to a dementia-like state, new-onset insomnia, new-onset autistic characteristics, and a decline in baseline skills including activities of daily living (Ghaziuddin et al., 2015; Worley et al., 2015). Research indicates that DSDD is accompanied by a significant decline in speech or language, as 94% of individuals with DSDD experience a speech impairment and mutism is observed in 57% of individuals with DSDD (Mircher et al., 2017). DSDD results in a decline in frequency of speech; however, many individuals with DSDD also experience a decrease in oral motor control, resulting in a significant decrease in speech intelligibility (Jacobs et al., 2016). Researchers have identified possible medical treatment options for DSDD, including electroconvulsive therapy, immunotherapy treatment, and various pharmaceutical treatments, (Cardinale et al., 2019; Ghaziuddin et al., 2015; Miles et al., 2019; Rosso et al., 2019). Some of these treatment methods have resulted in a temporary remission of symptoms and/or an improvement in activities of daily living, however individuals being treated have not yet shown improvement in speech impairments, mutism, or speech intelligibility (Mircher et al., 2017; Rosso et al., 2019)."--Abstract.