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The Relationship between Different Levels of Autonomy, Inhibition Dimensions and Working Memory in People with Down Syndrome

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Title: The Relationship between Different Levels of Autonomy, Inhibition Dimensions and Working Memory in People with Down Syndrome
Language: English
Authors: Martina Fontana, Sandra Pellizzoni, Maria Chiara Passolunghi
Source: International Journal of Disability, Development and Education. 2025 72(1):102-116.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 15
Publication Date: 2025
Document Type: Journal Articles
Reports - Research
Descriptors: Inhibition, Short Term Memory, Personal Autonomy, Down Syndrome, Adolescents, Adults, Foreign Countries
Geographic Terms: Italy
Assessment and Survey Identifiers: Raven Progressive Matrices, Matching Familiar Figures Test
DOI: 10.1080/1034912X.2024.2337171
ISSN: 1034-912X
1465-346X
Abstract: Inhibition and Working Memory (WM) are crucial predictors of everyday life autonomies in people with Down Syndrome (DS). We aimed to investigate the possible relationship between different levels of autonomy, inhibitory sub-components and WM in people with DS. Twenty-two adolescents and adults with DS were enrolled in the study and were assessed with tasks tapping on response inhibition, interference suppression and WM. With a questionnaire on levels of autonomy, educators evaluated the sample with DS. Considering levels of autonomy, we divided participants into two groups: one with lower levels of autonomy and one with medium-to-high levels of autonomy. Results showed differences between the two groups in WM tasks and both inhibitory dimensions. More specifically, interference suppression seems to have a major role in the acquisition of important, more structured aspects of autonomy such as shopping, behaviour on the road, communication and reading-writing skills. On the other hand, response inhibition seems to be linked to crucial aspects of learning, such as reading and writing and handling a telephone. The results are discussed in terms of possible implementation in training in clinical and educational settings.
Abstractor: As Provided
Entry Date: 2024
Accession Number: EJ1454192
Database: ERIC
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  Value: <anid>AN0181776757;54q01jan.25;2024Dec23.04:20;v2.2.500</anid> <title id="AN0181776757-1">The Relationship Between Different Levels of Autonomy, Inhibition Dimensions and Working Memory in People with Down Syndrome </title> <p>Inhibition and Working Memory (WM) are crucial predictors of everyday life autonomies in people with Down Syndrome (DS). We aimed to investigate the possible relationship between different levels of autonomy, inhibitory sub-components and WM in people with DS. Twenty-two adolescents and adults with DS were enrolled in the study and were assessed with tasks tapping on response inhibition, interference suppression and WM. With a questionnaire on levels of autonomy, educators evaluated the sample with DS. Considering levels of autonomy, we divided participants into two groups: one with lower levels of autonomy and one with medium-to-high levels of autonomy. Results showed differences between the two groups in WM tasks and both inhibitory dimensions. More specifically, interference suppression seems to have a major role in the acquisition of important, more structured aspects of autonomy such as shopping, behaviour on the road, communication and reading-writing skills. On the other hand, response inhibition seems to be linked to crucial aspects of learning, such as reading and writing and handling a telephone. The results are discussed in terms of possible implementation in training in clinical and educational settings.</p> <p>Keywords: Down syndrome; autonomy; adaptive behaviour; response inhibition; interference suppression; working memory</p> <hd id="AN0181776757-2">Introduction</hd> <p>Down syndrome (DS) is the most common form of Intellectual Disability (ID) with a prevalence of 1 in 700 newborns (Mégarbané et al., [<reflink idref="bib32" id="ref1">32</reflink>]; Sherman et al., [<reflink idref="bib43" id="ref2">43</reflink>]). The focus of the literature has shifted, in recent years, from the deficits to the abilities of people with DS, paying more attention to their inclusion, autonomy, community participation, quality of life and self-determination (Shogren & Shaw, [<reflink idref="bib44" id="ref3">44</reflink>]). DiMaggio et al. ([<reflink idref="bib17" id="ref4">17</reflink>]), reported that the high-frequency goals referred to people with ID consisted of satisfaction of needs of autonomy, to have economic independence and build up stable interpersonal relationships. The more balanced observations on the strengths and weaknesses of people with DS, from both the cognitive and the behavioural points of view, suggest difficulties more in specific executive functions, and less in social behaviour and emotional control, when compared with the typically-developing (TD) population (Daunhauer et al., [<reflink idref="bib14" id="ref5">14</reflink>]; Will et al., [<reflink idref="bib57" id="ref6">57</reflink>]).</p> <p>Several studies on people with DS investigate different components of Executive Functions (EFs), an umbrella term used to identify a set of cognitive processes that enable us to plan, focus attention, remember data and juggle multiple tasks successfully. A variety of abilities such as Working Memory (WM), Inhibition and Cognitive Flexibility are defined as core aspects of EFs (Diamond, [<reflink idref="bib16" id="ref7">16</reflink>]; Miyake et al., [<reflink idref="bib33" id="ref8">33</reflink>]).</p> <p>In particular, literature on DS investigated the role of WM, a limited-space memory that enables us to store information and process it while completing cognitive tasks (A. Baddeley, [<reflink idref="bib2" id="ref9">2</reflink>]). According to the multi-componential model proposed by A. D. Baddeley and Hitch ([<reflink idref="bib3" id="ref10">3</reflink>]), WM comprises two 'slave' systems involved in retaining verbal and visuospatial information (the phonological loop and visuospatial sketchpad), and a central executive system responsible for controlling and regulating different cognitive activities, and for coordinating the flow of information between the two slave systems. It is generally agreed that people with DS have more pronounced verbal than visuospatial WM impairments (Lanfranchi et al., [<reflink idref="bib27" id="ref11">27</reflink>]; Loveall et al., [<reflink idref="bib29" id="ref12">29</reflink>]), although several studies found that some aspects of visuospatial WM – such as the spatial-simultaneous component – are less well preserved than others (for a review, Yang et al., [<reflink idref="bib58" id="ref13">58</reflink>]).