What are the most important mental health concerns for people with Down syndrome? At least half of children and adults with Down syndrome face serious mental health concerns throughout their lives, with high rates of mental health problems in children and adults with multiple health problems.

1. Promising presentation - Rana Abdullah Tahan
PHD researcher
https://orcid.org/0000-0002-1093-7740
Mental health for people with Down syndrome?

2. What are the most important mental health concerns for people with Down syndrome?
At least half of children and adults with Down syndrome face serious mental health
concerns throughout their lives, with high rates of mental health problems in children and
adults with multiple health problems.
The following:
General anxiety, disorder includes the most common mental health concerns of obsessive
compulsive disorder and repetitive behaviors, stubborn and impulsive behaviors and
distractions, sleep difficulties, depression, autism spectrum conditions, and
neuropsychological problems characterized by the gradual loss of cognitive skills. The
pattern of mental health problems in people with Down syndrome varies by age or
developmental characteristics of a child or adult with Down syndrome as follows:
Young children and early school children with lack of language skills, communication,
cognition and non-verbal problem-solving abilities are more likely to be exposed to:
- Disruptive, impulsive, stubborn, distracting and hyperactivity behaviours (raising fears of
being associated with stubbornness disorder, hyperactivity disorders and distraction
- Behaviors of anxiety, attachment, repetition and inflexibility (raising fears of being
associated with general anxiety and obsessive compulsive disorders) deficiencies in the
formation of social constraints, self-contained behaviours and stereotypical behaviours

3. Recurrent (raising fears of association with autism and overall developmental disorders) chronic
sleep difficulties, daytime sleepiness, stress, mood problems (raising fears of associating them
with sleep disorders and sleep apnea) children in the older stages of school and adolescents as
well as young people with Down syndrome who have better language, communication and
cognitive skills are more likely to experience the following :
Depression, social withdrawal, diminished interests and coping skills, general anxiety, obsessive
compulsive behaviors.
- The decline in the loss of cognitive and social skills
Chronic sleep difficulties, daytime sleepiness, stress, and mood problems (raising fears that they
may be associated with sleep disorders and sleep apnea) are more likely to be exposed to:
Older adults
- General concern
- Depression, social isolation, loss of interest and diminished self-care relapse with reduced
cognitive and social skills
- Dementia
All these changes in behaviour appear as a reaction (or resulting from) a often socio-social or
environmental stressor, for example, a person's illness, separation or loss.

4. Who should you turn to for help assessing and treating mental health concerns?
Many families live in areas where there are no mental health professionals with the skill to deal
with children and adults with Down syndrome, so we recommend that families take the
following approach:
You can conduct a preliminary search in your area for potential service providers with
experience in dealing with children and adults with developmental disorders. This may include
asking your primary care provider, and inquiring your work from the employee responsible for
employee benefits and health coverage to provide you with a list of caregivers to evaluate
children and adults with developmental disorders, and it would be a good thing to have a
primary care doctor who can make referral recommendations or always know someone who's
best.
He can similarly make a suitable referral to you. If you have access to the Internet, you can visit
your health coverage provider's website and find specialists in your location who have indicated,
you can contact your local department or neighborhood case coordinator with their experience
in developmental disorders. Finally, your residence will ask about the additional services that
can be available in your area.
Visit a preliminary consultation to introduce the child or adult to the specialist and always make
sure that this is the right person for your needs. Such a preliminary visit will be useful, as it will
feel comfortable in the place and with a provider that will also enable the child or adult with
Down syndrome to take care of it, and this visit will enable you to get an appointment in time in
the event of any future crisis when any critical situation appears.

5. Doing so in order to get an initial appointment, it has become very difficult and may often be
difficult in known centers.
Especially critical cases please bear in mind that the ideal mental health care provider
specializing in syndrome
in dealing with children.
Down must have knowledge of developmental disorders and also have experience of a mental
health care provider working in a medical center and who has provided it is advisable to first
research children or work close to a paediatric clinic.
That in locations close to these services, it is always advisable to remember in every state in the
United States what is known as the University Center for Excellence in Developmental
Disabilities (UCEDD)
From the Association of University Centers in Developmental Disabilities. Many of these
programmer are part of a multidisciplinary care centre with multidisciplinary services, including
a mental health specialist for more than 30 years (child psychiatrists, psychologists and social
workers), as well as pediatricians specializing in behaviour and growth. Individuals with Down
syndrome.
Choosing a psychiatric caregiver with experience in drug management for individuals with if it is
very important to work close to a medical clinic or agency serving developmental disorders, it is
important to find someone with developmental disorders.

