Relationship between anxiety and executive functioning among youth with Down syndrome.
In school-age kids with Down syndrome, weak shifting or working memory today predicts higher anxiety a year later, and the pattern runs both ways.
01Research in Context
What this study did
The team followed the kids with Down syndrome for one year. Ages ranged from 7 to 17.
At the start they gave two kinds of tests: executive-function games and anxiety checklists.
One year later they repeated the same tests to see which score predicted the other.
What they found
Kids who scored low on shifting and working memory at Time 1 had higher anxiety one year later.
The reverse was also true: anxious kids at Time 1 showed weaker shifting and working memory one year later.
Links were small to medium, so results are hints, not guarantees.
How this fits with other research
Myers et al. (2018) tracked DS infants and found early joint attention predicted later language. Both studies show that today’s skills forecast tomorrow’s challenges, just for different skills and ages.
Anonymous (2019) saw that short-term memory sat between attention and language in DS kids. A et al. now add anxiety to that chain, suggesting memory problems may ripple into mood as well as academics.
Hoyle et al. (2022) tried to measure verbal fluency in DS and found phonemic trials unreliable. A et al. used shifting tasks that worked, so combining their tools may give you a fuller EF picture before you treat anxiety.
Why it matters
You already watch language and memory in DS; now add quick anxiety screens. If shifting or working memory scores drop, plan coping-skills teaching right away. Likewise, if a child shows new worries, check EF games for slipping scores. Treating both areas together could stop a downward spiral before it starts.
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02At a glance
03Original abstract
Down syndrome (DS) is commonly associated with various cognitive and behavioral challenges including difficulty with executive functioning (EF) and elevated levels of anxiety symptoms. In the general population, high levels of anxiety are associated with difficulties with EF tasks like initiation and cognitive shifting, with some bidirectional findings between these two constructs. Given the high overlapping behavioral presentation of symptoms of anxiety and challenges in EF, the present study examined the relationship between anxiety symptoms and EF in a sample of 139 individuals with DS ages 6-17 years to better understand their interrelationship and directionality in this population. Participants were rated by parents at two different time points, one year apart. For the entire sample, at baseline, concurrent associations were observed between several measures of EF and measures of anxiety and internalizing symptoms. Among the sample, some participants had co-occurring anxiety diagnoses prior to testing. Our results suggest that those with co-occurring anxiety exhibited more pronounced co-occurring difficulties in several areas of EF than those without co-occurring anxiety. Longitudinally, EF-shifting and EF-working memory at baseline predicted anxiety symptoms a year later while baseline anxiety predicted subsequent challenges with EF-shifting and EF-initiation a year later. Our findings suggest that while there are concurrent relationships between several measures of EF and anxiety, the longitudinal relationship is more nuanced. Our findings highlight the need for targeted mental health interventions in those with DS, as well as awareness of the overlap of anxiety with EF.
Research in developmental disabilities, 2025 · doi:10.1016/j.ridd.2025.105056