Down syndrome: Cognitive and behavioral functioning across the lifespan

Abstract

Individuals with Down syndrome (DS) commonly possess unique neurocognitive and neurobehavioral profiles that emerge within specific developmental periods. These profiles are distinct relative to others with similar intellectual disability (ID) and reflect underlying neuroanatomic findings, providing support for a distinctive phenotypic profile. This review updates what is known about the cognitive and behavioral phenotypes associated with DS across the lifespan. In early childhood, mild deviations from neurotypically developing trajectories emerge. By school-age, delays become pronounced. Nonverbal skills remain on trajectory for mental age, whereas verbal deficits emerge and persist. Nonverbal learning and memory are strengths relative to verbal skills. Expressive language is delayed relative to comprehension. Aspects of language skills continue to develop throughout adolescence, although language skills remain compromised in adulthood. Deficits in attention/executive functions are present in childhood and become more pronounced with age. Characteristic features associated with DS (cheerful, social nature) are personality assets. Children are at a lower risk for psychopathology compared to other children with ID; families report lower levels of stress and a more positive outlook. In youth, externalizing behaviors may be problematic, whereas a shift toward internalizing behaviors emerges with maturity. Changes in emotional/behavioral functioning in adulthood are typically associated with neurodegeneration and individuals with DS are higher risk for dementia of the Alzheimer's type. Individuals with DS possess many unique strengths and weaknesses that should be appreciated as they develop across the lifespan. Awareness of this profile by professionals and caregivers can promote early detection and support cognitive and behavioral development.

Psychopathology in Down Syndrome

“…Children with DS are more common to have externalizing behaviors than their siblings and peers despite being recognized as friendly, easygoing, good tempered, afectionate, and sympathetic individuals; these behaviors include hyperactivity, impulsivity, inatention, tantrums, agitation, stubbornness, disruptiveness/argumentativeness, oppositionality, repetitive movements, sensory dysregulation, and speech problems [3,5,6]. ADHD and anxiety comorbidities were found higher among individuals with DS-ID than in typically developed individuals [3,69].…”

“…The incidence of DS is about 1-1.5 of every 1000 live births. DS is the most frequent genetic cause of mental are more likely to have externalizing behaviors than their siblings and peers, including hyperactivity, impulsivity, inatention, tantrums, agitation, stubbornness, disruptiveness/argumentativeness, oppositionality, repetitive movements, sensory dysregulation, and speech problems despite being recognized as friendly, easygoing, good tempered, afectionate, and sympathetic individuals [3,5,6]. The rate of severe behavior disorder in children with DS is reported as 23% [7].…”

“…As for OCD, there is a lower prevalence of schizophrenia and bipolar disorder in individuals with DS [3]. In latest studies, the co-occurrence of DS and autism spectrum disorders (ASD) has increased ratio; approximately 6-10% of children have comorbid ASD [5]. Compared with the children with ASD in general, the children with DS are diagnosed with ASD in 6-16 years of age.…”

The Quality of Mainstreaming in Preschool: The Views of Parents of Children with Down Syndrome

“…Examinations made during pregnancy, along with advances in imaging and diagnostic techniques, provide detailed information about the kind of developmental differences that infants may experience (Farrel, Agatisa, & Nutter, 2014). Parents who are often unprepared for a negative picture have a baby with developmentally different and special needs, which also affects family patterns (Brynat, Puri, Dix, & Ahmed, 2016;Oktay & Unutkan, 2013;Skotko, 2015). DS, a disorder characterized by the division of chromosomes, is a syndrome of mental retardation that could be seen in every part of the world (Contestabile, Benfenati, & Gasparini, 2010).…”

Consideração da idade mental na avaliação do vocabulário expressivo de crianças com Síndrome de Down

“…The verbal and non-verbal mental age influence the cognitive flexibility of children with DS; there is a direct correlation between the verbal performance and the cognitive flexibility, and between the intellectual quotient and the functional, and participation development [5][6][7][8][9] .…”