</p> <p>While findings concerning WM in DS seem to be fairly consistent, those regarding another top-down general-domain function – inhibition – have been more contradictory. Inhibition is defined as a multi-componential construct that enables us to control our mental processes, ignore a given internal or external prompt and take alternative action (Diamond, [<reflink idref="bib16" id="ref14">16</reflink>]). Although they acknowledged the crucial influence of inhibition on academic achievement, self-regulation, emotional control, adaptive social skills and everyday life activities (Nakamichi, [<reflink idref="bib35" id="ref15">35</reflink>]; Pellizzoni et al., [<reflink idref="bib38" id="ref16">38</reflink>], [<reflink idref="bib37" id="ref17">37</reflink>]; Will et al., [<reflink idref="bib57" id="ref18">57</reflink>]), most studies on people with DS did not distinguish between the various components of this construct. Traverso et al. ([<reflink idref="bib51" id="ref19">51</reflink>]) recently showed that a two-factor model that distinguished between response inhibition (i.e. the ability to suppress dominant and impulsive responses and behaviours) and interference suppression (i.e. the ability to ignore distracting information or suppress competing stimuli) was better able to describe the inhibitory performance of both 5- to 6-year-old TD children and adolescents with DS. The authors demonstrated that both response inhibition and interference suppression develop later in people with DS than in TD children, and that individuals with DS have more severe impairments in the <emph>more complex</emph> interference suppression dimension (see also Fontana, Usai, & Passolunghi, [<reflink idref="bib21" id="ref20">21</reflink>]), which places a heavier load on WM (for a review, Best & Miller, [<reflink idref="bib7" id="ref21">7</reflink>]). Specifically, Fontana, Usai, Pellizzoni, et al. ([<reflink idref="bib22" id="ref22">22</reflink>]) suggested that individuals with DS showed an overall worse performance compared to TD children on response inhibition and delay of gratification, while no differences emerged on the interference suppression dimension. Comparing two groups of individuals with DS with different chronological age, authors indicated that older individuals with DS outperformed the younger ones both in response inhibition and in the delay of gratification, whereas the interference suppression still remains impaired in adulthood.</p> <p>Another crucial issue concerns the fact that some studies using inhibitory tasks reported much the same performance between people with DS and TD children (e.g. Carney et al., [<reflink idref="bib10" id="ref23">10</reflink>]; Daunhauer et al., [<reflink idref="bib14" id="ref24">14</reflink>]), while other studies pointed to a worse performance in the former (e.g. Amadó et al., [<reflink idref="bib1" id="ref25">1</reflink>]; Lanfranchi et al., [<reflink idref="bib28" id="ref26">28</reflink>]), or found mixed results when tasks tapping different inhibitory dimensions were administered (e.g. Borella et al., [<reflink idref="bib8" id="ref27">8</reflink>]; Costanzo et al., [<reflink idref="bib13" id="ref28">13</reflink>]; Traverso et al., [<reflink idref="bib51" id="ref29">51</reflink>]). The results of studies assessing inhibition with questionnaires were also few and inconsistent due to the type of matching used, e.g. by chronological or mental age (Loveall et al., [<reflink idref="bib29" id="ref30">29</reflink>]); and whether the raters were parents/caregivers or teachers (Gioia et al., [<reflink idref="bib24" id="ref31">24</reflink>]). In fact, as reported by Gioia et al. ([<reflink idref="bib24" id="ref32">24</reflink>]), only small-to-medium correlations emerged between parent' and teacher' reports, suggesting that EF performance may be interpreted differently by the two raters and the EF's demand may vary across school and home environments.</p> <hd id="AN0181776757-3">Autonomy, Independence, Adaptive Behaviour and Inhibition in Down Syndrome</hd> <p>Autonomy generally refers to two aspects: independence and volition. While, on the one hand, there is considerable congruence between these two concepts, on the other hand, autonomy is not only the possibility to act more independently (Wehmeyer et al., [<reflink idref="bib56" id="ref33">56</reflink>]) but also to <emph>behave like an adult</emph> and, by working first on the identity of adolescent and then on that of adult, learning <emph>how to be an adult</emph> (Contardi, [<reflink idref="bib12" id="ref34">12</reflink>]). Autonomous individuals display behaviours that are internally directed, they make choices and decisions without improper external influence (Deci & Ryan, [<reflink idref="bib15" id="ref35">15</reflink>]), and these choices are authentic reflections of self. Autonomy and independence are not synonymous: independence, in fact, implies being able to function self-sufficiently without the assistance of others, autonomy is defined within self-determination theory as volitional or self-endorsed functioning (Soenens et al., [<reflink idref="bib46" id="ref36">46</reflink>]). Often people with DS lives are complicated by restricted opportunities for independent living, and substantial under employment (Jobling & Cuskelly, [<reflink idref="bib25" id="ref37">25</reflink>]). At least in part, these aspects may be attributable to scarce levels of autonomy promoted in these people (Clark et al., [<reflink idref="bib11" id="ref38">11</reflink>]) this could be due to the scarce opportunities available to an individual with DS to acquire self-determination skills, as well as a deficit in the necessary skills to act autonomously (Van Gameren-Oosterom et al., [<reflink idref="bib55" id="ref39">55</reflink>]; Zigler et al., [<reflink idref="bib59" id="ref40">59</reflink>]).</p> <p>A variable that is often described at the base of Autonomy is the Adaptive behaviour (AB) (Schalock et al., [<reflink idref="bib42" id="ref41">42</reflink>]). This factor is a set of abilities fundamental to everyday life and to our achieving a good degree of autonomy and independence. It is well documented that different levels of autonomy and AB are crucial for both employment outcomes and for a future independent (Contardi, [<reflink idref="bib12" id="ref42">12</reflink>]; Tomaszewski et al., [<reflink idref="bib50" id="ref43">50</reflink>]). AB demands three sets of skills: conceptual (e.g. language, understanding money, time and numbers); social (e.g. following rules, interpersonal abilities, social problem solving); and practical (e.g. personal care, handling money, using transports) (Tassé et al., [<reflink idref="bib48" id="ref44">48</reflink>]). AB is usually found impaired in individuals with DS (Steingass et al., [<reflink idref="bib47" id="ref45">47</reflink>]), who have difficulties especially with managing money, cooking, moving