# Executive Function Intervention for Young Children with Down Syndrome

> **NIH NIH R61** · COLORADO STATE UNIVERSITY · 2024 · $694,434

## Abstract

Abstract
Down syndrome (DS) is associated with executive function (EF) challenges throughout the lifespan. Although
early intervention has the potential for positive downstream effects on adaptation in DS, to date, intervention
approaches have not proactively aimed to strengthen EF foundations in ways that capitalize on early
neuroplasticity in this population. This R61/33 proposal will refine and test the effects of EXPO (EXecutive
Function Play Opportunities), a 12-week caregiver-mediated intervention designed to strengthen EF in young
children with DS. EXPO is tailored to the behavioral strengths and challenges associated with DS, thus reducing
cognitive and linguistic barriers to EF intervention participation. A preliminary implementation of EXPO during
Spring/Summer 2023 has demonstrated promising feasibility and acceptability trends, as well as preliminary
efficacy trends at the overall group level. Additionally, heterogeneity in child intervention response was also
observed, which likely corresponds to varying degrees of delay in developmental skill acquisition observed in this
population during childhood. In line with the growing recognition of the need for personalized and precision
approaches to intervention, in this project, we will transform EXPO into an adaptive intervention to better meet
the needs of children who are slower to respond to the current intervention design. During the R61 phase, we
will incorporate usability and feasibility caregiver feedback and the preliminary efficacy data from the
Spring/Summer 2023 trial to refine the structure, organization, and materials of EXPO. We anticipate that we
will develop two adaptive EXPO pathways to be subsequently tested and compared: (1) lengthening the duration
of EXPO to allow for more practice of each skill, and (2) augmenting EXPO with activities that strengthen play
foundations necessary for EXPO engagement (e.g., establishing social routines). During the R33 phase, we will
test the EXPO adaptive intervention conditions via a two-arm, Singly Randomized Trial. Findings from this
R61/33 project will yield a novel adaptive EF intervention designed to meet a wide range of needs within the
population of young children with DS, in preparation for a large Randomized Controlled Trial.

## Key facts

- **NIH application ID:** 10879710
- **Project number:** 1R61HD115161-01
- **Recipient organization:** COLORADO STATE UNIVERSITY
- **Principal Investigator:** DEBORAH J FIDLER
- **Activity code:** R61 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $694,434
- **Award type:** 1
- **Project period:** 2024-07-10 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10879710

## Citation

> US National Institutes of Health, RePORTER application 10879710, Executive Function Intervention for Young Children with Down Syndrome (1R61HD115161-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10879710. Licensed CC0.

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