The neurological keys to help your child achieve better emotional management
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When your child with Down syndrome explodes in anger at a refusal, bursts into tears for a reason that eludes you, or seems unable to calm down despite your attempts to comfort them, you may wonder what is happening in their brain. The answer lies largely in a fascinating brain region: the prefrontal cortex. This area located at the front of the brain plays a crucial role in our ability to regulate our emotions, and its particular development in individuals with Down syndrome explains many of the emotional challenges you observe daily.
Understanding how the prefrontal cortex works and its specifics in Down syndrome is not just a theoretical exercise. It is the key to adapting your support, adjusting your expectations, and implementing truly effective strategies to help your child better manage their emotions.
The prefrontal cortex: the brain’s control center
Anatomy and location
The prefrontal cortex occupies the most anterior part of the brain, just behind the forehead. It is the region of the brain that has developed the most during human evolution, representing about one-third of the entire cerebral cortex. This area is not uniform: it consists of several sub-regions that collaborate to ensure complex cognitive functions.
The dorsolateral prefrontal cortex is involved in planning, reasoning, and working memory. The ventromedial prefrontal cortex plays a crucial role in decision-making and emotional processing. The orbitofrontal cortex participates in impulse control and reward evaluation. Finally, the anterior cingulate cortex, although technically distinct, works closely with the prefrontal cortex for emotional regulation and error detection.
Executive functions: the superpowers of the prefrontal cortex
The prefrontal cortex is the seat of executive functions, a set of higher cognitive abilities that allow us to function effectively in daily life. These functions include several essential skills.
Inhibition is the ability to curb an automatic or impulsive response. It is what allows us not to eat the cake when we are on a diet, not to say out loud what we think quietly, or not to hit someone who annoys us.
Cognitive flexibility allows us to change strategies when one approach does not work, to see things from a different angle, and to adapt to changes in situation.
Working memory allows us to temporarily hold information in mind and manipulate it. It enables us to follow a conversation, perform mental calculations, or remember the steps of a recipe while cooking.
Planning allows us to organize our actions over time, anticipate the consequences of our choices, and set goals and the steps to achieve them.
Sustained attention allows us to stay focused on a task despite distractions and fatigue.
The central role in emotional regulation
Emotional regulation is one of the most important functions of the prefrontal cortex. When we feel an emotion, it is first the limbic system, particularly the amygdala, that activates. This response is quick, automatic, and intense. It is a survival reaction, inherited from our ancestors, that prepares us to flee or fight in the face of danger.
The prefrontal cortex intervenes later to modulate this raw emotional response. It evaluates the situation more rationally, determines whether the emotional reaction is proportionate, and implements strategies to return to a state of balance. It allows us to take a step back from a stressful situation, to put a problem into perspective, and to calm down after a scare.
This top-down modulation from the prefrontal cortex to the limbic system is essential for navigating social and professional life. Without it, we would be at the mercy of our primitive emotional reactions, unable to delay gratification, manage conflict constructively, or cope with the inevitable frustrations of daily life.
The development of the prefrontal cortex in Down syndrome
A different development, not deficient
In individuals with Down syndrome, the development of the prefrontal cortex follows a different trajectory than that observed in the general population. Neuroimaging studies have shown structural and functional differences in this region of the brain, which partly explain the emotional regulation difficulties often observed.
It is crucial to approach these differences with the right mindset. This is not a “deficient” or “abnormal” brain, but a brain that functions differently. This difference involves specific challenges, but also specific strengths. And above all, it opens up avenues for tailored support.
The structural particularities
Research in neuroscience has identified several structural particularities of the brain in Down syndrome. The overall brain volume is generally reduced by about 20% compared to the average, with more marked reductions in certain regions, including the prefrontal cortex and hippocampus.
The prefrontal cortex shows a reduced cortical surface area and a lower number of neurons. The connections between neurons, the synapses, may also be fewer or organized differently. These structural particularities have direct functional consequences on emotional regulation capabilities.
