INT J LANG COMMUN DISORD, XXXX 2019,

VOL. 00, NO. 0, 1–11

Research Report
Verb-mediated anticipatory eye movements in people with Down syndrome
Natalia Arias-Trejo†, Armando Q. Angulo-Chavira‡ and Julia B. Barrón-Martı́nez†
†Laboratorio de Psicolingüı́stica, Facultad de Psicologı́a, Universidad Nacional Autónoma de México, Mexico City, Mexico
‡Universidad de Guadalajara, Instituto de Neurociencias, Guadalajara, Mexico

(Received December 2017; accepted March 2019)

Abstract
Background: Children and adults with neurotypical development employ linguistic information to predict and
anticipate information. Individuals with Down syndrome (DS) have weaknesses in language production and the
domain of grammar but relative strengths in language comprehension and the domain of semantics. What is not
clear is the extent to which they can use linguistic information, as it unfolds in real time, to anticipate upcoming
information correctly.
Aims: To investigate whether children and young people with DS employ verb information to predict and anticipate
upcoming linguistic information.
Methods & Procedures: A preferential looking task was performed, using an eye-tracker, with children and teenagers
with DS and a typically developing (TD) control group matched by sex and mental age (average = 5.48 years).
In each of 10 trials, two images were presented, a target and a distractor, while participants heard a phrase that
contained a semantically informative verb (e.g., ‘eat’) or an uninformative verb (e.g., ‘see’).
Outcomes & Results: Both DS and TD control participants could anticipate the target upon hearing an informative
verb, and prediction skills were positively correlated with mental age in those with DS.
Conclusions & Implications: This work demonstrates for the first time that children and teenagers with DS can
predict linguistic information based on semantic cues from verbs, and that sentence processing is driven by
predictive relationships between verbs and arguments, as in children with typical development. Clinicians can take
advantage of these prediction skills, using them in therapy to support weaker areas.

Keywords: prediction, Down syndrome, verb comprehension, anticipation.

What this paper adds

What is already known on the subject
Children and adults, under typical development, anticipate information based on verbal cues. After hearing a
semantically informative verb, children prefer to look at a target that matches such a verb than to a distractor. People
with DS exhibit good comprehension skills at the vocabulary level, particularly, in some grammatical categories as
nouns or verbs. Can they use verbal comprehension to anticipated linguistic information?

What this paper adds to existing knowledge

This study demonstrates that children and teenagers with DS anticipate upcoming information upon hearing a
semantically informative verb. Also, that prediction skills are associated with mental age. It concludes that people
with DS have sophisticated comprehension skills that call for new models to study their processing of language.

Address correspondence to: Natalia Arias-Trejo, Laboratorio de Psicolingüı́stica, Facultad de Psicologı́a, Av. Universidad 3000, Sótano Edificio
C, Col. Universidad Nacional Autónoma de México, C.U., Del. Coyoacán, C.P. 04510 Mexico City, Mexico, D.F.; e-mail: nariast@unam.mx
International Journal of Language & Communication Disorders
ISSN 1368-2822 print/ISSN 1460-6984 online  C 2019 Royal College of Speech and Language Therapists

DOI: 10.1111/1460-6984.12473
2 Natalia Arias-Trejo et al.

What are the potential or actual clinical implications of this work?

The results could contribute to the development of improvements in language interventions. Prediction skills facilitate
real-time interactions with other people and the environment. Training in language prediction skills could also assist
with other cognitive difficulties of people with DS, such as the production of number and tense morphemes.

