Category: Down Syndrome

INTRODUCTION

The study aims at taking a holistic view of the issues, problems, effect, and solutions of Down syndrome in Ireland. In plain English language, Down syndrome is a congenital disorder arising from a chromosome defect, causing intellectual impairment and physical abnormalities; including short stature and a broad facial profile in humans.

Down syndrome is a type of genetic disorder when a baby is being formed, during conception there is an error in cell division. In every individual, there are 46 chromosomes but when it is 47 chromosomes it is an error or there is a non-disjunction called Trisomy 21. With Down syndrome, there is a characteristic facial feature, physical growth delays, mild to moderate intellectual disability.

At birth, there would be certain characteristic features such as flat facial features, small head, and ears but during the first trimester of pregnancy with an ultrasound scab done it can be detected. This pre-natal screening is ingestion where a blood test is carried out and the scan can detect fluid at the back of the fetus’ neck which sometimes medicates Down syndrome.

People with Down syndrome may have a variety of birth defects. About half of all affected children are born with a heart defect. Digestive abnormalities, such as a blockage of the intestine, are less common.

It has also been established that individuals with Down syndrome are at a higher risk of developing several medical conditions which include celiac disease; an intolerance of wheat protein called Gluten and gastroesophageal reflux; a backflow of acidic stomach contents into the esophagus. It is estimated that about 15 percent of persons with Down syndrome have an underactive thyroid gland (hypothyroidism)

Women who are 35 years or older stand the risk of having a pregnancy affected by Down syndrome than the younger age. This is one key risk factor for Down syndrome. This maternal age factor from statistics show that a 25-year-old has 1 in 1200 chance of having a baby with Down syndrome, by 35 the risk can increase to 1 in 350, as of age 40, it is 1 in 100 and by 49, it is 1 in 10.

This is according to the national Down syndrome society which explains that the course of Down syndrome so not known but it correlates with a woman’s age. Down syndrome is not related to race, nationality, religion or socio-economic status but is more important to know about these individuals with Down syndrome is that they are more like others than they are different. Some of the physical characteristics are decreased muscle tone, flat face, eyes slanting up irregularly shaped ears, etc. Down syndrome patients can also be afflicted with other conditions, including heart disease, Alzheimer disease, and leukemia so also as a child they one usually smaller and their physical and mental developments are slower than younger people who don’t have Down syndrome.

This exists for people with Down syndrome because their physical and mental developments are slower. Some function in the mild to moderate range of delayed mental development while some children may function in the borderline to a low average range or some mentally retarded. In the area of developed mental progress in children, their motor development is slow so they get to start walking at 15 months to 36 months instead of 12 – 14 months. Language development is also delayed because of speech. Their hearing or ability to hear is also a barrier as 60-80% of children with Down syndrome have hearing deficits 40-45% of children with Down Syndrome have congenital heart disease and many will undergo cardiac surgery or under long term care by a pediatric cardiologist.

Intestinal abnormalities also occur at a higher frequency in children for a blockage of the food pipe (esophagus) small bowel and at the Anus are not uncommon with infants, which will need surgical correction for a normal functioning intestinal tract. Hypothyroidism between 15 and 20% of children with Down syndrome have this, which is more common due to thyroid disorder affecting normal central nervous system functioning. Other important medical aspects in Down syndrome also include seizure disorder, sleep apnea Alzheimer, leukemia, and skin disorder.

There is no medical treatment available presently even through many medications and various therapies have been attempted as the treatment for people with Down syndrome.

One of the biggest barriers facing children with Down syndrome in education is finally being dismantled.

The ‘soft’ barriers to enrolment that many parents of children with disabilities have faced have been removed with the announcement by the Minister for Education and Skills Richard Bruton that a new model for allocating Special Education Teaching Resources to mainstream primary and post-primary schools will be introduced from September 2017. (down syndrome Ireland 2019).

Today early intervention programmers, preschool nurseries and integrated special education strategies have demonstrated that youngster 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 families will result in progress that is usually not achieved by those infants who have not had such educational and stimulating experience. They can benefit from sensory stimulation, specific exercises like gross and fine motor skills /activities and instructing to cognitive development.

Preschool play important role in the early life so as to participate beyond the home and later in school, this can give the child a good foundation for life through the development of academic skill and physical as well as social abilities. This helps for later in life during adolescence the pre-vocational training has helped to learn good work habits and to engage in proper relationships.

What are the challenges people with DS have in society?

1. EDUCATION AND AWARENESS: -The importance of education for persons with Down syndrome cannot be overemphasized. It is vital for example; maternity professionals who have access to up to date and accurate information’s about Down syndrome support those expectant parents throughout their pregnancy. Other challenges are with the families who support them in relating, managing and assisting the newborn and nursing mother.
2. INTEGRATION AND ACCEPTANCE: – There is an issue relating to social integration and acceptance. Over the years and with improved education, awareness, and enlightenment program. Persons with Down syndrome are finding it much easier integrating into the society and the level of acceptance devoid of stigmatization has greatly improved.
3. HAVING A VOICE: How would the average person with Down syndrome be heard in the society, community and even my family? There are known limitations and both the public and private sector have helped create different programs to include seminar, conferences, meetings and so on, which are aimed at giving such person’s comparative advantage to be heard.
4. JOBS AND VOLUNTEERING: The issue relating to jobs and volunteering has also been challenging. How to transition persons with Down syndrome who have a high-performance ratio and functionality into the labor force, so they can live a healthy life like any other normal person. There have been different programs to assist them in these processes
5. HEALTH AND MEDICAL ISSUES: -Some health problems are more common among people with Down. Some of such health challenges are Intellectual disability, Cranial-Facial Anomalies, Speech and Language Impairment, Low Muscle Tone, Respiratory problems, Nervous and behavioral issues
6. STIGMATIZATION: The perception, reception, and acceptance of persons with Down syndrome within the society have been an issue of concern for all those involved in the care and service of the patient. Since some are not aware of the underline causes and features of Down syndrome, they may tend to stigmatize them when they meet such persons. The key is to create awareness, educate the masses and support those with such challenges while protecting them from stigmatization and encouraging them to interact with the broader society.
7. Behavioral Issues and Challenges: Behavioral can be categorized into two aspects 1. Cognitive 2. Learning. The issue arises when behavior becomes a challenge. This is the time when certain factors should be considered to assist the person with Down syndrome cope with the condition.

