Children born with Down syndrome can have rewarding lives and grow up to be fairly independent with support and early intervention. Some can even attend mainstream school like normal children.

“The severity of Down syndrome varies. Most will have some degree of motor difficulty and cognitive disability. Some may have medical problems such as congenital heart defects, hearing loss and poor vision,” says Dr Tan Wei Ching, Senior Consultant at the Department of Obstetrics and Gynaecology, Singapore General Hospital (SGH), a member of the SingHealth group.

“Early intervention, starting from birth to age three, is important in stimulating the motor, language and social development of a Down syndrome child as they tend to develop at a different pace,” adds Dr Tan.

Early intervention usually involves physical therapy, speech and language therapy, as well as occupational therapy.

What is Down syndrome?

Down syndrome (or Down's syndrome) is a genetic disorder that occurs in about one in every 700 babies in Singapore. It is a chromosomal abnormality in which the child is born with 47 chromosomes instead of 46. More precisely, an extra chromosome number 21.

For older women, the fear of giving birth to a Down syndrome baby is understandable as the risk increases with age. The risk of having a Down syndrome baby rises from 1 in 350 by age 35, to 1 in 100 by age 40, and 1 in 25 at the age of 45.

Screening for Down syndrome

Doctors recommend what is known as First Trimester Screening during the 11th-14th week of pregnancy. The screening, which involves a blood test and an ultrasound, is safe and non-invasive.

Amniocentesis is an invasive test. While it can diagnose Down syndrome, it carries a 0.5-1 per cent risk of miscarriage as it involves taking a sample of the amniotic fluid from the mother’s womb from the 16th week of pregnancy.

Distinct characteristics of Down syndrome

People with Down syndrome generally share these characteristics:

• Flat face
• Upward slanting eyes
• Short and broad hands, short fingers
• Small build
• Protruding tongue
• Poor muscle tone
• Impairments in speech, motor coordination, short-term memory, learning speed and ability
• Higher risks for congenital heart defects and gastrointestinal problems

Interacting with Down syndrome children

With a better understanding of the behaviours and mannerisms associated with Down syndrome, it becomes easier to relate to children having this genetic disorder.

• Self-talk
  Talking to themselves is how Down syndrome persons process information and understand the world. This self-talk is not a sign of mental illness.
• Fixation on routine and order
  Order and routine make a Down syndrome child feel secure and in control of their lives. Do not misread this “stubborn” streak as being rigid and uncooperative.
• Delayed response in social communication
  Because of slower speech and language development, a person with Down syndrome may take longer to respond. They may have difficulty hearing you or forming the words they want to speak. So be patient and speak slowly.
• Mild to severe cognitive disabilities
  No Down syndrome child is alike. Mental impairment ranges from mild to moderate to severe. Some are able to read and write, hold a conversation reasonably well, and even get a job once they reach adult age.

“A Down syndrome child will develop at his or her own pace. With supportive parents and therapists, the child can have a rewarding life like any normal child,” says Dr Tan.

Ref: T12