in the community, organising their time, functional academics and shopping (Tomaszewski et al., [<reflink idref="bib50" id="ref46">50</reflink>]). Most researchers judge socialisation and practical skills to be relative strengths in people with DS, and identify conceptual, communication and motor skills as weaknesses (Fidler et al., [<reflink idref="bib20" id="ref47">20</reflink>]). Contradictory findings have emerged; however, the DS population's developmental trajectories have been assessed. For instance, Tomaszewski et al. ([<reflink idref="bib50" id="ref48">50</reflink>]) reported that social skills remain a strength in adults with DS, while communication and practical skills are relatively weak. Makary et al. ([<reflink idref="bib30" id="ref49">30</reflink>]) found instead that practical skills remained stable in adolescence and adulthood, while conceptual and social skills declined over time. Other researchers found that abilities gradually declined in the areas of independence, communication and social skills in adults with DS beyond 30 (Bertoli et al., [<reflink idref="bib6" id="ref50">6</reflink>]) or 40 years of age (Esbensen et al., [<reflink idref="bib19" id="ref51">19</reflink>]; Sabat et al., [<reflink idref="bib41" id="ref52">41</reflink>]).</p> <p>As observed in the last paragraph, the components related to AB have been evaluated but leaving almost unexplored the construct of autonomy and its core aspect specifically related to decision-making and choices. Furthermore, as mentioned earlier, inhibitory skills and WM play a fundamental part in various crucial abilities needed in daily life (Nakamichi, [<reflink idref="bib35" id="ref53">35</reflink>]; Will et al., [<reflink idref="bib57" id="ref54">57</reflink>]). Their impairment in people with DS has been thought to be responsible for their social behaviour (Porter et al., [<reflink idref="bib39" id="ref55">39</reflink>]), and inhibition is considered a crucial predictor of anyone's ability to adapt their behaviour to their environment. Sabat et al. ([<reflink idref="bib41" id="ref56">41</reflink>]) recently found in a sample of individuals with DS that WM significantly predicted their conceptual AB, rather than inhibition or flexibility, based on their parents' reports, whereas the reverse was true when they were rated by their teachers. The authors suggested that WM plays a more important part in the conceptual skills needed in activities at home, while the school environment demands increasing levels of autonomy and the inhibition of inappropriate responses in people's actions and behaviour.</p> <hd id="AN0181776757-4">The Present Study</hd> <p>In general terms, the present study aimed to better investigate how specific cognitive functions could be related to an autonomous behaviour in daily life. More specifically, we are interested in evaluating a) the relationship between specific aspects of autonomy (e.g. socialisation, communication, handling money and using shops and personal hygiene and self-care) and abilities in some aspects of EFs such as response inhibition, interference suppression and WM (Will et al., [<reflink idref="bib57" id="ref57">57</reflink>]); and b) differences on WM and inhibitory performance between the two groups of participants with DS, one with lower levels of autonomy (LA) and the other with medium-to-high levels of autonomy (MHA) (Porter et al., [<reflink idref="bib39" id="ref58">39</reflink>]).</p> <hd id="AN0181776757-5">Materials and Methods</hd> <p></p> <hd id="AN0181776757-6">Participants</hd> <p>Our initial sample was composed of 26 participants, but we subsequently excluded four participants (two who had a known comorbid psychiatric or neurodevelopmental disorder and two who failed to complete all the required tests).</p> <p>The final sample was composed of 22 adolescents and adults with DS (13 females and 9 males) with a mean chronological age of 25.3 years (SD = 10.7, range: 13.3–53.3 years) and a mean mental age of 7.7 years (SD = 1.7). Mental age was assessed using the Coloured Progressive Matrices (Belacchi et al., [<reflink idref="bib5" id="ref59">5</reflink>]; Raven, [<reflink idref="bib40" id="ref60">40</reflink>]). All participants live with their families. Eight of them go to school, 11 are employed and 3 attend day-cares. All individuals had a confirmed diagnosis of DS (based on karyotype). Furthermore, we divided participants into two groups on the basis of their levels of autonomy. From the entire sample, we considered each participant that performed under one standard deviation by the mean score as belonging to the low-levels of autonomy (LA) group (<emph>N</emph> = 12), while participants that performed one standard deviation above the mean score were included in the medium–high levels of autonomy (MHL) (<emph>N</emph> = 10).</p> <hd id="AN0181776757-7">Measures</hd> <p>The <emph>Coloured Progressive Matrices</emph> test (Belacchi et al., [<reflink idref="bib5" id="ref61">5</reflink>]; Raven, [<reflink idref="bib40" id="ref62">40</reflink>]) was administered to measure fluid intelligence. This multiple-choice task consists of 36 items that vary in difficulty. Respondents see a target geometrical figure and are asked to choose which one of six items correctly completes the figure. The experimenter awards one point for each correct answer and the sum of the correct answers gives the final score (range: 0–36). The test–retest reliability was.83.</p> <hd id="AN0181776757-8">Inhibition Tasks</hd> <p>The <emph>Preschool Matching Familiar Figure task</emph> (PMFFT, Usai et al., [<reflink idref="bib54" id="ref63">54</reflink>]) assesses respondents' ability to inhibit impulsive responses and shift their attention from a target figure to other options. There is a target figure, shown at the top of a page, and respondents have to choose which one of five options underneath it is identical to the target figure, and point their finger at the right one. The task continues until the subject identifies the right figure. The number of errors (range: 0–56), and the mean latency from the presentation of a figure to a participant's response (range: 0 - no limit) were recorded. The test–retest reliability was.49 (Marzocchi et al., [<reflink idref="bib31" id="ref64">31</reflink>]).</p> <p>The <emph>Fish Flanker task</emph> (Usai et al., [<reflink idref="bib54" id="ref65">54</reflink>]), the flanker paradigm is used to assess interference suppression ability. In this computerised version, participants see three fish on screen: the one in the middle is the target fish, and the two fish flanking it may point in the same direction or in the opposite direction. Participants were asked to press a left or right button on the keyboard depending on the direction of the two flankers. A warning cross appeared for 500 ms before each stimulus, and the screen remained blank for another 500 ms after participants had given their answer. After training with two items for each condition, participants were shown with 48 randomised items (16 for each condition, half with the flanker fish facing right, and the other half with them facing left). The number of correct answers (range: 0–16), and the response times for the incongruent condition were recorded. The test–retest reliability was.50 (Usai et al., [<reflink idref="bib54" id="ref66">54</reflink>]).