Self-concept in children with Down syndrome
Monica Cuskelly and Inge de Jong
There are very few studies which have examined self-concept in individuals with an intellectual disability and none which have focussed on those with Down syndrome. The study found that children with Down syndrome with a developmental age of 4 to 6 years 11 months have a self-concept which is similar to that of normally developing children of a similar developmental age. The subscale means for both groups were positively skewed, and the subscale scores for both groups of children were found to be reliable over a one week period. Mothers' views of the self-concept of their child with Down syndrome were not correlated with children's own reports.
Cuskelly M, de Jong I. Self-concept in children with Down syndrome. Down Syndrome Research and Practice. 1996;4(2);59-64.
In general, research into the self-concept of individuals with intellectual
disabilities is very limited and no studies have examined the self-concept
of children with Down syndrome. Self-concept is considered to be a predictor
of coping with life stresses (Bandura,
1993) and there would appear to be a link between self-concept and academic
achievement. See, for example the meta-analysis of studies conducted by
Hattie (1992) and the studies by
Short (1992) and
A barrier to the examination of self-concept with persons with intellectual
disability is the lack of instruments designed specifically for use with
this group. Two strategies have been adopted to assess self-concept in this
population - (1) using scales designed for children with adults with intellectual
disabilities (for example,
and Ives, 1992), and (2) modifying the administration of existing scales
Zetlin, Heriot and Turner, 1985). The first strategy must be questioned
unless it can be shown that the same issues are relevant to both groups
and that the basis for the participants' judgements about themselves is
also similar. The second strategy also has problems.
Zetlin et al. suggested
that even with modification to item format, the cognitive demands of the
task exceeded the abstraction and generalisation abilities of persons with
As an alternative to standardised measures, semi-structured interviews have
been used. Jahoda, Markova, and Cattermole (1988) conducted interviews with
twelve adults with intellectual disabilities aged between 21 and 40 years
to test the hypothesis that people who are stigmatised by others (eg. those
with an intellectual disability) would develop a view of themselves as essentially
different from others and would evaluate themselves negatively. The researchers
found that, whereas all participants were aware of the stigma attached to
them, only three regarded themselves as "essentially different" from people
without intellectual disabilities and held a globally handicapped view of
If self-concept and self-perceptions are regarded as the product of cognitive
processes, it could be assumed that the organization of different aspects
of self-concept (i.e. its structure and content) would be sensitive to shifts
in cognitive development (Silon
and Harter, 1985). This would suggest that the structure and content
of self-concept of individuals with intellectual disabilities would be more
similar to that of mental age comparisons than to that of individuals of
similar chronological age. A study by
Silon and Harter (1985) provided some
support for this hypothesis. One hundred and twenty-six children with an
intellectual disability who were between the ages of 9 and 12 years completed
the Perceived Competence Scale for Children (Harter,
1982). Factorial analyses revealed a pattern which was dissimilar to
the factor solution for children without disabilities matched for chronological
age but similar to that for children of pre-school/kindergarten age on a
parallel form (Harter
and Pike, 1984). When examining perceived physical competence
and Collier (1990) also found that scores of children with mild intellectual
disability were similar to those of younger, normally developing children.
Damon and Hart commented in 1982 that of all the scales in the then current
literature "none anticipates or 'corrects for' developmental transformations
in the conception of self ... (or) includes a recognition that the conceptual
bases of a subject's self-evaluations may be differently construed and differently
weighed at different periods in the subject's development" (p 842). Harter
and her colleagues (Harter,
and Pike, 1984) addressed this complaint by developing a group of instruments
for use with children of different ages (4 to 11 years). The instruments
are similar in format but attempt to take developmental changes in the content
and structure of self-concept into account.