Lack of Confidence by Disabled People

One of the major barriers is the employment of disabled people is the lack of confidence they have. People with disabilities tend to suffer from a sense of low self-esteem and an overall lack of confidence in themselves. This is because of the additional challenges they must face in comparison to an individual who is not disabled as a result of their disability. Generally, most young people and teenagers as well as those with Down’s syndrome, struggle with self-esteem to a certain extent. They may also start to spot the differences between themselves and their counterparts. This can have an additional negative impact on their self-esteem. However, the development of healthy self-esteem can aid and encourage them to understanding and accepting who they are as people, rather than perceiving just the condition termed ‘Down’s syndrome’. This lack of confidence disabled people suffer from in turn has a knock-on impact on their willingness and zeal to be employed or remain in employment. A direct consequence of this limiting factor is the effect on performance and productivity by people with disabilities in the workplace.

People with disabilities can undergo necessary training and mentoring to improve their confidence in the workplace. The overall culture of celebrating people with disabilities in society would play a very major role in boosting the confidence of disabled people. For example, the Special Olympics for people with disabilities is a way of improving the confidence of people with special needs in the sports industry. Also, special recognition should be given to special achievements attained by people with special needs. Overall, the fair treatment of disabled people will help in picking up the confidence of disabled people. High self-esteem also allows us to accept who we are, with all our limitations and weaknesses and ask for help when necessary, simply because we can learn to focus on our strengths and what makes us unique as without self-esteem life will always feel a lot more cumbersome than it actually is.

Examples of good practice people with Down syndrome are expected to live a life as full as they want, this means they have the freedom to make choices of their own on what they need for themselves which is their person-centered planning. The society plays a major role in accepting people with Down syndrome where society develop an attitude that will prevent Down syndrome people to participate in community life. They should be offered a status that observes their right and privileges as citizens and in a real sense preserves their human dignity. More so people with Down syndrome will, in turn, prove society with a most valuable humanizing influence. There are various types of assistance available to people with Down syndrome in Ireland.

Newborn; there is the availability of professional experts and counselors for nursing mothers and their babies.

• Support Groups: This is various groups either within the community, hospitals, homes, volunteers ‘groups, who dedicate time, resource and energy to include finances in support of persons with down syndrome and their programs.
• Training: This is another good practice in training staffs, caregivers and families who will be caring for the person with Down syndrome. Most of the patients require special needs and with such comes high-level care and responsibilities. It is imperative to provide special training for those caregivers either paid or voluntary.
• Fund Raising: It is a known fact that because of the challenges of Down syndrome and the needs of most patients; there is a high cost and expense involved in caring for their needs. Fundraising and other means of generating funds in support of the programs and processes for care are good practices made available for persons with Down syndrome. The process of raising funds in continuous and there is no limit to the number of societies, communities, cooperate sponsorship and support, government support, religious places and a host of other organization have been known to come out in support of persons with Down syndrome

Awareness programs, social welfare, and care: To help build awareness, educate the masses and get the people informed, both public or private sector in involving in various support programs and processes geared towards creating social awareness to benefit persons with Down syndrome. Such programs range from sporting events, seminars and conferences, outreach programs, entertainment, cultural affairs, community events and celebrations and so on.

Education: Education is very important and essential for both adults and minors with Down syndrome. There are special programs considered in line with the Individual Education Plan (IEP) used for educating those children faced with the challenge of Down syndrome. Children with Down syndrome, who have a moderate assessment, receive an average of 3.5 teaching hours as oppose children with mild assessment who receive 2.5 hours.

There has been a change in attitude, mainly because people with Down syndrome no longer see themselves as recipients of charity, but as people who have rights as citizens to fulfill their potential. Government policies, both nationally and internationally, have exposed a vision where people with disabilities are valued, respected and included. This vision has provided a movement for change in the practices of people working in the disability area focusing on participation and interactions for people with a disability with others who do not have a disability in everyday living. Inclusion means involvement in activities, developing and maintaining relationships, and having a sense of belonging. It is important that people are not segregated due to their disability in living or working arrangements. (www.nap.ie national Action plan).

CONCLUSION

Down syndrome is no doubt a challenging condition, which has gained better and improved attention, knowledge and care over the years in Ireland. Due to the nature of the condition and requirements in caring for persons with Down syndrome, the demands for care-professionals is on the increase, awareness is growing and there has been improved programs and processes through research and planning in providing better treatment and management for persons with the condition.

I, therefore, conclude that having down syndrome is very difficult to have. The birth of a child with Down syndrome may demand a new lifestyle for the family. Parents of children with disabilities are subject not only to the pressures and tensions faced by parents of nondisabled children but also to the unique challenges and experiences associated with parenting a child with a disability. In about 95 percent of cases of children with Down syndrome have an extra chromosome 21. Just over 20 percent of infants with Down syndrome are born to mothers less than 35 years old, get these older mothers to have only 6 to 7 percent of children. However, the number of women having babies after 35 has been rising quite rapidly in the last few years.

Is Down syndrome in cats possible? This is one of the common questions animal health professionals are constantly faced with. Though the answer to this question comes in the negative, it is quite true that members of the feline population do posses some down syndrome-like symptoms from quirky physical appearances to unusual behavioral traits

For this write-up, we will be looking at the possible genetic mutations in kitties that can engender those down syndrome-like qualities including how to know when your feline is displaying such symptoms.

Down Syndrome Explained

Down syndrome is described as a congenial disorder among humans with both intellectual and physical effects on those diagnosed with the condition. The health problem is as a result of a chromosomal defect. The nucleus of each of the cells in humans contains 23 pairs of chromosomes and victims of Down syndrome have 3 copies, either partial or complete of chromosome 21. Certain physical traits may be evident in such people like short stature, low muscle tone, some degree of learning impairment, a flat nasal bridge and many more.

The felines have just 19 pairs of chromosomes. What this means in effect is that it is technically impossible for us to have Down syndrome in cats. This is not to say that they don’t exhibit some down-syndrome-like symptoms.

Can a Cat be Born with Down Syndrome?

Just like in humans, genetic mutations also occur among the felines. It is not uncommon to observe both neurological and physical abnormalities among our feline companions. However, abnormalities that are not within the most common forms of challenging behavior are not necessarily from extra chromosomes or gene mutations.

Furthermore, a cat’s genetic structure is quite distinct from that of human. Down Syndrome is essentially a chromosome irregularity, caused by the creation of what is referred to as a trisomy, or an additional chromosome within the Chromosome 21 pairing in humans. Because of the 19 chromosome pairing in cats where human have 23, a possible trisomy of the Chromosome 21 pairing in cats becomes impossibility.

So, the answer is no, Down syndrome in cats have never been diagnosed, though they do suffer from some neurological and physical abnormalities, which also include other abnormalities involving the chromosomes….just that Down syndrome is technically impossible with the feline genetic structure.

