1. Sinead Morrison PhD Student Cardiff University
Learning ability and mental health across development in 22q11.2 Deletion Syndrome
Sinead Morrison
PhD Student
Cardiff University

2. Learning ability in 22q11.2DS
People with 22q may have problems with learning and behaviour1.
IQ has often been used to understand ability in 22q2, but there are many different aspects of thinking and learning, and we want to better understand how these also develop.
1Niarchou et al, 2014; 2Gothelf et al, 2013

3. It is important to compare children with 22q to typically developing children to be able to tell where they are similar and where they are different3
There may be opportunities to prevent problems increasing if we can pinpoint when this happens4
Some research suggests that problems with learning may increase from childhood to adolescence in those with 22q1,2.
1Gothelf et al, 2013; 2Stoddard et al, 2011; 3Chawner et al, 2017; 4Gur et al, 2014

4. Mental health in 22q11.2DS
Are children or adolescents who experience mental health problems more likely to have problems with learning?1,2
1Niarchou et al, 2014; 2Sanders et al, 2017

5. Questions
1. What are the differences in learning ability between young people with and without 22q?
2. Do children and adolescents with 22q have different learning abilities?
3. Are children or adolescents with 22q and mental health problems such as ADHD, anxiety or ASD more likely to have learning problems?

6. Experiences of Children with Copy Number Variants study
In collaboration with Maastricht (Therese van Amelsvoort) and Leuven (Ann Swillen) universities
Child
(6-10 years)
Adolescent (10-18 years)
Siblings 23 36
22q 63 67

7. Thinking and learning in 22q
There are many different aspects of thinking and learning. I am concentrating on just 3 which have been linked to mental health problems.
Processing speed is the speed that different parts of the brain communicate to allow them to all work together quickly and correctly. This is important for reacting to the world around you, for example being able to listen to a teacher and write down what they are saying at the same time.
Sustained attention is the ability to be able to continue to pay attention to something. This is important for example concentrating all the way through a lesson or an activity, or listening to me talk!
Working memory is how we keep several different things in memory until we need them. For example, remembering multiple steps of something which is important in mental maths.
So they are all really important for day to day life and having difficulties with these can make it harder in school, home and social relationships.
After the children have completed the test we get a score for them which reflects how well they are doing in comparison to a group of the same age children from the general population.
Processing speed
Sustained attention
Working memory

8. Aim 1 What are the differences in learning ability between children with and without 22q?* * *
This graph shows the average performance of the siblings and the children with 22q. A score of 0 would mean that the child is performing as well as a child of that age. So we can see here that the siblings actually perform a little bit better than the general population on the processing speed task, because they are above 0. However, on the other two measures they are performing slightly below the general population. For 22q, we can see that performance is below 0 for all the tests, however, the different tasks are affected differently. So there seems to be the greatest difference between siblings and those with 22q on the sustained attention task. In general it can be said there are significant differences between siblings and those with 22q in all three areas of learning ability, which are shown with the asterisk symbol (p<0.001 in all cases).
* p<0.001

9. Aim 2 Do children and adolescents with 22q have different learning abilities?*
This graph compares children and adolescents, while taking into account the scores of the siblings. We can see that it appears that children perform a bit worse than adolescents on all the tasks, but this is only statistically significant for working memory (p=0.039) (processing speed, p=0.097; sustained attention, p=0.511). This doesn’t really support the theory that learning ability is worse at an older age, probably as a result of taking the sibling performance into account.
* p=0.039

10. Average learning problems
Aim 3 Are children or adolescents with 22q and mental health problems such as ADHD, anxiety or ASD more likely to have learning problems? * * *
Average learning problems
Children
Adolescents
Anxiety -
ADHD
ASD ↓ ↑
However, as childhood and adolescence is such a time of change, is it possible that underlying mental health problems could be linked to learning ability at only one of those time points. We found that children and adolescents with or without anxiety or ADHD performed the same on all tasks, so this was not linked. This graph shows individuals with ASD in blue and no ASD in red. You can see for each task that there is this same pattern of adolescents with ASD having maybe more difficulty with adolescents without ASD, but this is not the same for children, who are performing quite similarly or even better than those without ASD. This is interesting as it suggests that there may be relative strengths and weaknesses at different points in development for young people with ASD and 22q.
PS p=0.022 control for gender 0.035, SA p=0.016 control for gender 0.038, WM p=0.006 control for gender
* p<0.05

11. Summary
Young people with 22q may have problems with processing speed, sustained attention and working memory compared to their siblings. Children and adolescents with 22q show similar learning ability. Adolescents with ASD may have greater problems with learning than adolescents without ASD; however this may not be the case for children with ASD.

12. Future work
We are now including adults in these results, working with Maastricht (Therese van Amelsvoort) and Leuven (Ann Swillen)
We will be following up these results with the same children over time
I will be working on the third follow up of the children in our ECHO study

13. Our wonderful participants!
Marianne van den Bree Mike Owen Sam Chawner Therese van Amelsvoort Ann Swillen Elfi Vergaelen Claudia Vingerhoets ECHO team
To get involved in our research, please