Down’s Syndrome – Development
Children that are living with Down syndrome experience some challenges, including learning difficulties that lead to delays in development, but not all areas of development are affected negatively. Children living with Down syndrome do not progress as quickly as children that do not have Down syndrome. Compared to children not living with Down syndrome and children that have other learning disabilities, specific cognitive and behavioural patterns can be seen among children with Down syndrome. When you can understand these different patterns, you are able to adapt teaching methods that are more effective for these children.
• Social development
• Learning and visual supports
• Word reading
• Motor development
• Expressive language, grammar and speech clarity
• Numeracy skills
• Short term memory
Strengths further explained:
The social development of babies with Down syndrome is an area that isn’t really delayed in comparison to other areas. Despite the cognitive delay, children with Down syndrome can show empathy and be affectionate.1 Babies with Down syndrome can smile only a couple of weeks after other children and are normally very sociable and get along with other children very well. Toddlers with Down syndrome use non-verbal skills including, babbling and gestures.
Good social skills and appropriate behaviour is seen to further develop in adults with Down syndrome. Although a minority of people with Down syndrome do struggle with social situations and communication but this is in individuals that have had greater delays in speech and language development.
Learning and visual supports:
It is important that when teaching children with Down syndrome to read and write that the correct teaching methods are used. There are many studies that show that children with Down syndrome learn better with the use of visual aids, including the use of images, objects and gestures.
Reading abilities in children with Down syndrome develop more quickly than what you may expect when considering their cognitive skills. Reading can improve your child’s language and vocabulary development which can be of a particular benefit in a child with Down syndrome, with the specific language delays.
Difficulties further explained:
Children with Down syndrome develop motor skills slower than children without Down syndrome. These delays can affect both walking and talking. Motor delays can stop children from exploring their environment, hindering their cognitive development and can also affect them developing their language skills.
Expressive language, grammar and speech clarity:
There are specifically two types of difficulties children with Down syndrome face when it comes to expressive language, grammar and speech clarity. The first is the inability to master sentence structure and grammar and the second is difficulties pronouncing their words.
Language is an important tool for human learning, where language is internalised for thinking and remembering. Frustration can arise in children when they become aware of the gap between their understanding and their ability to express themselves, leading to behavioural problems. A delay in language development can also make people underestimate the child’s cognitive ability.
Children with Down’s syndrome struggle with basic number skills and their development is normally two years after their literacy skills. It is currently not known why numeracy skills are so late to develop and more research is needed in this area. The best way to develop your child’s numeracy skills is to draw on what is already known about the learning strengths of children with Down syndrome.
Verbal short-term memory:
Short term memory is the ability to keep information readily available and active in the brain for only a short period of time. It is easier for children with Down syndrome to hold onto visual information rather than verbal information, this can make learning in the classroom difficult. To improve recall, studies have shown that children with Down syndrome can retain more information when the verbal information is backed up with a visual aid.3
How to improve your child’s cognitive development:
Early communication (up to 2 years)
During the early years parents should encourage babbling in children. Make sure your child is facing you and make noises like ‘ooo’ and ‘ahh’ then consonants can be added in for example ‘m-m-m-m’ and ‘d-d-d-d’. When making these noises make sure to make over exaggerated mouth movements and your child should try and copy your actions.
As mentioned above visual leaning is particularly helpful in teaching children with Down syndrome. A good way to get your child to start learning a few words is to use their favourite toys and teach them the name of these objects. Your child is likely to enjoy activities when they can see their parents taking part.
Vocabulary building (ages 2-3)
You can start to help building your child’s vocabulary at this stage, a good way to do this is by using different objects. For example using signs and telling your child the meaning of that sign. Games are a great way to get your child engaging in educational activities. You can teach them what different colours are by collecting everyday objects that may be in the house and ask you child the colours of them. It takes children with Down syndrome a longer time to start putting together sentences and phrases, research has showed that children have around a 100 word vocabulary before they start using phrases.
Expanding vocabulary and sounds (ages 3-5)
The best time for your child to further develop their vocabulary is during family time, this can make their learning more interactive and relatable to tasks that are carried out in the house. Every time your child says a new word this should be backed up with congratulations to keep them motivated. Games where your child has to match words with pictures is a great method to teach children with Down syndrome to read due to their visual memory strengths. 4
While not every person with Down syndrome will have the exact same physical characteristics below is a list with some of the most common physical features that they might have.
• A flattened face, especially the bridge of the nose
• Almond-shaped eyes that slant up
• Small ears
• A tongue that tends to stick out of the mouth
• Tiny white spots on the iris of the eye
Small hands and feet that have:
• A single line across the palm of the hand (palmar crease)
• Short fingers
• Small baby fingers that sometimes curve toward the thumb
They may also have:
• Decreased of poor muscle tone
• Loose joints resulting in increased flexibility
• Shorter than the general population
• A short neck
• Small head
Children with Down syndrome will all have a degree of learning difficulties and developmental delay but this varies from person to person. Children with Down syndrome may have difficulties sitting upright, crawling and walking due to poor muscle tone but these will all improve over time and they will still meet all of the developmental milestones. Despite these physical features your child will still be able to participate in physical activities like any other child.5
You can help you child reach these milestones by using play to encourage this behaviour, you can show them how to play and grip their toys and encourage them to reach for their toys. By finding topics and subjects that your child enjoys you can use visual aids and talk about it with them to improve language, playing word associated games is another great way to improve their speech. It is also important to let your child mix with other children to improve communication and how they interact with other people. Not every activity that you do with your child needs to be educational, any activity with the family can be fun and will be beneficial in their development.
Many children with Down syndrome will get physiotherapy to help with any muscle weaknesses, they focus on gross motor skills including walking, crawling, standing and sitting. Physiotherapists will use massage techniques to improve muscle tone. Occupational therapy is used to improve fine motor skills, including grasping and holding objects, writing and feeding themselves.7
Down syndrome can cause hypotonia, this is decreased muscle tone and one of the main things that can affect the child’s growth.8 it can give the baby a floppy appearance and it is the main reason for the gap in physical development in children with Down syndrome and children that do not have Down syndrome. Children may seem like they have no control of holding up their head or limbs but this can be helped through exercise.
It is important to encourage your child to engage in physical activity every day whether it be at school or at home playing with friends. Physical activity guidelines recommend 60 minutes of moderate exercise every day. Children with Down syndrome have lower muscle strength and lower levels of cardiovascular fitness but this can be improved through exercise.
As a parent it is important that you engage with your child’s activity such as going on walks with them and playing in the park. Research has shown that adolescents with Down syndrome like participating in activities like yoga as it doesn’t involve competition.
Physical characteristics related to exercise:
• Increased muscle flexibility
• Increased flexibility of the joints
• Mild to moderate obesity
• Poor cardiovascular health
• Short stature
• Poor balance9
Aerobic exercise can be used to improve cardiovascular health, this could include walking, jogging, bike riding, swimming and dancing, such as Zumba classes. People with Down syndrome may also want to include some bodyweight strength training as part of their physical activity to improve muscle tone and balance. Some exercises that can be performed are squats, crunches on an exercise ball, push ups and bear crawls. The most important thing when it comes to exercise is to make sure your child is having fun, children don’t like sticking to exercise routines but as a parent you can make up fun games including some of these exercises to improves your child’s overall fitness.10