The role of the family in early therapeutic and educational intervention for children with Down's syndrome

Studied factors influencing the effectiveness of early therapeutic and educational intervention with 113 children with Down's syndrome (DS) aged 3 yrs or younger, compared to a control group of normal children in the same age range. The Vojta reflex locomotion method, the Castillo-Morales mouth and face regulation method, and elements of the sensory integration method were used with the children involved in the early stimulation program. Parents were advised on how to carry out effective home therapy. Many factors influencing the effectiveness of initiating early intervention were recognized. The significant role of a positive family environment in the success of therapy was confirmed, and positive development was especially noticed in children with the following: siblings, a mother with at least secondary education, comfortable financial means, and adequate material and living conditions.

Drug therapy of upper respiratory tract infections easiness in Downs: A survey on 328 persons

This is a retrospective study of a consecutive series of 328 home reared Down Ss tretad by drug therapy. Sample data: 188 M and 140 F; M/F ratio = 134.29; chromosomal diagnosis: standard trisomy 21 = 90.85%; mosaicisms = 3.66%; translocationa = 3.66%; only clinical diagnosis: 1.83%; Average age at first consultation; 77.70 ± 61.64 months; average age at last checkup; 116.60 ± 67.86 months; average therapy length: 48.04 ± 43.58 months. The reduction of upper respiratory tract infections (URTI) easiness after at least 1-year drug therapy was evaluated by the same 0-4 points scale used for scoring during the first consultation. The sample, as representative of the Italian population of Down Ss, had two age stratifications by two-years subsamples till 16 year inclusive, plus one subsample for the age 16;1 and more years. The first stratification is for scores at first consultation, and the second one for scores at last checkup. This URTI easiness decreases in the 4 subsamples from 2;1 to 10 years of age (.02 - .0009). From 10;1 years this reduction does not reach any significany level due to the superimposed age reduction effect (see: Cocchi, It. J. Intellect. Impair. 1997: 10: 143-149). The more severe URTI forms, which in non-treated Downs Ss disappeared since 14 years, were found non present since 8;1-10 years. Also the subsample of infants up to 2 years inclusive had a statistically significant reduction of that easiness (.047), but scoring was made after average six-months therapy. A list of drugs in use at last checkups was provided with their daily doses.

Is weight controlled suitable in Down syndrome people?

Investigated whether 251 1-55 yr olds with 251 Down's syndrome who lived in Albacete (Spain) in 1993 controlled their weight, and whether their growth was better reflected in charts by C. E. Cronk (1988), or by F. Orbegozo (1986). For Ss under age 18 yrs, the Orbegozo and Cronk charts were used. For those over age 18, the Body Mass Index was used. Results show that only 36, or 3% of this population, weighed regularly. Only 54 people dieted. It is concluded that the Cronk charts were more suitable than the Orbegozo charts for people with Down's syndrome under age 19. It is also concluded that weight control in people with Down's syndrome was insufficient.

Clinical-epidemiological aspects of Down's syndrome in Spain

Analyzed the prevalence and clinical aspects of Down's syndrome (DS) in Spain. Data on 1,380,917 liveborn infants (1,887 of them having DS) have been collected since 1976 by the Spanish Collaborative Study of Congenital Malformations. Mothers were classified and studied in 2 groups: those younger than 35 yrs, and those aged 35 yrs or older. The following aspects were studied: 1) specificity of 11 phenotypic traits for early clinical diagnosis; 2) frequency of DS at birth (by time, by geographic areas, and the impact of voluntary interruption of some affected pregnancies); 3) distribution by maternal age (aged 13-48 yrs) and the minimal figures for the risk for DS by one-year maternal age intervals; and 4) the defects most frequently observed in infants with DS. Results show that birth frequency of DS had diminished among infants of mothers 35 yrs old since voluntary interruption of the gestation has been permitted by law. It is concluded that variations in the impact of abortion account for the differences in prevalence among the Spanish regions.

Cerebral palsy in Down's syndrome children: another two cases

In a non-selected consecutive series of 551 home reared Down persons coming from all the Italian regions, only 5 of them presented CP. As for the origin of them, in 3 Ss CPs were surely postnatal, in another S it was almost surely the same, and the last CP cannot be decided if postnatal or other. Having previously reported the first three cases (Cocchi R. Riv. It. Disturbo Intellet. 1990, 3: 327-330), the two new cases are extensively described. The prevalence of CP in this cohort is nearly four times higher than in NT children, but the prevalence of postnatal CPs is absolutely an extraordinary figure. Although the occurrence of CP following pre-, peri- and neo-natal insults did not have been denied, the present epidemiological data seem even more supporting the hypothesis that Down Ss are protected during the foetal age, at birth and in first days of life from the paralytic outcomes of anoxic-ischaemic damages.

Which is the autonomy level of Down Syndrome people?

Investigated autonomy levels among 251 1-55 yr olds with Down's syndrome (DS) living in Albacete (Spain). The age at which autonomy began was evaluated for daily activities (washing, dressing, eating, sphincter control), environment relation (traveling & walking alone, shopping, watch, date, money), reading, writing, and oral communication (telephone, home door assistance, language). This was then related to age, sex, and rural or urban areas. Inquiries were made of the Ss and their parents. No significant statistical difference was found by sex in autonomy, except in oral communication, which was done better by women. In those over 29 yrs old, women did shopping more than men. Walking alone occurred with more frequency in small places. The authors observed better communication with unknown people than other authors have observed.