The corpus callosum, which connects the two cerebral hemispheres and allows for their communication, also shows differences. This can affect the integration of information between the two sides of the brain.
The functional particularities
Beyond structure, it is the functioning of the prefrontal cortex that is impacted. Functional imaging studies show that this region activates differently in individuals with Down syndrome during tasks involving executive functions.
Information processing may be slower, requiring more time to analyze a situation and develop an appropriate response. The connection between the prefrontal cortex and the amygdala, this “highway” that allows for the top-down regulation of emotions, may be less efficient. The ability to maintain prefrontal activation in the face of intense emotions may also be reduced.
These functional particularities explain why your child may struggle to curb an impulsive reaction, to calm down once upset, or to adapt to a change in situation. This is not a lack of will; it is a matter of brain wiring.
The late maturation of the prefrontal cortex
In all humans, the prefrontal cortex is one of the last regions of the brain to reach maturity. This maturation process continues until about the age of 25, which explains why adolescents and young adults may sometimes lack judgment or act impulsively.
In individuals with Down syndrome, this maturation may be even more prolonged. This means that emotional regulation capabilities continue to develop well beyond childhood and adolescence. This is good news: it is never too late to progress, and the learning that takes place in adulthood can bear fruit.
The prefrontal-amygdala balance: understanding emotional crises
The “blowing lid” model
To understand what happens during an emotional crisis, we can use the metaphor of a pressure cooker. The amygdala generates emotional pressure, like steam building up in the cooker. The prefrontal cortex plays the role of the lid, which keeps this pressure under control and releases it gradually in a regulated manner.
When the prefrontal cortex is functioning well, it can contain emotional pressure, evaluate it, and release it appropriately. But when the prefrontal cortex is less efficient, or when the emotional pressure is too high, the lid can blow off. That is the crisis.
In a child with Down syndrome, the lid is structurally less solid. It can contain some pressure, but its tolerance threshold is lower. Situations that would not have blown off a more robust lid can trigger an emotional explosion.
The amygdala hijack
Neuroscientist Daniel Goleman popularized the concept of “amygdala hijack” to describe what happens when the amygdala takes control and short-circuits the prefrontal cortex. In these moments, the person is literally “beside themselves”: their rational brain is temporarily out of service, replaced by primitive emotional reactions.
This phenomenon can occur in anyone facing intense stress or a perceived threat. But in a child with Down syndrome, this hijack can occur in situations we would consider minor. It is not that the child is exaggerating or throwing a tantrum: it is that their hijack threshold is lower.
Understanding this mechanism radically changes how we perceive crises. When your child is in the midst of an amygdala hijack, asking them to calm down or think is as futile as asking someone who is drowning to swim elegantly. The prefrontal cortex is no longer in control.
The recovery time
After an amygdala hijack, it takes time for the prefrontal cortex to regain control. This recovery time may be longer in individuals with Down syndrome. During this period, the child may still seem agitated, irritable, or vulnerable to a new crisis.
This recovery time is not a whim or a lack of will. It is a necessary physiological process. The brain must clear out the stress hormones released during the crisis (cortisol, adrenaline) and restore its chemical balance. Forcing the child to resume activities too quickly can keep them in a state of vulnerability and increase the risk of a new crisis.
The implications for daily support
Adapting developmental expectations
Understanding the atypical development of the prefrontal cortex in Down syndrome invites us to adjust our expectations regarding emotional regulation. Your child’s chronological age does not necessarily reflect their prefrontal maturity.
A 10-year-old child with Down syndrome may have emotional regulation capabilities comparable to those of a 5 or 6-year-old child. This gap is not a delay to be filled at all costs; it is a reality to consider in order to adjust our expectations and support.
This does not mean we should give up on progress. On the contrary, understanding where your child truly stands allows for setting realistic and achievable goals and celebrating each advancement appropriately.
Serving as an external prefrontal
Since your child’s prefrontal cortex is still developing and functioning differently, you can temporarily play the role of “external prefrontal.” In practical terms, this means taking on certain functions that your child’s prefrontal cortex cannot yet handle alone.
