The Research on the Problem of Downs Syndrome - Essay Example

Running Head Down syndrome Down Syndrome Inserts His/Her Inserts Grade Inserts 24 April 2009 At the beginning of the 20th century, the field of chromosomal disorders was subject to several diverse influences. First, the work of John Langdon Down, gave language development and academic potential cardinal roles in the classification of the children with such disorders. The idiot-imbecile-moron stratification was based largely on levels of language usage: the idiot, mostly mute; the imbecile, limited to a few words for common objects; and the moron, capable of short, focused sentences to express his needs. Currently, severe Down's syndrome is considered to be the result of a major disorder of the central nervous system. The disorder may be caused by a chromosomal abnormality (as in Down's syndrome), by a single gene (phenylketonuria), by prenatal infection (rubella), or by an endocrine disorder (hypothyroidism). Other cases are associated with a congenital malformation of the central nervous system such as hydrocephaly or with the motor disorder of cerebral palsy. Clearly, Down's syndrome is a heterogeneous classification that can have literally hundreds of causes, mostly rare. Down's syndrome, the most frequent known cause of Down's syndrome, accounts for only about 10% to 15% of the severely retarded (Stray-Gundersen, 2005). The researchers singles out the main genetic cause of the disease: an extra copy of genetic material on the 21st chromosome. This syndrome affects all nations and races. By the end of the 1950s, two major causes of Down's syndrome were identified. The first was related to abnormalities in fetal or post-natal development caused by genetic or other, often unknown, factors that responsible for only a small proportion of changes, primarily of a severe degree. Implicated as antecedents were the general factors of age and health of the mother; pregnancy complications that included toxemia, diabetes, and maternal infections; trauma and other complications of delivery; prematurity and/or low birthweight of the infant, and asphyxia-anoxia. The second cause seemed to be environmental, related to family living conditions as well as to cultural stimulation from outside the home. Apparently, the largest single environmental determinants were socioeconomic class and ethnic group membership. Environmental causes seemed to account for the largest proportion of children who were subnormal in intelligence, but appeared to be unrelated to the smaller, severely handicapped group. It had become apparent that attempts to account for Down's syndrome on the basis of a single cause were ill-fated. It also had become evident that the retrospective study could not provide reliable data on early risk factors. A large prospective study, beginning in pregnancy, was needed to examine the rarest disorders and provide sufficient variation in socioeconomic, ethnic, and geographic factors (Stray-Gundersen, 2005). The main manifestations of this disease are mental retardation, slow cognitive development and slow thinking processes. The main problems of misdiagnose are caused by inadequate standards and symptoms applied to children with Down's syndrome at the early stages of development. For instance, in the infancy periods, the velocity of neuromaturational and behavioral change is greater than at any other time. Subsequent development of children exposed to pre-, peri-, and postnatal problems is the result of an interchange among normal developmental processes, recovery of function (either physical or neurodevelopmental), and environmental influences (Ambrosini, 1988). Psychologists who work with neonates and infants are advised to consider several general guidelines. First is the concept of risk. Risk refers to influences that have a potential negative effect on the infant's development. In many cases, when a child shows anxiety or shyness he/she can be treated as ADHD. Second, behavioral/developmental, medical/biologic, and environmental/psychosocial risk and protective factors should be considered routinely when working with infants. Whereas risk factors are associated with developmental and mental health vulnerability, protective factors, in contrast, refer to attributes or situations that would enhance the infant's resilience or resistance to negative influences. The balance between risk and protective factors and the magnitude of each will determine the infant's ultimate level of adaptation (Ambrosini, 1988). For example, the infant's intrinsic biologic vulnerability can be moderated to some degree by the influence of extrinsic (environmental) protective factors (Stray-Gundersen, 2005). The article by Appl (1998) describes the relations between adult and a child with the Down's syndrome and suggests possible methods of communication and interaction. This research is based on substantial literature review and analysis of the current studies on this topic. The author concludes that "Adults working with young children need to be able to adjust their interactions and structure children's activities and environments in ways that support each child" (Appl 1998, p. 43). With the increasing rates of Down's syndrome, a frequent differential diagnostic question posed to child clinicians is whether behavioral disturbance is due to deficits in attention or the presence of anxiety. It is often assumed by nonclinicians that these conditions are mutually exclusive, whereas in fact, they may co-occur with considerable frequency. In fact, comorbidity in general is more common than not in psychopathological conditions in childhood. There is some