The Complex Interplay of Cognition, Emotion, and Behavior in Children with Down Syndrome: A Comprehensive Review
DOI:
https://doi.org/10.64229/nxtbxj75Keywords:
Down Syndrome, Behavioral Phenotype, Intellectual Disability, Executive Function, Social Cognition, PsychopathologyAbstract
Down syndrome (DS), resulting from trisomy of chromosome 21, is the most common genetic cause of intellectual disability. The unique neurobiological profile associated with DS gives rise to a distinctive behavioral phenotype characterized by relative strengths in social functioning and pronounced challenges in expressive language, executive function, and psychological well-being. This review synthesizes current research on the psychological and behavioral profile of children with DS. We explore the cognitive underpinnings, including the dissociation between verbal and visuospatial processing, and the profound impact of executive dysfunction on daily functioning. The article delves into the socio-emotional domain, examining the purported social strengths while highlighting the risks for autism spectrum disorder, attention-deficit/hyperactivity disorder, and internalizing disorders like anxiety and depression. Furthermore, we analyze maladaptive behaviors, including non-compliance, impulsivity, and the emergence of challenging behaviors, linking them to underlying cognitive and communication deficits. The review also discusses the critical role of co-occurring medical conditions, such as sleep apnea and hearing loss, in exacerbating behavioral challenges. Finally, we outline evidence-based intervention strategies that target cognitive, communicative, and emotional regulation skills. By integrating findings from neuropsychology, behavioral science, and genetics, this paper provides a holistic overview of the mental and behavioral landscape of children with DS, emphasizing the need for a multidimensional, strengths-based approach to support and intervention. This review further incorporates a detailed analysis of the neurobiological underpinnings of executive dysfunction, explores the significant impact of sensory processing differences, and underscores the critical role of family systems and parental well-being in shaping developmental outcomes. The paper concludes with a forward-looking discussion on the implications for gene-brain-behavior research and the necessity of lifelong, adaptable support systems.
References
[1]Fidler, D. J. (2005). The emerging Down syndrome behavioral phenotype in early childhood: Implications for practice. Infants & Young Children, 18(2), 86-103. https://doi.org/10.1097/00001163-200504000-00003
[2]Grieco, J., Pulsifer, M., Seligsohn, K., Skotko, B., & Schwartz, A. (2015). Down syndrome: Cognitive and behavioral functioning across the lifespan. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 169(2), 135-149. https://doi.org/10.1002/ajmg.c.31439
[3]Chapman, R. S., & Hesketh, L. J. (2000). Behavioral phenotype of individuals with Down syndrome. Mental Retardation and Developmental Disabilities Research Reviews, 6(2), 84-95. https://doi.org/10.1002/1098-2779(2000)6:2<84::AID-MRDD2>3.0.CO;2-P
[4]Abbeduto, L., Warren, S. F., & Conners, F. A. (2007). Language development in Down syndrome: From the prelinguistic period to the acquisition of literacy. Mental Retardation and Developmental Disabilities Research Reviews, 13(3), 247-261. https://doi.org/10.1002/mrdd.20158
[5]Kumin, L. (2006). Speech intelligibility and childhood verbal apraxia in children with Down syndrome. Down Syndrome Research and Practice, 10(1), 10-22. https://doi.org/10.3104/reports.301
[6]Brock, J., & Jarrold, C. (2005). Serial order reconstruction in Down syndrome: Evidence for a selective deficit in verbal short-term memory. Journal of Child Psychology and Psychiatry, 46(3), 304-316. https://doi.org/10.1111/j.1469-7610.2004.00352.x
[7]Daunhauer, L. A., Fidler, D. J., Hahn, L., Will, E., Lee, N. R., & Hepburn, S. (2014). Profiles of everyday executive functioning in young children with Down syndrome. American Journal on Intellectual and Developmental Disabilities, 119(4), 303-318. https://doi.org/10.1352/1944-7558-119.4.303
[8]Rowe, J., Lavender, A., & Turk, V. (2006). Cognitive executive function in Down's syndrome. British Journal of Clinical Psychology, 45(1), 5-17. https://doi.org/10.1348/014466505X29594
[9]Lee, N. R., Fidler, D. J., Blakeley-Smith, A., Daunhauer, L., Robinson, C., & Hepburn, S. L. (2011). Caregiver report of executive functioning in a population-based sample of young children with Down syndrome. American Journal on Intellectual and Developmental Disabilities, 116(4), 290-304. https://doi.org/10.1352/1944-7558-116.4.290
[10]Naess, K. A. B., Lervåg, A., Lyster, S. A. H., & Hulme, C. (2015). Longitudinal relationships between language and verbal short-term memory skills in children with Down syndrome. Journal of Experimental Child Psychology, 135, 43-55. https://doi.org/10.1016/j.jecp.2015.02.004
[11]Cebula, K. R., Moore, D. G., & Wishart, J. G. (2010). Social cognition in children with Down's syndrome: Challenges to research and theory building. Journal of Intellectual Disability Research, 54(2), 113-134. https://doi.org/10.1111/j.1365-2788.2009.01215.x
[12]Warner, G., Moss, J., Smith, P., & Howlin, P. (2014). Autism characteristics and behavioural disturbances in ~500 children with Down's syndrome in England and Wales. Autism Research, 7(4), 433-441. https://doi.org/10.1002/aur.1371
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Toyuri Yeztriski (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
