Down Syndrome: How can a multidisciplinary approach help?

Down syndrome is a genetic disorder that is caused by the presence of a third copy of chromosome 21. A person with down syndrome often has poor muscle tone, hypermobility, and distinct facial features in addition to heart defects, gastrointestinal defects, immune disorders, obesity and spinal problems. Because of these complications, a child with down syndrome will likely be delayed with meeting many milestones. Rehabilitative services will play an important role throughout the life of a child with down syndrome to help them meet milestones and be as independent as possible.  

How does PT help? 

A child with down syndrome may need PT on and off their whole life. An initial physical therapy evaluation will include birth and medical history, strength and range of motion assessments, and a functional mobility assessment. Because low tone (hypotonia) is one of the characteristics of down syndrome, PT will be beneficial to address strength, balance, and postural needs. Some people with down syndrome may present with atlantoaxial instability, which is the misalignment of the first two vertebrae and can lead to a spinal cord injury if there is hyperextension of the neck. The physical therapist will be mindful of this, especially at younger ages, when developing a treatment program. Some people with down syndrome may have heart surgery to correct congenital heart defects and will often have restrictions in positions and activity following. They may lose some functional skills due to these prolonged restrictions and may need physical therapy for a short burst to boost their functional skills back to pre-surgery status. As children grow, they may visit a physical therapist on and off to help with independent transfers and mobility and help with general strengthening due to the low muscle tone and hypermobility that is associated with down syndrome. Getting your child involved in sports or other activities, in addition to a home exercise program, will be helpful carryover from therapy and will help to prevent obesity.  

How does OT help? 
An occupational therapist will assess your child’s ability to participate in daily childhood occupations. This includes academic participation (fine motor skill development and executive functioning skills), play and social participation (gross motor and emotional regulation), as well as self-care and activities of daily living (dressing, feeding, toileting, grooming, etc.). The occupational therapist will generate a treatment plan to develop skills, advocate for accommodations, and help your child gain functional independence in all areas of their life. 

How does ST/feeding help? 

A child with Down Syndrome may benefit from feeding therapy for numerous reasons. Due to the often poor muscle tone, gastrointestinal defects, and distinct facial features that children with Down Syndrome of have, how they eat and what they eat may be impacted. Because low tone (hypotonia) is a common characteristic, oral motor exercises may be beneficial to address open mouth posture and tongue protrusion. Working along with a nutritionist, dietician, and/or their pediatrician may be necessary if weight is a concern.  Due to low tone, they may have little to no experience with a variety of textured food because it is hard for them to chew certain foods. Working with a feeding therapist to expand their diet to include variety of textured foods from different food categories may be beneficial. Therapy can also include helping children use utensils, drinking from straw cups and open cup.