How do you know a cat with Down syndrome

A cat with the condition will exhibit some intellectual impairment fraught with lack of response to some basic commands like failure to answer when called. Their appearance may be somewhat aloof, as if they are not capable of acknowledging their environment properly. The cause of this kind of neurological problem among our furry friends may be laid at the door step genetic or emotional factors. This disorder can be observed in all felines, irrespective of age or breed

Down Syndrome-Like Signs and Symptoms in Cats

Down syndrome-like symptoms among felines are too numerous, but we are going to discuss a good number of them

1. Relative to the slightly slanted and closer-set eyes of the felines, the ones suffering from the condition have rounded eyes that are wide-set. Their ears may look droopy and stunted rather than the normal alert-looking and pointy ears of felines. Button-like and upturned nose is evident as opposed to the gracefully pointed nose. The shape of their faces may also have that slightly off appearance.
2. Compared to normal cats, the behavior of felines with Down syndrome is considered abnormal with their wobbly and clumsily movement, as opposed to the normal grace and agile feline movement. Bad coordination is also evident as these cats tend to constantly bump and fall. What’s more, they display strange habits such as sitting and meowing in a different way.
3. Also affected is the manner in which the Down syndrome cat would socialize with humans and other household pets. Even in their litter, they exhibit a different behavior from the rest – where their mates shy away from strange and new companions, they tend to embrace any newcomer and are often friendly. There is also lack of response when you call them for reprimand.
4. Human victims of Down syndrome are susceptible to certain health issues; Down syndrome in cats makes them susceptible too. Some cats develop very poor muscle tones, impaired vision. Detrimental hearing problems are also evident.
5. Other symptoms include, Perpetually saddened face, Upturned eyes, Difficulty in excreting, Motor dysfunction, Hearing loss and many more.

Genetic anomalies that may looklike feline Down syndrome

Though Down syndrome does not really occur in cats, the members of the feline population are still susceptible to other genetic anomalies that are similar to Down syndrome. They include

Cerebral Hypoplasia

One of the genetic conditions that resemble Down syndrome in cats is cerebral hypoplasia. This happens when some parts of a feline’s cerebellum are not developed completely. Symptoms are difficulty with walking and standing, clumsiness that can make the cat experience leg tremors and bob their heads often.

Cerebral hypoplasia may be as a result of poisoning, malnutrition, or birth defect. The developmental disability has no known cure; you can only manage it by protecting the cat and ensuring that the chances of it coming to harm are limited.

Klinefelter Syndrome

Klinefelter syndrome is a genetic condition that causes a male feline to be born with an additional x chromosome. Male calico cats are rare, and when they do occur, they are most certain to be born with Klinefelter syndrome. Neutering is not necessary for these males as the condition causes sterility. Some odd behaviors may be observed in the cat, like enticing the other males to come and mate with him. Apart from this, the cat will be relatively normal.

Distal polyneuropathy

This is common and a type of nerve damage that is associated with diabetes mellitus causing numbness or pain in the cat’s limbs. Symptoms include seizures, paralysis, unsteady gait, tremors, and weakness. Diagnosis can be done through urine sample, blood work, or electrophysiology.

Some effective treatments for distal polyneuropathy include nutritional support and electrolyte therapy. However, the underlying cause is what will determine whether the cat will recover or not. If the cause is allergic reaction, then you just need to alienate your furry from the trigger. Important to note that cats with such condition may not live long.

Feline Dysautonomia

We cannot conclude talks on genetic condition that looks like Down syndrome in cats without considering feline dysautonomia or Key-Gaskell syndrome.

When there is failure in the autonomic system affecting the gastrointestinal and urinary tract, it leads to distension in the cat’s bowels, esophagus, and bladder. Symptoms are droopy eyes, swellings, weight loss, loss of appetite, depression, as well as a precariously slow heart rate. There is no cure available for this condition, you can only treat the symptoms and they occur.

Deletion syndrome (monosomy 1p36):

It is known to be one of the most widespread deletion mutations (structural mutation) and it is the most common terminal deletion syndrome observed in humans , occurs in one in every 5000 to 10000 live births , it is considered to be congenital genetic disorder caused by a genetic heterozygous deletion of the outermost band on the short arm (p) of chromosome (Heilstedt et al., 2008; Wiley ‐ Liss, 2007).

Clinical features:

The child with monosomy 1p36 is characterized by :

1. Moderate to sever mental retardation.
2. Developmental delay.
3. Impairment hearing and vision and absent speech.
4. Craniofacial features such as microcephaly and the anterior fontanel is large (delayed closing)
5. Seizure
6. Delayed growth.
7. Facial features such as flat nose, deep set eyes, pointed chain, straight eyebrows, long philtrum and mid-face hypoplasia.
8. Hypoplasia.
9. Obesity.
10. Congenital heart defect (Heilstedt et al., 2008).

Complications of 1p36 deletion syndrome:

Other features of monosomy 1p36 are associated with behavioral problems including seizures, left ventricular non-compaction (LVNC), hypothyroidism, obesity and hyperphagia. The patients may also be suffering with type 2 diabetes mellitus with marked insulin resistance due to hyperinsulinism and decreased glucose metabolism. Other complication is their left-ventricular non-compaction (LVNC) due to congenital heart disease as we mention previously, cardiac abnormalities such as structural cardiac defects and dilated cardiomyopathy are common disease in patients with monosomy 1p36 (Thienpont et al., 2007; Stagi et al., 2014).

Methods for detection of 1p36 deletion syndrome:

First of all, observe the characteristics facial appearance of monosomy 1p36 including straight eyebrows, deeply set eyes, depressed nasal bridge, and also observe craniofacial such as microcephaly and late closing anterior fontanel and other characteristics, then we can use FISH to detect at least two subtelomeric region – specific probes, can also use methods such as quantitative PCR, long-range PCR, multiplex ligation – dependent probe amplification (MLPA) and chromosomal microarray (CMA) that includes this gene/chromosome segment (Battaglia, 2013).

Down syndrome (trisomy 21)

Is a genetic defect caused by a mistake in cell division during premature development of the fetus, it is one of the most common genetic causes of mental retardation, in most cases Down syndrome is not inherited, only about 3-4% of children with Down syndrome inherited it from either their mother or father. It is occur when chromosome 21 make three full or partial copies of itself rather than two copies. There are some risk factors that increase having baby with Down syndrome include:

1. Advancing maternal age,
2. One of the parents being carrier of the genetic translocation for Down syndrome,
3. Having had one child with Down syndrome (American Family Physician , 2000).

Clinical features:

1. Defect in development such as language skills impairment and specific impairment in speech.
2. Mental retardation, intellectual disability, and learning difficulties.
3. Short‐term memory and the verbal memory in childhood and infancy.
4. Relative impairment in general movement skills (Fidler, 2005).

