Down Syndrome Facts - Literature review Example

? Down Syndrome Down Syndrome Intellectual disabilities are described as deficiencies in patients’ ability to think, understand problems and solve them, learn new things, adapting to daily situations and developing social skills with time and age. Intellectual disabilities may be caused by a plethora of reasons and etiological factors. These etiological factors include head injury, fetal alcohol syndrome and genetic causes for instance Down syndrome. Mostly the intellectual disability will be caused by any other underlying disease or disability. The intellectual disability causes an individual to lag behind in his development of communication skills, social abilities and even his ability to take care of his own self in a proper manner. Teaching and support services for the individuals with intellectual disabilities is designed in a completely different manner and is targeted to meet their learning and problem solving requirements. Creative and interactive teaching ideas should be implemented in order to obtain maximum results. Visual, audio and interactive lesson methods should be applied and the difficult ideas and problems should be made comprehensive for the learners. American Association of Intellectual and Development Disabilities are directed towards support services and development support for such individuals (The Church of Jesus Christ of Latter-Day Saints 2012). Fig 1: An image of a Down Syndrome Child accompanied by teaching services personnel (The Church of Jesus Christ of Latter-Day Saints 2012). Down syndrome is defined as a condition caused by a genetic defect which results in both physical and intellectual limitations in the affected individual. The normal number of chromosomes in an individual is 46 but in a Down syndrome individual the chromosome number is 47 instead (National Association for Down Syndrome 2012). It is considered as one of the most common syndromes present at birth called as congenital syndromes. One in every 700 births is estimated to be a child with Down syndrome. It has been observed that the possibility of developing Down syndrome increases as the maternal age increases at the time of conception. After the age of 35, the risk of Down syndrome in the child increase by many folds (Selikowitz 2008). The prevalence of Down syndrome in United States was estimated to be one in every 733 births by Centers of Disease Control and Prevention in the year 2010. Around 60,000 cases are diagnosed with Down syndrome annually (National Down Syndrome Society 2012). According to a study in the year 2007 carried out among 63000 babies in UAE, an approximate incidence of one Down syndrome case for every 449 new born babies was estimated. The study also highlighted the maternal age risk factor and showed that around 41 % of the UAE mothers had crossed the age of 35. This also showed that maternal age is a major etiological factor (Shaheen 2012). Fig 2: A representation of prevalence of Down Syndrome in the years 1979 – 2003 per 10,000 live births in United State (CDC.gov. 2011). Down syndrome presents in the individuals with a large range of variations in its characteristics and features. As discussed earlier, it is a chromosomal defect; hence every cell of the body’s each system is defective. Hence almost every system manifests with problems and pathologies. Around 120 different features for this syndrome have been described up till now but some children might manifest with only six or seven characteristic features. The characteristic features describing Down syndrome are visible in eyes, head and face. A Down syndrome individual has round face with a flat side profile, with brachycephaly (Flattened back of head). The eyes are slanted, small epicanthic folds which might give a false manifestation of squint or strabismus and the iris might show whitish spots called Brushfield spots. The neck of the young child has greater fat content at the back which is diminished with age and an adult individual will have a broader and smaller neck. Hands are shorter with usually one joint in the little finger and only one or sometimes two creases in the palm of hand. Hypotonia is another characteristic feature which presents with floppy upper and lower limbs. The general body size is also less as compared to the normal weight at birth. As adults their height is comparatively shorter and the approximate ranges for men is 145-168 cm and in women it is 132-155 cm (I. Cohen et al 2002 ; Selikowitz 2008). The brain of the Down syndrome affected individuals is majorly affected and they manifest with mental retardation. Researches have described frontal area atrophy and the defective development of the brain cells. Seizures are also observed in 5-10% of the patients. Endocrinological problems like hyperthyroidism, less growth hormone production are common in DS individuals. 