# Cognitive Predictors of Adaptive Behaviour in Children With Down Syndrome: A Systematic Review

## TL;DR

This review explores what cognitive factors influence daily functioning in children with Down Syndrome, finding that executive functions are key predictors.

## Contribution

The study systematically identifies executive functions as the strongest predictors of adaptive behavior in children with Down Syndrome.

## Key findings

- Executive functions are the strongest predictors of adaptive behavior in children with Down Syndrome.
- General cognitive skills have smaller associations with adaptive behavior outcomes.
- Deficits in executive and intellectual functioning limit autonomy and everyday functioning in Down Syndrome.

## Abstract

Children with Down Syndrome, caused by trisomy 21, frequently exhibit deficits in adaptive behaviour. This systematic review aimed to identify predictors of adaptive behaviour in children with Down Syndrome.

The review followed PRISMA guidelines and was registered in PROSPERO (CRD420251071028). Searches were conducted in June 2025 in PsycINFO, Scopus, ERIC, Web of Science and PubMed.

A total of 257 articles were yielded, of which eight met the eligibility criteria. Across studies, executive functions consistently stood out as the strongest predictors of adaptive behaviour, explaining variance in communication, socialisation and daily living skills. General cognitive skills were also associated, although with smaller effects.

Overall, these findings highlight that deficits in executive and intellectual functioning constrain autonomy and everyday functioning in Down Syndrome, underscoring the importance of targeted interventions to improve adaptive outcomes.