Early Intervention for Children with Down Syndrome

Early Support and Intervention

The first years of life are crucial for a child’s development.  During these early years, they achieve the basic physical, cognitive, language, social and self-help skills that lay the foundation for the future, and these abilities are attained according to predictable developmental patterns. The chart below outlines the average developmental timelines and shows how a child with Down syndrome will likely show delays in achieving developmental milestones.

Gross Motor Skills	Average Age	Children with Down Syndrome
Rolling	6-8.9 months	6 months
Sitting	8-11.8 months	8 months
Crawling	12-18 months	9 months
Standing	18-21 months	12 months
Climbing Stairs	20-30 months	18 months
Walking	23-32 months	18 months

Early intervention can start at any age, but the sooner the better! The most common early intervention services for babies with Down syndrome are physiotherapy, speech and language therapy, and occupational therapy. These providers aim to work together to enhance the development of infants and toddlers. They also help families understand their children and how best to help them achieve.

What are the benefits?

Most children are expected to achieve milestones at a designated time, also referred to as a “key age”. Babies with Down syndrome typically achieve all these milestones, but usually take more time getting there.  In monitoring the development of a child with Down syndrome, it is more useful to look at the sequence of milestones achieved, rather than the age at which the milestone is reached. The primary goal of early intervention programs is to enhance and accelerate development by building on a child’s strengths and by strengthening those skills that are weaker in all areas of development. Early intervention can also assist in monitoring as a child grows and can prevent a child with Down syndrome from reaching a plateau at some point in development. 

Programs of early intervention also have a great deal to offer to parents in terms of support, encouragement and information as raising a child with Down Syndrome can at times be overwhelming for parents. These programs teach parents how to interact with their infant or toddler, how to meet their child’s specific needs and how to enhance their development.

Physiotherapy Treatment

Children with Down syndrome want to sit, crawl, walk, explore their environment, and interact with the people around them. However, they can be limited by the physical characteristics associated with down syndrome including: hypotonia (low muscle tone), ligamentous laxity (looseness of the ligaments that causes increased flexibility in the joints) and decreased strength. Because of these physical limitations, they can’t develop motor skills in the same way that a typically developing child does, so they find ways to compensate for the differences in their physical make-up, and some of the compensations can lead to long-term complications, such as pain in the feet or the development of an inefficient walking pattern.

The goal of physiotherapy for these children is not to accelerate the rate of their development, as is often presumed, but to facilitate the development of optimal movement patterns.  This means that over the long term, physiotherapists will aim to help the child develop good posture, proper foot alignment, an efficient walking pattern, and a good physical foundation for exercise throughout life.

Tips for Parents

Here are some practical tips to help a child with Down syndrome grow through play:

• Become your child’s ‘play partner’. Show them how to play with their toys
• Notice what interests your child, follow their interest and copy their play.
• As well as playing in ways that interest your child, demonstrate how to do more interesting things with toys.
• Take turns with your child to demonstrate how to do something.
• Later on, join in with pretend play to show your child what to do. Help them to build a sequence of two or more actions in their play.  For example:
  – put a toy man (‘daddy’) in the car and then push the car– give dolly (‘baby’) a drink and then put dolly to bed.
  – ‘feed’ a toy farm animal and then make him run or jump.
• Use structured play. Children with Down syndrome usually need more repetition than other children before they are able to remember and master a task.  Your child will benefit if you break down tasks and games into small steps and show them how to complete each step.
• Use imitation as much as possible. Children with Down syndrome tend to be good at learning by imitating or copying other people.
• Praise your child and avoid frustration by making sure that most of the time your child gets satisfaction from playing and from toys.
• It can be very frustrating trying to do things that are beyond your ability.  They may express frustration by throwing or banging and it can be quite hard for them to get over it.  Music, holding hands or dancing are good ways of getting over it.

Before birth and in the first months of life, physical development remains the underlying foundation for all future progress.  Babies learn through interaction with their environment. Therefore, in order to learn, an infant must have the ability to move freely and purposefully.   An infant’s ability to explore his or her surroundings, reach and grasp toys, turn his or her head while watching a moving object, roll over and crawl are all dependent upon gross as well as fine motor development.  These physical, interactive activities require understanding and mastery of the environment, stimulating cognitive, language and social development for the future.

If you have a young child with Down syndrome, give us a call and let our experienced physios help you develop a plan to get them on track to experience the world and interact to their full potential.