Researchers have suggested that young children typically overestimate their
ability, and blur the distinction between their ideal and real selves (Anderson
and Adams, 1985;
and Pike, 1984;
Ulrich and Collier, 1990). Harter (1988) argued that this tendency was
not evidence that young children deliberately try to misrepresent themselves
or consciously decide to respond in a socially desirable way, but that it
reflects the inability of young children to use social comparison. She referred
to this inability to make realistic judgements as a normative distortion
based on cognitive limitations.
Rubel (1983) investigated the use of social comparison in the self-evaluations
of children by giving his subjects feedback on their own performance on
difficult tasks and information about the performance of other children
their age. The children were then asked for self-evaluations. Rubel found
that children younger than seven years made almost no reference to the information
about the performances of other children in their evaluations. Rather, they
based their evaluations on an "absolute standard" of whether or not they
were able to complete the task. Other authors have also reported that children
under 7 years of age do not use social comparison information in forming
their self-concepts but are focused on absolute physical and behavioural
and Nurius, 1986;
Wigfield and Karpathian, 1991).
The inability to use social comparison may be an important factor in the
very positive perceptions young children have of their own abilities. This
positive skew in self perceptions has also been reported by researchers
working with persons with intellectual disability (e.g.
and Ives, 1992;
Jahoda et al., 1988;
Zetlin et al., 1985). Self reports have sometimes been augmented with
information collected from parents, or occasionally carers, in studies examining
self-concept in children and individuals with intellectual disability.
Parental views of children's self-concepts: Parental reports of children's
self-concepts have been used for two distinct and essentially contradictory
purposes: (1) to determine the accuracy of children's ratings and thereby
to establish the concurrent validity of self-concept scales and (2) to determine
the accuracy of adults' (i.e. parents') predictions of children's self-concepts.
Beitchman and Corradini
(1988) listed some of the problems of accepting
parental views as accurate reflections of their children's self-concept.
They suggested that parental reports may be subject to inherent biases such
as over-or underreporting of problems, and may also be influenced by attitudes
and family interactions.
In an example of the second type of study,
Coleman (1984) examined the predictions
mothers made of the way their children with learning disabilities (mean
age = 9 years) would respond to items on the Piers-Harris Self-Concept Scale
and Harris, 1969). Mothers' estimates of their children's self-concept
were lower than the children's scores. The mothers of normally achieving
children, by contrast, overestimated the reports of their children. Both
groups of children achieved similar mean self-concept scores. Coleman explained
the underrating by the parents of children with learning disabilities in
terms of the indirect impact of labelling "as it alters the perception of
those who interact with the labelled individual" (p. 216).
This study addressed the question : Do children with Down syndrome who have
a mental age of 4 to 6 years have a self-concept that is similar to or different
from the self-concept of normally developing children of the same mental
age? An additional question related to mothers' ability to predict the way
that their children with Down syndrome would respond to questions about
their own competence. In order to answer these questions it is, of course,
necessary to use an instrument with demonstrated reliability. As no study
has established reliability for a self-concept instrument when used with
children with Down syndrome this study investigated the test-retest reliability
of a self-concept instrument (The Pictorial Scale of Perceived Competence
and Social Competence [Harter
and Pike, 1984]) in children with Down syndrome with a mental age of
4 to 6 years and in a comparison group matched for mental age across a one
week period. Test-retest reliability has not been established for this instrument
with children who are developing normally.
Nineteen adolescents with Down syndrome (6 girls, 13 boys; mean chronological
age: 14.2 years) and their mothers participated in this study. Families
were recruited from records held at the Schonell Special Education Research
Centre, University of Queensland. Initially the records of all adolescents
between the ages of 13 and 17 years were examined (n=46). Children who had
a developmental age of between 4 and 6 years 11 months (n=29) were selected
from this group. For the purposes of this initial identification, developmental
age was calculated using the most current data from assessments conducted
for an ongoing longitudinal study of the development of children with Down
syndrome. Information was available from one of three instruments: The revised
edition of the Peabody Picture Vocabulary Test (PPVT-R) (Dunn
and Munn, 1981), the Stanford Binet Intelligence Scale - Fourth Edition
Hagen & Sattler, 1986), and the Stanford Binet Intelligence Scale -
Form L-M (Terman
and Merrill, 1960). The mean elapsed time since the children's last
assessment was 16 months (range 6-24 months). Nine eligible children were
excluded as they lived too far away to visit. One child's parents declined
to be included in the study as they were experiencing behaviour problems
with their daughter. All children with Down syndrome remaining in the sample
were assessed with the PPVT-R (Form M) at the beginning of the study to
ensure that they still met the mental age selection criterion. One child
was excluded from the study as his mental age exceeded that which had been
set as a maximum for this study. The final sample size was 18.
