Cognitive development and adaptive functions in children with Down syndrome at different developmental stages

Renata Nacinovich 1,2,3, Monica Bomba 1, Silvia Oggiano 2, Simona Di Guardo 2, Fiorenza Broggi 2, Andrea E. Cavanna 4,5,6

1 Clinic of Child and Adolescent Neuropsychiatry, San Gerardo Hospital, Monza, Italy; 2 Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy; 3 Milan Center for Neuroscience (Neuro-MI), Milan, Italy; 4 Department of Neuropsychiatry, BSMHFT and University of Birmingham, United Kingdom; 5 Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology and University College London, United Kingdom; 6 School of Life and Health Sciences, Aston Brain Centre, Aston University, Birmingham, United Kingdom


Children with Down syndrome (DS) have learning difficulties resulting in mild to severe intellectual disability, whereas their adaptive functions are generally more preserved. Little is known about the developmental trajectories of cognitive and adaptive functions in this population. In the present study, cognitive and adaptive functions were assessed in children with DS at different developmental stages. 


Cognitive and adaptive functions were assessed in a total of 53 children with DS: 20 children aged 2 to 6 and 33 children aged 10 to 15. Cognitive development was assessed using the Griffiths Mental Development Scales 2-8 for younger children and the Wechsler Intelligence Scale for Children-Fourth Edition for older children. Adaptive functions were evaluated with the Vineland Adaptive Behavior Scale in both age groups.


Among cognitive functions, working memory was the most significantly affected, whereas the visuo-spatial component was relatively preserved. In terms of adaptive functions, children reported the lowest mental age in the expressive communication domain, and the highest mental age in the daily living skills. Adaptive functions were comparatively worse in the older group, whereas cognitive profiles were impaired to a similar degree between the two age groups.


Adaptive functions appear to be relatively more impaired than cognitive functions in older children with DS. The increasing demands from the environment that children have to deal with during pre-adolescence and adolescence might contribute to selectively affect their adaptive skills.

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