</p> <hd id="AN0181776757-9">Working Memory (WM) Tasks</hd> <p>The <emph>Visuospatial WM task</emph> (Lanfranchi et al., [<reflink idref="bib27" id="ref67">27</reflink>]) requires lower levels of WM control. Participants were given a 3 × 3 or 4 × 4 chessboard and two small plastic frogs. The experimenter showed a sequence of jumps on the chessboard (more than one jump every 2 s) and participants had to repeat it immediately afterwards, moving their frog from cell to cell. The level of difficulty increased, with more jumps to remember and the larger size of the chessboard (i.e. from 3 × 3 to 4 × 4). The experimenter awarded 1 point if the whole sequence was repeated correctly and 0 otherwise. The test–retest reliability was.36 (Lanfranchi et al., [<reflink idref="bib28" id="ref68">28</reflink>]).</p> <p>The <emph>Visuospatial dual task</emph> (Lanfranchi et al., [<reflink idref="bib27" id="ref69">27</reflink>]) involved stimuli presented on a 3 × 3 chessboard (with one of the 9 cells coloured red). Participants were asked to remember the frog's starting position and also to tap on the table when the frog jumped onto the red cell. The position of the red cell changed from one trial to the next. If participants remembered the frog's starting position and tapped on the table when the frog jumped on a red square, the experimenter awarded one point; if not, they scored 0. The test–retest reliability was.71 (Lanfranchi et al., [<reflink idref="bib28" id="ref70">28</reflink>]).</p> <hd id="AN0181776757-10">Autonomy questionnaire</hd> <p>To assess different aspects of autonomy, we used a questionnaire developed by Contardi ([<reflink idref="bib12" id="ref71">12</reflink>]) for the Italian Association for People with Down syndrome (AIPD) and for people with intellectual disabilities. The questionnaire is composed of 82 items divided into 11 sub-scales as described in Table 1. A score of 1 is assigned for the answer 'no', a score of 2 is assigned if the person with DS needs help to perform a given task, a score of 3 is assigned if the person with DS performs the task only if expressly asked, and a score of 4 is assigned if the answer is 'yes'.</p> <p>Table 1. Description of the autonomy questionnaire developed by Contardi ([<reflink idref="bib12" id="ref72">12</reflink>]).</p> <p> <ephtml> <table><thead><tr><td /><td>Example of items</td><td>Number of items</td><td>Min-Max score</td><td><italic>Chronbach's alpha</italic></td></tr></thead><tbody><tr><td>Socialisation</td><td><italic>He/she respects the person with whom he/she is related</italic>. <italic>He/she greets the persons of the group.</italic></td><td>8</td><td>8–32</td><td>.68</td></tr><tr><td>Communication</td><td><italic>He/she describes personal experiences</italic>. <italic>He/she communicates needs and desires.</italic></td><td>12</td><td>12–48</td><td>.74</td></tr><tr><td>Choose</td><td><italic>He/she is proactive towards the group.</italic></td><td>8</td><td>8–32</td><td>.78</td></tr><tr><td /><td><italic>He/she listens and chooses the activities he/she prefers.</italic></td><td /><td /><td /></tr><tr><td>Orientation</td><td><italic>He/she knows how to ask for information</italic>. <italic>He/she knows how to cross the road.</italic></td><td>12</td><td>12–48</td><td>.65</td></tr><tr><td>Transports</td><td><italic>He/she identifies the number/name of the transport</italic>. <italic>He/she validates the ticket.</italic></td><td>6</td><td>6–24</td><td>.82</td></tr><tr><td>Money</td><td><italic>He/she recognizes and distinguishes 1, 2, 5, and 10 euro</italic>. <italic>He/she recognizes all kinds of shops.</italic></td><td>11</td><td>11–44</td><td>.69</td></tr><tr><td>Time</td><td><italic>He/she can read the time</italic>. <italic>He/she is able at managing time.</italic></td><td>4</td><td>4–16</td><td>.73</td></tr><tr><td>Phone</td><td><italic>He/she uses the mobile phone</italic>. <italic>He/she uses the phone appropriately to communicate.</italic></td><td>7</td><td>7–28</td><td>.71</td></tr><tr><td>R-W</td><td><italic>He/she can read the words</italic>. <italic>He/she knows how to write words.</italic></td><td>5</td><td>5–20</td><td>.80</td></tr><tr><td>Care</td><td><italic>He/she washes himself/herself</italic>. <italic>He/she pays attention to his own things.</italic></td><td>5</td><td>5–20</td><td>.73</td></tr><tr><td>Unexpected</td><td><italic>He/she never got lost</italic>. <italic>He/she knows how to refuse inadequate help.</italic></td><td>4</td><td>4–16</td><td>.79</td></tr></tbody></table> </ephtml> </p> <p>1 Choose, ability to choose and proactive behaviour; Orientation, orientation and behaviour on the road; Transports, use of public transport; Money, handling money and using shops; Time, orientation in time; Phone, handling the telephone; R-W, reading and writing skills; Care, personal hygiene and self-care; Unexpected, unexpected situations.</p> <hd id="AN0181776757-11">Procedure</hd> <p>Adults with DS, the parents of adolescents with DS and the educators read, accepted and signed the written informed consent form in accordance with the Declaration of Helsinki. This study was conducted in accordance with the ethical guidelines of the Italian Association of Psychology and the ethical code of the Italian Register of Professional Psychologists. All participants were tested in a quiet room in different headquarters of Associations for people with DS during two separate sessions, each lasting about 20–30 min. Professional educators belonged to the same Associations and therefore working closely with individuals with DS, completed the Autonomy questionnaire during their team meetings.</p> <hd id="AN0181776757-12">Results</hd> <p>All statistical analyses were run with Jamovi Version 1.1. To test our first hypothesis, we conducted a linear correlation analysis using Pearson <emph>r</emph> between inhibitory and WM tasks and the Autonomy questionnaire subscales for the whole sample with DS. Further, a series of independent-samples Mann-Whitney <emph>U</emph> tests were run to evaluate possible differences in types of inhibition and WM in lower (LA) and medium-to-high (MHA) levels of autonomy.