You anticipate difficult situations for them. You help them plan their actions by breaking them down into simple steps. You remind them of rules and strategies at the right moment. You remain calm when they are not, providing a stable emotional anchor.
This role of external prefrontal is not permanent. As your child’s brain develops and their skills improve, you can gradually transfer responsibility to them. The goal is to guide them towards autonomy, not to do things for them.
Creating a supportive environment for the prefrontal cortex
The prefrontal cortex functions less effectively under certain conditions. Stress, fatigue, hunger, and sensory overload all diminish its efficiency. Conversely, a calm, predictable, and secure environment allows the prefrontal cortex to function optimally.
As a parent, you can influence the environment to promote the proper functioning of your child’s prefrontal cortex. Ensure they get enough sleep and proper nutrition. Reduce avoidable sources of stress. Create predictable routines. Arrange quiet spaces where your child can retreat when they feel pressure building.
These adjustments are not crutches that prevent your child from progressing. On the contrary, they create optimal conditions for their brain to develop and learn new skills.
> DYNSEO supports you: Our training Facilitating daily autonomy for children with Down syndrome: Routines and visual tools teaches you how to create a structured and predictable environment that supports the development of your child’s prefrontal cortex. You will learn how to implement effective routines, use appropriate visual supports, and organize daily life to reduce stress and promote autonomy.
Strategies to support the development of the prefrontal cortex
Training executive functions
The brain is plastic: it changes based on experiences and learning. Executive functions can be trained and improved, even in individuals with Down syndrome. This training requires time, patience, and repetition, but it pays off.
Memory games exercise working memory. Activities that require waiting for one’s turn train inhibition. Puzzles and construction games engage planning. Activities that involve following changing rules develop cognitive flexibility.
These trainings are more effective when integrated into fun and motivating activities. A child who is having fun learns better than a child who is bored or feels like a failure.
Explicit learning of emotional regulation
Where most children learn intuitively to regulate their emotions, children with Down syndrome often benefit from more explicit and structured learning. This means clearly naming emotions, explaining what happens in the body when we feel them, and teaching concrete strategies to manage them.
Deep breathing is one of the simplest and most effective strategies. When we breathe slowly and deeply, we activate the parasympathetic nervous system, which sends a signal of calm to the brain. Teaching your child to breathe with their belly, perhaps with the help of an object placed on their abdomen, gives them a tool they can use anywhere.
Movement can also help regulate emotions. Walking, jumping, squeezing a pillow tightly, stretching: these physical actions allow for the release of accumulated emotional energy and help return to calm.
Grounding techniques help reconnect with the present when anxiety or anger lead to catastrophic thoughts. Asking the child to name five things they see, four things they touch, three things they hear, etc., redirects their attention to the outside world and interrupts the emotional spiral.
Visual supports for regulation
The prefrontal cortex of individuals with Down syndrome particularly benefits from visual supports. These tools concretize abstract concepts and serve as external reminders when the prefrontal cortex is under pressure.
The emotional thermometer is a visual tool that represents different levels of emotional intensity. The child learns to identify where they are on this thermometer and to associate each level with specific strategies. In the green zone (calm), they can continue their activities normally. In the yellow zone (agitation), they can implement preventive strategies. In the orange zone (rising tension), they need to retreat to a quiet space. In the red zone (crisis), they need external help.
Strategy cards visually present the different options available to calm down. When the child feels tension rising, they can consult these cards and choose a strategy: breathe, drink water, squeeze a pillow, listen to music, ask for a hug, etc.
Visual sequences for returning to calm break down the regulation process into simple and illustrated steps. The child can follow these steps one by one, which reduces the cognitive load necessary to calm down.
> DYNSEO supports you: Our training Helping your child with Down syndrome manage their emotions provides ready-to-use visual tools and guides you in their daily use. You will learn to create a personalized emotional thermometer, develop a repertoire of strategies suited to your child, and gradually support them towards greater emotional autonomy.
