Generalized anxiety disorder, obsessive-compulsive disorder, attention deficit hyperactivity disorder, depression, autism spectrum disorders, sleep problems, neuropsychiatric problems with progressive loss of cognitive skills are the most common mental problems in children with Down syndrome.
If the mental problems in children with Down syndrome are not treated, they impair the child's daily life, education and social relations. It negatively affects her developmental level to a better level. It negatively affects compliance with the treatment related to his medical condition.
Mental and physical health are a whole, and both medical condition and mental condition must be treated simultaneously.
Down syndrome
While there is an article about developmental retardation and mental problems seen in many disorders associated with developmental retardation, there are very few studies and articles about the mental states and effects of children with Down syndrome. Therefore, we have little information on this subject. Considering the relatively large number of publications on autism spectrum disorder, we can say that the mental health issue of children with Down syndrome is neglected.
Down syndrome is the most common chronosomal disease. People born with Down syndrome have multiple congenital malformations and medical complications. It can be seen in all ethnic groups and socioeconomic levels.
The role of maternal age in the development of Down syndrome has not yet been fully explained. Having a baby over the age of 35 is still defined as the most important risk factor. The reason for this is the high number of children in the young age group. In other words, while advanced age continues to be a risk factor, it has been suggested that having many children at an early age and therefore a high rate of Down syndrome is seen in premature births.
Clinical findings
After birth in Down syndrome Diagnosis can be made easily with clinical evaluation. Hypotonia, weak Moro reflex, excessive skin fold on the neck, flattened face, upward sloping palpebral spaces, abnormal auricle, fifth finger clinidactyly, single palmar line on the palm are quite common findings in this period.
In Down syndrome. common facial anomalies Apart from that, problems with mental and physical development also occur. Affected individuals often have mild or moderate mental retardation.
The most important health problems of children with Down syndrome are congenital heart diseases, gastroesophageal reflux, frequent ear infections, hearing loss, obstructive sleep apnea, and thyroid disorders.
At the other end of the developmental spectrum, young children with Down syndrome appear to have lower overall rates of disruptive behavior, as well as lower distinctive social, motivational, and attention profiles.
Doctors who follow Down syndrome patients face two problems. they try to. The first is to increase patients' cognitive performance through the use of appropriate supportive measures and special education. The second challenge is to treat complications that can worsen disability and can occur at any age (mental problems, sleep apnea, epilepsy). It is important to be careful and to make necessary interventions, especially in terms of additional mental illnesses and regression (regression).
Misconceptions and facts about Down syndrome
Misconceptions
Facts
It is a genetic disease
It is a chromosomal difference
21 as a result of wrong division during cell division. It occurs when there is an extra chromosome in the chromosome pair.
It is a rare disorder
Down syndrome is not uncommon
Maternal age over 35 is a risk factor .
Children with Down syndrome and their parents are alone
Parents with a child with Down syndrome can get counseling and assistance regarding the difficulties the child will experience, health, social and legal rights, and family support at the relevant associations. The addresses of the associations reached by the volunteer working on this subject are given below.
All Down syndrome children experience severe intellectual disability
Most individuals with Down syndrome experience mild or moderate intellectual disability. With the special education support provided from an early age, serious progress is made in developmental, language, learning, self-care and social relations in these children. The child's development and language When other skills and abilities are taken into consideration, the problems experienced by children with Down syndrome related to intellectual disability cannot be considered as a multifaceted weakness. It is important to know that children with Down syndrome need enough time to solve events and respond, and to give them the time they need.
Children with Down syndrome are always sick?
Children with Down syndrome, Although they are at risk for real medical problems in terms of congenital heart diseases, respiratory and hearing problems, and thyroid disorders, they often lead a healthy life with the advancements in health and the treatment of these problems.
Separate special education for students with Down syndrome. programs are the only option in education.
Students with Down syndrome attend regular schools. Their education is planned so that they participate fully in social and educational environments.
Students with Down syndrome should also be included in special education programs due to their mental-developmental problems.
