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Down Syndrome

Individuals with Down syndrome need the usual healthcare screening procedures provided to everyone. For example, children with Down syndrome need the usual recommended immunizations and well-child care procedures. Similarly, adults with Down syndrome should have health evaluations using the standard accepted practices. Children with Down syndrome, however, have an increased risk of having certain congenital anomalies. Both children and adults may develop certain medical problems that occur in much higher frequency in individuals with Down syndrome. Described subsequently is a checklist of additional tests and evaluations recommended for children and adults with Down syndrome. These recommendations should take into consideration available local expertise and referral patterns.

One should be certain to use the specific Down syndrome growth charts in addition to regular charts to record height and weight. If the patient is below the third percentile or falling off the expected.

Laboratory Tests and Consultations

Thyroid function testing should be done yearly, hearing and vision evaluations every other year. Repeat cervical spine radiographs at 12 years and 18 years of age in the asymptomatic individual.

Developmental Monitoring

Repeat psychoeducational evaluations every year as part of an individualized educational plan. Monitor independent functioning. Continue speech and language therapy as needed. Health and sex education.

Recommendations

Begin functional transition planning at age 16. Twice-yearly dental examinations are appropriate. Consider enrollment for social security income.

Bacterial endocarditis prophylaxis is needed for susceptible individuals. Prudent diet and regular exercise.

Update estate planning and custody arrangements. Encourage social and recreational programs with friends. Encourage the patient in registering for voting and selective service.

Discuss plans for alternative long-term living arrangements such as community living. Reinforce the importance of good self-care skills (grooming, dressing, and money-handling skills).