6. If my child has a new "behavioural problem", are there some medical reasons to rule them out
first?
This is a common question that worried parents ask many medical and psychological providers.
There are a number of basic tests that must be completed to exclude cases associated with
children and adults with Down syndrome with the disease, which is often a "behavioural
problem".
Among these cases, we recommend that you take into account the following cases:
A primary care provider, a pediatrician specializing in growth and behavior, or even a psychiatrist
can perform thyroid function tests as part of the initial assessment.
Sleep-related difficulties should assess your primary caregiver, developmental or behavior
pediatrician or psychiatrist as part of the initial assessment with referral to a sleep disorders clinic
or laboratory as needed to rule out sleep apnea – see more discussion below.
A primary care provider or pediatrician specializing in growth and behaviour should also exclude
the contribution of constipation and bowel difficulties with interventions as needed and refer to
counselling. This may be a great opportunity to use a healthy diet as a dietitian's tool to promote
positive behaviors.
Ensuring that work and as part of the comprehensive checklist of potential medical conditions is
also important for an assessment of hearing (hearing), consideration (ophthalmology), anemia
(hematology) and gastro esophageal reflux of children (gastrointestinal tract) in children and
adults with Down syndrome.

7. .
Caveats or steps to consider in addressing any of the medical concerns and finally the potential
above in the context of treating "behavioral problems" include:
Step 1: Emotional and behavioral problems are common in children and adults with Down
syndrome and are not necessarily due to an underlying condition. However, these associated
conditions in children and adults with Down syndrome should be excluded as part of the
comprehensive assessment approach. For emotional and behavioral problems
Step 2: Conditions, even if not a cause, may exacerbate them or make a child or adult with
Down syndrome resist treating the emotional or behavioral problem.
Step 3: Treatment of the condition, for example: hypothyroidism, may not remove the problem,
for example: the child or adult with underlying emotional or behavioral injury. The opposite is
also true of hypothyroidism as well as depression, which is not available to respond to
treatment with anti-interventional and emotional problems with depression only unless
hypothyroidism is treated, given simultaneously.

8. .
What are the symptoms of general anxiety, obsessive-compulsive disorder and depression
in people with Down syndrome? How is it diagnosed and treated?
Public concern
This is one of the most prominent symptoms in children and adults with Down syndrome,
as it appears to be an increasing level of both basic and situational anxiety with pressure
factors that show situational anxiety during transitions and expectation of new situations.
Clear to both of them.
For example:
moving from home to school, crossing the road, and times of food or sleep. As well as
during new and unusual situations with uncertain expectations in the environment

9. Obsessive compulsive disorder
An increased level of insomnia and anxiety may lead to a typical behavior of a child or adult,
so that caregivers state that the child or may lead to a state of "attachment to a particular
behavior", where the adult often needs a familiar lifestyle in these cases. They also engage in
repetitive compulsive behaviours as well as ritual behaviours, raising the question of a state
of disorder in which a child or adult is unhappy, afraid, and can be obsessive-compulsive.
Both cases - general anxiety and obsessive compulsive behaviours - are often associated,
while children with disruptive, violent and distracting behaviour are often not inclined to
have Down syndrome. These problems are a major challenge in the name of happy and very
enthusiastic who is unhappy, but rather for parents and caregivers to face them, where the
child or adult with Down syndrome tends

10. .
The difference between anxiety symptoms, hyperactivity disorder and distraction in young
children?
Unlike children with Down syndrome who show impulsive and stubborn behavior patterns and
attention deficits, boredom, restlessness and compulsive behavior associated with general
anxiety have a specific beginning with. A detailed history is needed in all these cases in order to
determine the source of a more cutting trajectory or environmental stimuli that contribute to
concern about changing the environment of the home, school or direct work. In such cases, it is
necessary to assess precedents and behaviours and their consequences, and to develop a plan
to modify and manage behaviour. The use of antidepressants or anti-anxiety medications may
help, but it should be limited to persistent or more serious levels of symptoms