Introduction duction in those with DS lags behind that of their TD

counterparts (Miller 1992, Roberts et al. 2007), while
Prediction skill, an important component of human
others have found production in MA-matched groups
cognition, based on the pre-activation of potential can-
to be equivalent (Checa et al. 2016, Laws and Bishop
didates in response to a verbal or a non-verbal cue, allows
2003). Beyond these discrepancies, there is a consensus
people to respond rapidly and assertively to linguistic
that lexical development is relatively preserved in peo-
information (Federmeier 2007, Kuperberg and Jaeger
ple with DS, as compared with their performance in
2016). As early as 4 months of age, infants’ gazes an-
other linguistic domains, such as morphosyntactic abil-
ticipate the movement of stimuli (Haith et al. 1988).
ities, where errors such as lack of gender and number
During sentence comprehension, adults and children
agreement between articles and nouns have frequently
anticipate upcoming information by pre-activating cor-
been found (Eadie et al. 2002, Vicari et al. 2000). A
rect candidates, an ability that facilitates language pro-
dissociation in individuals with DS between phonolog-
cessing (DeLong et al. 2005).
ical skills (a weakness) and semantic skills (a strength)
Recent studies show an increased interest in the
can be proposed as the explanation for the discrepancies
ability to anticipate upcoming linguistic information,
between comprehension and production.
but mainly within the context of neurotypical devel-
Notably, children with DS and TD show similar
opment. People with atypical development, however,
comprehension scores for single words, but not for sen-
may experience differences in prediction skills. For in-
tences. This result was reported in a study of Italian
stance, Huettig and Brouwer (2015) demonstrated that
children with DS (mean MA = 30.6 months), using
in Dutch, adults with dyslexia employed grammatical
the Italian version of the Communicative Development
gender information in articles to anticipate a target ob-
Inventory; the DS group understood a smaller number
ject much later than typically developing (TD) con-
even of simple sentences than their TD counterparts
trols, and that their reading scores correlated with an-
(Vicari et al. 2000). Children with DS tend to pro-
ticipatory eye movements. Moreover, it may be that
duce fewer open-class words than expected for their MA
not only people with specific language disorders but
(Eadie et al. 2002, Vicari et al. 2000). A spontaneous
also those with syndromes involving language difficul-
speech study by Diez-Itza and Miranda (2007) found
ties show atypical skills in anticipating upcoming lin-
that Spanish-speaking participants with DS and a CA
guistic information. There is a lack of data regarding
between 7 and 19 years tended to make more produc-
the ability of children with Down syndrome (DS) to
tion or omission errors in grammatical categories such
anticipate information; it is possible that these chil-
as prepositions, conjunctions, personal pronouns and
dren have the resources to process upcoming infor-
verbs than in categories such as possessive and demon-
mation efficiently, despite their common expressive
strative pronouns.
language impairments (Diez-Itza and Miranda 2007,
Chapman et al. (1998) found that children with DS
Michael et al. 2012).
omitted more words with grammatical functions (such
DS is one of the most frequent biological causes of
as auxiliary verbs and articles) than their TD counter-
intellectual disability (Dierssen 2012). It is the conse-
parts with the same verbal MA. It remains unknown
quence of a genetic disorder caused by the presence of
whether the problem is due to limitations in the cog-
all or part of an extra copy of chromosome 21, and
nitive resources of the population with DS or a specific
estimated to occur in one in every 1000 babies born
problem of concordance between grammatical elements.
(Lubec and Engidawork 2002). In most cases, mental
While some believe there is a dissociation between gram-
age (MA), the average cognitive capacity that reflects a
mar and vocabulary (Fowler 1990, Vicari et al. 2000),
person’s maturational age (Facon and Facon-Bollengier
others have found a correlation between vocabulary and
1997), is behind chronological age (CA) (Roizen 2002).
grammatical skills in children with DS (Vicari et al.
One of the most affected cognitive areas in DS is lan-
2002).
guage production. Similar word comprehension scores
A few studies have questioned whether people with
have been claimed for children with DS and those with
DS have difficulties in understanding certain grammat-
TD matched by MA (see Næss et al. 2011 for a meta-
ical categories, or whether the problem is mainly in
analysis). Some studies have reported that word pro-
accurately generating these categories. Michael et al.
Verb-mediated anticipatory eye movements in people with Down syndrome
(2012) compared the performance of a group of peo-
ple with DS (CA = 11.9–32.8 years) and a group with
TD (CA = 3.2–13.5 years) paired by their receptive
vocabulary scores in a verb comprehension task. Partic-
ipants were instructed to point to the drawing repre-
senting a verb said by the experimenter (e.g., ‘swim’)
along with three other verbs (e.g., ‘sit’ [phonologically