indication that children with anxiety disorder and Down's syndrome may be less impulsive and more overactive than children with only the Down's syndrome diagnosis and less likely to develop a conduct disorder (. Indeed, it has been suggested that children with Down's syndrome and anxiety disorder and Down's syndrome and aggressive conduct disorder represent unique subtypes with different etiologies and developmental course). The research conducted by Jobling and Virji-Babul (2006) analyzes possible ways and methods of treatment and positive communication methods with children. The research is based on current studies by the authors themselves and literature reviews on the issue of communication and games for children with Down's syndrome. Similar to the previous research, the authors come to conclusion that: "It is proposed that if children who have difficulties with language, such as those with DS, can be given a "movement language" and experience using that language, an improved movement quality may occur" (Jobling and Virji-Babul 2003, p. 34). Investigators are focusing increasing attention on the observation that individuals who manifest psychopathological conditions often possess preexisting tendencies or traits for those particular conditions, especially when exposed to certain experiences and environmental stimuli. Shyness is depicted as feelings of discomfort in social situations but not nonsocial situations, whereas behavioral inhibition reflects a propensity to react with inhibition to both social and nonsocial novel situations. Infants and children with behavioral inhibition are described as being wary around unfamiliar people, excessively timid in situations that contain risk of harm, and highly cautious in situations that involve risk of failure. It has been estimated that up to 10% to 15% of White American children are born with a behavioral predisposition toward irritability as infants, shyness and fearfulness as toddlers, and cautiousness and introversion at school age. The article by Pary (2008) is an overview of the psychological care and emotional support of adults with Down syndrome. Emotional and behavioral concerns in adulthood range from the obvious (failure to thrive, pervasive developmental disorder to the very subtle (excessive irritability). However, adulthood, there are many adverse psychological symptoms or situations of a more "subclinical" nature that do not meet the criteria for a specific mental disorder. Developmental variations are within the range of expected behaviors and can be handled with reassurance. The second category involves behaviors that are sufficiently problematic as to disrupt the adult functioning within the family, yet are not severe enough to warrant the diagnosis of a mental disorder. Disorders, constituting the last category, are more extreme and warrant referral to mental health clinicians. In general, current research on the problem of Down's syndrome is dynamic, and as such, the infant is constantly rearranging and reorganizing cognitively, behaviorally, and emotionally in a transactional matrix. Risk factors that may disrupt development can be of an established, biological, or environmental nature. Conversely, protective factors may be infant- and/ or environmentally based. The vast numbers of permutations and combinations of these risk and protective influences, superimposed on a given infant's constitutional and behavioral predispositions, help to explain individuality. Early identification of an infant's problems and strengths is critical to afford comprehensive intervention and maximize development. Indeed, the inhibited children in their study manifested such difficulties as avoidant behavior on attending school as well as frequent symptoms consistent with separation anxiety. These traits may predict such specific behaviors as distress. These infants and toddlers require more effort by parents to deal with tantrums, crying, and oppositional behavior, and a difficult temperament in conjunction with other child risk factors such as developmental delays, language disorders, or physical handicaps may be particularly demanding on parents. Parents react by feeling inadequate, intimidated, threatened, and anxious, or by resenting and blaming the infant. Slow-towarm-up infants are often stressed by parental insistence that they adapt quickly to a new situation (e.g., day care), food, or a peer play activity. When an infant with an easy temperament develops a behavioral concern, the clinician should look to situational stresses or parenting issues as causative factors. Particular emphasis has been placed on infants and young children with behavioral inhibition. Moreover, investigations of the relationship between temperament and attachment (see below) have suggested an association between the pattern of mother-infant attachment and the infant's biological responses to stress. Most notably, the authors caution that many existing self-report measures of Down's syndrome may be outdated, thus accounting for the high correlation between measures of different constructs. References Appl, D. J. (1998). Children with Down Syndrome: Implications for Adult-Child Interactions in Inclusive Settings. Childhood Education, 75 (1), 43. Jobling, A., Virji-Babul, N., (2006). Children with Down Syndrome: Discovering the Joy of Movement. JOPERD--The Journal of Physical Education, Recreation 77 (6), 34. Pary, R. J., (2008). Psychiatric Aspects of Health Care of Adults with Down Syndrome. Mental Health Aspects of Developmental Disabilities, 11 (2), 61. Stray-Gundersen, K. (2005). Babies With Down Syndrome: A New Parent's Guide. Woodbine House. Read More