In Queensland, children usually enter school in the year in which they turn
6, although children born toward the end of the year may enter in the year
they turn 7. Children in preschool are therefore generally between the ages
of 4 and 6 years. Two preschools were approached for recruitment of comparison
children. The preschools were selected as they were located in the same
geographical area as most of the families of the children with Down syndrome
in the study. Children in the preschool groups whose parents gave consent
for them to be involved and who were present on both testing days (43% of
the possible group) were included in the study. The teachers at the preschools
were asked to nominate any child in the comparison group about whose development
they were concerned. No child was identified as developmentally delayed.
Subsequent to the data collection, one child was excluded from the study
as it was apparent during administration that he did not understand the
task. A comparison group of 20 children (6 girls, 14 boys) was obtained.
The Pictorial Scale of Perceived Competence and Social Acceptance (PPCSA)
and Pike, 1984) was designed for children aged between 4 and 7 years.
As Harter and her colleagues were unable to find activities that were appropriate
across the entire 4 to 7 year range, two forms of the scale were constructed
One form was designed for preschool and kindergarten children, and the other
for first and second grade children. The preschool/kindergarten version
was used for this study.
Each version of the instrument is made up of four subscales designed to
measure perceptions in different domains. The subscales are: Cognitive Competence,
Physical Competence, Peer Acceptance, and Maternal Acceptance. Each subscale
comprises six items. Each item consists of two pictures placed side by side.
The pictures depict children engaging in activities with different levels
of competence or social acceptance. Within each subscale pictures of more
or less competent/accepted children are counterbalanced so that half of
the pictures show the most competent/accepted children on the right and
half show these children on the left of the page. Separate booklets have
been designed for use with boys and girls. The only difference between these
forms is that the focus children depicted are either boys or girls. When
the scale is being administered the child in the pictures is the same sex
as the subject. The pictures provide the visual representation of the verbal
description provided by the tester and are intended to provide an aid to
understanding the items.
The item format used in this scale is designed to reduce children's tendency
to give socially desirable responses. The children are presented with each
item and read a brief statement about the focus child in the pictures. As
the items are read to the children, the examiner points to the appropriate
picture. For each item children are first required to choose the picture
with the child who is most like them. They are then required to decide whether
this child is a lot or a little like them and to indicate their choice by
pointing to a large or small circle which is situated below each picture.
The examiner points to the circles as the question is asked to facilitate
the understanding of the choices. The responses are scored on a four point
scale with four being the most competent/accepted and one the least competent/accepted.
The average scores for each subscale provide a profile of perceived competence
and social acceptance.
Harter and Pike (1984) provided evidence for the factorial validity of the
instrument by using oblique factor analysis of intercorrelations among items.
A two-factor solution was revealed with the two competence subscales defining
one factor and the two acceptance subscales the second factor. This was
true for both the kindergarten/preschool and first/second grade versions.
If children were able to give reasons for their responses this was regarded
by Harter and Pike to be an indication of convergent validity. Of the 91
first and second graders tested, 95% could give reasons for their responses.
Only the cognitive and physical subscales were examined in this way.