related], ‘walk’ [semantically related] and ‘throw’ [unre-
lated]). The DS and TD groups had similar numbers of
correct responses. This result would indicate that chil-
dren with DS understand the meaning of verbs and can
perhaps anticipate a referent by extracting semantic in-
formation from informative verbs: that they understand,
for example, that ‘eat’ is associated with food, but not
with clothes. While it seems difficult for people with
DS to produce adequate grammar and morphological
markers, including verb endings, their comprehension
of verbs based on semantics—their meaning—may be
key, as semantics is a strength in the language skills of this
population.
Verbal cues are central to the efficient processing
of upcoming language (Huettig and Brouwer 2015,
Mishra et al. 2012), leading to faster and more effi-
cient responses (Fine et al. 2013). Various verbal cues
in TD allow anticipation, including case and gender
markers (Arias-Trejo et al. 2013, Huettig and Brouwer
2015), semantic information embedded in verbs
(Altmann and Kamide 1999), syntactic information
(Federmeier and Kutas 1999), sentence context (van
Berkum et al. 2005), prosodic cues (Ito and Speer
2008) and phonological forms (DeLong et al. 2005).
It has been established that the language comprehen-
sion system constantly keeps track of predicted and
actual outcomes (e.g., Federmeier 2007). Studies have
employed various measures of prediction, including an-
ticipatory eye movements (e.g., Altmann and Kamide
1999, Tanenhaus et al. 1995) and event-related poten-
tials, as, for example, during word reading of ambiguous
sentences (e.g., DeLong et al. 2005). Neurophysiologi-
cal studies have demonstrated differences in processing
when a linguistic input matches or does not match pre-
dictions. The amplitude of the N400 component, for
example, an indicator of semantic congruency, is larger
when processing an incongruent semantic scenario, and
thus indicates whether or not a linguistic item is expected
(Kutas and Hillyard 1984). This response is under-
stood as the consequence of the cost of neural resources
caused by a contrast between a predicted and a displayed
word.
In a seminal work, Altmann and Kamide (1999)
demonstrated that adults anticipate referents based on
functional attributes of a verb. On hearing ‘eat’, for ex-
ample, they looked more to the image of an edible object
than a non-edible one. The ability to predict upcoming
information based on verbal cues develops from infancy
3
in typical development. Six-month-olds use transitional
probability to predict upcoming sounds or words (Peluc-
chi et al. 2009). In Spanish, 30- and 36-month-olds em-
ploy the indefinite article ‘un/una’ (masculine/feminine,
‘a’ or ‘an’ in English) to anticipate an unnamed referent
by means of the masculine/feminine grammatical gen-
der contrast (Arias-Trejo et al. 2013). However, some
factors seem to modulate predictive abilities from in-
fancy to adulthood: productive vocabulary scores dur-
ing infancy (Mani and Huettig 2012), reading skills in
childhood (Mani and Huettig 2014) and literacy during
adulthood (Mishra et al. 2012).
Mani and Huettig (2012) demonstrated that 2-year-
olds fixate a target image semantically related to a verb.
After hearing a sentence such as ‘The boy eats the big
cake,’ children preferred to look at the target image
(‘cake’) immediately after hearing the related verb (‘eats’)
and before hearing the name of the target. However,
the ability to predict a referent was related to toddlers’
productive vocabulary scores rather than their compre-
hension scores: high producers predicted the target, but
not low producers. In a similar experiment, 8-year-old
children also anticipated the related image before it was
named (Mani and Huettig 2014); participants’ reading
skills, but not other language skills, such as syllable detec-
tion, correlated with their predictive ability. Mishra et al.
(2012) reported that literacy and reading skills modu-
lated anticipation of a target upon hearing a related
word: low- and high-literacy adult speakers of Hindi
heard sentences containing an adjective associated with a
target (e.g., ‘high’ associated with a door) presented with
three unrelated distractors (‘bottom’, ‘flower’, ‘drums’).
High literates anticipated the target upon hearing the
adjective, but low literates were more likely not to look
at the target until it was named.
At present, it is unknown whether children and
teenagers with DS can employ semantic cues from verbs
to anticipate a referent: whether, for example, they can
employ the semantic information embedded in familiar
verbs to anticipate a target. The current study aims to
provide an answer to this question. Participants were pre-
sented with spoken semantically informative verbs (e.g.,
‘eat’) and non-informative verbs (e.g., ‘look’) to deter-
mine whether they could anticipate a target referent in
the informative scenario. The DS group was matched by
sex and MA with a TD control group to evaluate partic-
ipants of similar cognitive skills and to explore whether
general cognitive skills contributed to linguistic predic-
tion skills in participants with DS. Because our task was
grounded in semantic information at the comprehen-
sion level, which is a strength in DS (Næss et al. 2011,
