All individuals with Down syndrome have some degree of mental retardation. They learn more slowly and have difficulty with complex reasoning and judgment, but they do have the capacity to learn. For example, children with Down syndrome are often delayed in their 'developmental milestones' such as walking or talking. While they tend to do so later than other children, children with Down syndrome will learn to walk and talk. It is important to remember that it is impossible to predict the degree of mental retardation in an infant with Down syndrome at birth (just as it is impossible to predict the IQ of any infant at birth).
Down syndrome affects a child's ability to learn in different ways, but most have mild to moderate intellectual impairment. Children with Down syndrome can and do learn, and are capable of developing skills throughout their lives. They simply reach goals at a different pace. There is often a misconception that individuals with Down syndrome have a “static” or predetermined ability to learn. This simply is not true. It is now known that individuals with Down syndrome develop over the course of their lifetime and should be treated accordingly. The learning potential of an individual with Down syndrome can be maximized through early intervention, good education, higher expectations and encouragement.
While most children with Down syndrome have no significant medical problems, others may experience a variety of medical issues that require extra care. For example, about 40% of all children born with Down syndrome will have a congenital heart defect. Some of these defects are mild and require no treatment and others are more severe and may require surgery and medical management. However, remember that if 40% of children with Down syndrome are born with heart defects, that means that 60% of children with Down syndrome do not have heart problems.
Other medical conditions that may occur more frequently in kids with Down syndrome include thyroid problems, intestinal abnormalities, seizure disorders, respiratory problems, weight issues, and a slightly higher risk of childhood leukemia (about 1%). Upper neck abnormalities (atlantoaxial instability) are sometimes found and should be evaluated by a physician. Fortunately, many of these conditions are treatable and the treatments are the same for people with and without Down syndrome.
Hearing and Vision
Approximately half of all kids with Down syndrome also have problems with hearing and vision. Hearing loss can be due to differences in the structure of the inner ear bones or due to ear infections. Vision problems include crossed-eyes, lazy eye, near and farsightedness, and an increased risk of cataracts. Regular evaluations by an audiologist and an ophthalmologist are necessary to detect and correct any problems before they affect language and learning skills. Treatments are typically glasses and hearing aids.
Personality, Behavior and Psychological Conditions
Many older studies describe a ”Down’s syndrome personality.” However, this limited view is falling out of favor as more becomes known about Down syndrome. It can be hard to discuss common behavioral traits seen in people with Down syndrome without stereotyping these individuals. However, most parents with children with Down syndrome would report that their children are generally happy, sociable and outgoing. While this may generally be true, it is important not to stereotype individuals with Down syndrome. They experience a full range of emotions and have their own characteristics, strengths, weaknesses and styles. No two people with Down syndrome will have identical personalities.
While people with Down syndrome may not have a “personality type,” they often share certain behaviors or coping mechanisms. For example, many people with Down’s syndrome prefer routine, order, and sameness which is their way of dealing with the complexities of everyday life. This preference for routine can sometimes be seen as stubbornness. Another behavior often seen in people with Down syndrome is “self-talk.” Self-talk is the act of talking aloud to oneself and it is thought that people with Down syndrome use self-talk as a way of processing information and thinking things through.
While people with Down syndrome may have some behaviors and coping mechanisms in common, they also face an increased risk for certain psychological conditions. Higher rate of anxiety disorders, depression and obsessive-compulsive disorder have all been reported in Down syndrome. The treatment for these disorders in people with Down syndrome is the same as in people without Down syndrome - behavior modification, counseling and possibly medication.
While children with Down syndrome do have a recognizable features and common medical problems, it is important to remember that most children with Down syndrome are healthy. Their risk to develop certain medical problems may be slightly higher, but the problems seen in children with Down syndrome are no different than the problems can be seen in children without Down syndrome and the treatment is the same for both groups. Although a lot of different features have been described in Down syndrome not all of them are important or relevant and it is important to learn to tell the difference. While many older texts describe a ”Down syndrome personality,” this view is falling out of favor as more becomes known about Down syndrome. That being said, people with Down syndrome often have overlapping coping mechanisms and behaviors. Rather than chalking their behavior up to their genetic condition, it is most helpful to try to understand what is causing the particular troublesome behavior.
Stray-Gunderson, K., Babies with Down Syndrome - A New Parents Guide, Woodbine House, 1995.
Chen, H., Down syndrome, Emedicine, 2007