All children with Down Syndrome experience some form oflearning difficulty as the brain develops differently in those with the geneticcondition, making the learning process less efficient. However the severityvaries from child to child and cannot be predicted 5. This results in childrenwith the condition reaching milestones later than others who do not have thecondition 1. Although every child is different, most children with DownsSyndrome have many characteristic strengths, including social interaction. Withencouragement they are often able to develop these skills alongside their peersin an age-appropriate manner.
Most children think visually and digestinformation best when it is presented by pictures or gestures. Due to this,many children with Down Syndrome begin communicating using signing 3. Anotherstrength associated with children affected by the condition is their readingability, as it builds upon their visual learning skills. 2Children with the Down Syndrome also have somecharacteristic weaknesses, including verbal communication, and many childrenexperience significant delay in learning to talk 3.
Hearing problems contributesignificantly to this, as they often lead to difficulty in picking up otherpeople’s speech. This can have negative effects on the child’s learning 7. Adelay in verbal communication also arises from difficulty controlling thetongue, lips and facial muscles as well as poor short term (working) memory.Vision problems can also lead to a slower development of the child’s visual learning.2 Milestones Before the age of 5 months, the child should react tosounds, however they may not respond to the same sound every time.
This can bedue to congested middle ear fluid 7 or the child may not have the ability toturn their head towards the source of the sound. During this time period it isimportant that the child is talked to and read books on a daily basis toencourage the development of speech 4. As the child reaches 6 months old,you should start to expect them to recognise and explore where sounds arecoming from, especially if they are sudden.
They should be able to recognise shortinstructions, such as “no”, although they may not completely understand thecommand yet. As the child approaches 10 months, they should begin to babble ortalk to themselves 2. This is an important skill as it indicates their abilitiesto vocalise in later life.
Failure to babble may result in further oralstimulation being required to assist with the development of the movementsneeded for speech production 4. At around 16 months, the child should understand around 50words but will still not be able to speak. They should however be interested inmaking and repeating simple noises, such as animal sounds. To further developtheir speech the child must learn to organise the sounds of speech 8. Thechild should enjoy listening to simple stories and recognise objects inpictures within the book. Now the child should be able to stand and walk shortdistances, and should have developed the necessary oro-motor skills to chewsolid foods and drink through a straw 2.
Feeling should now be expressedopenly on the child’s face and they should now display the ability to makesimple choices such as choosing a favourite toy 4.By 25 months the child should be sociable and want tointeract with others , and they should be able to retrieve objects when shownhow to through demonstration. There should be signs of obvious comprehension oflanguage and they should be able to understand a variety of word, includingnouns and verbs, however many children will not be able to produce spoken wordsdue to poor oral motor skills 4.
By 30 months the child’s comprehension should have continuedto grow and they should now be able to follow a simple command. They shouldbegin to communicate verbally and should be able to say their own name or callfor “mummy” and “daddy”. However their oral motor skills will not haveprogressed enough for them to speak clearly and be completely understood byothers 4.As the child approaches 35 months, they should begin topronounce some words more clearly and try to communicate verbally a lot more.They may begin to try to form sentences, however they may not be intelligible.The child should now be able to listen to stories that are up to 20 minuteslong and they should be able to understand around 250 words. Many children arevery inquisitive at this age and often ask “why?”. Some children with lessprogressive oral motor skills still find it difficult to use the tip of theirtongues and struggle to pronounce consonants 4.
From 36 to 40 months, the child should begin to hold shortconversations and can produce up to 150 words, however some are still notpronounced correctly. Many children can recognise colours and can use pronounsin their sentences. Sometimes the gender is still confuses and he is usedinstead of she or vice versa 4.By 60 months most children can easily pronounce many wordsand retell short stories.
Similar environments and symbols can often berecognised. Most letters of the alphabet are known and around 20 written wordscan be recognised 4.Around 70 months the child begins to produce longersentences of 4 words and around 10,000 words can be comprehended.
Over 400words can be spoken clearly and many children can now read short sectionswithin stories 4. Puberty People with Down Syndrome go through puberty at the same timeand in the same order as other individuals of their age group, however they areoften less emotionally mature, meaning it can be a difficult time for them 1.It is important that the child understands the changes which are occurring andthey should be given information about the topic in a way they can easily understand9.For girls, breast development begins around the age of 8 to13, followed by the first period at 12 years old (slightly before the age ofthose in the general population). Girls usually have a growth spurt at thebeginning of puberty however their height only increases slightly throughoutthe rest of puberty 9.
It is advisable to plan ahead how to help the child withtheir first period, most people with the condition who are more independent maycope well, however other may need additional help 9. Research suggests that around 70% of women with DownSyndrome are fertile and in many cases women with the condition have givenbirth and both mother and baby have been healthy. However, there is an increasedchance of miscarriage and there is a 50% chance that the child will also haveDown Syndrome. Children born to a mother with the condition are also morelikely to premature or stillborn, so the pregnancy will need to be closelymonitored. Problems may also arise if the mother has a heart defect as therewill be considerable strain on the heart during childbirth 9.
In boys, puberty normally begins from the ages of 9 to 14with the growth of testicles. It is important if puberty starts outside thisage range that medical advice is sought, as thyroid problems are more common inpeople with Down Syndrome and can affect the timing of puberty. Boys willusually experience a growth spurt during puberty, and changes in the skin, bodyodour and mood will also occur 9.Although men with Down Syndrome have lower fertility thanthe general population, there have been people with the condition who conceive.Therefore it is important that contraception is used unless the couple areplanning a pregnancy 9. Independent life Each person with Down Syndrome is effected by the conditionto varying degree, so some children attend mainstream school whereas othersattend a school that caters for their more specific needs.
This is the samewhen people with the condition become older, some are able to live fairlyindependent lives and have jobs, whereas others need more assistance in theform of sheltered housing with care assistants 10.There are lots of employment options for those with thecondition and people are often helped through supported employment. This iswhen people with a disability can be given extra support to help them in thework place 11. There are many different types of work which may be suited to differentpeople, including paid work, supported apprenticeships and volunteering. All ofthese activities help to encourage independence, develop social skills and gainconfidence 12.
Growing older People with Down Syndrome have a life expectancy of around50-60 years, however as they age, more problems are likely to develop in thosewith the condition, for example hyperthyroidism, diabetes and arthritis. This maymean that more assistance is required as the person grows older 1.Depression is also a common occurrence in older people. Oftenpeople with Down Syndrome rely heavily on their parents and family for physicaland emotional support. When there is a bereavement in the family it can be a verydifficult time and they may need additional support to get through this period1. Onset seizures are common, starting around the age of 40 inmales and 50 in females.
These seizures have be shown to be associated with thedevelopment of Alzheimer’s disease inlater life 13. Older people are more likely to develop dementia in general,with an 80% risk of people with Down Syndrome developing the condition at theage of 65 14.