Down’s syndrome

Down syndrome

Down’s Syndrome

What is Down’s syndrome?

Down’s syndrome is chromosomal condition caused by the addition of an extra chromosome. People with Down’s syndrome have 47 chromosomes in their cells instead of 46. The duplicate chromosome is chromosome 21, which is why Down’s syndrome is also referred to as Trisomy 21. Down’s syndrome occurs at conception and can affect both genders, people from all ethnic and social groups and to parents of all ages. It can affect the person’s cognitive ability and physical growth, cause mild to moderate developmental issues

What are the common features of Down’s syndrome?

People with Down’s syndrome may have some of the following features:

Physical features include:

  • Flattened nose
  • Small teeth
  • Stunted growth
  • Short neck
  • Shortened hands
  • Low set and rounded ears
  • Shortened extremities
  • Atypical fingerprints
  • Flexible ligaments
  • Smaller genitalia
  • Separation of the abdominal muscles

Some Developmental features:

  • Intellectual disability
  • Learning difficulties
  • Developmental delay
  • Speech and communication difficulties
  • Difficulty with coordination
  • Difficulty with fine and gross motor skills

Some difficulties experienced by a child with Down’s syndrome include:

They may have difficulty understanding the conventions of social interactions.

  • Speech may be affected and they may struggle with articulation of sounds.
  • They may have academic challenges including reading and writing.
  • A child with Down’s syndrome may have immature play skills/interests. 
  • They may be resistant to change, very rigid in their routine.
  • They can be impulsive or aggressive.
  • They may have difficulties understanding and using non-verbal communication.
  • They may struggle with understanding instructions, questions or jokes.
  • Fine and gross motor skills may be difficult
  • They may struggle to access the school curriculum.

Some strategies to support the child with Down’s syndrome include:

  • Set up an individualised plans and goals with parents/carers that are meaningful to the child and carers.
  • Develop social stories to improve appropriate behaviour in social situations.
  • Always apply encouragement and reinforcement of positive achievements.
  • Provide opportunities for the child to succeed by simplifying activities.
  • Teach new skills in a step by step manner and use visual aids when possible    .
  • Introduce new skills or environments on an individual basis before introducing peers.
  • Use simplified language and instructions.
  • Allow extra time for completion of tasks.
  • Recognise and reinforce the child’s strengths regularly.
  • Ensure table height and seat height is appropriate for the child.
  • Set realistic and achievable goals for all activities. 
  • Ensure participation not competition is the goal.
  • It is important that good communication is used between health professionals, educational staff and charities to ensure all relevant information is communicated to all appropriately. 

Therapy strategies that can support the child and/or their carers: 

  • Develop the child’s range of skill for all life skills.
  • Make use of social stories to provide ideas and education around social development and appropriate behaviours.
  • Advocating and support the child’s transition to school and from class to class liaising with teachers and other professionals as required.
  • Visual cues can be used to support routine and to introduce new activities, or a change in tasks.
  • Therapy will help determine the current stage of the child’s motor skills (both fine and gross) so that they can be graded appropriately for success.
  • They can develope functional and achievable goals collaboration with the child, parents and teachers so that therapy has a common focus beneficial to everyone involved.
  • Therapists can help educating parents/carers, teachers and others involved in the child’s care about Down’s syndrome and the stage of skills the child abilities.
  • They will help provide management strategies and ideas that can support the child with Down’s syndrome at school, home or other venues as appropriate.
  • Providing alternative ways to encourage task engagement.
  • Developed the underlying skills necessary to support the child’s ability in both gross and fine motor skills. These may include programs to work on such as providing activities to: 
  • balance and coordination
  • strength and endurance
  • attention and alertness
  • body awareness
  • movement planning
  • Direct skill teaching through a task based approach.

Communication strategies and activities that can support the child and/or their carers may include

  • Speech and language assessment is not just about speech it can help the family understand how the child is processing, understanding, learning and using language and communication.
  • Therapists can provide the family with strategies and techniques to increase and enhance communication with the child.
  • Therapist can provide daily activities which can help the child to understand the environment, routines and language.
  • They can help the child understand and use richer language and to use language more spontaneously.
  • Therapists can help the child develop conversation skills, turn taking and picking up on non-verbal communication.
  • Therapists can help the child developing concept skills, especially abstract concepts, such as time (e.g. yesterday, before, after).
  • Visuals aids can be used to help with understanding and the child’s ability to express their needs, wants, thoughts and ideas.
  • Therapists can help the child develope their social skills e.g. knowing when, how to use language in social situations.
  • Therapists can help enhance verbal and non-verbal communication including natural gestures, speech, signs, pictures and written words.
  • Therapists can help with the development of using visual information to help the child understand, organise and plan their routines.
  • Therapists can liaise with educational staff regarding the nature of the difficulties and ways to help the child to access the curriculum.
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