Down Syndrome Lab

Question 1

what are the key body function and structure considerations for a child with down syndrome?

Answer 1

hypertonia (hypermobile joints, decreased strength, increased flexibility)
Hypokyphosis, hyperlordosis
genu valgum
pes planus, excessive pronation

Question 2

what are common interventions used for early intervention in a child with Down syndrome?

Answer 2

Tummy time (Wentz 2017)
Sensorimotor therapy
Lower extremity orthotic intervention
Onset of independent walking unless excessive pronation leads to standing in poor alignment
Treadmill training- 0.2 m/s for 8 min/day, 5 days/week (Looper 2010)

Question 3

what are some aspects of motor learning you want to consider when treating a child with Down syndrome?

Answer 3

Task-specific practice
Increased repetitions
Limit verbal cues and increase visual feedback or modeling
Slow movements when modeling to accommodate slower cognitive processing

Question 4

You have a 6 year old child that comes into your clinic with down syndrome. what are some intervention you want to include in your treatment?

Answer 4

Strength
Postural control
Whole-body vibration
Orthoses (SMOs or FOs)
Aerobic training
Physical activity (eg, bike riding, dance)
Jump training (eg, trampolines, hopscotch) jumping can be more difficult
Bike riding (MacDonald, 2012)
Hippotherapy (confirmed AO instability is a contraindication)
Increase parent involvement with HEPs

Question 5

what is the life expectancy for a person with down syndrome?

Answer 5

~60 years

Question 6

when does adult transition planning start for a child with down syndrome?

Answer 6

16 years old

Question 7

what is the primary concern with transitioning to adulthood for a child with Down syndrome? what are two other concerns that are included in the transition to adulthood?

Answer 7

(1)
Primary concern – mental health
30% of adults with DS have depression
>50% have Alzheimer disease for adults 50+ yrs with DS

(2)
Obesity
Orthopedic conditions (eg, osteoporosis, degenerative joint disease)

Question 8

legislatively what are some laws/ acts that are in place for prenatal and postnatal care of a child with Down syndrome?

Answer 8

Prenatally & Postnatally Diagnosed Condition Act (Public Law 110-374) in 2008
To increase the readiness of accurate and balanced information about Down syndrome
The federal law was not funded, left up to states
Currently, 23 states have passed Down syndrome information bills

Question 9

key take away: Is a diagnosis of Down syndrome straight forward and one size fits all?

Answer 9

Down syndrome is a highly variable diagnosis with multisystem involvement

Question 10

key take away: What are the common impairments seen in down syndrome?

Answer 10

Common impairments include hypotonia, ligamentous laxity, inefficient postural control, and cognitive deficits

Question 11

Key take away: when writing goals for a child with down syndrome what might help inform you?

Answer 11

Goals may be informed by the established motor growth curves

Question 12

Key take away: what should you use to guide your examination and interventions?

Answer 12

Use observational movement analysis to guide your examination and intervention

Question 13

key take away: true or false? pt intervention should be standardized and sit what the practitioners goals?

Answer 13

False
PT intervention decision-making should be individualized and in-line with each child and family’s personal movement goals

Question 14

Sample Exam Question: Children with Down syndrome show delayed development of postural control that is MOST affected by?
a. Hydrocephalus
b. Small cerebellum
c. Visual Impairment
d. Low bone density

Answer 14

small cerebellum