What Medical Problems Are Associated with Down Syndrome?
5-10%may have gastrointestinal abnormalities
75% may have hearing loss
Close to 50% may have heart defects and disease
50-75% have sleep apnea
Increased respiratory and ear infections
Increased colds, bronchitis, tonsillitis, and pneumonia
Higher risk of childhood leukemia
Spinal cord compression
Thyroid disease approx. 15%
Pre mature aging
- Alzheimer’s type symptoms <40yrs old
Implications For Development
As well as medical implications, there a delays in various areas of development associated with Down Syndrome.
According to The Down Syndrome Association of Victoria “ Everyone with Down syndrome will experience some delay in their development and some level of learning disability, but the extent and specific areas of delay vary from one individual to another” (Better Health Victoria, 2000, Para. 8)
An Overview of Developmental progress from 5-11years in Children with Down Syndrome http://www.down-syndrome.org/information/development/childhood/?page=3
The Communicating Child
It is believed that Speech and Language development provide the greatest developmental delay.
Ability to understand speech however difficulties expressing speech
Use gestures and signs to communicate non verbally from a young age.
Sue Buckley describes the delay: “ Spoken language skills are usually delayed relative to the children's non-verbal ability and this suggests a profile of specific language impairment.” (Buckley S, 2000, Para. 2)
The 75% rate hearing loss in children with down syndrome may play a part in this delay.
Once talking, correct use of speech communication is used
Difficulties with grammar and clear speech
Class Tone and grammar exercise
May experience difficulties with Syntax -the order of words and elements related to structure in sentences.
Increased difficulty with posture (Spinal Cord Compression)
Gross motor mile stones are variable for example a child with DS might begin to walk around two or may not walk until the age of four or five.
Increased heart and health issues may make the body weak at times adding delay to this area of development
A child with Down Syndrome sitting with back support
The Thinking Child
Low short term memory skills compared to typically developing children at the same age
inhibitory processes in learning (delayed thought process)
chronological age vs. mental age
Putting it into Perspective (Mental Age) To the Early Childhood Field
A study was performed by Clinical Linguistics & Phonetics, titled Patterns of Syntactic Development in Children with and with out Down's syndrome.
It was found that a child with DS may be 8.7 years old with a Mental age of 4.6yrs. The study states that the average typical developing child who is chronologically 4.4 has a mental age of 5.0. (Joffe, Victoria – Varlokosta, Spyridoula 2007, Para. 1)
Therefore in an early childhood setting we need to be aware of this and support children's developmental abilities.
Statement Made By Father of a Child with Down Syndrome
“ My son Stan is six, and he cannot talk, but he communicates very well using the Makaton sign-language system. At times, you’d think he has the abilities of a three year-old, but on another occasion, he’ll help make breakfast and lay the table. His care and attention to people’s feelings is startling and the sort of thing you expect from a twelve-year-old. I’m so excited about what Stan can achieve.”
Interactions with others implicated due to language expression barrier at a young age
Generally display more solitary play as well as onlooker play
The Feeling Child
Can switch emotions very quickly
Can express emotions in a variety of ways
Delayed understanding of what feelings are and may express this through behaviour
The Creative Child
There are no identified implications for this area of development, however the expression of creative development may be stalled due to cognitive delay in the process of thought. Therefore this may be the link to the imagination of the experience to applying it.
The Childs Sense of Self
Links with the delay of cognitive development
Sense of self is identified and expressed at a later age
The Spiritual and Moral Child
Children may take longer to understand the desired and appropriate behaviour and therefore understanding right from wrong.
Links back to ‘mental’ age.
Children with Down Syndrome are at higher risk of medical complications such as ADD which may result in a developmental delay in this area.
Linking Spiritual and Cognitive Development
The NSW Curriculum framework links the development of spirituality with cognitive development. “This sense evolves along with cognitive development and increasing capacities to take the perspective of others and to appreciate the impact of ones own behaviour on other people.” (Department of Community Services p. 72)
Adapting A Children's Service To Support a Child with Down Syndrome
Avoid having foods at the centre that the child may have allergies to as there may be food sensitivities.
Support in language expression- language cards, knowledge and use of of sign language and symbols that the child and their family may use to communicate with the child.
Extra resources for stimulation and strengthening of muscle development added to centre program. This includes adapting play resources to create equal opportunities. E.g. have available a wider beam as well as balance beam at a lower level.
Additional needs support resources such as back supportive chairs and railings down ramps.
Support the family and other families at the centre with resources and services regarding the additional need. This could be brochures and books.
Ensure all staff have knowledge of aspects of Down Syndrome as well as how to communicate with the child at a level the child is going to understand.
Offer extra support in areas such as meal times, helping the child to eat due to low muscle tone.
Working With Families
Work together to form a partnership with families and create a consistent care giving routine at the centre and at home. E.g. communication book, meetings and phone calls, and open door policies.
This coincides with QIAS Accreditation Principle 2.1 which states “Staff and families communicate effectively to exchange information about each child and the centre”. (NCAC, 2006 p. 6)
Benefits of having partnerships with families who have a child with down syndrome include- support network for family and staff members, constant feedback on development as well as a consistency with care routines and providing best possible support for the child. Also the child will feel secure when trusting caregiver and development enhanced when families and staff work together.
Living With Down Syndrome from a Parents Perspective
Parents of three children with Down Syndrome discuss their experiences and challenges.
Tips are also discussed which are important to adapt to in an early childhood setting to ensure the best support and development.
This includes gross motor activity important to a program and the importance of supplying healthy nutrition due to 15% speed of the metabolism for a non- down syndrome child.