</p> <p>Correlation analysis between Autonomy questionnaire, response inhibition task, interference suppression task and WM task is reported in Table 2. Specifically, the PMFFT (i.e. response inhibition measure) response time showed significant correlations with the ability to choose (<emph>r</emph> = −.45), handling the phone (<emph>r</emph> =.53); while the accuracy score significantly correlates with orientation in time (<emph>r</emph> = −.54), reading-writing skills (<emph>r</emph> = −.45), personal hygiene and self-care (<emph>r</emph> = −.43). The Flanker task (i.e. interference suppression measure) accuracy correlates with use of public transports (<emph>r</emph> =.44), orientation in time (<emph>r</emph> =.53), handling phone (<emph>r</emph> =.53), personal hygiene and self-care (<emph>r</emph> = −.47) and with PMFFT response time (<emph>r</emph> =.46); while the response time score significantly correlates with ability to choose and proactive behaviour (<emph>r</emph> = −.53), handling money and using shops (<emph>r</emph> = −.43), PMFFT errors (<emph>r</emph> =.57) and Flanker accuracy (<emph>r</emph> =.49). Finally, the WM visuo-spatial task significantly correlates with orientation and behaviour on the road (<emph>r</emph> =.68), while the dual task correlates with the use of public transport (<emph>r</emph> =.47), handling money and using shops (<emph>r</emph> =.70), orientation in time (<emph>r</emph> =.45), PMFFT response time (<emph>r</emph> =.56), Flanker accuracy (<emph>r</emph> = −.50). Furthermore, the CPM score (i.e. non-verbal mental age measure) significantly correlates with the Total score of the Autonomy questionnaire (<emph>r</emph> =.43, <emph>p</emph> =.05).</p> <p>Table 2. Pearson's correlations through inhibitory tasks, working memory tasks and sub-scales of the autonomy questionnaire.</p> <p> <ephtml> <table><thead><tr><td /><td><italic>Investigated skills</italic></td><td>1</td><td>2</td><td>3</td><td>4</td><td>5</td><td>6</td><td>7</td><td>8</td><td>9</td><td>10</td><td>11</td><td>12</td><td>13</td><td>14</td><td>15</td><td>16</td><td>17</td><td>18</td></tr></thead><tbody><tr><td>1.Socialisation</td><td><italic>Autonomy</italic></td><td>1</td><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /></tr><tr><td>2.Communication</td><td><italic>Autonomy</italic></td><td>.03</td><td>1</td><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /></tr><tr><td>3. Choose</td><td><italic>Autonomy</italic></td><td>.22</td><td>.26</td><td>1</td><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /></tr><tr><td>4.Orientation</td><td><italic>Autonomy</italic></td><td>.20</td><td>.34</td><td>.04</td><td>1</td><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /></tr><tr><td>5.Transport</td><td><italic>Autonomy</italic></td><td>.02</td><td>.25</td><td>.26</td><td>.76***</td><td>1</td><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /></tr><tr><td>6.Money</td><td><italic>Autonomy</italic></td><td>−.13</td><td>.02</td><td>−.04</td><td>.56**</td><td>.47*</td><td>1</td><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /></tr><tr><td>7.Time</td><td><italic>Autonomy</italic></td><td>.30</td><td>.16</td><td>−.01</td><td>.72***</td><td>.55**</td><td>.63**</td><td>1</td><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /></tr><tr><td>8.Phone</td><td><italic>Autonomy</italic></td><td>.11</td><td>.05</td><td>.02</td><td>.11</td><td>−.16</td><td>.29</td><td>.31</td><td>1</td><td /><td /><td /><td /><td /><td /><td /><td /><td /><td /></tr><tr><td>9.R-W</td><td><italic>Autonomy</italic></td><td>−.20</td><td>.16</td><td>.02</td><td>.25</td><td>.19</td><td>.68***</td><td>.53*</td><td>.39</td><td>1</td><td /><td /><td /><td /><td /><td /><td /><td /><td /></tr><tr><td>10.Care</td><td><italic>Autonomy</italic></td><td>−.11</td><td>−.07</td><td>−.16</td><td>.04</td><td>−.27</td><td>.02</td><td>−.01</td><td>.34</td><td>−.10</td><td>1</td><td /><td /><td /><td /><td /><td /><td /><td /></tr><tr><td>11.Unexpected</td><td><italic>Autonomy</italic></td><td>−.11</td><td>.02</td><td>.33</td><td>.13</td><td>.41</td><td>.17</td><td>−.10</td><td>−.52*</td><td>−.05</td><td>−.32</td><td>1</td><td /><td /><td /><td /><td /><td /><td /></tr><tr><td>12.Tot autonomy</td><td><italic>Autonomy</italic></td><td>.19</td><td>.49*</td><td>.42*</td><td>.78***</td><td>.69***</td><td>.69***</td><td>.70***</td><td>.34</td><td>.56**</td><td>.01</td><td>.26</td><td>1</td><td /><td /><td /><td /><td /><td /></tr><tr><td>13.PMFFT rt</td><td><italic>Inhibition</italic></td><td>.39</td><td>−.45*</td><td>−.34</td><td>.13</td><td>.04</td><td>.20</td><td>.53*</td><td>.33</td><td>.17</td><td>.22</td><td>−.25</td><td>.08</td><td>1</td><td /><td /><td /><td /><td /></tr><tr><td>14.PMFFT err</td><td><italic>Inhibition</italic></td><td>−.01</td><td>−.19</td><td>−.22</td><td>−.28</td><td>−.35</td><td>−.54**</td><td>−.34</td><td>−.45*</td><td>−.43*</td><td>−.07</td><td>.25</td><td>−.49*</td><td>−.11</td><td>1</td><td /><td /><td /><td /></tr><tr><td>15.Flanker acc</td><td><italic>Inhibition</italic></td><td>.25</td><td>.18</td><td>−.03</td><td>.44*</td><td>.27</td><td>.53*</td><td>.53*</td><td>.29</td><td>.47*</td><td>−.01</td><td>−.30</td><td>.46*</td><td>.19</td><td>−.32</td><td>1</td><td /><td /><td /></tr><tr><td>16.Flanker rt</td><td><italic>Inhibition</italic></td><td>.26</td><td>−.53*</td><td>−.42</td><td>−.15</td><td>−.43*</td><td>−.22</td><td>.15</td><td>−.01</td><td>−.05</td><td>.11</td><td>−.13</td><td>−.34</td><td>.57**</td><td>.49*</td><td>−.16</td><td>1</td><td /><td /></tr><tr><td>17.WM v-s</td><td><italic>Working memory</italic></td><td>.18</td><td>.06</td><td>.68***</td><td>.03</td><td>.24</td><td>.21</td><td>−.04</td><td>.16</td><td>.19</td><td>−.16</td><td>.08</td><td>.33</td><td>−.30</td><td>−.42</td><td>.22</td><td>−.62**</td><td>1</td><td /></tr><tr><td>18.WM dual</td><td><italic>Working memory</italic></td><td>.07</td><td>.19</td><td>.19</td><td>.47*</td><td>.70***</td><td>.45*</td><td>.39</td><td>.04</td><td>.32</td><td>−.20</td><td>.22</td><td>.56**</td><td>.07</td><td>−.50*</td><td>.34</td><td>−.38</td><td>.40</td><td>1</td></tr></tbody></table> </ephtml> </p> <ulist> <item>2 *<emph>p</emph> <.05, **<emph>p</emph> <.01, ***<emph>p</emph> <.001.</item> <item>3 Socialisation; Choose, ability to choose and proactive behaviour; Orientation, orientation and behaviour on the road; Transports, use of public transport; Money, handling money and using shops; Time, orientation in time; Phone, handling the telephone; R-W, reading and writing skills; Care, personal hygiene and self-care; Unexpected, unexpected situations; Tot autonomy, total score of Autonomy questionnaire; PMFFT, Preschool Matching Familiar Figure Task; WM v-s, visuo-spatial working memory task; WM dual, working memory dual task.</item> </ulist> <p>Descriptive statistics are reported in Table 3. A series of independent-samples Mann-Whitney <emph>U</emph> tests for chronological age, mental age and levels of autonomy for the two groups were conducted. No differences emerged between the LA and the MHA groups for chronological age (<emph>U</emph> = 51.00, <emph>p = 0.94</emph>), but significant differences emerged for mental age (<emph>U</emph> = 25.00, <emph>p = 0.05)</emph> and for levels of autonomy (<emph>U =</emph> 1.00, <emph>p =</emph>.001).