40-60% associations with heart defects are another common feature. Leukemia, hearing loss, obstructive sleep apnea, chronic middle ear infections, thrombocytopenia and increased risk of testicular cancer are common findings associated with Down syndrome. Because of the mental retardation and steady growth and development the DS individual is faced with various learning and communication differences. The child represents with challenging behaviors caused by the differences in his or her learning and understanding skills (I. Cohen et al 2002). Fig 3: An image of a child with Down Syndrome (Down Syndrome Education Online 2012). Teaching a child of Down syndrome requires different teaching strategies which focus on various aspects of the child which include cognitive development, social skills, memory, attention, communication abilities and self-care skills. The cognitive development refers to mental development of the child which encompasses a comprehensive knowledge of one’s surroundings and environment. During the second year of life, structured teaching methodologies should be applied which involve teaching verbal skills, coloring, following the instructions given by the teacher, imitating the activities of the teacher and other planned teaching methods. With play methods, the child’s knowledge about his surroundings and world events are increased. The language and speech skills of the child should also be assessed with time and at a younger age of 1-5 years home-visiting teachers can be availed by parents for the education of their child. Speech and language therapy should be started at the early stage which include turn taking games for instance peek-a-boo, auditory exercise, imitation of sounds and oral co-ordination skills like lip movement and tongue usage should be taught in comprehensive manner to the babies (Buckley & Sacks 2001; National Down Syndrome Society 2012). In teaching literature, grammar skills of the DS child are improved through various methods. Initially the child is taught only those sentences which the child cannot speak completely for instance “He eat apple” instead of “He is eating an apple”. Language books were also used where sentences accompanied illustrations to explain the structure and meaning of the sentence. Conversation diaries were also used where the child was encouraged to write significant events of his day and share them with his family and friends for instance “I visited the zoo with my friends today.” This improved their grammar as well as vocabulary. Phonology or speech sound production of the DS child was improved by many techniques. In a study of the method technique, the parents were asked to meet for speech and language development. Ten words were chosen by the parents who were most frequently used by the child and then the phonological errors and development was noticed. Contrasting pair of words with different sound production like pat/bat, toe/dough were applied or egg/leg and eight/gate were used to observe the deletion of the first consonant. The parents were asked to use the chosen words as much as possible through games, conversations and other planned situations. The children presented with successful results through this teaching method of proper speech sound production (Buckley 2000). It has been observed through researches that Down syndrome children have more difficulty understanding mathematical problems as compared to learning reading and writing. Thus, it is suggested that the number related problems should be made easier and descriptive so that the DS child can solve it more easily. If the mathematical questions are presented in the form of daily use events like using the money or telling the time, they will be able to understand in a more rewarding manner. The teaching methods that should be applied include focus on practical association with the number skills and repeated practice and understanding of the basic mathematical skills. Children are encouraged to use different equipments like cubes, Dienes, abacus to help them subtract or add numbers and break a number into tens and units. In 8-11 years many the numerical skill goals include subtraction, addition to 20, numbers till 100, basic level multiplication and division and counting the numbers in groups of tens, fives or twos (Bird & Buckley 2001). Fig 4: An example of mathematical lesson for Down syndrome child with illustrations to understand addition (Horstmeier 2004). Fig 6: An example of mathematical lesson of addition with 2 and 3-Digit numbers for children with Down syndrome (Horstmeier 2004). The children with Down syndrome also have a very short-memory and have working memory problems. This is the major problem which results in their difficulty in memorizing new words and also following the instructions given by the teacher or parents. The memory skills of the child with Down syndrome can be improved by aiding words with illustrations to help the child get a better understanding of the literature. The sequences and lists can be made simpler and in a short form for the child (Lewis & Norwich 2007). Occupational therapy is focused on improving the child’s social and self-care skills. The child is taught to manage the things that are used in everyday events like opening or closing a jar, picking up toys, operating simple toys, stacking toys and using different buttons and switches of toys. The therapists or teachers also teach the child to how to take care of their eating habits, dressing up and communication abilities with other children in the play-area. Self-help skills like feeding and dressing by themselves can be taught by an occupational therapist. Gross and fine motor skills play an important role in these tasks and the therapist along with the help of the parents can facilitate the child to overcome these hurdles. Play and leisure skills are also polished at a pre-school and school level by occupational therapy (National Down Syndrome Society 2012). The children with Down syndrome require support from their family members both parents and their siblings. Family support is crucial not only for boosting up the confidence levels of the child but also in facilitating the learning