Down syndrome medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]

Treatment of individuals with Down Syndrome depends on the particular manifestations of the disease. For instance, individuals with congenital heart disease may need to undergo major corrective surgery soon after birth. Other individuals may have relatively minor health problems requiring no therapy. Patients suffering from Down syndrome require rigorous follow-up in order to prevent the complications associated with the syndrome. Close monitoring of growth, hearing evaluation, ophthalmologic evaluation, thyroid profile, cardiac evaluation, dental care and close monitoring of complete blood counts in order to identify hematological maliganancies should be a part of care for a Down syndrome patient.

There is no specific treatment for Down syndrome. Patients suffering from Down syndrome require rigorous follow-up in order to prevent the complications associated with the syndrome. The following are the essential components of care of a Down syndrome patient:^{[1][2][3][4][5][6][7]}

• When breast-feeding, the baby should be well supported and fully awake. The baby may have some leakage because of poor tongue control. However, many infants with Down syndrome can successfully breast-feed. Obesity can become a problem for older children and adults. Getting plenty of activity and avoiding high-calorie foods are important.

• Before beginning sports activities, the child's neck and hips should be examined.

• Behavioral training can help people with Down syndrome and their families deal with the frustration, anger, and compulsive behavior that often occur.
• Parents and caregivers should learn to help a person with Down syndrome deal with frustration. At the same time, it is important to encourage independence.
• Adolescent females and women with Down syndrome are usually able to get pregnant.
• There is an increased risk of sexual abuse and other types of abuse in both males and females. It is important for those with Down syndrome to:
  • Be taught about pregnancy and taking the proper precautions
  • Independency
  • Be in a safe environment

• Special education and training is offered in most communities for children with delays in mental development.
• Speech therapy may help improve language skills. Physical therapy may teach movement skills.
• Occupational therapy may help with feeding and performing tasks. Mental health care can help both parents and the child manage mood or behavior problems. Specialized educators should be part of the team taking care of a patient suffering from Down syndrome.

• Physicians should be vigilant about the potential symptoms of gastroesophageal reflux disease (heartburn, decreased food intake), celiac disease (fatty stools, bloating, abdominal pain, eczema herpeticum), obstructive sleep apnea (snoring, excessive daytime sleepiness), atlantoaxial dislocation
• Immunizations should follow schedule. Pneumococcal vaccine (23 valent) after 2 years of age for chronic cardiac or pulmonary complications
• Early intervention: physical, occupational, and speech therapy
• Chromosomal studies in all
• Vocational training, hygiene and self-care, group homes
• Encourage discussion about behavioral issues
• Discuss about puberty, and gynaecologic care
• During adolescence and adulthood- sexual education, and counseling regarding interpersonal relationships, risk of sexual abuse, contraception and sexually transmitted diseases
• Parental genetic counseling and prenatal diagnosis

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