Michael et al. (2012), we expected their understanding
and anticipation of information based on the meaning
of semantically informative verbs to be similar to that of
the MA control group.
4 Natalia Arias-Trejo et al.
Table 1. Demographic characteristics of the sample
Down syndrome (DS),
mean (SD)
Chronological age 19.28 (8.18)
Mental age 5.49 (1.76)
Note: The p-value is for the comparison between DS and TD with independent t-tests. Bold numbers represent significant values.
Method
Participants
A total of 63 children and teenagers, all monolingual in
Mexican Spanish, were included in the study, of which
five were excluded due to failure in calibration (n = 3)
and experimental error (n = 2). Of the 58 remaining
participants, another 20 were excluded after applying the
criteria for trial preservation (see the Results section for
details). The final sample consisted of 38 participants:
one group of 19 participants with DS (10 females),
with a mean CA of 19.28 years (SD = 8.18) and a
mean MA of 5.48 years (SD = 1.76); and another of
19 children with TD (10 females), with a mean CA of
5.49 years (SD = 1.77) and a mean MA of 5.63 years
(SD = 1.36). According to parental reports, participants
had normal or corrected-to-normal vision and did not
have severe hearing problems. Parents or guardians gave
written informed consent after a full explanation of the
procedure. The DS and TD groups differed significantly
in CA but not in MA (Table 1).
Mental age evaluation
The MA was obtained via an abbreviated version of three
subtests, either of the Wechsler Preschool and Primary
Scale of Intelligence (WPPSI-III; Wechsler 2011) or
the Wechsler Intelligence Scale for Children (WISC-IV;
Wechsler 2007), depending on the age of the partic-
ipant. The WPPSI-III was used for children under 6
years of CA or for older participants who could not take
the WISC-IV because of intellectual disability, and the
WISC-IV for those over 6 years of age. These restric-
tions conform to the norms of the WISC-IV, which
is designed to test subjects from 6 to 16 years of age.
The WPPSI abbreviated version included the receptive
vocabulary, object assembly and block design subtests.
This abbreviated version has high reliability (r = .93)
and validity scores (s = .74). The WISC abbreviated
version included the block design, matrix reasoning and
picture completion subtests, which also has high relia-
bility (r = .93) and validity scores (s = .83). Both are
among the 10 most recommended abbreviated versions
(Sattler 2010). Both tests were administered according
to the guidelines in the instruction manuals.
The receptive vocabulary subtest measures partici-
pants’ language comprehension. Participants are asked
Typically developing (TD),
mean (SD) t-value p-value
5.49 (1.76) 7.18 0.001
5.63 (1.36) 0.29 0.760
to look at a group of four images and point to the one the
researcher names aloud. The score is the number of trials
in which participants select the correct image. The object
assembly subtest measures non-verbal reasoning skills as
visuo-perceptual organization, integration and synthesis
of part–whole relationships. Participants are presented
with the pieces of a puzzle in a standard arrangement and
asked to put them together to form a meaningful whole
picture in 90 s. The final score is the number of pieces
correctly assembled. The block design subtest measures
spatial visualization ability and motor skills. Participants
are presented with models in a stimulus book and asked
to re-create the designs within a specific time limit. The
final score consists of the number of correct designs plus
a bonus for speed. The matrix reasoning subtest mea-
sures visual processing and abstract–spatial perception.
Participants are presented with an array of related pic-
tures and asked to find one that is missing from among
five options. The final score is the number of correctly
selected pictures. The picture completion subtest mea-
sures visual detection and fluid reasoning. Participants
are asked to observe an incomplete picture and indi-
cate the missing part by saying its name or pointing
to it.
Auditory stimuli
Forty familiar verbs and 20 nouns were selected from
the MacArthur Inventarios del Desarrollo de Habilidades
Comunicativas (Jackson-Maldonado et al. 2003). All
were digitally recorded by a native speaker of Mexi-
can Spanish in a single session and edited to remove
background noise, match peak-to-peak amplitude and
equalize volume. All the auditory stimuli were presented
using the speakers of the presentation screen. The num-
ber of words heard was the same in each group. Half
the verbs were semantically related to a visual referent
(e.g., ‘eat’, related to ‘cake’) and the other half were
unrelated (e.g., ‘look’, without a semantic relation ei-
ther to the target or the distractor). Table 2 presents
the entire set of stimuli employed. The semantic rela-
tionship, or lack of a relationship, between targets and
distractors, and between verbs and nouns was confirmed
using Normas de Asociación de Palabras para el Español
de México (Arias-Trejo et al. 2015), a corpus of word
association norms for Mexican Spanish used by young
adult speakers. Forty syntactically appropriate sentences
Verb-mediated anticipatory eye movements in people with Down syndrome 5
Table 2. Auditory stimuli employed in the prediction task

