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Down Syndrome is a medically diagnosed syndrome caused by the presence of an extra chromosome 21 and occurs in approximately one in 900 births. Distinctive physical characteristics include: small ears, upwardly slanting eyes, short stubby hands, a flattened facial profile, a large tongue, short stature, and a gap between the first and second toes. A child with Down Syndrome may also experience: visual or auditory problems, thyroid disease, decreased muscle tone, cardiac conditions or loose ligaments. Children with Down Syndrome typically function in the mild to moderate range of mental retardation (MR).
Because Down Syndrome is recognizable at birth, Early Intervention (EI) services are available. Up to age 3, the child can receive services at home to address speech, motor, cognitive and social needs. As the child approaches age 3, EI will make a referral to the Committee on Preschool Special Education (CPSE) to continue with services. At the CPSE level, services will be provided at the home, a daycare, or in a preschool. The CPSE is responsible to develop an Individualized Educational Plan (IEP) that outlines the goals for the child and the services, such as Occupational Therapy (OT), speech, or Physical Therapy (PT), the child will receive. A couple of months prior to the child's fifth birthday, a referral needs to be made to the Committee on Special Education (CSE). The CSE will do an updated evaluation and create a new IEP.
Children with Down Syndrome who are mildly mentally retarded will most likely be in the general education setting for most of the school day. If a Down Syndrome child is receiving related services, such as OT or speech, he might be pulled out for those services. As with any mildly MR student, there are modifications and adaptations that need to be made in the general education setting. The child may need worksheets that have been simplified, directions repeated, extra examples and additional time to complete tasks. Language Arts will most likely be taught in a self-contain setting to work on language, communication and speech skills.
Moderately MR children with Down Syndrome are quite often taught in a self-contained class for academics, vocational skills, life skills, community awareness and social skills. They benefit from the general education setting for specials such as art or music. In addition to OT and speech, a moderately MR child might need Adaptive Physical Education, Physical Therapy and/or group counseling.
Because children with Down Syndrome tend to be affectionate, they need to learn and be held accountable for age-appropriate behavior. For example, a 13 year old boy should not be sitting on his teacher's lap. A 16 year old girl needs to learn to give "high 5's" in place of hugs. Appropriate behavior needs to be modeled and needs to be recognized.
Given the appropriate education and support, children with Down Syndrome can become productive community members. Most of these children will receive an IEP diploma and will be able to have a job that has a lot of repetition to it. They will benefit from job coaches and will respond well to verbal praise.