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INTEGRATIVE NEUROREHABILITATION STRATEGY FOR INDIVIDUALS
WITH DOWN SYNDROME: CLINICAL AND FUNCTIONAL METHODS FOR
STIMULATING SPEECH AND COGNITIVE DEVELOPMENT
Khakimova S. Z.
Doctor of Medical Sciences, Associate Professor,
Department of Neurology, Faculty of Postgraduate Education
Nasrieva P.Sh.
Independent Researcher, Department of Neurology,
Faculty of Postgraduate Education
https://doi.org/10.5281/zenodo.15302668
Abstract.
The article presents the concept of an integrative neurorehabilitation
approach to stimulating speech and cognitive development in individuals with Down
syndrome. Based on the analysis of current scientific data on neurophysiological and
neuropsychological features in trisomy 21, a comprehensive strategy is proposed that
combines neurostimulation, speech therapy, neuropsychological, and psychological-
pedagogical methods. The principles of early intervention, differentiated approach to various
age groups, and evaluation of the effectiveness of rehabilitation measures are described.
Special attention is paid to the interdisciplinary interaction of specialists and family
involvement in the rehabilitation process as key factors for successful neurorehabilitation.
Keywords:
Down syndrome, neurorehabilitation, speech development, cognitive
development, early intervention, neuroplasticity, interdisciplinary approach.
Introduction.
Down syndrome (DS) is the most common chromosomal abnormality,
occurring with a frequency of approximately 1:700 newborns [1]. The genetic imbalance
caused by trisomy of the 21st chromosome leads to a characteristic phenotype, including a
complex of physical features and varying degrees of intellectual impairment. Among the most
significant manifestations of DS are delays in speech and cognitive development, which
significantly affect social adaptation and quality of life [2].
Modern research on brain neuroplasticity and early neurorehabilitation opens new
perspectives for optimizing the development of children with DS. According to neuroimaging
studies, DS is characterized by specific features of brain morphology, including a reduction in
total brain volume (especially the cerebellum, hippocampus, and frontal lobes), altered
patterns of neural connections, and impaired synaptic plasticity [3,4]. These neurobiological
features correlate with the characteristic profile of cognitive and speech disorders [5].
The relevance of developing an integrative neurorehabilitation strategy is due to the
need to overcome traditional fragmented approaches to rehabilitation and create a holistic
system that takes into account the specifics of the neurocognitive profile in DS and is based on
the principles of evidence-based medicine [6]. The integration of various rehabilitation
methods becomes particularly important, as it allows for a comprehensive impact on all links
in the pathogenesis of speech and cognitive disorders.
Down syndrome (DS) is the most common chromosomal abnormality, occurring in
approximately 1 in 700-800 newborns worldwide. The genetic nature of this syndrome,
caused by trisomy of the 21st chromosome, determines a specific phenotype with
characteristic physical features and a wide spectrum of neurological and functional
peculiarities. Cognitive and speech disorders in Down syndrome have a complex pathogenetic
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basis, including structural and functional changes in the central nervous system,
neurochemical features, and neuroplasticity disorders.
Speech development in children with Down syndrome is characterized by pronounced
delay, asynchrony between speech comprehension and expressive speech ability, and specific
phonological and articulatory disorders. The cognitive profile in Down syndrome is uneven:
relatively preserved visual-spatial and socio-emotional domains contrast with deficits in
verbal memory, executive functions, and abstract thinking. These characteristics necessitate
the development of specialized approaches to stimulating speech and cognitive development
in individuals with Down syndrome.
Modern neuroscience has significantly expanded our understanding of the
neurobiological mechanisms of cognitive function and speech development in Down
syndrome. Research in neuroplasticity, functional neuroimaging, and cognitive
neuropsychology has created a theoretical foundation for developing effective
neurorehabilitation methods. In recent years, the paradigm of habilitation and rehabilitation
for individuals with DS has changed significantly: from isolated methods of correcting
individual functions to comprehensive integrative approaches that consider the
interconnection of different aspects of development and are based on the principles of
evidence-based medicine.
CONCLUSIONS:
The developed integrative neurorehabilitation strategy for individuals
with Down syndrome, based on a comprehensive multidisciplinary approach, demonstrates a
statistically significant positive impact on indicators of speech and cognitive development
compared to traditional methods. Clinical and functional stimulation methods integrating
neuropsychological, speech therapy, and sensorimotor components contribute to the
activation of compensatory mechanisms of neuroplasticity and the formation of alternative
neural connections, which is confirmed by positive dynamics of neurophysiological indicators.
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