Verb Noun
Phrase Related Unrelated Article/preposition Target Distractor

He/she/it is going to bark [ladrar] show [enseñar] the [el] dog [perro] door [puerta]
[va a]
I am going to [voy a] cry [llorar] look for [buscar] the [el] baby [bebé] stairway [escalera]
We are going to swim [nadar] see [ver] in the/ the [en/la] pool [alberca] coloured pencils
[vamos a] [colores]
They are going to ride [manejar] hide [esconder] the [la] motorcycle [moto] book [libro]
[van a]
I am going to [voy a] put on [ponerme] buy [comprar] the [el] shoe [zapato] bed [cama]
He/she/it is going to drink [tomar] fall [caer] the [la] milk [leche] dish [plato]
[va a]
We are going to bite [morder] give [regalar] the [la] apple [manzana] swing [columpio]
[vamos a]
They are going to write [escribir] give [dar] the [el] pencil [lápiz] ball [pelota]
[van a]
I am going to [voy a] eat [comer] drop [tirar] the [la] cookie [galleta] drum [tambor]
We are going to talk [hablar] throw [aventar] the [el] phone [teléfono] scissors [tijeras]
[vamos a]
He/she/it is going to open [abrir] look [mirar] the [la] door [puerta] dog [perro]
[va a]
I am going to [voy a] climb [subir] move away [quitar] the [la] stairway [escalera] baby [bebé]
We are going to draw [dibujar] have [tener] with the/the [con/los] coloured pencils pool [alberca]
[vamos a] [colores]
They are going to read [leer] move [mover] the [el] book [libro] motorcycle [moto]
[van a]
He/she/it is going to sleep [dormir] touch [tocar] in the/ the [en/la] bed [cama] shoe [zapato]
[va a]
I am going to [voy a] wash [lavar] grab [agarrar] the [el] dish [plato] milk [leche]
We are going to play [jugar] leave [dejar] in the/ the [en/el] swing [columpio] apple [manzana]
[vamos a]
They are going to kick [patear] buy [comprar] the [la] ball [pelota] pencil [lápiz]
[van a]
I am going to [voy a] play [tocar] pull [jalar] the [el] drum [tambor] cookie [galleta]
We are going to cut [cortar] take out [sacar] the [las] scissors [tijeras] phone [teléfono]
[vamos a]
Note: Target stimuli, target location on screen and verbs were counterbalanced across participants.