Individuals with Down syndrome graduate from high school, receive their diplomas and some of them can go to university
People with Down syndrome cannot be active members of the society
When the activities of down syndrome associations are followed up, it is seen that children with down syndrome do individual and group work in the fields of folk dances, exercises, arts and education very successfully.*
People with Down syndrome are valued members of their families and communities and make meaningful contributions to society.
People with Down syndrome are always happy.
People with Down syndrome feel what everyone else feels.
Experience all kinds of emotions.
They care about friendly approaches and they get hurt-sad and suffer because of thoughtless behavior.
Adults with Down syndrome are unemployed.
Businesses employ adults with Down syndrome in a variety of locations, such as banks, companies, hotels, hospitals, nursing homes, offices and restaurants. They also work in the music and entertainment industry, childcare, sports, and the computer industry. People with Down syndrome They value their jobs and want to work.
Development characteristics of children with Down syndrome
Children with Down syndrome follow their peers behind in terms of motor skills, language and social interaction. In other words, they have problems in mental and motor development. The areas where they have problems are reasoning, problem solving, designing, abstract thinking, judgment, learning at school, learning from experience. For this reason, they have problems in self-care, social relations and academic skills, varying in severity according to each child. It is important for the family to support the child in terms of these developmental characteristics and to be in active interaction in order to gain new skills in children who have the above problems from the early period. For this reason, families should spend enough time with their children, be in active one-to-one social interaction, bring the child together with their peers, and create environments that enable them to play and engage in other activities. Children who are brought together with their peers in social environments receive support that can be considered important for learning rules, language development and social development. Again, starting from the early period, individual special education support and physiotherapy support for the development of motor skills should be taken. Since mental problems added to developmental problems will negatively affect the support that the child will receive from special education, a child psychiatrist should be consulted from an early period to determine whether there are additional problems.
The mental health of children with Down syndrome
All children with Down syndrome At least half of children and adults face a major mental health problem in their lifetime. Children and adults with multiple medical problems experience higher levels of mental health problems.
Mental symptoms in school-age and youth with limited language and communication skills
Destructive, impulsive, inattentive, hyperactive and oppositional behaviors (ADHD, conduct disorder and oppositional defiant disorder comorbidities are more likely to be seen)
Anxious, clinging, obsessive, inflexible behaviors (generalized anxiety and obsessive-compulsive disorder comorbidities are more likely)
Inadequate social relations, introversion/interference to the outside world apathy, repetitive stereotypes (autism spectrum disorder comorbidity is more likely)
Chronic sleep difficulties, daytime sleepiness, fatigue and mental problems (sleep disorders, sleep apnea and depression comorbidity are more likely)
>The following mental problems can be seen in school, adolescence, and young adulthood, despite having better communication and cognitive skills.
Depression, social withdrawal, decreased interests and coping skills
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Generalized anxiety disorder
Obsession-compulsive disorder
Regression-regression resulting in loss of cognitive and social skills
Chronic sleep problems, rigging in daily sleep , loss of appetite, mood-related problems (mood disorders, sleep disorders, sleep apnea are more likely to be seen as additional diagnoses.
The following mental problems may be seen in older adults:
Generalized anxiety disorder
Depression, social withdrawal, decreased interests and coping skills
Regression-regression resulting in loss of cognitive and social skills
Dementia
In Child « If there is a new » "emotional/behavioral problems (mental problems)", the medical reasons that should be investigated first:
When a non-existing behavioral problem occurs, there are some things to be done to determine whether it is due to a medical condition. There are tests
Thyroid function tests
Tests to be performed in sleep problems, sleep laboratories
It is important to take a nutritional history and eliminate problem areas in constipation or intestinal difficulties. You can be referred to a specialist for diet when necessary.
It is important to make sure that you are evaluated for hearing (audiology), vision (ophthalmology), anemia (hematology), and gastrointestinal system.
Emotional/behavioral problems and The path to follow when medical problems coexist:
Emotional/behavioral problems are common in children and adults with Down syndrome and are not always caused by an underlying medical condition. However, these medical conditions in children and adults with Down syndrome have not been comprehensively evaluated.
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