Ten to 40% of persons with Down syndrome have hypothyroidism, and hyperthyroidism is slightly more common than it is in the general population. Symptoms may be subtle, and may be confused with features associated with Down syndrome. Lethargy, cognitive impairments, and skin dryness, for example, are often seen in children with Down syndrome even when thyroid function is normal. It’s important to ensure that these youngsters are screened regularly for thyroid disorders.

About 14% of the individuals with Down syndrome have increased mobility of the cervical spine at the level of the first and second vertebrae. This is a condition known as atlantoaxial instability (AAI). Most are asymptomatic, but about 10% of those with AAI have symptoms of spinal cord compression (neck pain, torticollis, change in gait, loss of upper body strength, or changes in bowel/bladder functioning).

In order to prevent further complications, it’s important for nurses familiar with the child to report any of these changes to the primary health care provider as soon as they occur. Nurses can also guide the child and family into exercise and sports options that are safer for persons with AAI. For example, Special Olympics, Inc. bars athletes with AAI from competing in equestrian sports, diving, alpine skiing, snowboarding, and other sports that increase the risk for spinal cord compression.

Children with Down syndrome are more prone to seizure disorders than their typically-developing peers. Seizures in these youngsters seem to peak in infancy, increase a little in adolescence, and then peak again when the individuals are 30 or 40 years old. Babies with Down syndrome may have infantile spasms, which can be successfully treated with steroid or anticonvulsants.