Down Syndrome

Down syndrome is the most common genetic condition, occurring in around 1 in 700 live births. People with Down syndrome are born with an extra chromosome. About 95% of people with Down syndrome have Trisomy 21, an extra copy of chromosome 21. 

Structural differences in the brain could lead to developmental delays in multiple areas, such as feeding, communication and motor abilities.

Feeding and Nutrition: What You Need to Know  

People with Down Syndrome may present with

• Drooling
• Coughing or choking when eating or drinking
• Difficulty chewing 
• Food residue in the mouth during mealtime
• Prolonged meal duration
• Poor growth and malnutrition 

These could be contributed by poor oral, sensory and motor abilities of people with Down Syndrome.

Ways to support challenges with mealtime and nutrition include

• Adjusting and/or supporting the posture during mealtime 
• Modifying food textures and/or fluid consistency
• Pacing feeding
• Speech therapy to improve and develop oral motor skills
• Diet modification to optimise nutrition

Speech therapists can support your child’s chewing and feeding development. A dietitian can help optimise your child’s nutrition.

How Down syndrome Affects Speech Development

People with Down syndrome often have speech and language delay. They may present with

• Late talking
• Unclear pronunciation 
• Poor understanding of what’s said to them
• Difficulty expressing themselves

About 80% of people with Down syndrome have moderate intellectual disability, and about 60-70% have hearing loss. These increase the challenges in their speech and language development.

Ways to support the communication development of children with Down syndrome  

• Early intervention to develop their pre-verbal skills, such as joint attention, imitation, turn-taking
• Alternative and augmentative communication, such as gestures, signing and pictures can be introduced at an earlier age to give them a mode of communication
• Speech therapy to improve speech clarity, understanding and use of language

Speak to a speech therapist to discuss what might be suitable for you and your child.

Movement and Motor Skill Challenges 

Motor skills, such as standing and walking, are usually developed at a later age, in children with Down syndrome.

They may also present with

• Low muscle tone
• Poor balance
• Reduced muscle strength (both gross and fine motor)
• Poor coordination of movements

People with Down syndrome may also have co-existing medical conditions, such as heart conditions, respiratory problems, that may further limit their activity level and motor development.

Ways to support the motor development of children with Down syndrome

• Exercises to target their balance and motor skills like rolling, sitting, crawling, walking, hand functions
• Make use of play, music, daily routines to help your child practise the target skills

 

An occupational therapist or a physiotherapist can support you and your child in the development of his/her sensory and motor skills and functions.

Supporting Your Child’s Development 

Research has shown that early intervention improves outcomes in people with Down syndrome. At Magic Beans, our speech therapists can support you and your child in his or her feeding and communication development. 

To support your child’s communication at home, you can

• Talk at your child’s eye level 
• Talk about your child’s interest
• Give your child time to talk
• Talk slowly to help your child imitate your speech more clearly, e.g. one syllable at a time

To support your child’s motor development at home, you can

• Engage in activities that are useful for developing fine motor skills, such as play-doh, squeezing clothes pegs, slotting coins into a piggy bank. 
• Create opportunities for your child to practise self-help skills, such as self-feeding, dressing and undressing, toothbrushing

To support your child’s feeding at home, you can

• Create positive mealtime experiences, e.g. eating as a family
• Reduce distractions during mealtimes, e.g. removing screentime 
• Expose your child to a variety of tastes and textures (while being mindful of what your child can cope with without choking)

People with Down syndrome may need more repeated practice to learn a skill compared to their peers. Keep on trying! 

Reference

Arslan FN, Dogan DG, Canaloglu SK, Baysal SG, Buyukavci R, Buyukavci MA. Effects of early physical therapy on motor development in children with Down syndrome. North Clin Istanb. 2022 Apr 18;9(2):156-161. doi: 10.14744/nci.2020.90001. PMID: 35582517; PMCID: PMC9039636. 

Malak R, Kostiukow A, Krawczyk-Wasielewska A, Mojs E, Samborski W. Delays in Motor Development in Children with Down Syndrome. Med Sci Monit. 2015 Jul 1;21:1904-10. doi: 10.12659/MSM.893377. PMID: 26132100; PMCID: PMC4500597. 

Martin GE, Klusek J, Estigarribia B, Roberts JE. Language Characteristics of Individuals with Down Syndrome. Top Lang Disord. 2009 Apr;29(2):112-132. doi: 10.1097/tld.0b013e3181a71fe1. PMID: 20428477; PMCID: PMC2860304.

Serel Arslan, S. Swallowing Related Problems of Toddlers with Down Syndrome. J Dev Phys Disabil 35, 697–707 (2023). https://doi.org/10.1007/s10882-022-09875-4