Session 11: Early development and executive function
Developmental foundations in infants with Down syndrome: Research to inform anticipatory practices.
Debbie Fidler, Professor and Director Developmental Disabilities Research Laboratory - Human Development and Family Studies (colostate.edu)
Contact: deborah.fidler@colostate.edu
This presentation will examine advances in our understanding of the early emergence of cognitive and regulatory features in young children with Down syndrome. Recent work characterizing the early foundations of executive function and goal-directed behavior in infants with Down syndrome will be reviewed, with an emphasis on early visual behavior, action planning, and caregiver ratings of regulatory function. New evidence for the longitudinal association between early regulatory processes and later neurodevelopmental outcomes in children with Down syndrome will be reviewed as well. Findings from this line of research will be explored as a potential springboard for innovation in the development of novel syndrome-informed early interventions that aim to strengthen critical cognitive and regulatory foundations in this population.
Cross-national feasibility of a novel, parent-mediated executive function intervention for young children with Down syndrome
Authors: Miranda E. Pinks1, Madison M. Walsh1, Kaylyn Van Deusen1, Nathaniel R. Riggs1, Susan L. Hepburn11, Lisa A. Daunhauer1, Sarah Looney1, Francesca Pulina2, Sara Onnivello2, Chiara Marcolin2, Sara Colaianni2, Benedetta Ceci2, Sylvia Lanfranchi2, & Deborah J. Fidler1
Email: miranda.pinks@colostate.edu
Background: This presentation introduces Executive Function Play Opportunities (EXPO), a parent-mediated intervention designed for preschoolers with Down syndrome (DS) to support executive function (EF) skills.
Research question: The study examines feasibility and acceptability findings from a cross-national pilot of the intervention in the US and Italy.
Method: Families of children 3-7 years old with DS completed the 12-week program and regularly completed brief surveys about activity completion, activity difficulty level attained, and participant satisfaction. Participants (US: n=16, Italy: n=19) had similar baseline characteristics, including chronological (CA) and mental ages (MA), between sites.
Results: Families logged an average of 13 activity sessions per two-week block, exceeding the minimum goal, with 85.71% completing 6 or more activities. Most sessions (84.49%) lasted 10 minutes or less, reflecting intended session lengths. In Italy, activities were evenly distributed across difficulty levels, while US families tended toward easier activity levels. Both parents and children reported high enjoyment of activities (87.7% and 89.7%, respectively).
Feasibility outcomes were analyzed in relation to CA and MA, showing higher baseline MA predicted increased activity difficulty (β=0.02, p=.03). Overall, families demonstrated high adherence to program guidelines, with consistent satisfaction across sites. Despite minor differences between sites, such as activity completion rates, findings were generally consistent.
Conclusion: The preliminary trial of EXPO indicates its feasibility, acceptability, and scalability among families of preschoolers with DS. The study underscores the importance of tailored interventions like EXPO in addressing EF challenges in this population, with promising implications for future research and applications. The next phase involves adapting EXPO into an adaptive intervention and conducting a clinical trial to evaluate efficacy.
Developmental profiles, variability, and skills acquisition in preschool age children with Down syndrome
- Onnivello1, E. Toffalini2, S. Colaianni1, C. Marcolin1, F. Pulina1, E. Rossi1, C. Locatelli3, G. Ramacieri4,5, F. Catapano4, F. Antonaros6, M. C, Pelleri6, S. Lanfranchi1
- Department of Developmental Psychology and Socialization, University of Padova, Italy
- Department of General Psychology, University of Padova, Italy
- Neonatology Operating Unit, IRCCS A.O.U. of Bologna, Policlinic of Sant'Orsola, Italy
- Department of Medical and Surgical Science (DIMEC), University of Bologna, Italy
- Specialist School of Child Neuropsychiatry, University of Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Italy
Contact: sara.onnivello@unipd.it
Background: Down Syndrome (DS) typically manifests in children with a distinctive pattern of relative developmental strengths and challenges. Previous research has extensively outlined this profile and its variability across different age groups. However, a gap exists in understanding the developmental characteristics of preschool-aged children with DS. Furthermore, there is a need to explore the timing of cognitive and communication skills acquisition within this age range.
Research Questions: This study aims to (1) examine the developmental profile of preschool children with DS, (2) explore the variability of scores within domains of functioning, and (3) estimate the average chronological (CA) and equivalent age (AE) at which children with DS acquire specific cognitive, communication, and language skills. A comparative analysis with typically developing (TD) children trajectories is also conducted.
Method: A cohort of 43 Italian children with DS (Mean months=55.12; SD months=12.54; age range months=38-76) participated in the study. The Griffiths-III scale was employed to assess fundamental aspects of learning during the early years, language and communication, fine-motor skills, personal-social-emotional skills, and gross-motor skills. Multivariate linear models were run to delineate the developmental profile and assess variability within scales. Logistic regressions were conducted to investigate the performance of children in specific items, utilizing CA and AE as alternate predictors.
Results: The study revealed a developmental profile characterized by relative higher scores in personal-social-emotional and gross-motor skills among preschool children with DS. Increased variability was observed in scales assessing language and communication, as well as personal-social-emotional skills. Furthermore, the time of acquisition of specific skills indicated variations compared to the TD group matched for AE, with some skills acquired earlier, some simultaneously, and some later.
Conclusions: The findings contribute to understanding the developmental profile of preschool-aged children with DS, adding valuable insights to the heterogeneous nature of DS. Additionally, the study provides foundational information essential for formulating a developmental schedule for cognitive and language milestones in infants with DS.