</p> <p>Table 3. Participants' descriptives for the two groups.</p> <p> <ephtml> <table><thead><tr><td /><td><italic>Lower levels of autonomy</italic></td><td><italic>Medium-to-High levels of autonomy</italic></td></tr><tr><td /><td>M</td><td>SD</td><td>Range (min-max)</td><td><italic>M</italic></td><td>SD</td><td>Range (min-max)</td></tr></thead><tbody><tr><td>Chronological Age</td><td>24.6</td><td>9.38</td><td>13.3–38.2</td><td>25.7</td><td>11.6</td><td>13.7–53.3</td></tr><tr><td>Mental Age</td><td>6.9</td><td>0.8</td><td>5.2–7.7</td><td>8.1</td><td>1.9</td><td>4.8–11.5</td></tr><tr><td>Participants (Male)</td><td>12 (3)</td><td /><td /><td>10 (6)</td><td /><td /></tr><tr><td>Tot autonomy</td><td>244</td><td>11.00</td><td>228–259</td><td>275</td><td>9.59</td><td>257–295</td></tr></tbody></table> </ephtml> </p> <p>4 Tot autonomy, total score of Autonomy questionnaire.</p> <p>Mann-Whitney <emph>U</emph>, comparing the group with LA and the group with MHA, shows differences between the two groups in the following tasks: PMFFT errors (<emph>U</emph> = 15.00, <emph>p</emph> =.009), Fish flanker accuracy (<emph>U</emph> = 11.00, <emph>p</emph> =.001), WM dual task (<emph>U</emph> = 15.50, <emph>p</emph> =.009), while no differences emerged between RT score (see Table 4).</p> <p>Table 4. Means, standard deviations and comparisons for the two groups on tasks.</p> <p> <ephtml> <table><thead><tr><td /><td>Groups</td><td>Mean (SD)</td><td>Range (min-max)</td><td><italic>U</italic></td><td>Sig.</td><td>Cohen's <italic>d</italic></td><td>Comparisons</td></tr></thead><tbody><tr><td>PMFFT (errors)</td><td>LA</td><td>1.38 (.63)</td><td>.36–2.14</td><td>15.00</td><td>.009</td><td>1.50</td><td>LA > MHA</td></tr><tr><td /><td>MHA</td><td>.60 (.47)</td><td>.00–1.64</td><td /><td /><td /><td /></tr><tr><td>PMFFT (RT)</td><td>LA</td><td>12.49 (15.23)</td><td>2.21–45.50</td><td>31.00</td><td>.142</td><td>.31</td><td>LA = MHA</td></tr><tr><td /><td>MHA</td><td>16.15 (10.26)</td><td>2.90–41.40</td><td /><td /><td /><td /></tr><tr><td>Flanker (accuracy)</td><td>LA</td><td>9.00 (5.10)</td><td>3–16</td><td>11.00</td><td>.001</td><td>2.15</td><td>LA < MHA</td></tr><tr><td /><td>MHA</td><td>15.47 (1.36)</td><td>11–16</td><td /><td /><td /><td /></tr><tr><td>Flanker (RT)</td><td>LA</td><td>4689.53 (5609.68)</td><td>1409.00–17264.00</td><td>31.00</td><td>.142</td><td>.76</td><td>LA = MHA</td></tr><tr><td /><td>MHA</td><td>222.60 (1213.67)</td><td>982.00–5408.00</td><td /><td /><td /><td /></tr><tr><td>WM v-s</td><td>LA</td><td>5.57 (1.40)</td><td>3–7</td><td>31.00</td><td>.129</td><td>.70</td><td>LA = MHA</td></tr><tr><td /><td>MHA</td><td>6.53 (1.36)</td><td>4–8</td><td /><td /><td /><td /></tr><tr><td>WM dual</td><td>LA</td><td>1.57 (1.40)</td><td>0–4</td><td>15.50</td><td>.009</td><td>1.42</td><td>LA < MHA</td></tr><tr><td /><td>MHA</td><td>4.80 (2.57)</td><td>1–8</td><td /><td /><td /><td /></tr></tbody></table> </ephtml> </p> <p>5 LA, group with lower levels of autonomy; MHA, group with medium-to-high levels of autonomy; PMFFT, Preschool Matching Familiar Figure Task; WM v-s, visuo-spatial working memory task; WM dual, working memory dual task; RT, response time. Time is reported in milliseconds for the Fish flanker task.</p> <hd id="AN0181776757-13">Discussion</hd> <p>Considering the multiple inhibitory dimensions, and its relevance to quality of life for people with DS, this article is one of the first attempts to jointly investigate the influence of specific components of inhibition and WM on the autonomy in everyday life of people with DS. In the correlations between the cognitive measures and levels of autonomy, it emerged that response inhibition, interference suppression and WM were all linked with total scores for autonomy. This could indicate the crucial role that all the three components have on autonomy, and on crucial skills such as handling money (Sabat et al., [<reflink idref="bib41" id="ref73">41</reflink>]). Relating to the interference suppression – a more complex inhibitory dimension that also demands WM – our results indicated that this dimension seems to have a major role in the acquisition of important, more structured aspects of autonomy in adolescents and adults with DS such as handling money and using shops, orientation in time and behaviour on the road (also associated with WM), communication and reading-writing skills. In clinical practice, it is well known that people with DS have difficulty with time management, which is a crucial skill in everyday activities. This problem is strongly related to a low impulse control and poor resistance to distractions, both in TD populations and in samples with neurodevelopmental disorders (Cabezas & Carriedo, [<reflink idref="bib9" id="ref74">9</reflink>]). Despite their language deficit, many individuals with DS learn to write and read, but they are usually better at word recognition than in reading comprehension (for a review, see Næss et al., [<reflink idref="bib34" id="ref75">34</reflink>]). Furthermore, the ability to understand, manage and use money is closely associated with arithmetical skills, and that people with DS have more difficulty than TD children in basic mathematical reasoning, and consequently in arithmetic (Belacchi et al., [<reflink idref="bib4" id="ref76">4</reflink>]). These aspects could have crucial implications for an independent life, such as the possibility to autonomously pay for dinner in a restaurant or to buy a new t-shirt in a shop or even more to pay for a train or a bus ticket. An increasing amount of research highlights that it is possible to also train money handling and shopping skills with specific programmes in adolescents and in adults with DS (e.g. O'Neill & Gutman, [<reflink idref="bib36" id="ref77">36</reflink>]).</p> <p>Like interference suppression, our results suggested that response inhibition seems to be linked to crucial aspects of learning, such as reading, writing and handling a telephone. The literature shows that WM and inhibition have a core role in the association between executive functions and academic achievement in people with DS (Will et al., [<reflink idref="bib57" id="ref78">57</reflink>]). As regards using the telephone, it has been demonstrated that the ability to communicate with others in social situations (i.e. to use pragmatic language) is strongly related to the ability to follow the rules of conversation, and to monitor and regulate one's behaviour (Udhnani et al., [<reflink idref="bib53" id="ref79">53</reflink>]). Together with response inhibition, WM is associated with salient aspects relating to orientation and the use of public transport – both of which rely on the ability to remember crucial landmarks in an environment (Toffalini et al., [<reflink idref="bib49" id="ref80">49</reflink>]). Clearly, being able to orient ourselves in time and space and to use public transport autonomously are fundamental prerequisites for living independently and a good quality of life.