Down Syndrome

January 31, 2018 | Author: Anonymous | Category: Science, Health Science, Immunology
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Down Syndrome PRESENTATION created by FTTA

Disclaimer

Please note that FTTA presenters, lectures and staff are not medical professionals. This information is designed to be used for education assistants under the supervision of professionals and some parts may be incorrect, outdated or the authors’ opinion.

Down Syndrome Down Syndrome occurs because of a chromosomal abnormality that happens while

the cells are pairing and dividing at conception.

It is the most common genetic condition where people have an extra set of chromosomes. People with Down Syndrome all share similar, unique facial features. FTTA

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What is Down Syndrome?

Generally people have 46 chromosomes in each cell with 22 pairs and 2 sex chromosomes.

While the egg begins to divide, each cell divides and so each cell will have the same genetic code. If the cells do not pair off correctly, an error called nondisjunction occurs. 47 chromosomes are now developing, duplicating itself and a baby with Down

Syndrome develops. FTTA

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/// How is DS

Diagnosed?

Pre-natal Diagnosis Screening Test: estimates the risk of having a baby with DS Between 15 and 20 weeks gestation “The Triple Screen” blood test Ultrasound i.e. thickness of skin around neck

IS NOT AN ACCURATE DIAGNOISIS

Diagnostic Tests Diagnostic Test: determines if baby actually has DS Amniocentesis performed between 15 and 20 weeks gestation Chorionic Villus Sampling (CVS) conducted between 8 and 12 weeks

If a baby is suspected to have a chromosomal abnormality, a blood test analysis is conducted shortly after birth

Percutaneous Umbilical Blood Sampling (PUBS) performed after 20 weeks

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Types of Down Syndrome Mosaic Down Syndrome

Trisomy 21 Most common form affecting 94% Chromosome aligns with 21st pair of chromosomes (hence Trisomy 21)

Translocation Down Syndrome 3-4% of cases,

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2-3% A mosaic effect of cells that have and have not divided correctly. People affected with Mosaicism MAY be affected by the syndrome

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/// Common Facial Characteristics

Epicanthal fold - Eyes that have a slant and

an extra fold of skin on the inner side

A thinker neck, or extra fold of skin Brushfield spots - Small white flecks on the iris

Ears are generally smaller and tops may slightly fold over and sit lower on the face

Smaller, flatter nose Broader face FTTA

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Transverse palmer crease - Single crease across the broader hand with a pinkie

/// Common

that may appear crooked

physical characteristics

Low muscle tome and loose ligaments

Big toes widely spaced

Range of associated medical conditions, including vision and hearing problems and reduced immune function FTTA

Congenital heart defects found

in 50% from before birth

Smaller and or shorter limbs and smaller and chubbier fingers

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SOME FACTS /// Young mothers can have a child DS

It is not the age of the mother, but the health of her eggs that is the factor.

Not all eggs age at the same rate

A woman is born with over one million eggs. Genetic, environmental, age of eggs and other factors all play an impact on the health of the eggs.

It was once considered a high social status to have a child with DS Women who had children in later years were often wealthy and naturally at a higher risk of having a child with DS.

1950’s movie star Mickey Rooney was rumoured to have DS Mosaic Down Syndrome does not always affect intelligence unlike the other types of DS.

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Downs Syndrome STATS In Australia, babies born with DS is approx 1:1100

Since 2007 around 270 babies a year are born with DS

There are over 13,000 people with DS in Australia

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Current life expectancy for a person with DS is around 60

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///What is early intervention? In WA, most babies born with Downs Syndrome are referred to the Disability Service Commission to have an Individual and Family Services Program (IFSP) developed. Occupational Therapy Provides support for infants and young children with developmental delays or disabilities

Speech Therapy

Physiotherapy FTTA

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/// Developmental Milestones

If it is expected, a child by 5 will be walking, toilet trained, dress with minimal help and feed themselves

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Visual Learners. Focus on using

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Teaching Strategies

visual processing and visual memory skills More is understood than is said

Classroom rules and behaviours can be followed. Structure and routine are important Use shorter phrases and visual clues

Keep the expectations for behaviour and attitude high, as with any other child

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/// Functional

Curriculum

needs

When

1:1 teaching

learning social skills

Small group work

Possible whole class instruction

Repetition

Taking off jumper

of activities

skills are a

priority

is valuable

Recognising correct toilets

Eating lunch / recess at correct

Toileting

Contingency plan for

needs must be accidents

time

considered

Toilet trained

Walking out route so student

Modified FTTA

understands how long it takes

Curriculum

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Celebrate success…however small

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You were being told to do something you were unsure of?

///

How may you act if…

Your language skills were not developed enough to express your concerns or views?

Children with DS like structure. Refusal can

occur when trying to get

the child to try new things. You did not understand why you have to do something this new way that you do not understand?

