Down Syndrome Analysis
This blog post will talk all about Down Syndrome - from general facts to advice about how to best help those with downs.
Students with Down syndrome (DS) tend to have a variety of defects due to a chromosomal condition that causes a partial or full duplication of the 21st chromosome. Generally, those with DS can be identified with flat facial features, an upward slant of the eyes, and a larger tongue. Along with that, those with DS tend to struggle with neurological impairments, musculoskeletal abnormalities, respiratory disorders, obesity, and some type of heart defect or thyroid issue.
Despite the difficulties individuals with DS may have, they also have many strengths. Although children with DS may tend to learn how to speak later than normal, they tend to learn to use gestures and non-verbal cues sooner. With that, they excel in the area of visual processing.
All of these things are important to know when working with those with Down syndrome so that any potential issues can be identified if not already known. This also helps in terms of lesson planning so mentors and teachers can already have an idea of what type of activities may be best for an individual with DS.
Those with Down syndrome are often known to wander, have attention deficit issues, and can have obsessive behaviors. This can be a problem when it comes to any type of activity--it's important that mentors know how to keep their mentees interested and focused on the activity at all times, while also keeping some sort of routine each day so mentees feel comfortable with wherever and whatever they're supposed to be doing.
Many individuals with DS are visual learners so it's important to physically show an activity prior to beginning as it could help them understand better and, in turn, help with their success rate.
Instability is also an issue due to their musculoskeletal abnormalities so participating in high impact or repetitive activities may cause fatigue and potential injury in children with DS. It's important to help reduce impact as much as possible and help students with balance whenever needed to prevent any injury.
Since children with DS are more visual learners, it's important to keep any instruction short and sweet both to help with retention and to prevent potential behavior issues.
When working with those with Down syndrome, it's advised that a behavior treatment plan should be implemented. Specifically, the National Down Syndrome Society (NDSS) says to use the ABC's of behavior--Antecedent, Behavior, Consequence of the behavior. With this model, the mentor would be able to anticipate what activities/commands cause the mentee's opposition before any consequence would have to be used. In terms of attention deficits and autistic behaviors, medication could be prescribed if issues are prominent enough.
In children of all abilities, it is important to participate in at least 60 minutes of physical activity per day to uphold a healthy lifestyle. If this recommendation isn't followed, chances are higher that these children will suffer from being overweight, obese, or have some type of chronic illness later in life. This is especially important for those with disabilities, and in this case Down syndrome, since they typically have shorter life spans and more bodily impairments than those that are more high-functioning. With these factors, those with Down syndrome are more likely to be overweight and obese to begin with. In order to stay healthy, they must exercise daily even though it may be more difficult for them simply so that they can be more independent from their families and caretakers.
After Shields et al. conducted their research among the 20 children, it was proven that children with Down syndrome who exercise and participate in cardiovascular fitness daily are significantly more healthy in terms of body composition and BMI than their more sedentary counterparts.
However, it's also been found that those with DS generally have lower levels of physical activity and this activity only decreases with age. This is important to note as a mentor because the mentees' time with us may be their only opportunity to participate in physical activity that day, and maybe even that week as they may not have the proper programming available to them.
To me, it was surprising to find that being active can even affect memory later in life; if an individual has low enough physical activity levels, then their chance to develop dementia is higher. Exercise helps everything in terms of health, so coming up with activities for mentees that are both challenging enough to get their heart rates up and rewarding enough to keep them coming back for more is crucial.
When working with children with DS, it's important to ensure that the student fully understands an activity prior to beginning. The instruction portion of describing and acting out an activity is vital for students to have better retention and potentially better success with a given activity. Specifically, showing an object or activity while also speaking it aloud helps children with DS, especially if they are being instructed in a group setting. By doing this regularly, it also helps with the student's ability to keep their attention focused for a longer periods of time. Listing and grouping are good strategies to keep in mind to help with retention, as well as keeping the verbal cues short. Throughout an activity, instructors can question students to test their memory of the cues.
For children of all abilities, it's important to do at least 60 minutes of physical activity daily. However, for those with Down syndrome, it's even more important since they already experience lower muscular strength and cardiovascular issues. It's been found that nearly 60% of those with Down syndrome don't regularly participate in physical activity. With that, obesity percentages are higher in those with Down syndrome than those without. This percentage only becomes worse with age because once they reach the age of 30, it's been found that physical activity is nearly immeasurable.
As stated before, those with DS are generally more likely to have learning difficulties as they tend to suffer from both neurological and musculoskeletal impairments. This is especially apparent when it comes to learning basic motor skills when they are young and it's important to identify and have an intervention early on to prevent any further delay of motor skill ability.
Children with DS move slower and often get distracted when performing any given task compared to those who are more high-functioning. They're often known to be clumsy and have slower movements; if a student is told to do something fast, they will likely have more difficulty and have a lower success rate. With that, it's important to start with small, simple tasks, and individualized attention and to build on from there. If an exercise is too difficult to start with, it's likely that the student will not continue being active and will have a more sedentary lifestyle.