Complications of trisomy 21 (Down syndrome):

The children with Down syndrome are at high risk of suffering from multiple complications including, heart congenital defects, about 50% of the children with Down syndrome are born with some defects in their hearts. These heart problems can be fatal and may require prompt surgery in premature childhood. Gastrointestinal Tract (GIT) defects, may include abnormalities of the intestines, esophagus, and anus. the risks are increase as the patients can exposure to problems such as GI blockage, heartburn (GERD) or some digestive disorders. Immune disorders, they are have more tendency to develop autoimmune disease including cancers. Obesity, they are have greater tendency to become obese than normal people (Boseley et al., 2000).

Methods for detection of Down syndrome:

There are some methods that use during gestational months especially for women above 35 years old to detect and diagnose the likelihood of having baby with Down syndrome include blood test , this blood test measures the levels of the maternal serum concentrations known as human chorionic gonadotropin (HCG) and pregnancy-associated plasma protein-A (PAPP-A) were determined by microtiter-plate ELISA. Abnormal levels of HCG and PAPP-A may indicate a problem with the baby. Nuchal translucency test, an ultrasound is used to measure a specific area on the back of the fetus neck to examine if the fluids in this region are within the normal range or not (Tsai et al., 2001).

Down syndrome is a genetic condition that occurs at conception. It occurs due to the division of chromosome 21, which is why Down syndrome is referred to as trisomy 21. Which means it is an extra copy of a chromosome. Down syndrome is not an illness and cannot be cured, and each person who has Down syndrome is different in physical features, health and intellectually. There is no known cause for Down syndrome and can happen to anyone world wide. “Down syndrome is the most common chromosome disorder that we know of. One in every 700-900 babies world wide will have Down syndrome. Although this number is lower in Australia.”(Down Syndrome Australia) Because no two people are the same the impact that having Down syndrome is also different however there will be an intellectual and development delay to some extent. Common differences to Down syndrome are a bent little finger, excess skin on the back of the neck, low muscle tone which can affect development physically plus swallowing and eating. Some other developmental experiences may be delayed, they can be physical delays such as sitting up and walking, short in stature and speech delay. Some people with Down syndrome can have heart and thyroid disease, hearing and eyesight problems. A student with Down syndrome that has health issues may need regular time off school for appointments which will impact on the education of that student. A student may also require reinforcement of rules and expectations to maintain correct behaviours. Due to physical development they may take longer to complete tasks such as eating lunch, going to the bathroom and general movement through out the class which can be disruptive to other students. Accommodations however have to be made to insure the needs of the student are being met.

A teacher aide can support the needs of a student that has Down syndrome under the guidance of the classroom teacher in many ways. A student may require assistance with following instructions if they are hearing impaired and an assistant can help the student with understanding with clear, simple and face to face instructions. The teacher aide can also assist with key word signing if language is delayed, prompting can also help. A teacher aide also has a responsibility to promote equality and diversity by encouraging the student’s interactions and inclusion in activities and games with other students by modelling correct and appropriate use of language, and educating students about peoples differences, similarities and needs will ensure the students have empathy and respect towards each other. Some adaptations to activities may be required depending on the students level of need, making small changes to assist in their fine and gross motor skills. Having larger paint brushes and pencils to help them grip and hold better, assisting with using scissors. Allowing extra time with running and have mats or cushioning on the ground if climbing or balancing activities.

A student with Down syndrome may require ongoing care and support from a number of specialists, these may include special education teachers, speech therapists, occupational therapists and physical therapists. A child’s physical and mental development will benefit greatly if they have intervention from specialists from a very early age. “ The early years lay the foundation for all future development. Recent scientific evidence shows that early experiences literally shape our lives by affecting the way the young brain develops. What happens to us in the early years has a major effect on our health and social development right through to adulthood.”(Down syndrome Australia)

A physical therapist will help a child to build strength and support motor skill development to enable the child to reach physical milestones such as rolling over, crawling and walking plus balance and co ordination which can be hindered by the low muscle tone that people with Down syndrome have. Speech therapy will help strengthen the muscles that help a child to chew, swallow and construct speech. They also help a child to not only speak clearly but to understand the words. An occupational therapist will assist with a child’s fine motor skill development, such as getting dressed, cleaning their teeth and writing. Occupational therapists also help to improve everyday functions and promote independence for the child. Special education teachers are called upon to work in collaboration with the other specialists and the classroom teacher to create a learning program that is tailored to meet the needs of the student by adapting the curriculum.

A teacher aide can demonstrate empathy and respect by caring and listening to the thoughts and feelings that the student may have. Asking open ended questions and questioning if they need assistance after allowing them to try, not just taking over and doing things for them for example opening a jar or cutting with scissors. Being positive in my own attitude towards the student and modelling respectful behaviours and communication is also a way to demonstrate respect and empathy. A student with Down syndrome will benefit from constructive praise especially with the good things they do, remembering rules of the class or a routine without being reminded or told. Assisting a child with Down syndrome with interactions and guiding them with appropriate conduct when playing with others, sharing games and equipment will encourage inclusion with their peers which is a boost for self esteem as well as developing their social skills. When a student shows improvement or try’s something new, being praised and encouraged will help to develop and increase their self-esteem. “ By providing opportunities for the student with Down syndrome to interact, learn and play with their peers will help them to build friendships which will in turn increase their self-esteem, problem solving skills and social skills. Having students learn or negotiate taking turns at using resources or playing games is extremely important in their development.”(Down syndrome guide, 2016)

There is so much equipment and resources available to help a student with Down syndrome. Equipment used will depend on the learning activity, computers and IT will help students as holding a pencil and forming letters can be difficult. Computers assist visual learners and non verbal students with Down syndrome. The computer programs used can be adapted to the learning needs of the student with literacy, forming sounds with letter combinations or matching pictures with words. Fine motor skills can be developed and assisted with activities such as threading coloured beads, this can also be a mathematical activity with counting and classifying the colours or beads. Between class activity rotations or to recognise breaks times the students on the teachers command may toss a cushion, small ball or bean bag to each other or into a bucket. This will also assist the student with Down syndrome with not only catching and motor skill development, but with peer interactions and understanding what is coming up next in the day. Classroom strategies such as having defined activity changes, bold bright coloured posters with rules and expectations for the students to follow and communicating with short sentences,clear language and appropriate facial expressions are ways to support a student. Allowing a student with Down syndrome to have extra time to finish exercises and answer questions. Assigning a ‘buddy’ to help the student if needed, or assigning specific jobs for the student to do, such as, handing out worksheets or lunch boxes from the fridge are all strategies that can assist a student with Down syndrome with either social interactions or class learning.

