Development in Children with Down Syndrome

In general, children with Down syndrome follow the same developmental sequences as their non-disabled peers, albeit at a slower pace. It is rare to see a youngster with Down syndrome who is developmentally on-track in any given domain. However, within these parameters, there are great variations in the developmental skills of individuals with Down syndrome at any given age level.

Speech and language delays are virtually universal in this population, with receptive language (what the child hears and understands) being significantly more advanced than expressive language (the ability to express what the child wants to communicate). Sign language, as well as augmentive communication devices such as picture boards, are commonly used to bridge the gap between the youngster’s communicative intent and his ability to verbally express the message.

Although gross motor delays are prevalent in children with Down syndrome, most youngsters do learn to walk, jump, and run. Some children with Down syndrome have more significant gross motor delays secondary to health issues (such as congenital heart disease or respiratory disorders), visual-motor problems, lower-than-normal muscle tone, and motor apraxia (a motor planning disorder that interferes with the message being sent from the brain to the muscles).

Fine motor problems are almost universal in individuals with Down syndrome, and may be complicated by visual-motor integration issues, perceptual problems, and motor apraxia. Sensory processing problems may interfere with the child’s ability to integrate the input from his senses, and further impair the attainment of fine motor skills.

Cognitive impairments are universal in children with Down syndrome, with mild to moderate retardation being the norm for this population. Concrete thinking skills are better than abstract conceptual learning, and visual processing tends to be much better than auditory processing. Many children with Down syndrome do best when they learn by observation and hands-on practice, rather than lecture and didactic information. Practical, put-it-to-use-right-now information is much more readily absorbed.

Children with Down syndrome generally need a little extra time, teaching, and practice to learn self-help skills such as bathing, dressing, grooming, cooking, and other activities of daily living. However, these life skills are essential for the child to attain the highest possible level of independence.

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At any given age, children with Down syndrome will demonstrate similar motor and self-help skills.