Autism & Developmental

Profiles and trajectories of executive functioning in young children with Down syndrome.

Dimachkie Nunnally et al. (2023) · Journal of intellectual disability research : JIDR 2023
★ The Verdict

Language play gives preschoolers with Down syndrome a tiny, brief flexibility boost that vanishes without follow-up.

✓ Read this if BCBAs serving preschoolers with Down syndrome in clinic or early-intervention rooms.
✗ Skip if Teams looking solely for long-lasting EF gains or working with school-age and adult clients.

01Research in Context

01

What this study did

The team ran a randomized trial with preschoolers who have Down syndrome.

Kids got the JASPER-EMT play-based language program.

Researchers tracked executive-function skills before, during, and after.

02

What they found

Flexibility ticked up right after the sessions, then slid back.

No lasting change showed up in working memory, shifting, or planning.

The boost was real but tiny and brief.

03

How this fits with other research

Karaaslan et al. (2013) saw big, lasting gains when moms used Responsive Teaching with the same age group.

Their effect was large and held for six months; this trial’s effect was small and faded fast.

Hoyle et al. (2022) gave teens and adults a 12-week exercise program and also found a small bump in everyday executive skills.

Together the picture is clear: short interventions can nudge EF, but you need longer or multi-part plans to keep it.

04

Why it matters

If you run play-based language sessions, expect a quick win in flexibility, then plan for booster lessons.

Pair the work with parent coaching or add exercise blocks for older kids to stretch the gain.

Track the skill monthly so you can re-teach before it drops.

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→ Action — try this Monday

Add a five-minute flexibility game at the end of each JASPER-EMT session and schedule a brief booster next month.

02At a glance

Intervention
not applicable
Design
randomized controlled trial
Sample size
76
Population
down syndrome
Finding
weakly positive
Magnitude
small

03Original abstract

BACKGROUND: Language acquisition strongly predicts executive functioning (EF) in early childhood in typical development and in children with Down syndrome (DS). Both language and EF are critical contributors to later positive social and academic outcomes yet are often areas of concern in children with DS. Despite the wider availability of interventions targeting language development in DS, no efforts have been made to understand how these interventions may influence the development of EF in this population. METHODS: This study examined secondary data from 76 preschoolers with DS collected as part of a randomised waitlist control trial of an early social communication intervention (JASPER-EMT). Children's EF skills were measured using the BRIEF-P, at three timepoints over 6 months. Linear regression was used to examine the baseline relationship between child characteristics and the three indices of the BRIEF-P: Emergent Metacognition, Flexibility and Inhibitory Self-Control. Linear mixed effects models were used to estimate change across the three indices of the BRIEF-P and whether that change was moderated by treatment. RESULTS: Children in this sample exhibited an uneven profile of EF at baseline, with relative strengths in the Flexibility Index and the Inhibitory Self-Control Index, and relative weaknesses in the Emerging Metacognition Index. Chronological age was associated with all indices at baseline (all P < 0.05). Children in the intervention group exhibited improvements in the Flexibility Index from entry to exit (3 months later) compared with the control, although this treatment effect did not maintain at the follow up at 6 months. CONCLUSIONS: Baseline EF profiles of children were consistent with findings of other studies with children with DS. Longitudinal findings suggest that behavioural interventions targeting language may have positive collateral effects on certain EF skills, however these effects may be transitory without ongoing support. These findings illustrate both the need for further exploration of the impact of early language interventions on EF abilities and the malleability of certain EF domains in young children with DS.

Journal of intellectual disability research : JIDR, 2023 · doi:10.1111/jir.13008