The role of co-regulation
What is co-regulation?
Before being able to self-regulate (self-regulation), the child needs to experience shared regulation with a caring adult. This is called co-regulation. The adult lends their own regulation system to the child, creating a calming experience that the child will eventually internalize.
Co-regulation is the foundation of emotional learning. A crying baby who is held by a calm parent experiences the transition from distress to calm. This experience, repeated thousands of times, gradually builds the neural circuits of regulation.
In a child with Down syndrome, this co-regulation process remains important for a longer time. It is not a pathological dependence but a necessary step in building self-regulation. With time and appropriate support, the child increasingly internalizes these skills.
How to practice co-regulation?
Co-regulation starts with your own emotional state. If you are stressed, anxious, or angry, your child perceives it, amplifying their own distress. The first step in co-regulation is therefore to regulate your own state. Breathe deeply, relax your shoulders, adopt a calm and steady tone of voice.
Your physical presence plays an important role. Depending on your child’s preferences, physical contact (a hand on the shoulder, a hug) or simply reassuring proximity can have a calming effect. Some children need distance during a crisis and prefer that you remain available without touching them.
Your voice can also serve as a vehicle for regulation. A calm, slow tone, with short and simple sentences, helps the child synchronize with your state of calm. Avoid questions, long explanations, or complex reasoning that would require a temporarily out-of-service prefrontal cortex.
Emotional validation is another pillar of co-regulation. Acknowledging your child’s emotion, even if their expression seems disproportionate to you, shows them that they are heard and understood. “I see that you are very angry” or “This is really hard for you right now” are simple phrases that validate the child’s experience without judging it.
From co-regulation to self-regulation
The transition from co-regulation to self-regulation is gradual and non-linear. There will be advances and setbacks, good days and bad days. The important thing is the overall trend over the long term.
To facilitate this transition, you can start verbalizing what you are doing when you help your child regulate. “I am breathing slowly with you,” “We are going to a calm place,” “I am placing my hand on your back.” This verbalization makes the regulation process explicit.
Gradually, you can invite your child to take a more active role. “Do you want us to breathe together?” then “Do you remember our belly breathing?” and finally “What could help you calm down?” This transfer of responsibility occurs as the child develops their skills and confidence.
Factors influencing the functioning of the prefrontal cortex
Sleep: essential for the prefrontal cortex
Sleep is not wasted time for the brain. On the contrary, it is during sleep that learning is consolidated, metabolic waste is eliminated, and cognitive resources are regenerated. A lack of sleep directly affects the functioning of the prefrontal cortex.
Individuals with Down syndrome often experience sleep disorders. Obstructive sleep apnea is common due to anatomical peculiarities of the airways. Difficulties falling asleep or waking up at night may also be present.
If your child has sleep difficulties, an evaluation and appropriate management can have a significant impact on their daytime emotional regulation. Sleep hygiene strategies (regular routine, conducive environment, limiting screens in the evening) can also help.
Nutrition and hydration
The brain is a very energy-hungry organ. It consumes about 20% of our total caloric intake while representing only 2% of our body weight. A balanced diet, with regular meals, provides the brain with the fuel it needs to function properly.
Blood sugar plays a particular role. When blood sugar levels drop (hypoglycemia), the brain suffers the consequences. Irritability, difficulties concentrating, impulsivity: these symptoms resemble those of a struggling prefrontal cortex. Regular meals and snacks, with complex carbohydrates rather than quick sugars, maintain stable blood sugar levels.
Hydration is also important. Even mild dehydration can affect cognitive performance. Ensure that your child drinks regularly, especially in hot weather or during physical activities.
Physical activity: a boost for the prefrontal cortex
Physical activity has proven beneficial effects on the functioning of the prefrontal cortex. It increases blood flow to the brain, promotes the release of neurotransmitters favorable to learning, and can even stimulate the growth of new neural connections.