Medical treatment and rehabilitation of eyes anomalies in Down children

Examined characteristic external anomalies of Down's Syndrome (DS) vision organ: epicanthic fold, short narrow fissure, accompanying various disorders of internal structure and relating eye function pathologies. DS children's sight impairment increases with time and is parallel with the regressive changes of the nervous system. 130 DS children in 2 age groups--0-3 and 4-16 yrs of age--were compared with a control group of 56 normal children in 2 stages. In stage 1, external examination of vision organ was carried out. In stage 2 the interior of the eye was examined with an ophthalmoscope and refraction by sciascopia. Results indicated that all Ss are characterized by a different external structure of the sight organ. All have epicanthic fold. Among more than half, the palpebral fissures are short, slanted, narrow, the eyeballs smaller, set in the cross position convergens alternans or one sided. A majority of Ss showed the following changes to the eyeball: dystrophic iris and refraction impairments which require correction. Early and comprehensive diagnostics of vision organ enables improvement of psychomotorand intellectual development and relating improvement of standard of living.

Time course of hyperkinesis in Down's syndrome: A survey on 498 persons

An unselected consecutive series of 548 Down's syndrome subjects undervent investigation of time course of hyperkinesis and possibie gender differences. Excluded psychotic subjects and more than 17-years older people,the remaining 498 Ss (288 M + 210 F; usual distribution of the chromosomal anomalies; age: 62.94 ± 50.61 months at first consultation) showed a 150% increasing of hyperkinesis in males (.009). MIF ratio too had a significant increasing with age (.03).
The time course of hyperkinesis did not have any gender difference, according to our analysis on 10 age bands from 1 to 204 months. The age decreasing of hyperkinesis had a significant trend in females (.005) but not in males. Pubertal hormones seemed not show the same cutting or hiding action on hyperkinesis as it happens in non-Down adolescents.

Is the oral hygiene suitable in Down syndrome people?

Examined whether people with Down syndrome (DS), who lived in Albacete in 1993, had good oral hygiene and if their dental visits were frequent. 251 people with DS took part in this study. The authors did an inquiry to them and their parents. Forty-nine per cent of the population had never gone to the dentist. 36% of them had been only for teeth extraction. Ss 10-20 yrs old visited the dentist more than others. When Ss were living in towns, they visited the dentist more than if they were living in rural areas. When the study level of the parents was better they visited As dental hygiene and dental visits frequency were inadequate among Ss, the authors recommend that educating parents about their importance will improve oral hygiene.

Opposite half-brain dominance of specific functions? Another case in a Down child under drug therapy

The emerging of opposite words, in a Down's syndrome girl aged eight, is reported along with her development and drug therapy course since she was 20 months. The use of the opposite word in normal language seems limited to the semantic field without any emotional involvement.
Suggested explanation refers to the poor function of the mechanism suppressing the opposite engram. This fact accounts for supposed temporary opposite half-brain dominance for only a part of the semanic field, sometimes dealing with the emerging of the opposite word.

The role of the family in educational and rehabilitative programs for disabled child: Which conditions can make it work?

Many authors affirm the importance of the role of the family in educational and rehabilitative programs for children with disabilities. The authors' group has been dedicated to properly involve families of brain injured and children with Down's syndrome in an educational and therapeutic way for 20 yrs. From the authors' experiences, some considerations are discussed. These deal on necessary and sufficient conditions to begin and to continue the route of activation and adaptation of the disabled child's family. The authors want it to become a true rehabilitative and educational resource. Such conditions concern both family and operators.

Drugs therapy of stress on upper respiratory tract infections easiness in Downs: Survey on one-year and two-years results

This is a retrospective study of a series of 185 home-reared Down Ss. All they had therapies for one year, 145 of them for two years, because presenting various degrees of easiness to Upper Respiratiory Tract infections (URTI). 185 Ss sample data: 96 M and 79 F, M/F ratio = 121.52, chromosomal diagnosis: standard trisomy 21 = 90.81%; mosaicisms = 3.24%; transiocations = 5.41%; only clinical diagnosis.- 0.54%; Average age at first consultation: 56.83 ± 49.35 months, average therapy length: 60.99 ± 42.18 months. 145 Ss sample data: 79 M and 66 F, M/F ratio = 119.70; chromosomal diagnosis: standard trisomy 21 = 90.34%; mosaicisms = 3.45%; transiocations = 5.52%; only clinical diagnosis: 0.68%. Average age at first consultation. 55.50 ± 49.70 months; average therapy length: 73.42 ± 39.41 months.
The reduction of URTI easiness after l-year or 2-years drug therapy was highly significant (0009 for both samples). The disappearance of it took place in 20.53% after one-year therapy and 41.38% after two-years therapy. As seen in children up to nine years old 155 Ss) and up to eight years (116 Ss) at 1st consultation, the age growing favoring effect was considered as negligible.
The paper reports the list of drugs prescribed at 1st consultation - mainly , pyridoxine and a low doses benzodiazepine -, with their daily doses. The same for the percent of any drug used and the rationale for their use.