11. Symptoms of depression
Children or adults who show symptoms of depression often suffer from severe social
isolation, feelings of sadness (but without anxiety), and the inability to enjoy many activities
that parents or primary caregivers state that the child's or adult's behavior was not what
they liked. Children or adults with Down syndrome are associated with harmful
environmental stimuli. This can include unknown health diseases, pain or previous stress
factors.
for example: a older brother's transition to college, or a disease

12. Sudden or chronic death of a family member, the death of a pet at home, or the absence of a
teacher (leave or illness).
All these normal situations seem exceptional for children or adults with Down syndrome and
have a disproportionate psychological impact when compared to an ordinary person in similar
circumstances.
In short, children or adults with Down syndrome remain highly sensitive to changes in their
environment that they see as unfavourable. We therefore recommend the preparation of
support counselling services and support personnel, which are often trying to treat depression
for its impact, often , If any negative changes are expected in anticipation of chronic in the
context of continuing pressure of useless drug intervention without individual support, there is
a need to rely on combination therapy that includes both psychosocial and pharmacological
components, while the need to adopt pharmacological intervention is reinforced if a child or
adult with Down syndrome already has biological impairment
(e.g. Positive family history, previous depressive episode, concurrent medical diseases.

13. What are the symptoms of attention-dispersion, impulsiveness, hyperactivity and vandalism in
people with Down syndrome? How is it diagnosed and treated?
Children or adults with Down syndrome often have great difficulties in focusing attention on
tasks Loyal , Treatment shows very noticeable difficulty for children with cognitive and linguistic
deficiencies in terms of receiving and expression – especially when difficulties in attention are
often accompanied by impulsive and hypermobility behaviors for younger age groups. This type
of attention-dispersion, impulsiveness and hyperactivity are consistent with the diagnosis of
ADHD. That's why many children who exhibit such characteristic behaviors are treated with
stimulant medications.
The response of children with Down syndrome has not yielded encouraging results. In a subset
of children or adults with Down syndrome, this has clearly stimulated harmful behaviour in
response to these medications: irritability, emotion and aggressive behaviours. The most
common negative effects include transitional anxiety, and sleep-related problems. It is therefore
necessary to alert parents or caregivers to start treatment, and it can be a preview of these
harmful effects because they may occur after a very, very short time for them. However, a small
group of children with disturbing symptoms may benefit from ADHD and attention-distracting
medications, but even for them they may increase anxiety as well as symptoms of obsessive
compulsive disorder. And that's why the primary focus should be in

14. Treatment of symptoms similar to ADHD and distraction on behavioral and therapeutic
strategies
To enhance adaptive and functional performance at home and study environments.
for children who had a high degree of impulsiveness and disruptive behaviors was using a
dose , in its effectiveness, where it can, but this drug can be limited low of beneficial
cloone dine Day-out for some children. It should be emphasized that the use of clonidine -
to the limit leads to drowsiness a Only in the treatment of impulsive, disruptive and
hypermobility behaviors, not itself, can be effective.
Necessarily improves basic attention. Eating clondin at bedtime may also help the child to
Get to sleep.

15. .
What are common behavioral concerns associated with chronic sleep difficulties?
How is it evaluated and treated?
Children or adults with Down syndrome usually experience a range of sleep-related
difficulties either as a major sleep disorder or in a manner associated with mental
health problems, for example: general anxiety and mood disorders.
Regardless of the causes, sleep difficulties weaken the ability of children or adults
with Down syndrome to maintain daytime praise as well as maintain a better level
of control, to be vigilant and attentive.
For example:
endure frustration. Therefore, a thorough assessment of chronic sleep difficulties in
children or adults with Down syndrome should be thoroughly assessed by a
multidisciplinary team to rule out any other conditions that may be involved.