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This is because they resort to doing what they know

is safe

You may appear Stubborn! ///

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What does stubbornness look like?

sitting

withdrawing

Not looking Throwing themselves down FTTA

pouting

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Strategies for

“Stubbornness”

Start seeing the behaviour as resistance to the unknown Discuss the Prepare the child for the

changes

upcoming changes Help child to

Social stories

feel safe with new activity FTTA

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Inform student you are displeased

Structure

///

with voice and body language Routine

Behaviour Management Strategies

Black and white rules

Explicit and clear expectations

Developmentally appropriate consequences Consistency and follow through CATCH THE STUDENT BEING GOOD! FTTA

Strategies to alleviate resistance to change

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Types of Physical & Medical Conditions Specific Learning Difficulties

Hearing Eyesight

Immune system

Heart Defects

Speech and Language Gross & fine motor skills

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Do lots of reading activities – this builds knowledge base

Allow extra time for response

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for when their speech communication improves Model what you want

Communication Strategies

Poor listening skills

Have visual cue cards for the child to point to when communicating

Teach hand gestures for the child to use when communicating. Makaton is

Having higher receptive (understanding) skills than expressive skills, frustration can easily occur when not understood

useful. Ask child to show what they want Encourage lots of speech and sounds –

Give clear and simple

spend at least 5 minutes a day talking

instructions one at a

with the student

time Eye contact

FTTA Do not allow other children to respond for the child

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Hearing

implications

1

Delayed speech and language

2

Student may not notice

3

During hearing infections, loss of

Frequent colds and

upper respiratory infections and small ear canals can cause varying degrees of hearing loss FTTA

development

instructions being given in noisy

classroom

hearing can be up to 40 db in one day. Playground siren may not be heard

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Hyperacusis: over-sensitive to

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Possible refusal to join noisy

loud noises

situations such as assembly

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Hearing

strategies

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1

Sit student close to teacher and not

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‘Face-to-face’ instructions

3

Clear language suited for

4

Include visual cues and signing

5

Reduce background noise or

looking into bright light

developmental level of child

move student to quieter part of room. Headphones.

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///

Behaviours to watch

Implications for

Eyesight

Impaired vision is very common

for include: Tilting head too far back

Regular eye

Seating

checks

position

Working too

close to a book

Ensure glasses are worn

Very sensitive to sun exposure FTTA

Hat and

Gradual

sunglasses

deterioration of

worn outside

eye tissue

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Immune System

Implications & Strategies

Illness such as upper respiratory infections are more common

Frequent use of antibiotics may affect toileting

An underdeveloped immune system is common FTTA

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Heart Defects Found in up to 40% of students Heart defects are operable

implications May tire easily

Some physical activities can be

harder for full participation

strategies Obtain current medical information

A ‘pigeon chest’ is no need for concern

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Monitor physical activities and allow student to sit out when required

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Poor muscle tone

Poor motor planning

Possible ‘flat’ footed

///Implications & strategies for Gross Motor Skills

Floppy & loose jointed

Difficulties with co-ordination and gait

Difficulty problem solving with using equipment May have less stamina than peers

Encourage participation Make games friendly FTTA

Model and talk

Assist child verbally

student through

and physically while

problem

gaining confidence with play equipment

Allow for extra rest time

Ensure orthotic devices are in

correct shoe 26

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Poor dexterity and manipulation skills

Songs and games

Fine Motor Skills strategies & implications

Difficulty cutting, handwriting etc

Too small for furniture, box under feet

that develop muscle

Messy writing

strength in arms,

picture

wrists, hands and fingers - pictures

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‘Key Steps’ program

Extra structured handwriting program 27

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High level of supervision in areas of risk

Toilet procedures may need extra monitoring

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Response plan if student leaves the school

Duty of care

grounds Poor understanding of boundaries and other concepts. Show exactly where student can play

Greater responsibility for the

Protective Behaviours program

Mandatory reporting

Swimming lessons – does

welfare of the student is needed

student need ear plugs, can they hear with swim cap, extra supervision in bathrooms, assistance with clothing?

FTTA Buddy system

Monitor and remind student about weather needs i.e. jumper, hat

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Want to know more? http://www.genetics.edu.au/Publications-and-Resources/Genetics-FactSheets/FactSheet28/view

http://www.thesebrokenvases.com/2010/10/physical-characteristics-of-down.html

www.downsyndrome.org.au/down_syndrome_popuation_statics.html

http://www.australianreview.net/digest/2012/05/spandagou.html www.ndsccenter.org/resources/general-information/ds-news-articles/stubborn-isas-stubborn-does/ http://www.dswaasn.au/what-is-down-syndrome.html http://www.nads.org/pages_news/fact.html FTTA

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