DOWN SYNDROME & SPECIAL EDUCATION

MUHAMMED KOCABIYIK PHYSICAL MEDICINE & REHABILITATION

IV. CLASS V. GROUP

 Down syndrome is a genetic disorder that causes lifelong mental retardation, developmental delays and other problems. Down syndrome varies in severity, so developmental problems range from moderate to serious. Down syndrome is the most common genetic cause of learning disabilities in children.

Symptoms
Children with Down syndrome have a distinct facial appearance. Though not all children with Down syndrome have the same features, some of the more common features are:
Flattened facial features Small head Short neck Protruding tongue Upward slanting eyes, unusual for the child's ethnic group
Unusually shaped ears Children with Down syndrome may also have: Poor muscle tone

Broad, short hands with a single crease in the palm

Relatively short fingers Excessive flexibility

Infants with Down syndrome may be of average size, but typically they grow slowly and remain shorter than other children of similar age. In general, developmental milestones, such as sitting and crawling, occur at about twice the age of children without impairment. Children with Down syndrome also have some degree of mental retardation, most often in the mild to moderate range.

Causes

There are 3 possible abnormalities which all result in extra genetic material from chromosome 21,which causes Down syndrome.

Trisomy 21

More than 90 percent of cases with Down syndrome are caused by Trisomy 21. With Trisomy 21 there are 3 copies of chromosome 21, instead of the usual 2 copies.

Mosaic Down syndrome

rare form of Down syndrome With Mosaic Down syndrome some cells have an extra copy of chromosome 21, but not all. Mosaic Down syndrome is caused by abnormal cell division after fertilization.

Translocation Down syndrome

MOST cases of Down syndrome are NOT inherited. There are no known behavioral or environmental factors that cause Down syndrome.

occurs when part of a chromosome 21becomes attached onto another chromosome, before or at conception. Children with Translocation have the usual 2 copies of chromosome 21, but have additional material from chromosome 21 stuck to the translocated chromosome.

Risk factors
Advance Maternal Aging
A womans chance of giving birth to a child with Down syndrome increases with age. Age 35 = 1 in 385 chance Age 40 = 1 in 106 chance Age 45 = 1 in 30 chance

Women who already have a child with Down syndrome typically have a 1 % chance of having another child with Down syndrome.

Parents who are carriers of the translocation for Down syndrome can pass the genetic translocation onto their children.

Tests and Diagnosis

The most efficient two step screening is done during the 11th week and 14th week of pregnancy. First the doctor does an ultrasound to get results, those results are then paired with blood tests.

When this two-step screening is done during the 11th week of pregnancy, researchers say it can identify 87 percent of babies with Down syndrome.
If a screening test indicates a high chance of Down syndrome, more tests are done to see if the baby actually had Down syndrome.

Tests for positive results

If your tests came back positive or are at a high risk for Down syndrome, you can have further testing.

Percutaneous umbilical blood sampling (PUBS)

To exam for chromosomal defects, blood is taken from the vein in the umbilical cord. This test has a greater risk for miscarriage than both Amniocentesis and CVS. Test usually is only done if completely necessary.

Amniocentesis

A sample of amniotic fluid is withdrawn from the mothers fetus, this sample is used to analyze the chromosomes of the fetus. The chance of miscarriage from taking this test is 1 in 200.

Chorionic villus sampling (CVS)

To analyze the fetal chromosomes, cells are taken from the mothers placenta. The risk for miscarriage by taking this test is 1 in 100.

Complications
Children with Down syndrome can have a variety of complications, some of which become more prominent as they get older, including: Heart defects Leukemia Infectious diseases Dementia Sleep apnea Obesity Other problems. Down syndrome may also be associated with other health conditions, including gastrointestinal blockage, thyroid problems, early menopause, seizures, hearing loss, premature aging, skeletal problems and poor vision.

Special Ed Children with Down Syndrome

 There are some simple strategies that will assist those teaching special needs students with Down syndrome. These strategies have been proven successful and create a win-win situation for the teacher and student. When discussing teaching strategies of special needs children with Down syndrome, there are some generalizations that can be made. For example, children with Down syndrome are largely concrete thinkers and learn best when visual learning is emphasized. This may not hold true for every child with Down syndrome, but is true for the majority. Strategies that work well for teaching special needs with Down syndrome included are:
Focusing on Visual Learning Using Hands-on Activities Making Lessons Relate to Life Experience

Minimizing Fine Motor Demands

Use Short and Long Term Memory Aids Shorten Assignments or Break Them Down into Smaller Tasks These strategies will be helpful for modifying curriculum for inclusion in the mainstream classroom.

 Focusing on Visual Learning Lessons will best be remembered by the special needs students when accompanied by a picture or visual representation of a concept. Visual aids are common in elementary school, but are used less often in junior-high or high-school. Modifications will need to be made as often as possible to include visual aids. Sequenced photo representations of a student's school schedule have also been shown to be very helpful. These pictures help them understand what is expected of them throughout the day and encourage participation in lessons.

 Using Hands on Activities Many of us can identify with the concept of learning better through hands-on application. For many people, it is easier to remember something if we are given the opportunity to do the task ourselves. Special needs children with Down syndrome learn best when they are shown how to do something step by step. Model the correct way to do something and allow the student to copy your direction. Some examples include teaching color by identifying a color in the classroom and teaching addition problems with counters and beans rather than worksheets.

 Making Lessons Relate to Life Experience The ultimate goal for special needs students with Down syndrome is for them to be able to incorporate the skills they learn at school into their everyday life. When teaching the student about money, we want them to have the ability to use money independently. Role-play real life situations as often as possible to help the student make the connection between what they are learning and daily living skills. Using money when shopping, reading signs, and measuring quantities for cooking are just a few ways lessons may assist with living skills. Role-play a grocery shopping situation with the student to help them understand how money can be used and also help them commit what they have learned to memory.

 Minimizing Fine Motor Demands Special needs students with Down syndrome often have a difficult time manipulating small objects. Reducing frustration while learning and ensuring a successful experience will keep them motivated to learn. Lengthy assignments writing numbers or copying information may cause the special needs student to lose interest in the assignment. Minimize fine motor demands whenever possible without interfering with the learning process. Long-Term and Short-Term Memory Aids Musical rhythms, visual representation of concepts and mnemonic devices are examples of memory aids that will help special needs students with Down syndrome retain what they learn. When the student is struggling to master an educational concept, incorporate these memory aids as often as possible. Songs can help with learning the alphabet, counting, and learning word families for mastering phonics. Pies and pizzas cut up into sections are examples of clear visual aids for working with fractions. Shortening Assignment Length Keeping special needs students motivated is critical. Many students develop avoidance behaviors when it comes to classroom instruction they find particularly difficult. Keep the lessons enjoyable and ensure success by reducing the work to smaller tasks. Use positive feedback, or possibly a reward, when lessons are completed successfully to encourage participation.