Modifications to activities can include; for a writing activity the student could type the words or use speak to text if their language is clear. For a mathematical activity using visual clues like 4 apples or 3 red cars can assist a student to understand the problem better. And for reading, an audio book if the student is beginning to read and then they can follow the words being said in the book, or having larger font and colourful books which will engage the student in the activity.

A student with Down syndrome is expected to follow and adhere to the same class and school rules as other students, and because of a students intellectual immaturity can sometimes find it difficult to follow but with simple rules given and reminding the students of the rules and even asking if they understand what is being asked for example ‘No speaking while the teacher talks’. Having a reward system can also be a way to encourage correct behaviour from all students not just the student with Down syndrome. Having visual reminders around the room for the student to see and reinforcing the expectations as well as using descriptive praise when the student does behave correctly; Well done Sophie for not calling out or for sitting quietly and patiently are a good way to set boundaries within the classroom and establish expectations.

To help a student with Down syndrome develop problem solving skills you can have activities with puzzles, role play games, painting, sharing resources with others and cooking and gardening. Problem solving skills are very important for cognitive development and asking open questions while engaging in these activities will help with the processing of information. For instance what are the steps that need to be taken to pot a plant; the right size pot, how much soil and when to water it.

For an inclusive and successful education to be achieved for a student there has to be a combined effort with regular communication between the parents, teacher, specialists and support workers. No two people with Down syndrome are the same, and any strategies, modifications and plans that are put in place need to be monitored regularly. Creating activities that encourage the student to learn and engages them with things that they like will help the student to develop and reach their learning goals.

The highly discussed Down-Ageing Syndrome is right at the top of numerous other changes that are taking place in the world today and thus, is a topic of great interest. All over India, urbanized people who have reached 40s and even 50s are completely defying their age not just simply by looking young but also through their lifestyles, personas and behaviors. Middle-aged actors, industrialists and even common people are doing every possible thing one associate with the bubbling juvenility. Jeans and T-shirts, which is normally associated with the youth, has become the default dress style of all. It has also been observed that the middle-aged people are fervent consumers of those products that are mainly used by the young. However, marketing strategies have a lot to do in making these people behave like teens. Various products, which promise to make them look and feel young, have brought about a belief among them that looking young has many advantages. According to a study by IMBR, it has been found that almost 41% of middle-aged Indians feel that it is important to appear attractive to the other sex. The consumption patterns have changed and now the marketers are not only targeting the young but also those who are youthful. (Sangameshwaran, 1)

This vanity consciousness between the middle-aged people is not new as the beauty industry is more or less built on it. The number of beauty parlors and gymnasiums has also increased in the past few years. People are more and more asking for treatments, like botox, to look younger. Some even visit the beauty clinics to look more appealing in their workplaces. The syndrome is also due to a mental change in the people who no longer tone down their behavior with age. They still look forward to things, which they could not have as youngsters. For example, a lot of them have a profound interest in tech products. They buy sleek laptops, funky mobile phones, music players, and even Playstations. They also prefer adventurous and offbeat holidays rather than simply the relaxing ones.

From the above we can easily understand that the down-aging syndrome will last for a long time. The older customers are more and more looking for the youth dominated fashion categories like mobiles and denims. The middle-aged people are seen with sports cars flashing funky designs. As a result of all of this segmentation has become very important and various companies will need to develop products with details to supply these sub-segments, thus, modifying their marketing mix strategies. However, as we live in an environment with apparently converging consumption styles, the seasoned marketers have the opinion that we should try and not be deceived by the traditional marketing traps. The result of changing the target audience before properly understanding the needs of the customers can sometimes be disastrous. Not all middle-aged consumers are attracted to products that are meant for the youth. However, if the marketers broaden their target audience to include both the young and old, they might lose the older customers. Thus, it is important for the brands to target the young consumers as they more likely to stay with it longer and they benefit from this as the older consumers consider the brand to be youth centric too.

Works Cited

Sangameshwaran, Prasad; The Great Down-aging Syndrome: Why 40 is the new 20;

The Economic Times, (New Delhi, India), Wednesday, 2009.

Introduction

Blood tests for Down syndrome are ethical and should be available to everyone. In my opinion, this decision is the most ethical because it invites parents to make an informed decision. The rationale for finding this option is the most ethical theory of utilitarianism. An action is morally justified if it leads to the greatest welfare for the greatest number of people (Pence, 2016). This theory works because prenatal testing minimizes the negative consequences for all participants in the scenario. The key points of contention in the discussion are the justification of the risks, the ethical choice on the principle of health, and the responsibility for stigmatization.

Opposite Position

The key term in this discussion is ‘prenatal testing’, specifically referring to blood testing during the first trimester of pregnancy. The ubiquity of this screening becomes close to eugenics, in which people choose to reproduce children only with certain characteristics (Nov-Klaiman et al., 2022). The strength of this argument is that children with Down syndrome have a chance to grow up able-bodied. However, my opinion is that all parents should be able to make an informed choice.

Most Important Things:

1. Prenatal testing is safe for future mothers and fetuses.
2. When developing new medical technologies, ethical considerations must be taken into account.
3. During pregnancy, parents should be able to make an informed decision.

Ethical Theory

The fundamental point in utilitarianism is proceeding from a moral assessment of the result of an action. The parents of the child are either prepared for possible difficulties, or they make a balanced decision. The child also benefits: their parents are either fully committed to doing everything possible for their health and development, or they are not experiencing pain. Expectant parents are mentally prepared, thereby significantly reducing the risk of postpartum depression (Smith et al., 2018). Parents can take training courses, and a child with Down syndrome will be more likely to grow up healthy.

Conclusion

Prenatal testing can be considered ethical. Screening blood tests provides an opportunity for parents to decide on the birth and upbringing of a child with special needs. When making a positive decision, future parents have the opportunity to prepare mentally for the birth. Prenatal testing for Down Syndrome has nothing to do with eugenics, as the decision is made by the parents themselves. Providing every prospective parent with the possibility of such testing should become mandatory.

References

Nov-Klaiman, T., Raz, A. E., & Hashiloni-Dolev, Y. (2022). A test of faith? Attitudes of ultraorthodox Jewish parents of children with down syndrome toward prenatal testing. Disability & Society, 1-21.

Pence, G. E. (2016). Medical Ethics: Accounts of Ground-breaking Cases, 8^th edition. London: McGraw-Hill.