and comprehending skills of the child. At the school, the child’s first interaction is with the teacher and the class fellows. The teacher should apply creative and simple methodologies which are understood by the child easily and are comprehendible. The community services are responsible for spreading awareness and knowledge about the disease. The importance of Down syndrome screening and the risk factors associated with increased maternal age at the time of conception should also be highlighted. Therapists, home-visiting teachers and counselors should be provided to the children with Down syndrome, which would help them cope up with their circumstances. Fig 6: An image of support services provided by the community in South Africa (DSSA 2012) It is very important for the teachers that they are motivating and use creative methods for their students. They should be patient with their students and focus on each student’s individual learning capacities and behaviors. The learning limitations should be dealt accordingly then. Family of children with Down syndrome should be counseled and educated about the genetic etiology of the disease. They should be advised to read as many books and articles on this disease to increase their understanding of the clinical features and cognitive limitations. Talking to other families with similar situation will also help in finding answers of many questions. There are many myths related to Down syndrome which cause a false image of the disease in many minds. One such myth is that a person with Down syndrome is always happy! However, this is not true and the individuals with Down syndrome have feelings and emotions like any other person. Another false opinion is that people with Down syndrome are unable to socialize and get married. The truth is that they can date, marry and have friends with social skills like other people (National Down Syndrome Society 2012). According to a news article published in ABC news in 2009 by Susan D. James discusses the decision of many women to abort their babies when they hear about the news of Down syndrome. This is majorly because of the lack of awareness and myths spread about the disease. She has shared the story of McLaughlin who was also told by the doctors that her child will have Down syndrome and heart defect. In spite of her initial fears and confusions about Down syndrome, after the birth of her child she was happy that she did not take any wrong decision. Moreover, her introduction to a family with a child of 5 years with Down syndrome helped her to understand the disorder in a better way and made her overcome her fears related to the disease (James 2009). Fig 7: Grace (in the center), McLaughlin’s daughter, with Down syndrome (James 2009). References Bird, G. & Buckley S.J..(2001). Number skills for children with Down syndrome (5-11 years). Down Syndrome Issues and Information. Retrieved from: http://www.down-syndrome.org/information/number/childhood/ Buckley, S. (2000).Speech, language and communication for individuals with Down syndrome: An overview. Southsea: Down Syndrome Educational Trust. Buckley, S., & Sacks, B.. (2001).An overview of the development of infants with Down syndrome (0-5 years). Southsea: Down Syndrome Educational Trust. CDC.gov. (2011). Down Syndrome Cases at Birth Increased. Centers for Disease Control and prevention: Data and Statistics by Date. Retrieved from: http://www.cdc.gov/features/dsdownsyndrome/ Cohen, W. I., Nadel, L., & Madnick, M. E. (2002). Down syndrome: Visions for the 21st century. New York: Wiley-Liss. Horstmeier, D. (2004). Teaching Math to People with Down Syndrome and Other Hands-on Learners. Excerpt from Woodbine House. Retrieved from: http://www.woodbinehouse.com/excerpt.asp_Q_product_id_E_1-890627-42-9 Down Syndrome Education Online.(2012). An overview of the development of children with Down Syndrome (5-11 years). Down Syndrome Issues and Information: Development Overviews: Down-syndrome.org. Retrieved from: http://www.down-syndrome.org/information/development/childhood/?page=3 DSSA (2012). Down Syndrome South Africa. Downsyndrome.org.za. Retrieved from: http://www.downsyndrome.org.za/main.aspx?artid=53 Lewis, A., & Norwich, B. (2007). Special Teaching for Special Children? Pedagogies for Inclusion. Maidenhead: McGraw-Hill International (UK) Ltd. National Association for Down Syndrome. (2012). Facts about Down Syndrome. NADS.org. Retrieved from: http://www.nads.org/pages_new/facts.html National Down Syndrome Society. (2012). CDC Study of Prevalence of Down Syndrome. News Room: NDSS. Retrieved from: http://www.ndss.org/index.php?option=com_content&view=article&id=153:position&limitstart=2 National Down Syndrome Society. (2012). Education, Development & Community Life. NADS.org. Retrieved from: http://www.ndss.org/index.php?option=com_content&view=article&id=221:early-intervention&catid=72:early-intervention Selikowitz, M. (2008). Down syndrome. Oxford: Oxford University Press. Shaheen. (2012). UAE sees high rates of Down Syndrome. The National . Retrieved from: http://www.thenational.ae/news/uae-news/uae-sees-high-rates-of-down-syndrome James, S.D. (2009). Down Syndrome Births are Down in U.S. ABC news. Retrieved from: http://abcnews.go.com/Health/w_ParentingResource/down-syndrome-births-drop-us-women-abort/story?id=8960803#.Tzvb1sX9MfV The Church of Jesus Christ of Latter-Day Saints. (2012). Intellectual Disability. Disability Resources: LDS.org. Retrieved from: http://www.lds.org/disability/list/intellectual-disability?lang=eng Read More