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Managing Down’s

Early intervention ensures kids with Down’s Syndrome get to learn important life skills, writes Meera Murugesan

WORLDWIDE, one in every 1,000 babies is born with Down’s Syndrome. The genetic disorder is linked to learning disabilities and developmental delays.

But with proper care, early intervention and a good understanding of the condition, parents of such children can ensure they lead fulfilling lives.

Universiti Malaya Specialist Centre consultant developmental paediatrician and senior lecturer at the university’s department of paediatrics, Dr Subhashini Jayanath, shares some insight on this condition.

Is every child with Down’s Syndrome different?

The severity of the delay varies, and there is also a wide range of cognitive performance.

Intellectual ability can vary — there are people with Down’s Syndrome who have moderate intellectual disability and those who only have mild cognitive difficulties. Severe intellectual disability is rare.

It is important to understand that each person needs to be seen for his or her individual strength.

Visual and social skills are relative strengths in a big number of people with Down’s Syndrome.

These skills play an important role in determining how each person adapts to the environment and copes with life’s challenges.

A late pregnancy, at age 35 or older poses a higher risk for Down’s Syndrome. Picture:Designed by Valeria_Aksakova / Freepik.
A late pregnancy, at age 35 or older poses a higher risk for Down’s Syndrome. Picture:Designed by Valeria_Aksakova / Freepik.

At what age should therapy or intervention begin?

The general rule is, the earlier the better. Nevertheless, intervention needs to be developmentally appropriate for the child.

Intervention can be done in many ways at home, guided by therapists, from birth onwards.

Parents can talk to their children, play with them and bond from the beginning. These are all forms of therapy or intervention.

More formal methods are also important to ensure these children acquire the necessary skills to optimise their function and long-term outcomes.

Other than language, motor skills can be delayed in these children. Therapy can improve fine motor control and function, balance and coordination.

When formal therapy should start depends on the developmental profile of abilities that a child has at different age.

What factors influence the ability to benefit from therapy?

The timing of intervention is crucial. Speech difficulties in children with Down’s Syndrome are largely caused by hearing difficulties, for which they are at higher risk.

If hearing impairment is not detected and treated promptly, this can lead to long-term difficulties with language.

Another example is the introduction of solids when feeding. If this is inappropriately delayed, it can also lead to expressive language issues.

Additionally, the child’s overall developmental level at any given age will influence the acquisition of skills and how much they benefit from therapy at that time.

This does not mean that children with fewer developmental skills will not benefit from therapy. It means the more the child’s skills improve (due to therapy), the more the child benefits from it.

“People factor” is possibly more important than other things as the strength of their relationships with parents or primary caregivers has a significant impact on their ability to learn new things and develop.

Emphasis on everyday life skills is crucial in helping them learn skills that are needed for day-to-day living. Therapy needs to be grounded in practical skills for children to get the best improvement.

What can parents do to ensure their child’s progress?

Parents should keep the lines of communication open with teachers, carers, therapists and healthcare staff who support families of children with Down’s Syndrome.

Recognising and emphasising the strengths that the child has is crucial. It can be overwhelming for families who need to negotiate services for children with different needs.

However, in addition to identifying areas in which their children can benefit from improvement in skills, they should also ensure encouragement, support and recognition of their children’s abilities.

This will go a long way in bolstering self-esteem and has a spillover effect on improvement of other skills.

Parents/caregivers play a significant role in the lives of children with Down’s Syndrome. Picture:Designed by senivpetro / Freepik.Designed by Freepik.
Parents/caregivers play a significant role in the lives of children with Down’s Syndrome. Picture:Designed by senivpetro / Freepik.Designed by Freepik.

What are the misconceptions about children with Down’s Syndrome?

Sometimes, I hear parents mention that they do not want their child to be placed in a class with a child with Down’s Syndrome. This is very unfair as children are different and we should not pigeonhole them.

The majority of children with Down’s Syndrome whom I have encountered are delightful and very sociable. Sociable children can be a good influence on classmates who are less socially-inclined.

Additionally, people perceive them as not being capable of learning. This could not be further from the truth. Many have very good visual skills and can retain a large amount of information when presented and taught in appropriate ways.

The speech and communication skills of children with Down’s Syndrome are often thought to be poor. Their language skills can at times lag behind but it is crucial that hearing impairment is screened for and regularly monitored.

If detected early and treated appropriately, this helps optimise pronunciation of words and reduces the likelihood of speech difficulties.

Dr Subashini says visual  and social skills are relative strengths in a significant proportion of people with Down’s  Syndrome.
Dr Subashini says visual and social skills are relative strengths in a significant proportion of people with Down’s Syndrome.

UNDERSTANDING DOWN’S SYNDROME

*Happens when there is an extra copy of Chromosome 21.

* Associated with advanced maternal age (pregnant women aged 35 and above).

* May cause heart conditions from birth in some, impaired growth and development, obesity, dental issues and visual impairment.

* Some will not have any medical issue.

* As adults, they have a slightly higher risk of dementia.

meera@mediaprima.com.my

–New Strait Times:https://www.nst.com.my/lifestyle/heal/2020/07/606485/managing-downs