Smith, S. K., Cai, A., Wong, M., Sousa, M. S., Peate, M., Welsh, A., & Barclay, M. (2018). Improving women’s knowledge about prenatal screening in the era of non-invasive prenatal testing for Down syndrome–development and acceptability of a low literacy decision aid. BMC pregnancy and childbirth, 18(1), 1-14.

Introduction

Down syndrome appears to be the most widespread human chromosome disorder. It is associated with multiple problems connected with cognitive abilities and chronic health conditions. In addition, in the context of the present-day developments, the possibility to detect a free-cell fetal DNA stays extremely relevant, and new suggestions in this regard are introduced. For this reason, pregnant women need more assistance and useful scales, which are highly likely to provide the essential help in conducting the most rational decision. For this reason, modern scientists attempt to research multiple issues connected with the presence of Down syndrome, from its detection to minimizing its negative consequences on further life. Therefore, the purpose of this paper is to review the recent publications on Down syndrome, outline key questions, and supply modern solutions in case it is possible.

Chronic Health Conditions and Cognitive Deficits

Patients with revealed Down syndrome are highly likely to have a range of chronic health conditions. However, the question of their influence on cognitive ability still stays unanswered. A group of researchers, Gandy et al., explore this issue in the article The Relationship between Chronic Health Conditions and cognitive Deficits in Children, Adolescents, and Young Adults with Down Syndrome: A Systematic Review. Its objective is “to assess this relationship by evaluating studies that measure cognitive performance in the context of Down syndrome-associated chronic health conditions” (Gandy et al., 2020, p. 1). The research includes participants of different ages, namely children, adolescents, and young adults with Down syndrome, and involved quantitative studies, the number of which comprised 15 items. Furthermore, the conclusions regard both chronic health conditions and cognitive abilities. The study revealed the connection between sleep disorder and cognitive dysfunctions and the presence of Down syndrome. Such patients have problems with attention, verbal processing, and execution, and they may be aggravated by sleep disorders. Therefore, it is important to take appropriate actions at the early stages to prevent adverse cognitive outcomes.

Down Syndrome and Congenital Heart Disease

Approximately half of the patients with Down syndrome have congenital heart disease (CHD), and the complete atrioventricular septal defect is the most widespread. Children, who are not diagnosed with CHD, have significantly better outcomes. The same tendency is characteristic for the patients, who addressed this problem at early stages. Islam et al. (2020) state:

“Some reported increase mortality rates, length of hospital stay, and morbidities such as duration of ventilation and infection rates, whereas others suggested similar or improved outcomes for patients with Down’s syndrome who underwent atrioventricular septal defect repair” (p.35).

The studies on the consequences of congenital heart surgery are conflicting, so the article Down’s Syndrome with Congenital Heart Disease: Our Surgical Experience is aimed to clarify this issue. It is based on the surgery practice of the authors and analysis of patients’ outcomes. The study reveals that CHD appears to be the primary reason for morbidity and mortality. Congenital Heart Surgery contributed to the solution to this problem and supplied better outcomes with a satisfactory level of morbidity and mortality.

Prenatal Testing for Down Syndrome

At the end of the last century, the possibility to analyze fetal DNA and detect a free-cell one, which appears in the maternal bloodstream, was applied to the practice. This approach is highly likely to be accurate for revealing Down syndrome in the fetus. In addition, this methodology may be considered more advantageous compared to the first trimester combined screening, as it implies minimization of miscarriages due to the non-invasive nature. Thus, prenatal testing for Down syndrome implication in standard NHS practice is perspective in the long run. For this reason, Bills et al. (2016) published the article Non-invasive Prenatal Testing for Down Syndrome in General Maternity Services. It is devoted to multiple issues connected with this approach.

The researchers provide a comparison between the first trimester of combined screening and non-invasive prenatal testing (NIPS). The latter implies significant advantages, such as a more accurate detection (99,2 %), “low false-positive rates (0,09%), non-invasive nature, and ability to reveal other syndromes (Bills et al., 2016, p. 557). However, there are some “special patient groups”, such as obese pregnant women, in whom the results may not be fully validated (Bills et al., 2016). In addition, the test may be conducted from 11 weeks gestation, and the process of additional testing and decision-making may endure to 15 weeks, which is an advanced gestational age (Bills et al., 2016). Moreover, there is a question regarding which health care specialists should deliver the counseling and conduct NIPS to match high standards (Bills et al., 2016). Thus, the method is progressive and highly likely to be beneficial in the long run, though it is crucial to address the issues mentioned above.

Pregnant Women’s Attitudes and Decision-Making

A limited amount of literature describes both how the Down syndrome diagnosis is established and how the decision is conducted by pregnant women, which incurs the impact of the social context, social media, and family. The article Pregnant Women’s Attitudes and Decision-Making Regarding Prenatal Down Syndrome Screening and Diagnosis: Scale Development and Validation is aimed to fill this gap. Its purpose is to “test the validity and reliability of a scale that measures pregnant women’s attitudes and decision-making concerning prenatal Down syndrome screening and diagnosis in urban areas of Taiwan” (Huang et al., 2020, p. 1). The study proved that the scale is valid and reliable enough to comprehend pregnant women’s attitudes and the process of conducting decisions on the question of Down syndrome screening and diagnosis. In addition, it appears to help establish appropriately tailored consultations for these women in clinics.

Apart from the aforementioned use, the scale can be applied for designing tailored messages needed in the process of decision-making. Huang et al. highlight: “using the scale in a clinical setting can provide healthcare providers to understand pregnant women’s attitudes and decision-making process before using decision aid tools” (2020, p. 8). Therefore, it presents a sufficient option, which may significantly contribute to reaching the most rational solution.

Conclusion

In conclusion, it should be mentioned that a great number of innovations and explorations are advanced in the field of Down syndrome research. Some of them do not provide a solution, which is effective in 100% of cases, though they significantly contribute to the improvement of the current situation and lead to a better lifestyle. In addition, some of the innovations in case of further adjustments and improvements may be beneficial in the long run and highly likely to provide the best possible options, which minimize the negative consequences. However, it is crucial to take all the details and specialties into consideration.

References

Bills, V., Ford, J., Duffner, A., & Soothill, P. (2016). Non-invasive prenatal testing for Down syndrome in general maternity services. British Journal of Midwifery, 24(8), 556-561. Web.

Gandy, K. C., Castillo, H. A., Ouellette, L., Castillo, J., Lupo, P. J., Jacola. L. M., Rabin, K. R., Raghubar, K. R., & Gramatges, M. M. (2020). The relationship between chronic health conditions and cognitive deficits in children, adolescents, and young adults with down syndrome: A systematic review.PLoS ONE, 15(9), 1-13. Web.