were created in order to embed the verbs and nouns. Design

The syntax of the phrases had the following structure:
the form ‘going to’ with a varied subject (not explicitly
mentioned, but inferred, as Spanish grammar does not
require use of a subject noun or pronoun), the infinitive
principal verb, and the name of the target. For exam-
ple, in Spanish: ‘voy a comer’ (‘I am going to eat’) ‘la
manzana’ (‘the apple’). Use of this structure allowed us
to present the verb in its infinitive form and thus avoid
the need to process person, aspect or tense of the critical
verb.
Visual stimuli
Twenty colour images of real objects were employed,
corresponding to the 20 nouns, of 600 × 800 pixels
each. Each image was centred in a grey frame. Im-
ages were prototypical (according to a previous rating
study).
The experiment consisted of 10 trials that simultane-
ously presented two images: target and distractor. Half
the trials were Related (with a semantic association be-
tween the verb and the target) and the other half Unre-
lated (no semantic association). Four different sequences
of trials and presentation were created, and participants
randomly assigned to one. In each sequence, targets (e.g.,
‘dog’) were used either with a Related verb (e.g., ‘bark’)
or an Unrelated verb (e.g., ‘show’), but not with both, to
avoid presentation to the same participant of the same
target in Related and Unrelated contexts and to balance
any possible visual preferences for a given target image.
Across the four sequences all images appeared as targets
and distractors the same number of times in each condi-
tion and the same number of times on the left and right
sides of the screen.
Each trial had a total duration of 6000 ms and was
divided into three phases of 2000 ms each: baseline,
6 Natalia Arias-Trejo et al.
Figure 1. Example of a trial in the Related condition (bark-dog). [Colour figure can be viewed at wileyonlinelibrary.com]
prediction and noun. Figure 1 illustrates the trial dis-
tribution. Both images appeared simultaneously and re-
mained on screen for the duration of the trial. In the
baseline phase, participants heard the carrier phrase that
ended at 2000 ms with the offset of the critical infinitive
verb (Related or Unrelated); this phase was taken as a
baseline measure of image preference. The prediction
phase consisted of silence from 2000 to 4000 ms; in this
period, participants’ visual preference for the images was
measured as an effect of having heard the critical verb.
Finally, in the third phase of the trial, the name of the
target was heard at 4000 ms and participants’ ability to
find it was confirmed.
Procedure
At the beginning of the session, participants performed
the neuropsychological evaluation to calculate MA. As
previously noted, the WPPSI-III was used for children
with a CA under 6 years. Older participants were first
given the Block Design subtest from the WISC-IV; how-
ever, if they failed the first three trials, the WISC-IV test
was discontinued, and they were given the WPPSI-III
subtests. Otherwise, they continued with the three sub-
tests from the WISC-IV.
After the MA evaluation, participants performed
the prediction task. Visual preferences were recorded
using a Tobii TX2-30 eye-tracker located immediately
below a 24-inch screen. This eye-tracker records gazes at
30 Hz (one data point approximately every 33 ms) with
an average accuracy of 0.5° visual angle. Participants sat
by themselves on a chair centred in front of the screen.
The images were shown at eye level at approximately
60 cm. Before proceeding with the experimental trials,
participants’ gaze was calibrated using a five-point pro-
cedure in which an attention-getter appeared in the four
corners and at the centre of the screen. The experimental
trials began when three or more points were successfully
calibrated for both eyes. Parents were asked to remain
quiet in the few cases in which children had to be seated
on their laps. In all other cases, the experimenter and
parents remained out of participants’ sight during the
task. The instructions given to participants were to look
at the images on the screen, listen to the audios, and
remain quiet and still.
Results
Prediction task
For each experimental trial, two areas of interest were
defined, according to the size of the individual im-
ages (600 × 800 pixels): one for the target and one
for the distractor. In Related trials, the target was the
image semantically related to the verb; in Unrelated
trials, where neither of the images had a direct asso-
ciation with the verb, it was either one of the images.
Trials in which participants did not look at least 20%
(1200 ms) of the total duration and participants who
provided data for fewer than 50% of the trials (at least
five trials) were excluded. If DS participants were ex-
cluded after applying these criteria, then their paired
MA age control was also excluded; if a TD participant
was excluded after applying these criteria, then they
were replaced with a new participant to complete the
paired-sample design. A total of 10 participants with DS
and their MA controls were excluded; another four TD
controls were replaced by four other TD children. Of
the remaining 38 participants (19 in each group): 317
(83.42%) of the 380 trials originally presented were
analyzed, 156 for the DS group and 161 for the TD
group.
The total looking time was calculated for all three
phases: baseline, prediction and noun. For each phase,
the proportion of fixation to the target (T) and the dis-
tractor (D) in related and unrelated trials was calculated
as T/(T + D). The statistical analyses were performed
only for the first two phases, except where otherwise
stated, since the effect of the verb was measured from
the first to the second phase. The third phase, with the
noun named, was presented to ensure that participants
Verb-mediated anticipatory eye movements in people with Down syndrome 7