16. Children and adults with Down syndrome in particular are at increased risk of obstructive sleep
apnea, with mild to moderate levels of sleep apnea that may lead to hyposaturation of oxygen
in the blood. Although the suspected diagnosis of interruption, including evidence of sleep, is
based on the often sick and tired history of the day, further tests are necessary to confirm this
diagnosis through referrals at major medical centres.

17. .
What are the main environmental triggers for behavioral and emotional problems?
Children and adults with Down syndrome are often highly sensitive to stressors
Psychological and environmental. Illness or loss of a close relative or family member can
be particularly devastating and lead to a sad and complex reaction during which a child
or adult may suffer in his or her ability to think, analyze, remember and treat Regressive
people with Down syndrome from information change learning. Psychological and
environmental stimuli can also lead to a state of public anxiety Symptoms of OCD,
depression and sleep difficulties. It can be associated with weight loss, poor self-care
and lack of motivation to go to school or workplaces. If the situation continues, and
there is no concerted attempt to intervene with psychosocial guidance, appropriate
drug treatment and behavioral interventions, the psychological state may continue and
be associated with a long-term decline in psychosocial and cognitive performance.

18. Is challenging and stubborn disorder common in children or adults with Down syndrome?
Many children and adults with Down syndrome have great behavior, who love to joke, make
jokes, laugh for fun and love, and their interactions generally prevail, which can lead to reckless
intrusive and social behaviors. Many respond to structural and behavioural interventions with
clear reinforcements and rewards. Sometimes these behaviors become out of control and fully
control interactions. They become increasingly opposed to their thinking, self-contained, unable
to listen and very stubborn, for example: sitting, lying down, refusing to wake up, or continuing
to be active while ignoring the consequences at meals, bathing and sleeping times or during
self-directed times of transition. Anti-individual behaviors occur at all levels of cognitive and
language skills, but become more difficult to manage in people with communication difficulties
in receiving and expressing.
Behavioural management and individual assistance in classroom environments may help keep
the situation under control and enable them to learn. Problems of stubborn behaviors in
children with cognitive, receiving and expression deficiencies are also associated with an
increased level of impulsive and hyperactivity behaviors associated with symptoms of ADHD and
attention deficits.
Are mood disorders and bipolar disorder often common in children and adults with Down
syndrome?
There is a need for a comprehensive approach to the assessment of a child or adult with Down
syndrome on which you appear

19. a state of mood instability. It is necessary to exclude any underlying medical and
neurological conditions, particularly in the possibility of a harmful effect from medications
that may lead to a secondary mood instability. A young child with Down syndrome who
exhibits opposing, impulsive, subversive, emotional and aggressive behaviors should be
considered as likely to have a mood disorder. Through our experience. And you must.
Clinically, the association of real bipolar disorder and Down syndrome was relatively
unknown to think about using anti-seizure drugs (such as mood stabilizers) only under
careful supervision. Similarly, the use of atypical antipsychotic drugs should be considered
only as a last resort, and again with careful control of their potential side effects. For their
lifetime, an increased appetite that will lead to weight gain associated with atymtic
antipsychotic drugs can upset their balance. Therefore, the accompanying behavioural and
dietary interventions are harmful.

20. Are we approaching a new era with an improvement in the assessment of mental health
concerns in children and adults with Down syndrome?
We see a marked development in assessing mental health concerns in children and adults
in recent years. There is now a wide range of diagnostic and screening tools available to
assess psychological conditions in different developmental age groups in terms of
measuring several aspects, such as: non-verbal problem solving capabilities, language,
communication, adaptive and behavioural performance. Much of our current knowledge
depends on clinical experience, and although the focus varies depending on the
orientation of each caregiver, for example: behavioral modifications, pharmaceutical
interventions and training in social skills, it is wise for parents to pursue a comprehensive
philosophy of integrated care (medical and mental health, behaviour, medicines, and
social skills).
Despite the fact that many individuals with Down syndrome suffer from apparent delayed
cognition of abilities, each individual and other physical conditions, they have a very wide
range of them developing at their own speed. Although they may be late in their
progress, many achieve significant development goals and lead a very enjoyable and rich
life. There is a need to develop a better evidence base that includes extensive research
into aspects of mental health for Down syndrome, but increased awareness of mental
health issues bodes well for the future.

21. Thank you for listening so well.