EXPO: Executive function Play Opportunities

At a Glance

Researchers at Colorado State University and University of Padua have developed EXPO (EXecutive Function Play Opportunities), a specialized intervention to support the development of thinking and problem-solving skills in young children with Down syndrome. The program focuses on strengthening “executive function” skills, which are the cognitive processes that allow individuals to remember information, plan, inhibit, and shift between tasks. Unlike previous methods, this program is designed to be implemented by caregivers within their existing daily routines. By targeting these skills in early childhood, the intervention aims to improve long-term independence and academic success for children with intellectual disabilities.

Background

Executive function is a critical predictor of long-term outcomes in individuals with Down syndrome, directly impacting academic achievement, independence in activities of daily living, and employment outcomes in adulthood. Current interventions primarily utilize computer-based working memory training for school-aged children, leaving a significant gap during early childhood years. There is a pressing need for syndrome-informed protocols that address the unique neurocognitive profiles of individuals with Down syndrome, such as language and motor delays, while targeting foundational skills like inhibition and cognitive flexibility.

Overview

EXPO is an adaptive intervention divided into distinct “blocks” designed to transition from foundational engagement to more complex cognitive tasks. The program begins by establishing social communication and turn-taking routines to create play routines for the child. As the intervention progresses, it systematically introduces exercises focused on four core EF domains: working memory, inhibition, cognitive flexibility, and planning. The final stage of the program integrates these skills to promote generalization across different environments.

The methodology distinguishes itself by utilizing a caregiver-led model supported by weekly virtual consultations with a professional. This approach leverages everyday activities in familiar settings rather than isolated clinical tasks, allowing for the integration of routines that have a clear beginning, middle, and end. By incorporating these predictable structures, EXPO maximizes engagement and addresses the specific developmental patterns observed in young children with Down syndrome, providing a scalable alternative to traditional clinic-based interventions.

Benefits

• Syndrome-Informed Design: Tailored to the unique developmental profiles of children with Down syndrome.
• Early Intervention: Targets the preschool years to build a foundation for school readiness before academic challenges arise.
• Comprehensive Skill Targeting: Supports practice in each of the areas of executive function: working memory, inhibition, flexibility, and planning.
• Caregiver-Led Integration: Facilitates skill development within natural home environments and daily routines.
• Predictable Structuring: Uses specialized routines to maintain interest and reduce transition-related anxiety.

Applications

• Early Intervention Programs: Adoption by state and local agencies providing services for children with developmental delays.
• Allied Health Services: A specialized tool for occupational therapists and speech-language pathologists.
• Educational Software/Materials: Commercial kits or digital platforms for caregiver-implemented cognitive coaching.
• Special Education Curricula: Integration into preschool programs for children with conditions associated with intellectual and developmental disabilities.