Figure 2. Mean (±1 standard error) proportion of target looking (PTL) measure by group and condition. Horizontal lines indicate chance
level. Statistical significance marks represent the interaction Window × Relationship: dotted lines represent the analysis of variance (ANOVA)
post-hoc t-test; individual asterisks represent chance level analysis. ∗ p ࣘ 0.05; ∗∗ p ࣘ 0.01.

were familiar with the object names and to minimize
their possible frustration at not knowing where to look
if objects were unnamed. Figure 2 presents the propor-
tion of fixation to the target in the three phases.
The proportion of target looking (PTL) was the
dependent variable used in the analysis. A 2 × 2 ×
2 mixed-design repeated-measures analysis of variance
(ANOVA) with Window (baseline and prediction), and
Relationship (semantically related and unrelated) as
within-subjects factors, and Group (DS and TD) as
between-subjects factor was performed. This ANOVA
design and multiple comparisons were computed by
participant (F1 , t1 ) and by item (F2 , t2 ) to observe
whether individual items skewed the effects. Item PTL
was computed by averaging the values of all subjects in
each target-item separately for Related and Unrelated
conditions.
The data analysis revealed a significant effect of Re-
lationship (F1 (1,36) = 6.73, p = .01, ɳ2 = .15; F2 (1,18)
= 6.35, p = .02, ɳ2 = .26) and an interaction between
Window and Relationship (F1 (1,36) = 4.58, p = .04,
ɳ2 = .11; F2 (1,18) = 4.68, p = .04, ɳ2 = .20). Post-hoc
t-test comparisons conducted to explore the interaction
showed that in the prediction window (t1 (37) = 3.08,
p = .004, d = .47; t2 (19) = 2.85, p = .01, d = .64),
participants looked more at the target image in the se-
mantically Related condition (M1 = 0.58, SD1 = 0.18;
M2 = 0.56, SD2 = 0.10) than in the Unrelated con-
dition (M1 = 0.46, SD1 = 0.16; M2 = 0.45, SD2 =
0.13). In the baseline window (t1 (37) = 0.64, p = .52;
8 Natalia Arias-Trejo et al.
Table 3. Mean proportion of target looking and standard deviation by condition and trial window
Condition Window
Related Baseline
Prediction
Noun
Unrelated Baseline
Prediction
Noun
Note: Bold numbers represent significant values above chance level.
t2 (19) = 0.50, p = .61), no differences were found be-
tween the Related condition (M1 = 0.49, SD1 = 0.15;
M2 = 0.48, SD2 = 0.07) and the Unrelated condition
(M1 = 0.47, SD = 0.16; M2 = 0.47, SD2 = 0.11).
Participants looked more at the target image in the pre-
diction window (M1 = .58, SD1 = 0.18; M2 = 0.56,
SD2 = 0.10) than in the baseline window (M1 = 0.49,
SD1 = 0.15; M2 = 0.48, SD2 = 0.07) in Related tri-
als (t1 (37) = 2.55, p = .01, d = .38; t2 (19) = 2.94,
p = .008, d = .58), but no differences were found be-
tween the prediction (M1 = 0.46, SD1 = 0.16; M2 =
0.45, SD2 = 0.13) and baseline windows (M1 = 0.47,
SD1 = 0.16; M2 = 0.47, SD2 = 0.11) in the Unre-
lated trials (t1 (37) = 0.31, p = .75; t2 (19) = 0.56, p =
.57). Post-hoc t-tests to chance level (.50) revealed that
in the Related trials, participants looked significantly
above chance in the prediction window (t1 (37) = 2.63,
p = .01, d = .44; t2 (19) = 2.97, p = .008, d = .60),
but not in the baseline window (t1 (37) = 0.30, p =
.76; t2 (19) = 0.61, p = .54), while in Unrelated trials,
participants’ attention was no different from chance in
the baseline (t1 (37) = 1.06, p = .29; t2 (19) = 0.89,
p = .38) or prediction window (t1 (37) = 1.47, p = .15;
t2 (19) = 1.39, p = .17). Descriptive data by group are
presented in Table 3.
Participants looked significantly above chance in
both Related trials (M1 = 0.58, SD1 = 0.18; t1 (37)
= 2.77, p = .009, d = .44; M2 = 0.57, SD2 = 0.15;
t2 (19) = 2.16, p = .04, d = .46) and Unrelated trials
(M1 = 0.57, SD1 = 0.20; t1 (37) = 2.09, p = .04, d
= .35; M2 = 0.59, SD2 = 0.13; t2 (19) = 3.13, p =
.005, d = .69) in the noun window, which confirmed
that they were able to associate the heard noun with the
corresponding image.
Correlation analyses
A prediction score was calculated by subtracting the pro-
portion of target looking in the prediction window for
Unrelated trials from that in Related trials (PTL Related
– PTL Unrelated). To explore whether the predictive
ability of DS and TD participants was correlated with
Down syndrome (DS) Typically developing (TD)
Participant Item Participant Item
Mean (SD) Mean (SD)
0.48 (0.18) 0.48 (0.08) 0.50 (0.14) 0.50 (0.07)
0.58 (0.20) 0.57 (0.10) 0.58 (0.18) 0.57 (0.11)
0.56 (0.18) 0.53 (0.16) 0.61 (0.19) 0.62 (0.15)
0.47 (0.15) 0.46 (0.10) 0.48 (0.18) 0.49 (0.14)
0.42 (0.15) 0.43 (0.13) 0.50 (0.16) 0.49 (0.14)
0.57 (0.22) 0.61 (0.15) 0.57 (0.20) 0.59 (0.13)
MA, a Pearson correlation test was performed with the
prediction and MA scores for all participants (n = 19
for each group). There was a positive significant corre-
lation for the DS group (r = .612, p = .007): that is,
predictive ability increased with MA. This correlation
was not found in the TD group (r = .10, p = .76).
Discussion
This study investigated whether children and teenagers
with DS (mean MA = 5.48 years) and their TD
counterparts matched by MA and sex could anticipate
a familiar target based on relevant semantic infor-
mation embedded in verbs in Spanish. A preferential
looking task was presented using an eye-tracker.
Using short versions of intelligence scales, participants’
MA was also correlated with prediction skills, with
the aim of understanding the possible contribution
of general cognitive skills to the ability to predict
information based on linguistic cues. In the pref-
erential looking task, participants heard either a
semantically informative or uninformative verb while
two images were presented on screen: a target and a
distractor. Upon hearing the informative verb, but
before the target image was named, participants’ prefer-
ence for the target or distractor was noted. Upon hearing
an uninformative verb, they were expected to look ran-
domly at the images. Participants with DS, like their TD
peers, exhibited different patterns of looking behaviour
when presented with semantically informative versus
uninformative verbs. In both groups, participants who
heard a verb that contained a semantically informative
cue (e.g., ‘eat’) preferred to look at the target image
(an edible item) over the distractor (a non-edible item).
In contrast, when participants heard an uninformative
verb, one that did not provide cues about the nature of
a potential target (e.g., ‘see’), they showed no significant
preference for one of the two images on the screen.
Both groups of participants showed preferences above
chance after hearing the name of the target, confirming
that they were familiar with the target and ruling out
an effect caused by unfamiliarity with the target image.
Verb-mediated anticipatory eye movements in people with Down syndrome
The results of this study are consistent with previous
work (Michael et al. 2012) reporting that despite their
problems in producing verbs, children with DS under-
stand their meaning, but they also expand upon this
knowledge with the finding that these children’s com-
prehension of verb meaning allows them to anticipate
online information. This is true, moreover, in Span-
ish, despite the problems that children with DS have in
producing the appropriate inflectional morphology for
verbs in that language (Diez-Itza and Miranda 2007).
An experiment that simultaneously tests verb compre-
hension and production in DS participants is necessary
to explain the discrepancy between these two modali-
ties. One advantage of the present study is that it al-
lowed evaluation of the ability to anticipate referents