For a sample of preschool/kindergarten children, internal consistency was
found to range from .62 to .87 for the individual subscales (Harter
and Pike, 1984). For the total scale, internal consistency was established
at .88. When the subscales were combined according to factors, the internal
consistency for the competence subscales was .76 and for the acceptance
subscales .87. Test-retest reliability was not established by Harter and
Pike. Holguin and Sherrill (1990) used the 1st and 2nd grade version of
the scale with 30 learning disabled boys (mean age 8.2 years) and found
the test-retest reliability on individual subscale scores to range from
.76 to .92. The testing interval was not specified in the report of this
Eighteen adolescents with Down syndrome were selected as described above.
The PPCSA was administered to each of the children at their homes twice,
approximately a week apart (minimum 5 days, maximum 8 day s). The second
author conducted all the sessions. The initial session involved administering
the PPVT-R (Form M) first. This was generally done in the presence of the
mothers. Next, the PPCSA was administered to the child. Mothers were not
present during this time. Finally, the PPCSA was presented to the mothers
who were asked to respond to each item in the way that they thought their
children would have. The examiner used a similar administration procedure
to that used when presenting the scale to the children. Mothers were reminded
regularly to answer the way they thought their child would have - not should
have - answered. Parents were asked not to discuss the session with their
children during the coming week. The second session, which involved re-administering
the PPCSA to the children, was also conducted at home. Those mothers who
wished to see their children's responses to the items were shown the records
of both sessions at the completion of the second visit.
The comparison group of children were administered the PPCSA twice with
an interval of one week. The sessions took place in the preschools. Both
authors were involved in these sessions, and the scale was re-administered
to each child by the person who had originally administered it.
In order to examine the test-retest relaibility of the PPCSA the correlation
coefficients between the subscale scores obtained at Time 1 and Time 2 were
calculated for both groups. Correlation coefficients were also calculated
between the scores on each of the four subscales at Time 1. As this analysis
involved multiple correlations, Bonferroni probabilities were calculated.
Table 1 provides the correlations between all subscale scores for the group
with Down syndrome and Table 2 the correlations for the comparison group.
Table 1. Correlations Between Subscale Scores for the Down
CC: Cognitive competence
PC: Physical competence
PA: Peer acceptance
MA: Maternal acceptance
1 refers to data collected at time 1
2 refers to data collected at time 2
* = p < .05; ** = p < .01; ***= p < .001
Table 2. Correlations Between Subscale Scores for the Comparison
CC: Cognitive competence
PC: Physical competence
PA: Peer acceptance
MA: Maternal acceptance
1 refers to data collected at time 1
2 refers to data collected at time 2
*= p < .05; **= p < .01; ***= p < .001
Responses were found to be stable between Time 1 and Time 2 for all the
subscales for the group with Down syndrome. The correlations between Time
1 and Time 2 scores for each subscale were significant at or below the .01
level with the exception of the Cognitive Competence subscale for which
the correlations were significant at the .05 level. Correlations between
Time 1 and Time 2 scores for each subscale for the comparison group were
significant at or below the .01 level except for the Cognitive Competence
subscale which failed to reach significance (p = .057). For both groups,
therefore, perceptions of Cognitive Competence were the least reliable.
Different patterns of intercorrelations between subscale scores at Time
1 were found for the Down syndrome and comparison groups. The only significant
intercorrelation that was found for the comparison groups was between Cognitive
Competence and Maternal Acceptance (p = .02). For the group with Down syndrome,
Peer Acceptance subscale scores correlated significantly with all other
A repeated measures MANOVA was used to determine whether a difference existed
in the self-concept scores obtained by children with Down syndrome in comparison
to children without disabilities, matched for mental age at both Time 1
and Time 2. A significant effect for sex was found for the data collected
at Time 1 (F,(1,33) = 4.603, p < .04), however there was no effect for group
and no significant interaction. No main or interaction effects were found
for group or sex at Time 2. Boys' scores were significantly higher than
girls' scores for both the Cognitive Competence subscale and the Peer Acceptance
subscale at Time 1(p < .02, p < .01 respectively). The means for the Cognitive
Competence subscale were M = 3.27 for the total sample of girls, and M =
3.71 for the total sample of boys. For the Peer Acceptance subscale they
were M = 2.94 for the total sample of girls, and M = 3.40 for the total
sample of boys.
