• F.D.

Understanding the Feelings of Children with Down Syndrome


Looking after a down syndrome child can be an uphill battle for parents as their behavior can be unpredictable. Down syndrome is commonly connected to intellectual disabilities (Morris et al., 2012). Their characteristics are almost universal such as facial appearance, learning disability, muscle hypotonia and motor dysfunction (Antonarakis et al., 2004). Most parents should be able to observe that children with Down Syndrome’s behavior based on their characteristics varies greatly from neurotypical children.

A consensus about the intellectual disability in individual with Down Syndrome is typically between mild and severe range but based on a research, it was found that majority of these individual have moderate intellectual disability (Chapman & Hesketh, 2000). Normally an individual with Down Syndrome shows weakness like the lack of motor ability, auditory processing, verbal short-term memory, and expressive language while showing some relative strengths in visuospatial processing, receptive language, and some social functioning abilities but these varies with every individual (Daunhauer & Fidler, 2011).

When it comes to observing children with down syndrome, parents should study how their child behaves to take certain interventions. Despite they are having low levels of psychopathology or mental disorders compared to individual with developmental disabilities (Elisabeth M. Dykens & Kasari, 1997), individual with Down Syndrome shows a higher rate of behavioral issues compared to neurotypical children plus certain comorbid psychiatric diagnoses such autism spectrum disorder with depression and dementia (Collacott et al., 1992). Furthermore, studies on children and teenagers with Down Syndrome aged between 4 to 19 years of age display a high chance of maladaptive behavior in children and teenager based in the Achenbach’s Child Behavior Checklist (Elisabeth M. Dykens et al., 2002).

The Achenbach’s Child’s Behavior Checklist (CBCL)* is a type of behavioral evaluation relating to total behavior problems and specific syndromes of internalizing behaviors such as anxiety, depression and withdrawn behaviors or externalizing behaviors such as aggression or destruction based on an extensive system of scales, including teacher rating, self-report, and classroom observation (Fidler et al., 2006). Anecdotally, should parents detect shifts in their Down Syndrome children’s behavioral style from a placid, easy temperament infant to a highly tempered infant can be stressful for parents as the sudden mood changes and withdrawal from situations leaves parents puzzled (Fidler et al., 2006). Despite the easier temperaments during infancy for children with Down Syndrome, it does not predict lower levels of maladaptive behavior thus parents should shift in observing their children’s behavior even more than normal parents. Therefore, parenting support should be necessary in fully strategizing on how to handle behavior of the Down Syndrome children.


Applied Behavior Analysis (ABA):

Applied Behavior Analysis is a method for therapists to detect the development of Down Syndrome's children behavior. It focuses on interventions addressing socially significant age-appropriate behaviors and connection to their immediate importance utilizing precise measurement of those behaviors focusing for improvement. Interventions, are based on the basic principles of behavior like reinforcement and extinction are described in the manner of being easily replicated and their effectiveness is determined by the children’s performance.

Functional Behavior Assessment (FBA):

Some behaviors such as escaping or demanding attention are quite common with children with Down Syndrome. However, challenging behaviors that are not only divided by either function to obtain or avoid but also dependent on either social or non-socially motivated behaviors may serve a variety of functions within and across a child. Therefore, addressing the challenging behavior is key in determining the specific challenging behavior a child has using the functional behavior assessment process is necessary to connect the events in a child’s environment and the challenging behavior to determine the factors.


Children with Down Syndrome are at higher risk for any appropriate behavior if not taken care effectively. Thus it is important for parents to observe children with Down Syndrome as their behaviors can be unpredictable. If parents and interventionist are able to cooperate in finding a solution for the child with Down Syndrome's behavior, they would be able to act quickly to resolve the issues. The right and most suitable intervention strategy would lead children with Down Syndrome be more in control of their behavior and ensuring their mental and social development are nurtured better. This ensure that they can live with neurotypical children for their long-term development in the years to come.

*Our clinical psychologist are able to perform this assessment for you. Find out more here.