For children with Down syndrome, physical activity also has the advantage of developing motor skills, promoting social integration, and channeling energy positively. Swimming, dancing, walking, cycling, and adapted sports are all options to explore based on your child’s preferences and abilities.
Physical activity can also serve as a strategy for emotional regulation in itself. When your child is agitated or tense, a movement session can help them release that energy and return to a state of calm.
> DYNSEO supports you: Our training Understanding and stimulating motor development in Down syndrome guides you in implementing physical activities tailored to your child’s particularities. You will discover how motor development and cognitive development are linked, and how to stimulate one to promote the other.
Chronic stress: the enemy of the prefrontal cortex
Acute, short-term stress can paradoxically improve cognitive performance. It is stress that allows us to excel during an exam or competition. But chronic stress, which lasts over time without the possibility of recovery, has the opposite effect. It deteriorates the functioning of the prefrontal cortex and can even affect its structure in the long term.
Children with Down syndrome may be exposed to various sources of chronic stress: academic difficulties, teasing or social rejection, repeated feelings of failure, aggressive sensory environments, demands inappropriate to their abilities. Identifying and reducing these sources of stress helps preserve the functioning of the prefrontal cortex.
Developmental perspectives
Brain plasticity: a founded hope
The brain is not fixed. It changes throughout life based on experiences and learning. This brain plasticity means that the prefrontal cortex of individuals with Down syndrome can develop and improve, even if the trajectory is different.
Early interventions take advantage of this plasticity by stimulating brain development during periods of greater receptivity. But plasticity persists into adulthood, and it is never too late to progress.
Advances in research
Research on Down syndrome is progressing rapidly. Neuroscientists are gaining a better understanding of the brain mechanisms involved, opening up avenues for more targeted interventions. Clinical trials are exploring pharmacological and non-pharmacological approaches to improve cognitive functions.
These research efforts offer encouraging prospects for the future, even if practical applications still require time. In the meantime, the support strategies described in this article have proven effective and can significantly improve the quality of life for your child and your entire family.
A positive trajectory
Despite the challenges, the developmental trajectory of individuals with Down syndrome is generally positive. Emotional regulation skills improve over time, experience, and support. Many adolescents and adults with Down syndrome achieve good management of their emotions, allowing them to lead fulfilling social and professional lives.
Your role as a parent is crucial in this trajectory. By understanding the particularities of your child’s brain, adapting your support, providing a favorable environment, and offering appropriate tools, you actively contribute to their cognitive and emotional development.
Key takeaways
The prefrontal cortex plays a central role in emotional regulation, and its particular development in Down syndrome explains many of the emotional challenges faced by those affected. Understanding this brain functioning allows for more effective and compassionate support.
The difficulties in emotional regulation are not character flaws or educational problems. They are manifestations of a brain that functions differently and needs tailored support.
As a parent, you can support the development of your child’s prefrontal cortex in many ways: by creating a favorable environment, playing the role of external prefrontal when necessary, training executive functions through play, explicitly teaching regulation strategies, and practicing co-regulation.
Progress is possible at any age thanks to brain plasticity. With patience, perseverance, and the right strategies, your child can develop emotional regulation skills that will significantly improve their quality of life.
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DYNSEO, your partner in supporting Down syndrome
At DYNSEO, we provide comprehensive training to help you understand and support the development of your child with Down syndrome. Our programs are designed by experts and offer practical tools applicable in daily life.
Discover our training:
- Helping your child with Down syndrome manage their emotions: Proven strategies to guide your child towards better emotional regulation.
- Facilitating daily autonomy for children with Down syndrome: Routines and visual tools: Create a structured environment that supports cognitive development.
- Understanding and stimulating motor development in Down syndrome: Discover the links between motor development and cognitive development.
Together, let’s support your child towards the flourishing of their full potential.
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This article was written as part of the DYNSEO blog, dedicated to healthy aging, memory, education, and supporting individuals with cognitive disorders. Our content aims to inform, support, and equip families and professionals in their daily lives.
