Executive dysfunction as a treatment target for DS clinical trials: An evaluation of its real-world and neural correlates.

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PROJECT SUMMARY/ABSTRACT As highlighted in the NIH Research Plan on Down Syndrome (DS) and the INCLUDE Project Research Plan, there is a need to assemble large cohorts of individuals with DS for studies that examine risk and resilience factors relevant to health and well-being. These studies have implications not only for those with DS but for individuals in the general population. The parent award to the proposed administrative supplement examines the neural and real-world correlates of executive dysfunction (i.e., impairments in cognitive control processes that are important for self-regulation and the completion of complex tasks) in young adults with DS (n=200). One real-world correlate studied in the parent grant that will be the focus of the proposed administrative supplement is vocational outcomes. Specifically, the administrative supplement seeks to extend the parent grant by completing a second wave of (online) data collection from caregivers of adults with DS (targeted n=120) focused on two influences on vocational outcomes not measured in the parent award. The first is an important, but overlooked, aspect of vocational functioning, work readiness, or the individual’s potential employability based on their “soft skills.” Vocational status (as assessed in the parent grant) provides a categorical characterization that is dependent on broader societal (e.g., economic) and local (e.g., service provision) factors. Work readiness provides a complementary and continuous metric of vocational potential independent of these broader and variable contextual/environmental factors influencing employment for individuals with DS. Thus, the second influence on vocational outcomes to be quantified as part of this extension to the parent grant is these critically important contextual/environmental factors. More specifically, the administrative supplement seeks to identify through both quantitative and qualitative means potential contextual/environmental factors (e.g., parent motivation, access to transportation) that are likely to modify or obscure relations between executive dysfunction and vocational outcomes. Through greater refinement of vocational metrics and contextual/environmental influences, the administrative supplement will support the parent grant in setting the stage for future research examining mechanisms to optimize vocational outcomes in adults with DS.