Down Syndrome

Down Syndrome

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Down Syndrome

People with Down syndrome are first and foremost human beings who
have recognizable physical characteristics due to the presence of an
extra chromosome 21. The estimated incidence of Down syndrome is
between 1 in 1,000 to 1 in 1,100 live births. Each year approximately
3,000 to 5,000 children are born with this chromosome disorder. It is
believed there are about 250,000 families in the United States who are
affected by Down syndrome.
Children with Down syndrome are usually smaller, and their physical and
mental developments are slower, than youngsters who do not have Down
syndrome. The majority of children with Down syndrome function in the
mild to moderate range of mental retardation. However, some children
are not mentally retarded at all; they may function in the borderline to
low average range; others may be severely mentally retarded. There is a
wide variation in mental abilities and developmental progress in children
with Down syndrome. Also, their motor development is slow; and instead
of walking by 12 to 14 months as other children do, children with Down
syndrome usually learn to walk between 15 to 36 months. Language
development is also markedly delayed. It is important to note that a
caring and enriching home environment, early intervention, and
integrated education efforts will have a positive influence on the child's
development.
Although individuals with Down syndrome have distinct physical
characteristics, generally they are more similar to the average person in the
community than they are different. The physical features are important to the
physician in making the clinical diagnosis, but no emphasis should be put on
those characteristics otherwise. Not every child with Down syndrome has all
the characteristics; some may only have a few, and others may show most of
the signs of Down syndrome. Some of the physical features in children with
Down syndrome include flattening of the back of the head, slanting of the
eyelids, small skin folds at the inner corner of the eyes, depressed nasal
bridge, slightly smaller ears, small mouth, decreased muscle tone, loose
ligaments, and small hands and feet. About fifty percent of all children have a
gap between the first and second toes. The physical features observed in
children with Down syndrome usually do not cause any disability in the child.
Although many theories have been developed, it is not known what actually
causes Down syndrome. It has been known for some time that the risk of having

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a child with Down syndrome increases with advancing age of the mother; i.e.,
the older the mother, the greater the possibility that she may have a child with
Down syndrome. However, most babies with Down syndrome are born to
mothers younger than 35 years. Some investigators reported that older fathers
may also be at an increased risk of having a child with Down syndrome.
Parents who have a child with Down syndrome have an increased risk of having
another child with Down syndrome in future pregnancies.

The child with Down syndrome is in need of the same kind of medical
care as any other child. The pediatrician or family physician should provide
general health maintenance, immunizations, attend to medical emergencies,
and offer support and counseling to the family. There are, however, situations
when children with Down syndrome need special attention.
Forty to Forty-five percent of children with Down syndrome have congenital
heart disease. Many of these children will have to undergo cardiac surgery and
often will need long term care. Children with Down syndrome often have more
eye problems than other children who do not have this chromosome disorder.
For example, 3 percent of infants with Down syndrome have cataracts. They
need to be removed surgically. Other eye problems such as cross-eye, near-
sightedness, far-sightedness and other eye conditions are frequently observed
in children with Down syndrome.
Although many medications and various therapies have been touted as
treatment for people with Down syndrome, there is no effective medical
treatment available at the present time.
Today early intervention programs, and pre-school nurseries, have
demonstrated children with Down syndrome can participate in many
learning experiences which can positively influence their overall
functioning. Research has shown that early intervention, environmental
enrichment, and assistance to the families will result in progress that is
usually not achieved by those infants who have not had such educational
and stimulating experiences. Later, the school can give the child a
foundation for life through the development of academic skills and
physical as well as social abilities. Experiences provided in school assist
the child in obtaining a feeling of self-respect and enjoyment. School
should provide an opportunity for the child to engage in sharing
relationships with others and help to prepare the child to become a
productive citizen. Contrary to some views, all children can learn, and
they will benefit from placement in a normalized setting with support as
needed. During adolescence, youngsters with Down syndrome should be
exposed to prevocational training in order to learn good work habits and
to engage in proper relationships with co-workers. It is important that
society develop attitudes that will permit people with Down syndrome to
participate in community life and to be accepted. They should be
offered a status that observes their rights and privileges as citizens, and
in a real sense preserves their human dignity. When accorded their
rights and treated with dignity, people with Down syndrome will, in
turn, provide society with a most valuable humanizing influence.
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