Huang, W.-H., Shih, S.-F., Lin, C.-L., & Liu, C.-H. (2020). Pregnant women’s attitudes and decision-making regarding prenatal Down syndrome screening and diagnosis: Scale development and validation.BMC Pregnancy and Childbirth, 20(407), 1-9. Web.

Islam, M. Z., Jahan, S. I., Moinuddin, S., Rushel, K. S. S. Z., Islam, S., Islam, F., Hasan. K. A. (2020). Down’s syndrome with congenital heart disease: Our surgical experience.Cardiovascular Journal, 13(1), 35-39. Web.

Introduction

There is nothing more satisfying than jovial people who are full of life and happiness despite their medical conditions. Jovial mood greeted me when I visited a nuclear family, which has a child aged ten years who suffers from Down’s syndrome. Down’s syndrome is a congenital disorder, which emanates from the inheritance of an extra chromosome from either parent. The disease is caused by chromosomal aberrations during fertilization or after conception. Down’s syndrome is not a fatal malady because most of the people survive into their adulthood. The only demerit, inherent among the people with Down’s syndrome, is that males are at high risk of impotence and females at a high risk of bareness. In this view, this report narrates the story of a ten-year-old child called Martin, who suffers from Down’s syndrome.

Life History of Martin

Martin, the firstborn, is a ten-year-old child, who has been suffering from Down’s syndrome since birth. Her mother says that she had a normal pregnancy when she conceived Martin, and she was not aware of any anomalies, which would affect his son. The mother attended prenatal care clinic regularly for normal check-ups, and there was no evidence that her foetus had any form of defects to warrant advanced medical examination. The parents were so happy and expectant because Martin was their first child. However, when Martin was born, the parents noted some abnormal facial features, which indicated that Martin had apparent physical defects.

To understand the kind of abnormality their child was suffering from, the parents sought medical attention from the nearby hospital where doctors performed numerous diagnoses. Given that Down’s syndrome is a rare disorder, though has a wide global distribution amongst all races, the doctors did not immediately establish the cause of the abnormality. After careful deliberations on the possible causative factor, the doctors suspected Down’s syndrome and decided to perform numerous tests.

The Outcomes

The detection technique involved drawing blood from the veins and checking for the number of chromosomes. To their consternation, the test turned out to be positive. Martin’s mother could not withstand the shock and even fainted. When she regained consciousness, the couple decided to inquire from the doctor to answer any questions that lingered in their minds. They wondered if it was their fault in aspects of lifestyle or diet.

As parents were dejected, the doctor tried to answer them appropriately that Down’s syndrome did not occur due to their fault, but it is caused by the uncontrollable genetic phenomenon. The parents felt reprieved for they would never have forgiven themselves if it had occurred due to their folly. The guilt would have haunted them for the rest of their lives. The relief, however, was short-lived for the doctor went ahead and burst their only bubble of hope when he told them the disease was incurable. They both broke down. Nevertheless, the only solace came when they were told that the disorder is manageable.

Managing Down’s syndrome

Martin’s parents attend regular lectures to learn on how to manage Down’s syndrome, and so far, they have excelled in it. Martin lives in a serene environment, full of love and care, as the parents never argue in front of him. A visit to Martin’s room shows how he is happy because his room is full of all kinds of toys and learning materials. Toys and visual materials are good for a child’s mental and physical development since they help nurture a child’s artistic skills and thinking patterns. The toys and visual materials are particularly important bearing in mind that Martin is a slow learner, who is behind his peers in learning.

During our interaction, Martin accompanied us to his room and immediately started to ride his train. He was really having a good time. When I asked about his schooling, I was told he learns at home. His parents have hired a private tutor, who teaches him during weekdays from 8 am to 2 pm because he requires a relatively long time to learn.

Martin requires special intervention to help manage his condition. He has a slightly impaired vision and hearing. He wears spectacles and regularly visits his oculist for eye check-ups. He also wears an assistive device to improve his hearing. After playing for a while, he followed us to the living room, and I was moved to tears when he took my hand into his and asked my name. It was the first time I was encountering his social skills. I told him, and he took his time to respond. He also has a speech impediment for he has a relatively small mouth and a big tongue. His mother told me they take him for speech therapy classes.

A miraculous improvement I noted is that Martin can now talk despite the fact that he had autism when he was young, thanks to speech therapy. His vision is good, proven by his ability to reach out for things, with ease. Martin has a short stature, about that of a five-year-old because he has low levels of growth hormone. I realized the family incurred huge medical expenses in treating Martin’s condition. His parents say the government comes to their aid by catering for some of these expenses. Currently, Martins’ parents are members of a charity organization that helps people with Down’s syndrome.

The parents prepared snacks, and Martin did not waste time to partake his share. He ate normally and even asked for more. Soon the doorbell rang, and to my surprise, Martin left the dining table and ran to the door. It was his friend, Joash, from next door. Joash is Martins’ age mate and has known each other since they were little. Martin shook his hand, and they immediately went to his room and started playing with Joash’ tennis ball. A short while later, they requested to leave the house to go and play in the garden. We followed them outside and watched as the two enjoyed playing time. Soon it was my time to leave. Martin and his parents escorted me to their small gate, and it was all smiles as I left, Martin waved goodbye and requested me to visit them again.

Conclusion

Though the children are suffering from Down’s syndrome, it does not mean they are lesser beings compared to normal children and should not be treated as such. They only suffer from a genetic condition that is neither their parents’ nor their fault, but simply an act of nature and one that cannot be controlled. Although a cure does not exist, the disease is manageable with special care and interventions. The children live normal lives and grow up to become responsible adults throughout their lives. The disease is not restricted to people living in certain regions or a particular race, nevertheless, it is a global scourge. Essentially, people with Down’s syndrome are not abnormal, but they only have an extra chromosome.

Genetic and Biological Nature

Down syndrome refers to the genetic condition under which an individual has 47 chromosomes instead of the accepted 46. The major cause of the syndrome is associated with the existence of extra copy of the 21^st chromosome. This kind of Down syndrome is referred to Trisomy 21. The presence of extra chromosome leads to pathology of brain activity.

From a biological point of view, Down syndrome is considered the most frequent reason for human birth defects. However, there is no evident connection between parent’s activities before and during pregnancy and form of Down syndrome (U.S. National Library of Medicine n. p.). Any physical activity that a future mother can perform cannot influence the development of the disease.

Despite this, the probability of the emergence of Down syndrome is highly associated with the maternal age, particularly with teenage pregnancy. The occurrence of the deviation is also possible for the pregnant of older age. Consequently, genetic counseling should play a decisive role in defining the causes of Down syndrome.

