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 youngsters 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 childs 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
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.