Cognitive intervention in people with Down syndrome

Aura Foundation explains in this article how they perform cognitive intervention in people with Down syndrome and other intellectual disabilities with NeuronUP in their foundation.

In September 2017, the Aura Foundation began the implementation and adaptation of the NeuronUP program for people with Down syndrome and other intellectual disabilities.

One of the main reasons why we chose this program is because of the type of activities it offers. The NeuronUP exercises comply with the principles of “generalization and/or transference”. These principles fit with the philosophy-methodology of work that Aura has always followed, the methodology of mediated learning.

We have been able to verify that it represents a great benefit both at a cognitive and functional level because it is easily applicable in daily life. Likewise, it favors the increase in the degree of motivation and involvement of the person and improves personal autonomy and self-esteem. As well as maintaining the psychosocial skills necessary for the activities of daily life and social of these people.

«Working with computers and tablets is more stimulating and motivating.»

Focusing on the area of cognitive training, and to work on the different skills, we make sure to do the previous work of program introduction and preparation that consists of “learning to learn”. This includes defining each of the cognitive functions and the different processes.

For example, explaining what attention means and describing the subtypes (sustained attention, selective attention, alternating attention) by looking for practical examples from everyday life in different contexts of life (family, work, leisure,…).

Cognitive intervention in people with Down syndrome

Aura Foundation explains how to perform a cognitive intervention in people with Down syndrome.

First phase of intervention

In the first phase of cognitive intervention in people with Down syndrome we started with a small group of participants using NeuronUP as a cognitive stimulation program. We review “one by one” all the activities of the program (both the digital version and the printable ones). Then we design a program with different levels of difficulty.

One of the most positive aspects of working with NeuronUP is that the adult activities offered show very practical and functional content. They also have an attractive presentation based on photographs.

Of all the cognitive functions that NeuronUP works with, we have selected those that we believe can be most beneficial for people with Down syndrome and other intellectual disabilities, planning the sessions in such a way that they are gradually worked on from less to more difficulty in order to adjust them to the progress and needs of the participants.

Changes in cognitive intervention in people with Down syndrome

Throughout the months in which the program has been applied, we have made some adaptations in relation to the time of application and the type of activities.

For example, we eliminated some activities because they were difficult for them to understand. In addition, we have extended the time of completion because they did not have time to read the statement when the activity started. The following are some of the changes made.

Extend the time of reasoning activities.
Increase the time of memory activities.
Increase time for activities with a lot of reading content.
Reduce time for sustained attention activities.
Reduce the time of monotonous activities.
Increase time for simulator or game activities.
Eliminate activities that involved complex reasoning (e.g., copying mirror models, subtractions, etc.)

One of the aspects that has been very useful is the possibility of being able to listen to the instruction while it is being read. Also, something that is very beneficial is being able to do a brief training of the activity to ensure that it has been properly understood and assimilated.

Second phase of intervention

In a second phase of cognitive intervention in people with Down syndrome we designed a new program with the same levels of complexity as the previous ones but with new activities.

These programs included the changes that we had already contemplated with the objective of adapting them to the profile and needs of our participants, adding new activities as well as simulators, with the aim of favoring specific aspects related to the activities of daily life.

At the same time, we have been able to gather from the observations made that, after six months of practice with NeuronUP, the participants show a greater degree of autonomy and initiative as well as a greater ability to carry out the activities and use the computer and the NeuronUP page, to initiate and manage their own session, etc.

Likewise, when making the transference to daily life activities, using the methodology of mediated learning, have also improved in the ability to identify the cognitive functions worked on by relating them to activities and / or tasks they perform in their day to day.

Thanks to all these changes, we have been able to increase the adherence to cognitive stimulation sessions, motivation and number of participants.

Third phase of intervention

Currently, already in a third phase of cognitive intervention in people with Down syndrome, we have developed a new program to which we have added new activities and which can be worked on based on 5 different levels of difficulty.

These levels respond to different needs and abilities that we have observed in our participants, since the profiles are very different among them:

High level: for participants who have a good understanding and a good cognitive level. They work in a totally autonomous way.
Medium-high level: for participants who read and write well but have a slower pace and/or need occasional support.
Medium level: for people who read and write but with medium-low understanding.
Medium-low level: for those participants who have difficulties in reading but with visual support are able to solve simple reading activities.
Low level: designed only with visual activities for all those people who have not acquired reading and writing skills and need support.

The methodology we use allows us to work on the different skills by planning them with their specific objectives, sequencing them and analyzing the strategies used, favoring the discussion of ideas and the generalization of what has been learned, as well as the evaluation of the progress made periodically.

«The participants value this program very positively since the activities are motivating and, in many occasions, a challenge to overcome.»

More and more people have requested to work with NeuronUP and this gives us a lot of satisfaction, since we are convinced that it has an impact on the improvement of cognitive performance and influences positively on the acquisition of skills and personal autonomy, in short, it facilitates labor insertion and a better quality of life.

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Cognitive intervention with NeuronUP in people with Down syndrome and mild impairment

Likewise, we are applying it in a personalized way as a non-pharmacological therapeutic intervention in a small group of people who are already in the post-working stage and who participate in the Aura Vital program. Some of these people have started a process of slight deterioration and others have already been diagnosed with Alzheimer’s disease in the first phase.

We are convinced that the NeuronUP program makes it possible to promote the preserved functions and to stop the evolution of the cognitive deterioration, since it is based on the fundamental principles of cognitive intervention that are, neuroplasticity and psychostimulation.

Conclusion

In summary, at Aura Foundation we bet on NeuronUP as it allows us to adapt the intervention to the capacities and needs of the participants, as well as to favor the maintenance and/or the cognitive improvement.