online through verbs with a method of visual tracking,
rather than offline tasks, such as observational studies
and parental reports. That is, the task prevented the
participants in both groups from generating specific re-
sponse strategies.
The results demonstrate that children and teenagers
with DS can anticipate a correct referent by creating a
congruent association between the meaning of a verb
and a corresponding target. This ability to use linguistic
cues to predict upcoming information, but also to avoid
mistakenly establishing a potential target on the basis
of insufficient cues, reflects an online and active lin-
guistic processing in these participants. The results also
demonstrate that children and teenagers with DS are
not passive listeners waiting for complete information
to execute a response. They can raise hypotheses as in-
complete but sufficient information is displayed. Finally,
the results replicate previous findings regarding TD chil-
dren’s ability to anticipate upcoming information online
(Arias-Trejo et al. 2013, Mani and Huettig 2012, 2014).
The findings suggest that linguistic information, in con-
crete functional cues embedded in a verb’s meaning, can
help children with atypical neurodevelopment and lan-
guage deficits to pre-activate congruent referents, as it
does with TD children and adults.
The finding that young people with DS anticipate
information based on their semantic knowledge sup-
ports evidence that linguistic comprehension is a relative
strength in DS, even in grammatical domains. The role
of the phonological component in expressive language
deficit does not seem to affect language comprehension
to the same extent as production, even with respect to
the grammatical category that can affect production in
children with DS, namely verbs (Nash and Snowling
2008). Production tasks, which are used often, rely on
more fine-grained phonological representations, which
are likely to be impaired.
A correlation between MA and the ability to pre-
dict was found for children with DS but not with TD.
This finding was expected for the TD children: using
9
a very similar task, a previous study found the ability
to use verb meaning to predict upcoming information
during different stages of childhood (Mani and Huettig
2012, 2014). The correlation found between MA and
prediction skills for participants with DS indicates that
the likelihood of improving these abilities increases with
MA. An increase in general cognitive ability, and poten-
tially in language knowledge, also affects the ability of
DS participants to employ semantic cues to anticipate a
referent.
What is the cognitive process involved in this pre-
diction ability, not only for people with learning dis-
abilities like DS, but also for those with typical devel-
opment? Janse and Jesse (2014) reported that verbal
working memory skill predicts older adults’ ability to
use context information for the recognition of upcom-
ing words in oral sentences. Huettig et al. (2011, p. 141)
proposed that ‘working memory grounds language in
space and time, allowing for short-term connections be-
tween objects and linking linguistic and visuospatial rep-
resentations’. Processing speed is also related to linguis-
tic prediction. In a language anticipatory task, Huettig
and Janse (2016) demonstrated that, in adults, working
memory correlated positively, and processing speed neg-
atively, with anticipatory looking. Speed in the transmis-
sion of information is an important factor in prediction
because it allows faster pre-activation of possible lexi-
cal candidates and faster correction of prediction errors.
Further research is necessary to clarify these mechanisms
in young people with and without DS.
Representations at the semantic level should con-
strain interpretation at lower levels. Thus, hearing a
semantically informative verb is likely to restrict acti-
vation of other related candidates, for example at the
phonological level. According to Clark’s (2013) model,
listeners develop fine-grained probabilistic expectations
about how lexical alternatives are likely to be realized in a
context that propagates from top to bottom through the
levels of a hierarchically organized system representing
progressively more finely grained perceptual informa-
tion. In our study, participants’ attention favoured the
target when it was preceded by an informative semantic
cue over an uninformative one; temporary hypotheses
entertained by both DS and TD groups thus compete
and are resolved when the predicted target is evaluated
against the options displayed, at least when the options
are two images. The activation of the target should be
inversely proportional to the activation of the distractor,
which might be activated, as it is visible, and children
tend to implicitly label available familiar images (Mani
and Plunkett 2010).
We have restricted our experiment to the context of
anticipatory language processing by means of semantic
information. The results of this study confirm that vo-
cabulary knowledge is a relative strength in young people
10
with DS. Furthermore, it clarifies that this strength is
not restricted to the domain of noun comprehension,
but also extends to verb comprehension, as our partic-
ipants, both those with DS and matched TD children,
were able to use semantic information carried by a verb.
Given the previous reports indicating that vocabulary
comprehension, unlike grammatical processing, is rela-
tively preserved in people with DS (Berglund et al. 2001,
Checa et al. 2016), the obvious direction for this line of
research, which we are currently pursuing, is to explore
whether children with DS can employ other cues, such
as grammatical information (e.g., gender or number),
to extract useful information for referent anticipation.
Such studies would also help us to understand better
the discrepancies between comprehension and produc-
tion for words that include morphological cues. Finally,
our results are an invitation to adjust the approaches of
the research on language skills in children with DS. It
may be that centring our attention on their errors and
omissions in speech production has prevented us from
appreciating that their comprehension abilities extend
beyond isolated words to phenomena such as meaning
representation.
These results could contribute to improvements in
language interventions and programs. Since prediction
skills are a relative strength in people with DS, clini-
cians could use these skills to support the weaker areas
of grammar, syntax and morphology. The use of pre-
diction skills in clinical environments could be imple-
mented through analogies between predictable and less
predictable sentences, using strong semantic relation-
ships between nouns and verbs to reduce the load on
working memory in processing morphology and gram-
mar. Prediction skills are, moreover, not restricted to
language; they are a basic feature of the brain. Thus,
although our results concern the language domain, it is
possible that clinicians could also use prediction skills to
support general domain skills like numerical processing.
Acknowledgements
We wish to thank participants, parents, teachers, caregivers, and the
institutions Fundación CTDUCA I. A. P., Integración Down I. A. P.,
Fundación Mosaico Down A.C. and Familias extraordinarias. We are
also grateful to the members of the Laboratorio de Psicolingüı́stica
at UNAM for their assistance. Declaration of interest: The authors
report no conflicts of interest. The authors alone are responsible for
the content and writing of the paper.
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