Down Syndrome - Goals for child with DS

Providing activities and experiences to help the infant develop:

• auditory, e.g. experience what a bell sounds like,
• visual skills and memory,
• tactile skills including sensory exploration and sensory feedback, e.g. experience sensations while touching velvet or sandpaper

In the treatment program focus on:

Sensory stimulation

The massage program, e.g. using the NUK massager - description of the program in an article by Kumin and Chapman (1996).

• To tolerate touch in the lip and tongue area, e.g. brushing teeth
• To accept certain textures of foods (mixed food textures). 

Begin with the arms and legs - Gradually move toward the face and intra oral area.

Use:

• oral massage
• direct muscle stimulation
• oral normalization program

Once the child can tolerate touch and can freely move the articulators, an oral motor skills program is introduced

·         blowing whistles

·         blowing bubbles

·         making funny faces

·         making sound imitation activities

Generally, the clinician will imitate the child rather than providing a model to imitate.

Feeding therapy

Speech is an overlaid function in the human body. Feeding and respiration involve many of the structures and muscles used in speech.

Social interaction

Turn taking can be developed at a very young age through play (MacDonald, 1989);

• Peek-a-boo games
• Handing a toy
• Musical instruments

Conversational skills

Although speech is the most difficult communication system for children with Down syndrome, more than 95% of children with Down syndrome will use speech as their primary communication system. Babbling and sound making increase after the oral normalization activity.

Pre-language skills Therapy should begin early, before the child speaks the first word (Kumin et al., 1991).