</p> <p>Comparing our two LA and MHA groups of individuals with DS added further detail to the debate on whether different components of inhibition and WM could differently influence autonomy. The MHA group outperformed the LA group on response inhibition, interference suppression and WM accuracy scores, whereas no differences emerged between the two groups as regards RT on both inhibitory tasks. This divergence between accuracy and RT has been seen in other studies investigating both measures. People with DS, like preschoolers, seem to be unable to control their RT in order to be more accurate – and that can be considered a possible explanation of why RT cannot be considered as a reliable indication of executive control in such populations - (Smith et al., [<reflink idref="bib45" id="ref81">45</reflink>], Fontana et al. [<reflink idref="bib22" id="ref82">22</reflink>], [<reflink idref="bib23" id="ref83">23</reflink>]; Traverso et al., [<reflink idref="bib51" id="ref84">51</reflink>]). Our data also seem to corroborate those of other studies examining inhibitory sub-components, which found that people with DS performed worse on the more complex components of inhibition, such as interference suppression and proactive interference (Borella et al., [<reflink idref="bib8" id="ref85">8</reflink>]; Traverso et al., [<reflink idref="bib51" id="ref86">51</reflink>]). Finally, we deem it as important to underline that although the two groups did not differ for chronological age, the group with LA showed an overall impaired profile of cognitive functioning both on levels of mental age and on inhibitory and WM abilities, suggesting possible further investigations on different individual profiles (Tsao & Kindelberger, [<reflink idref="bib52" id="ref87">52</reflink>]).</p> <p>The present study has some limitations to mention, concerning the small number of participants and the use of only one task to measure specific components of inhibition. Furthermore, the mental age level seems to be a little higher than those observed in other studies (Dykens et al., [<reflink idref="bib18" id="ref88">18</reflink>]; Kittler et al., [<reflink idref="bib26" id="ref89">26</reflink>]) and this could imply difficulties in extending the results to the entire population with DS. Future studies should consider the possibility to a) control for non-verbal mental age when analysing the WM and inhibitory measures and b) analyse the role of language skills in autonomies of daily life of individuals with DS. Furthermore, due to the small sample size, it was difficult to conduct other types of analysis. Despite these limitations, the study findings have some important implications, partly because the idea of people with DS living independently is becoming an important issue for researchers and clinicians alike. Given the relationships between different dimensions of inhibition and WM that seem to emerge in our sample with DS, parallel studies on daily life autonomy and cognitive aspects would be needed to address specific intervention programmes to improve the autonomy of people with DS. Our research seems to have identified a crucial role for inhibitory skills, and the more complex interference suppression dimension of inhibition – which also requires WM abilities –, in the acquisition of different types of autonomy. Our findings possibly point to the feasibility of training both inhibitory components to increase the level of autonomy of individuals with DS. In fact, from an educational point of view, it is important to consider and understand the levels of inhibitory abilities in each individual with DS with the aim of promoting targeted interventions for the development of autonomy in daily life. For example, the ability of orientation and behaviour on the road requires high levels of inhibitory abilities (e.g. know how to stop before the pedestrian strips, check the traffic light, make sure that vehicles do not arrive from all directions). Therefore, a person with DS that shows significant difficulties in response inhibition and in interference suppression abilities will need to be better supported in crossing the road. It is important to remember that good levels of autonomy requires a long and step-by-step process with a clear beginning in early stages – for example, by teaching how to recognise the fundamental road signs for crossing pedestrian and reinforcing simple levels of inhibition such as the ability to control our mental processes and behaviours and to perform an alternative action – and progressively promote more complex learnings (e.g. enhance the ability to manage interfering information and distractions while in parallel work on the ability to cross the road with the monitoring of the educational figure), until finally arriving at higher-order autonomies such as the ability to cross the street by himself and to manage independently some acquired inhibitory abilities.</p> <p>In considering this possibility, however, we need to bear in mind some issues not strictly related to these individuals' cognitive functioning and abilities. For example, the distance between the place where the person with DS lives (e.g. suburban areas that do not near provide services) and the possibility of using public transport to reach the desired location should not be taken for granted. Moreover, some families may not be ready to embark on a path of growth themselves, along with their children with DS, or there may be logistic constraints (distances that make it difficult to use public transport, or to reach certain places). Be that as it may, we firmly believe that a specific aim of working with people with DS should be to take action simultaneously on the multiple factors that can promote their independence and autonomy, and thereby ameliorate their quality of life, wellbeing, self-esteem and mental health.</p> <p>In conclusion, in this article we investigated the possible relationship between AB and cognitive abilities (i.e. inhibitory dimensions and WM) in people with DS specifically in order to underline the presence of a correlation between cognitive factors and AB. In this light, acknowledging different levels of executive functions' skills and different levels of autonomy in daily life of people with DS seems a crucial a starting point to build a person-centred planning design. Quite often, performance of people with DS is considered as a general statistical mean on different cognitive and behavioural functioning, acquisition steps and characteristics; however, these data often hide specific cognitive profile that needs explicit attention, also in terms of goals that each person could acquire in different contexts. In setting goals for the life project of the person with DS, it is essential to consider the person's role in order to identify the strengths from which to build shared goals for achieving the greatest possible level of autonomy for the person. Future studies should have the potential to implement an evidence-based intervention to promote inclusion, autonomy and community participation. These aspects are crucial for the achievement of satisfactory levels of quality of life, self-determination and to shed new life on social inclusion possibilities for people with DS.