In addition to examination of the data sets taken on the two separate occasions,
the data was also compared across the two occasions using repeated measures
MANOVA. Each subscale was examined separately. An effect for sex was found
for the Cognitive Competence subscale only (F(1,33) = 4.581, p < .04). Girls
increased their score on this subscale over time and boys' scores were lowered.
There was no effect for group and no significant interaction.
The means, standard deviations and ranges of scores on each sub-score for
the Down syndrome and comparison groups at the time of first testing are
provided in Table 3. The means and standard deviations for the sub-scores
reported by Harter and Pike (1984) are included in this table as additional
information. Inspection of the means and standard deviations show very similar
scores for the comparison group and
Harter and Pike's sample. This provides
tentative support for the use of the means established by Harter and Pike
with Australian children. The subscale means for both groups used in this
study were positively skewed.
Table 3. Means and Standard Deviations of Subscale Scores for
the Down Syndrome and Comparison Groups at Time 1 and Normative Group
(n = 18)
(n = 19)
|Harter and Pike (1981)
(n = 146)
CC: Cognitive competence
PC: Physical competence
PA: Peer acceptance
MA: Maternal acceptance
Correlations between the maternal reports of the self-perceptions of their
children with Down syndrome and the reports obtained from the children were
calculated. The scores obtained by the children during the first testing
session were used in this calculation. Pearson correlation coefficients
were all nonsignificant and ranged from .205 to .454.
The subscale scores on the Peer Acceptance, Maternal Acceptance and Physical
Competence subscales for both the Down syndrome and comparison groups were
found to be highly correlated between the two data collection sessions.
For both groups, the Cognitive Competence subscale scores were the least
stable. This may either indicate something about the usefulness of the scale
as an indicator of perceived cognitive competence, or may indicate something
about the way children at this chronological and mental age perceive cognitive
An interesting difference was found between the groups on the examination
of the intercorrelations between subscales. Peer Acceptance scores were
found to correlate significantly with all other subscales recorded during
the first testing session for the group with Down syndrome. This was not
the case for the comparison group; nor was this found by
Harter and Pike
(1984). Further research is needed to examine the importance of perceived
peer acceptance in the structure of self-concept in children with Down syndrome.
Most mothers reported that they were concerned about their children's peer
relationships and were particularly interested in examining their children's
responses on the Peer Acceptance subscale. The report of an ethnographic
study of adolescent girls with intellectual disabilities included the concern
expressed by staff at special schools and parents of children with intellectual
disabilities that the girls had few friends and experienced difficulties
forming friendships (Gunn
and Bramley, 1989).
No significant differences were found between the scores obtained by the
children with Down syndrome and the comparison children on the subscales
of the PPCSA. The results of this study may be taken as a tentative indication
that children with Down syndrome with a mental age comparable to that of
normally developing children in preschool use similar cognitive processes
in forming self-concept as do these comparison children. As the instrument
used does not assess the processes but rather the products or manifestations
of self-concept formation, this speculation must be regarded with caution.
When the products of cognitive processes are alike, one may not assume that
the processes used to arrive at them are necessarily similar.
Both groups in this study had means which were positively skewed for all
four subscales. Other researchers have similarly found that young children
typically judge their competence and acceptance positively (Anderson and
Adams, 1985; Harter and Pike, 1984;
Ulrich and Collier, 1990).
argued that these findings indicate children's inability to make realistic
judgments. She described this as a normative distortion based in young children's
inability to make social comparisons.