Further, it has been proven that participating in sport activities such as gymnastics and swimming helps improve memory, learning, and ability to do basic motor skills in children with DS. By building off of one small task at a time, not only did students have a higher retention rate, students were also able to successfully do eight gymnastics motor tasks after a 14 week program. With this program, both students' form and coordination of basic motor skills showed great development. When children with DS participate in regular routines, they show much better improvement than when activity is more sporadic.
It's best to start with activities that children with DS do naturally and build on from that. With that, it's important to keep the child motivated so having them work towards a goal can be beneficial.
Be sure that the child is ready to participate in the activity before beginning--if they are tired or not feeling confident, it's going to affect the child's success rate and desire to improve. It doesn't matter so much as how long the activity is done, but in how well the activity is done; quality is greater than quantity.
Since children with DS tend to be visual learners, they often see and want to emulate what they see their peers are doing. They may try to do things such as crawl and walk but have much more difficulty due to their musculoskeletal impairments. With that, they make their own modifications to each skill, but if these modifications aren't monitored it's likely that they could cause complications later on. A benefit is that most children with DS do have the ability to do basic motor skill activities, but it's important for mentors to keep a watchful eye, assist when needed, and keep up a routine and progression of small tasks.
Any person tends to have some sort of struggle with self-esteem in their adolescence. This struggle is only worsened if this person has a disability. In this article, "Wheelchair dancing and self-esteem in adolescents with physical disabilities," the authors discuss different levels of self-esteem and how dancing can help improve it altogether. Self-esteem's connotative meaning is simply the ability to handle difficulty while still being happy with one's own persona. If a person's self-esteem is low, they tend to get into more trouble and don't succeed as much as someone with a higher self-esteem.
It's been found that those with disabilities generally have lower self-esteems since they often struggle to do everyday tasks without assistance and often can't develop relationships as well as others. This is why dancing may have some value in terms of providing a fun way for camaraderie and expression. Dancing, and especially wheelchair dancing as mentioned in the article, provides opportunity for people of all abilities to engage and feel included. In their experiment, the authors used 43 participants where half participated in wheelchair dancing and half were in a control group with no participation. Prior to beginning, they asked participants general questions like, "How often do you feel clumsy," etc. and held the program for four weeks total.
In the end, it was found that there was mainly increase and some decrease in self-esteem in both groups. The authors note this could be due to various factors, but the main reason for this is "meaningful engagement and approval from significant peers." Generally, it can be assumed that wheelchair dancing could be a great way to get students of all abilities feeling more comfortable and confident in terms of self-esteem.
When teaching and learning dance in our class, it seemed to me that students mostly had a positive reaction. The atmosphere was fun and inclusive and there was assistance available all around the room if students needed it. In terms of teaching, I found that the dances went much smoother when they were more well-known and when they were broken up into small steps and movements, and were countable. It seemed to work best to follow the notion that once the group was able to successfully do one step, to add on another step and practice them together. For me and for my mentee, it helped both with retention and ability to do the given movement. If there were too many steps, it was difficult for everyone to remember unless an instructor was helping nearby.
Roughly 18% of children in the United States have some type of disability, but there is still a lack of opportunities for these children to participate in recreational sports. The article goes into detail about what it means to participate in sport. Participation not only fosters physical health, but also mental health in that it encourages peer-to-peer interaction, creativity, and overall life purpose. Sports are a great way to promote camaraderie among individuals with and without disabilities alike. With that, sports area also great on an individual level, specifically it's been found, "Special Olympics participants show heightened self-esteem, perceived physical competence, and peer acceptance when compared with nonparticipants."
The biggest reason as to why individuals with disabilities choose not to participate in sport is the inability to pay for specialized equipment or programming. Since it is often so rare to find such things, it's hard for families to take this needed step. Although individuals with disabilities are barred from participation, it's much more difficult for them to participate without the things they need to succeed.
In general, it's important for everyone to understand that participation in sport is crucial for any individual's well-being, whether it be physically or mentally beneficial. Even if only for 30 minutes, it's highly recommended to participate in physical activity every day.
Other than mindless childhood fun, outdoor recreation has been proven to help build confidence in those who participate in it. As people participate in such activities, they are more willing to take physical risks and therefore tend to be more fit and healthy individuals. Once they know they are able to do an activity, they are more likely to continue doing the activity.
Outdoor recreation is often used as a form of therapy for those who are recuperating from injury or suffering from illness. It’s a fun way to get people active and slowly build up to more difficult tasks. As stated in the article, Darice Britt said, “the primary focus of treatment services, which are often referred to as recreational therapy, is to restore, remediate, or rehabilitate in order to improve functioning and independence as well as reduce or eliminate the effects of illness or disability.” In recreational therapy, participants are encouraged to find their abilities rather than focus on their disability. By focusing on the right thing, whether that be through self-determination or positive reinforcement, the participant is more likely to be more successful and willing to continue with treatment and recreation.
Overall, outdoor recreation seems to have positive effects on those who participate. Some of those effects include “improvement in physical health status, psychosocial status, cognitive status, and an improved ability to deal with life, recreation, and community activities.” By simply doing fun activities, individuals can ultimately change their lifestyle.