</p> <hd id="AN0181776757-14">Acknowledgments</hd> <p>The authors would like to thank each participant with Down syndrome, their families, Professional Educators and Occupational Therapists that took part in this study. A special thanks goes to the Associazione Italiana Persone Down sez. Marca Trevigiana for their support to the broader research project.</p> <hd id="AN0181776757-15">Disclosure Statement</hd> <p>No potential conflict of interest was reported by the author(s).</p> <ref id="AN0181776757-16"> <title> References </title> <blist> <bibl id="bib1" idref="ref25" type="bt">1</bibl> <bibtext> Amadó, A., Serrat, E., & Vallès-Majoral, E. (2016). The role of executive functions in social cognition among children with down syndrome: Relationship patterns. 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Items – Name: Title
  Label: Title
  Group: Ti
  Data: The Relationship between Different Levels of Autonomy, Inhibition Dimensions and Working Memory in People with Down Syndrome
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  Data: English
– Name: Author
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  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Martina+Fontana%22">Martina Fontana</searchLink><br /><searchLink fieldCode="AR" term="%22Sandra+Pellizzoni%22">Sandra Pellizzoni</searchLink><br /><searchLink fieldCode="AR" term="%22Maria+Chiara+Passolunghi%22">Maria Chiara Passolunghi</searchLink>
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  Data: <searchLink fieldCode="SO" term="%22International+Journal+of+Disability%2C+Development+and+Education%22"><i>International Journal of Disability, Development and Education</i></searchLink>. 2025 72(1):102-116.
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  Data: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
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  Data: 15
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  Data: 2025
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  Data: Journal Articles<br />Reports - Research
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  Label: Descriptors
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  Data: <searchLink fieldCode="DE" term="%22Inhibition%22">Inhibition</searchLink><br /><searchLink fieldCode="DE" term="%22Short+Term+Memory%22">Short Term Memory</searchLink><br /><searchLink fieldCode="DE" term="%22Personal+Autonomy%22">Personal Autonomy</searchLink><br /><searchLink fieldCode="DE" term="%22Down+Syndrome%22">Down Syndrome</searchLink><br /><searchLink fieldCode="DE" term="%22Adolescents%22">Adolescents</searchLink><br /><searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Foreign+Countries%22">Foreign Countries</searchLink>
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  Data: <searchLink fieldCode="SU" term="%22Raven+Progressive+Matrices%22">Raven Progressive Matrices</searchLink><br /><searchLink fieldCode="SU" term="%22Matching+Familiar+Figures+Test%22">Matching Familiar Figures Test</searchLink>
– Name: DOI
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  Group: ID
  Data: 10.1080/1034912X.2024.2337171
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  Label: ISSN
  Group: ISSN
  Data: 1034-912X<br />1465-346X
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Inhibition and Working Memory (WM) are crucial predictors of everyday life autonomies in people with Down Syndrome (DS). We aimed to investigate the possible relationship between different levels of autonomy, inhibitory sub-components and WM in people with DS. Twenty-two adolescents and adults with DS were enrolled in the study and were assessed with tasks tapping on response inhibition, interference suppression and WM. With a questionnaire on levels of autonomy, educators evaluated the sample with DS. Considering levels of autonomy, we divided participants into two groups: one with lower levels of autonomy and one with medium-to-high levels of autonomy. Results showed differences between the two groups in WM tasks and both inhibitory dimensions. More specifically, interference suppression seems to have a major role in the acquisition of important, more structured aspects of autonomy such as shopping, behaviour on the road, communication and reading-writing skills. On the other hand, response inhibition seems to be linked to crucial aspects of learning, such as reading and writing and handling a telephone. The results are discussed in terms of possible implementation in training in clinical and educational settings.
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  Data: 2024
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  Data: EJ1454192
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        Value: 10.1080/1034912X.2024.2337171
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      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 15
        StartPage: 102
    Subjects:
      – SubjectFull: Inhibition
        Type: general
      – SubjectFull: Short Term Memory
        Type: general
      – SubjectFull: Personal Autonomy
        Type: general
      – SubjectFull: Down Syndrome
        Type: general
      – SubjectFull: Adolescents
        Type: general
      – SubjectFull: Adults
        Type: general
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Italy
        Type: general
      – SubjectFull: Raven Progressive Matrices
        Type: general
      – SubjectFull: Matching Familiar Figures Test
        Type: general
    Titles:
      – TitleFull: The Relationship between Different Levels of Autonomy, Inhibition Dimensions and Working Memory in People with Down Syndrome
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Martina Fontana
      – PersonEntity:
          Name:
            NameFull: Sandra Pellizzoni
      – PersonEntity:
          Name:
            NameFull: Maria Chiara Passolunghi
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2025
          Identifiers:
            – Type: issn-print
              Value: 1034-912X
            – Type: issn-electronic
              Value: 1465-346X
          Numbering:
            – Type: volume
              Value: 72
            – Type: issue
              Value: 1
          Titles:
            – TitleFull: International Journal of Disability, Development and Education
              Type: main
ResultId 1