A main effect for sex was found at Time 1, with boys' responses being more
positive on the Cognitive Competence and Peer Acceptance subscales. At Time
2 girls' scores on the Cognitive Competence subscale were higher than at
Time 1 and boys' were lower. As Cognitive Competence was not a particularly
reliable scale these findings should be treated with caution.
Even though the sample size for this study was small (37 as opposed to 146
for Harter and Pike 1984), the means and standard deviations for the comparison
group were similar to those found by Harter and Pike. This provides some
support for the use of the norms obtained by Harter and Pike with children
in Australia. However, the patterns of intercorrelations found for either
of the groups did not fit the expectation, based on Harter and Pike's findings,
that the Competence subscales and Acceptance subscales would be most highly
correlated. Harter and Pike did find, however, that the factor loadings
and intercorrelations in their preschool/kindergarten group were less significant
than those found for the older children. The researchers explained this
finding in terms of self-concept being less well differentiated in younger
The correlation between maternal reports and reports by children with Down
syndrome were not significant. Due to a number of potential limitations
of self-report measures, it has been suggested that maternal reports and
observations may be useful in assessing the self-concept of children with
intellectual disabilities and in providing concurrent validity for scales
of self-concept (Beitchman
and Corradini, 1988;
Hart, 1982; Harter,
Wigfield and Karpathian, 1991). The problems with self-report scales
for this population include difficulties with understanding the vocabulary
and response formats, reading difficulties, and the cognitive ability to
evaluate feelings and attitudes. However, the validity of using the reports
of significant others for the purposes of providing concurrent validity
or an insight into children's self-concepts can be questioned, as it is
the child's perceptions that are of interest rather than the interpretations
made by others from the children's behaviours or the accuracy of children's
Mothers of children with Down syndrome were asked to respond to the test
items in the way that they thought their children would have. Frequent comments
were made by mothers that indicated that they found this task difficult
and they often lapsed into providing answers that reflected the way they
thought about their children's competence and acceptance. Most mothers also
commented that they generally found it very difficult to know how their
children interpreted experiences and most were eager to see their child's
responses. Mothers spontaneously provided examples of their children's experiences
as they were thinking about or trying to "work out" the reasoning their
children may have used when responding to individual items. Peer acceptance
was of particular concern to these parents.
Once the children's responses were shown to the mothers, a few mentioned
that they could think of examples that had demonstrated their children's
positive self-judgments. A few gave explanations for why they believed their
children had responded as they had. "She really does not have any friends
she will stay at overnight, but she visits her older sisters/aunts and uncles
from time to time... She probably counts all these people as friends." "We
ask him who the fastest runner or the best soccer player in the world is
and he always says: 'Me'" "She can make knots in her shoelaces. To her,
being able to tie them at all means that she can tie them well."
When questioned whether they thought that their children may be providing
positive responses in order to impress, mothers consistently said that they
did not think their children were doing this, but that they were confusing
what they would like with the way things were.
The study found tentative support for the idea that children with Down syndrome
with a developmental age of 4 to 6 years 11 months use similar cognitive
processes to normally developing children of a similar developmental age
in deriving their self-concept. Support for this view comes from the findings
that no significant differences were found on the self-concept profiles
of the PPCSA, the subscale means for both groups were positively skewed,
and that the subscale scores for both groups of children were found to be
reliable over a one week period. Due to the small sample size of this study,
however, results must be viewed with caution. In addition, the study has
highlighted a number of questions which remain to be investigated, for example
the differences in intercorrelations between sub-scores found for the two
groups, the key importance of peer acceptance in children with Down syndrome,
possible gender differences, the influence of recent experience, and the
use of social comparison information in the self-perceptions of these children.
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DSE's Reading and Language Intervention for Children with Down Syndrome (RLI) is an evidence-based programme designed to teach reading and language skills to children with Down syndrome.
RLI incorporates best practice in structured activities delivered in fast-paced daily teaching sessions. It was evaluated in a randomised controlled trial and found to improve rates of progress compared to ordinary teaching.
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