Antonarakis, S. E., Lyle, R., Dermitzakis, E. T., Reymond, A., & Deutsch, S. (2004). Chromosome 21 and Down syndrome: From genomics to pathophysiology. In Nature Reviews Genetics (Vol. 5, Issue 10, pp. 725–738). Nature Publishing Group. https://doi.org/10.1038/nrg1448

Bambara, L. M., Koger, F., Katzer, T., & Davenport, T. A. (1995). Embedding Choice in the Context of Daily Routines: An Experimental Case Study. Journal of the Association for Persons with Severe Handicaps, 20(3), 185–195. https://doi.org/10.1177/154079699502000303

Chapman, R. S., & Hesketh, L. J. (2000). Behavioral phenotype of individuals with down syndrome. In Mental Retardation and Developmental Disabilities Research Reviews (Vol. 6, Issue 2, pp. 84–95). Ment Retard Dev Disabil Res Rev. https://doi.org/10.1002/1098-2779(2000)6:2<84::AID-MRDD2>3.0.CO;2-P

Collacott, R. A., Cooper, S. A., & McGrother, C. (1992). Differential rates of psychiatric disorders in adults with Down’s syndrome compared with other mentally handicapped adults. British Journal of Psychiatry, 161(NOV.), 671–674. https://doi.org/10.1192/bjp.161.5.671

Daunhauer, L. A., & Fidler, D. J. (2011). The down syndrome behavioral phenotype: Implications for practice and research in occupational therapy. Occupational Therapy in Health Care, 25(1), 7–25. https://doi.org/10.3109/07380577.2010.535601

Dykens, E. M., & Kasari, C. (1997). Maladaptive behavior in children with Prader-Willi syndrome, Down syndrome, and nonspecific mental retardation. American Journal on Mental Retardation, 102(3), 228–237. https://doi.org/10.1352/0895-8017(1997)102<0228:MBICWP>2.0.CO;2

Dykens, E. M., Shah, B., Sagun, J., Beck, T., & King, B. H. (2002). Maladaptive behaviour in children and adolescents with Down’s syndrome. Journal of Intellectual Disability Research, 46(6), 484–492. https://doi.org/10.1046/j.1365-2788.2002.00431.x

Fidler, D. J., Most, D. E., Booth-LaForce, C., & Kelly, J. F. (2006). Temperament and behaviour problems in young children with Down syndrome at 12, 30, and 45 months. Down’s Syndrome, Research and Practice : The Journal of the Sarah Duffen Centre / University of Portsmouth, 10(1), 23–29. https://doi.org/10.3104/reports.302

Lee, K., Choutka, C. M., & Sokol, N. G. (2002). Assessment-Based Antecedent Interventions Used in Natural Settings to Reduce Challenging Behavior: An Analysis of the Literature on JSTOR. Education and Treatment of Children, 25(1). https://www.jstor.org/stable/42900519?seq=1

Michael, J. (1982). DISTINGUISHING BETWEEN DISCRIMINATIVE AND MOTIVATIONAL FUNCTIONS OF STIMULI. Journal of the Experimental Analysis of Behavior, 37(1), 149–155. https://doi.org/10.1901/jeab.1982.37-149

Michael, J. (2000). IMPLICATIONS AND REFINEMENTS OF THE ESTABLISHING OPERATION CONCEPT. Journal of Applied Behavior Analysis, 33(4), 401–410. https://doi.org/10.1901/jaba.2000.33-401

Morris, J. K., Alberman, E., Mutton, D., & Jacobs, P. (2012). Cytogenetic and epidemiological findings in Down syndrome: England and Wales 1989-2009. American Journal of Medical Genetics, Part A, 158 A(5), 1151–1157. https://doi.org/10.1002/ajmg.a.35248

O’Neill, R. E., Albin, R. W., Storey, K., Horner, R. H., & Sprague, J. R. (2015). Functional Assessment and Program Development - Robert E. O’Neill, Richard W. Albin, Keith Storey, Robert H. Horner, Jeffrey R. Sprague - Google Books. Cengage Learning. https://books.google.com.my/books?hl=en&lr=&id=697KAgAAQBAJ&oi=fnd&pg=PR4&dq=Functional+Assessment+and+Program+Development+for+Problem+Behavior:+A+Practical+Handbook&ots=4xr9C-OR7_&sig=rwtCDKX3eLeLS4BjVBvyLl1ymBY#v=onepage&q=Functional%20Assessment%20and%20Program%20Development%20for%20Problem%20Behavior%3A%20A%20Practical%20Handbook&f=false

16 views0 comments