Editing Down syndrome (section)

==Management==
Efforts such as [[early childhood intervention]], therapies, screening for common medical issues, a good family environment, and work-related training can improve the development of children with Down syndrome and provide good quality of life. Common therapies utilized include physical therapy, occupational therapy and speech therapy.<ref>{{Cite web |title=What are common treatments for Down syndrome? |url=https://www.nichd.nih.gov/health/topics/down/conditioninfo/treatments |access-date=28 March 2023 |website=NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development|date=31 January 2017 }}</ref> Education and proper care can provide a positive [[quality of life]].<ref name=Roi2003/> Typical childhood [[vaccination]]s are recommended.<ref name=Hick2012/>

===Health screening===
{| class="wikitable" style="float:right; margin-left:10px"
|+ Recommended screening
|-
! Testing !! Children<ref name=Bull2011>{{cite journal | vauthors = Bull MJ | title = Health supervision for children with Down syndrome | journal = Pediatrics | volume = 128 | issue = 2 | pages = 393–406 | date = August 2011 | pmid = 21788214 | doi = 10.1542/peds.2011-1605 | doi-access = free }}</ref>!! Adults<ref name=Malt2013/>
|-
| Hearing || 6 months, 12 months, then yearly || 3–5 years
|-
| [[thyroxine|T4]] and [[thyroid stimulating hormone|TSH]] || 6 months, then yearly||
|-
| Eyes || 6 months, then yearly||3–5 years
|-
| Teeth || 2 years, then every 6 months||
|-
| Celiac disease || Between 2 and 3 years of age,<br> or earlier if symptoms occur||
|-
| [[polysomnography|Sleep study]] || 3 to 4 years, or earlier if symptoms<br> of [[obstructive sleep apnea]] occur||
|-
| Neck X-rays || Between 3 and 5 years of age||
|}

A number of health organizations have issued recommendations for [[screening (medicine)|screening]] those with Down syndrome for particular diseases.<ref name=Bull2011/> This is recommended to be done systematically.<ref name=Hick2012/>

At birth, all children should get an [[electrocardiogram]] and [[echocardiogram|ultrasound of the heart]].<ref name=Hick2012/> Surgical repair of heart problems may be required as early as three months of age.<ref name=Hick2012/> [[Heart valve]] problems may occur in young adults, and further ultrasound evaluation may be needed in adolescents and in early adulthood.<ref name=Hick2012/> Due to the elevated risk of testicular cancer, some recommend checking the person's testicles yearly.<ref name=Malt2013/>

===Cognitive development===
<!-- Hearing and Speech -->
Some people with Down syndrome experience hearing loss. In this instance, [[hearing aids]] or other amplification devices can be useful for language learning.<ref name="Hick2012" /> [[Speech-Language Pathology|Speech therapy]] may be useful and is recommended to be started around nine months of age.<ref name="Hick2012" /> As those with Down syndrome typically have good hand-eye coordination, learning [[sign language]] is a helpful communication tool.<ref name="Reil2012" /> [[Augmentative and alternative communication]] methods, such as pointing, body language, objects, or pictures, are often used to help with communication.<ref name="Price2007">{{cite journal | vauthors = Roberts JE, Price J, Malkin C | title = Language and communication development in Down syndrome | journal = Mental Retardation and Developmental Disabilities Research Reviews | volume = 13 | issue = 1 | pages = 26–35 | year = 2007 | pmid = 17326116 | doi = 10.1002/mrdd.20136 }}</ref> Behavioral issues and mental illness are typically managed with counseling or medications.<ref name="Nelson2011" /><!-- School -->

Education programs before reaching school age may be useful.<ref name=Wei2010/> School-age children with Down syndrome may benefit from [[inclusive education]] (whereby students of differing abilities are placed in classes with their peers of the same age), provided some adjustments are made to the curriculum.<ref>{{cite web|title=Inclusion: Educating Students with Down Syndrome with Their Non-Disabled Peers|url=http://www.kcdsg.org/files/content/Educating%20Students%20with%20Down%20Syndrome%20With%20Their%20Typical%20Peers.pdf|publisher=National Down Syndrome Society|access-date=5 February 2014|url-status=live|archive-url=https://web.archive.org/web/20141127111652/http://www.kcdsg.org/files/content/Educating%20Students%20with%20Down%20Syndrome%20With%20Their%20Typical%20Peers.pdf|archive-date=27 November 2014}}</ref> In the United States, the [[Individuals with Disabilities Education Act]] of 1975 requires public schools generally to allow attendance by students with Down syndrome.<ref>{{cite book| vauthors = New RS, Cochran M |title=Early childhood education an international encyclopedia|year=2007|publisher=Praeger Publishers|location=Westport, Conn.|isbn=978-0-313-01448-2 |page=305 |url=https://books.google.com/books?id=JulOlhMP3JAC&pg=PA305 |url-status=live|archive-url= https://web.archive.org/web/20170123083030/https://books.google.com/books?id=JulOlhMP3JAC&pg=PA305 |archive-date=2017-01-23}}</ref>