Types of Tests Identifying Down Syndrome

There exist a great number of prenatal tests that can help to identify the presence of Down syndrome during pregnancy. They involve triple screen test, MSAFP test, cordocentesis/PUBS, and amniocentesis, first trimester screen, chorionic villus sampling, and the Quad test.

By means of triple screen test, it is possible to identify a maternal bond between mother and fetus (American Pregnancy Association, n. p.). The test also looks for such specific substances as Estriol, human chorionic gonadotropin (hCG), and alpha-fetoprotein (AFP). The test is a non-invasive procedure that is carried by means of blood test with low risk for a developing baby.

The triple screen test serves to identify Down syndrome in cases the level of AFP is low and the levels of hGG and estriol exceed the norm. The triple screen test is a safe procedure and no health risk is associated with it. Similar effect is produced by the Quad Test.

The Maternal Serum Alpha-Fetoprotein Screening (MSAFP) is carried out during the second trimester an it is also known as Alpha-Fetoprotein Test (AFP). The procedure allows to examine the level of AFP during pregnancy. It is performed as a part of triple screen test.

MSAFP identifies alpha-fetoprotein, which is found in amniotic fluid and fetal serum. The test does not pose any threats to health, except for the discomfort that a patient might feel during blood drawing.

Cordocentesis, also known as Percutaneous Umbilical Cord Blood Sampling (PUBS), examines fetus blood to identity fetal pathologies. The test is carried out by means of ultrasound that determines the location of umbilical cord’s insertion into the placenta.

The test can detect chromosome pathologies, such as Down syndrome and define any malformations of the fetus. Although, cordocentesis is recognized as a safe procedure, there is a potential risk of miscarriage that might occur one or two times for every hundred procedures.

Amniocentesis test is often chosen by parents who have genetic or inherited concerns and is used to predict if there are specific abnormalities. While carrying the procedures, the health professionals resort to ultrasound as a guide to define the safe needle location in the amniotic sac.

Just like PUBS, the amniocentesis test is used to discover chromosome abnormalities and genetic disorders, among which Trisomy 21 is the most common genetic pathology. The procedure can pose serious threats to health of a mother and a fetus.

The women can also take a test that combines both an ultrasound evaluation and a maternal blood test to detect risk for various chromosomal abnormalities, including Trisomy 21 and Trisomy 18. There are no serious risks and side effects linked to the First Trimester screen, except for the discomfort caused by drawing blood.

Parents should be ready for the probability for receiving abnormal results, but further testing can still define that the future baby does not have any pathology.

Chorionic Villus Sampling (CVS) implies removal of chorionic villi cells of the placenta at the point of its attachment to the uterine wall. The procedure opens access to DNA of a potential father to compare it with the DNA of a future baby. The test also defines Down Syndrom by detecting chromosome abnormalities. No associated risk relate to this procedure.

In conclusion, because Down Syndrom has a genetic and biologic nature, the above-described tests can be efficient in detecting the genetic abnormalities. In particular, the test can also define different reasons and nature of the genetic pathology.

Works Cited

American Pregnancy Association. Prenatal Testing. 2012. Web.

U.S. National Library of Medicine. “Down Syndrome”. PubMed Health. 2012. Web.

Down syndrome is a chromosomal disorder resulting from the existence of an extra copy chromosome 21. The condition got its name from John Land Down; the doctor who first described it. Down syndrome is associated with symptoms that impair cognitive ability, physical development and often alter facial appearance.

Down syndrome patients are also prone to various health complications including heart disease, hearing problems, dementia, gastroesophageal reflux disease, recurrent ear infections, obstructive sleep apnea and complications with their intestines, eyes, skeleton, and thyroid. Research has shown that the odds of having a baby with Down syndrome grow as the woman ages.

People with Down syndrome have largely varying levels of mental developmental disability. A few of these individuals have notable to extreme mental disability while others show little or no mental problem symptoms. Downs syndrome occurrence is estimated at about 1 in 800-1000 births.

A number of factors affect this statistic but the most profound influencing factor has been found to be the age of the mother. It is not unusual for people with the proper set of chromosomes to share some physical features associated with Down syndrome. Some of these shared features may include an unusually small chin, an unusually round face, a large protruding tongue, Simian crease across palms, uneven toe spacing and poorly toned muscles (Kumin, 113).

The health and overall development of children with Down syndrome can be greatly improved by early intervention, regular screening for any complications, vocational training, and the existence of a caring and supportive social environment. The physical implications of Down syndrome caused by the chromosomal disorders can however not be overcome. Ironically, Down syndrome has some positive health implications; Down syndrome patients have been observed to have greatly reduced incidences of cancer.

Mental development in children with Down syndrome varies greatly and at birth, it is not possible to predict the extent to which the child will be affected in terms of physical symptoms and cognitive development. Intervention methods for these children are normally unique depending on the individual and are developed soon after birth to ensure that the child gets the best chance at leading a normal life (Dykens, 250).

Speech delay is common among individuals with Down syndrome and the individuals need to be taken through speech therapy to help them develop speech. Walking in children could also be impaired by Down syndrome. Some children will not walk up to age 4, while others are able to walk at age 2.

Language learning can be enhanced by screening for ear problems and hearing loss, employing hearing aids (as necessary) and fostering timely communication intervention. The use of augmentative and alternative communication methods is common to aid in communication. Some of these methods include body language, pointing, signs, objects, and specially designed graphics.

Down syndrome does not have a cure or standard management program due to the diversity in its manifestation. Some individuals may need intensive surgery and therapy while others have minimal health complications and can lead normal lives without the need for any therapy. Parents of children with Down syndrome have come together to try and find alternative therapies to improve mental growth and physical appearance. Suggested methods are plastic surgery and nutritional supplements (Roizen, 150).

Ethically, there have been concerns about the number of abortions associated with Down syndrome. In the year 2002, 91-92% of pregnancies in the US diagnosed with Down syndrome were terminated. In the UK, the figure remains relatively constant at about 92%.

Strides have been made to ensure that individuals with Down syndrome are accepted more in society to facilitate their leading normal lives. Parents, teachers and other stakeholders have in recent years advocated the inclusion of these individuals in society rather than exclude them in isolated institutions as was the case before.

Works Cited

Dykens, Elisabeth M. “Psychiatric and behavioral disorders in persons with Down syndrome.”Mental Retardation and Developmental Disabilities Research Reviews 13(2007):272-278

Kumin, Libby.”Speech and language skills in children with Down syndrome.”Mental Retardation and Developmental Disabilities Research Reviews 2(1996):109-115

Roizen, Nancy J. “Complementary and alternative therapies for Down syndrome.”Mental Retardation and Developmental Disabilities Research Reviews 11(2005):149-155.