Profiles of everyday executive functioning in relation to adaptive behaviour in children and adolescents with Down syndrome

Executive functions (EF) are higher-order cognitive processes that support goal-directed behaviour. Previous research has shown that individuals with Down syndrome (DS) often experience EF impairments, with a profile of strengths and weaknesses. However within-group variability remains underexplored.

The present study aimed to explore EF profiles in 111 children and adolescents with DS aged 7–17 years using caregiver-reported data from the BRIEF-2 scales. A latent profile analysis was conducted to derive EF subgroups and it revealed a three-profile solution: a Clinically Elevated Profile, characterised by widespread EF difficulties; a Moderate Difficulties Profile, with milder and more selective impairments; and a Preserved Profile, with scores largely within the normative range. These profiles differed in both overall severity and domain-specific configuration of EF.

Significant differences emerged between the profiles in adaptive behaviour, assessed using Vineland-II standard scores, but not in verbal or non-verbal cognitive abilities, evaluated using the WPPSI-III. The most consistent effects were observed in Socialization. These findings demonstrate meaningful EF heterogeneity in school-aged children with DS and underscore the value of person-centered approaches in assessment and intervention, with important implications for individualised educational and clinical support.

This research was co-funded by the Italian Complementary National Plan PNC-I.1 “Research initiatives for innovative technologies and pathways in the health and welfare sector” Ministerial Decree D.D. 931 of June 6, 2022, within the initiative “DARE – DigitAl lifelong pRevEntion” initiative, code PNC0000002. Fundings for Mi.Ci. (CUP: B53C22006450001), S.O. (CUP: B53C22006250001) and G.S. (CUP: B53C22006490001) derive from this project. Cognitive and behavioural evaluations were supported by a donation from SVS S.r.l.

Department of Developmental Psychology and Socialization, University of Padua, Via Venezia 16, 35131, Padua, Italy Elisa Rossi, Sara Onnivello, Chiara Marcolin, Aurora Platè, Sara Colaianni & Silvia Lanfranchi Neonatal Intensive Care Unit, IRCCS Azienda Ospedaliera-Universitaria di Bologna (A.O.U.BO), Bologna, Italy Department of Medical and Surgical Science (DIMEC), University of Bologna, Bologna, Italy Unit of Histology, Embryology and Applied Biology, Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy Specialty School of Child Neuropsychiatry, Alma Mater Studiorum, University of Bologna, Bologna, Italy The authors declare no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material.

You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.