<!-- Early Intervention&nbsp;Therapies -->
Individuals with Down syndrome may learn better visually. Drawing may help with language, speech, and reading skills. Children with Down syndrome still often have difficulty with sentence structure and grammar, as well as developing the ability to speak clearly.<ref>{{Cite news|url=https://www.dseinternational.org/en-us/about-down-syndrome/development/|title=Development and learning for people with Down syndrome|language=en-US|access-date=2016-11-18|url-status=live|archive-url=https://web.archive.org/web/20161119055326/https://www.dseinternational.org/en-us/about-down-syndrome/development/|archive-date=2016-11-19}}</ref> Several types of early intervention can help with cognitive development. Efforts to develop motor skills include physical therapy, speech and language therapy, and occupational therapy. Physical therapy focuses specifically on motor development and teaching children to interact with their environment. Speech and language therapy can help prepare for later language. Lastly, occupational therapy can help with skills needed for later independence.<ref>{{Cite web|url=http://www.ndss.org/resources/therapies-development/early-intervention/|title=Early Intervention – National Down Syndrome Society|website=www.ndss.org|access-date=2016-11-18|url-status=live|archive-url=https://web.archive.org/web/20161119060027/http://www.ndss.org/resources/therapies-development/early-intervention/|archive-date=2016-11-19}}</ref>

===Other===
[[Tympanostomy tube]]s are often needed<ref name=Hick2012/> and often more than one set during the person's childhood.<ref name=Rod2012>{{cite journal | vauthors = Rodman R, Pine HS | title = The otolaryngologist's approach to the patient with Down syndrome | journal = Otolaryngologic Clinics of North America | volume = 45 | issue = 3 | pages = 599–629, vii–viii | date = June 2012 | pmid = 22588039 | doi = 10.1016/j.otc.2012.03.010 }}</ref> [[Tonsillectomy]] is also often done to help with sleep apnea and [[pharyngitis|throat infections]].<ref name=Hick2012/> Surgery does not correct every instance of sleep apnea and a [[continuous positive airway pressure]] (CPAP) machine may be useful in those cases.<ref name=Rod2012/>

Efforts to prevent [[respiratory syncytial virus]] (RSV) infection with [[human monoclonal antibodies]] should be considered, especially in those with heart problems.<ref name=Wei2010/> In those who develop dementia there is no evidence for [[memantine]],<ref>{{cite journal | vauthors = Mohan M, Bennett C, Carpenter PK | title = Memantine for dementia in people with Down syndrome | journal = The Cochrane Database of Systematic Reviews | volume = 2009 | issue = 1 | pages = CD007657 | date = January 2009 | pmid = 19160343 | pmc = 7197456 | doi = 10.1002/14651858.CD007657 }}</ref> [[donepezil]],<ref>{{cite journal | vauthors = Mohan M, Carpenter PK, Bennett C | title = Donepezil for dementia in people with Down syndrome | journal = The Cochrane Database of Systematic Reviews | volume = 2009 | issue = 1 | pages = CD007178 | date = January 2009 | pmid = 19160328 | pmc = 7208846 | doi = 10.1002/14651858.CD007178.pub2 }}</ref> [[rivastigmine]],<ref>{{cite journal | vauthors = Mohan M, Bennett C, Carpenter PK | title = Rivastigmine for dementia in people with Down syndrome | journal = The Cochrane Database of Systematic Reviews | volume = 2009 | issue = 1 | pages = CD007658 | date = January 2009 | pmid = 19160344 | pmc = 7197503 | doi = 10.1002/14651858.CD007658 }}</ref> or [[galantamine]].<ref>{{cite journal | vauthors = Mohan M, Bennett C, Carpenter PK | title = Galantamine for dementia in people with Down syndrome | journal = The Cochrane Database of Systematic Reviews | volume = 2009 | issue = 1 | pages = CD007656 | date = January 2009 | pmid = 19160342 | pmc = 7197502 | doi = 10.1002/14651858.CD007656 }}</ref>