Students who have Down syndrome may have a second diagnosis that may complicate their learning style. Additionally, hearing a dual-diagnosis can be challenging for parents so they may prefer to not share the second diagnosis with others even though teachers can greatly benefit from knowing a student’s full diagnosis. If it seems that a student in your classroom has a unique learning style from other students with special needs, they may have a dual diagnosis.
Down syndrome and Alzheimer’s Disease
People with Down syndrome have an increased risk of Alzheimer’s Disease due to chromosome 21 and the specific proteins on that chromosome that can cause Alzheimer’s. There are three stages of this disease, those being early, middle, and late. Early stage includes: short term memory loss, difficulty learning and retrieving new information, degression in language/word usage, receptive language change, worsened ability to plan or sequence, spatial disorientation, difficulty doing complex/multi-step tasks. Middle stage includes: decreased ability to do everyday or self care tasks, worsened short term memory with preserved long-term memory, difficulty recognizing familiar people and objects, poor personal safety and decision making, mood and behavior fluctuations. Also physical changes related to the disease, such as, onset seizures, bathroom use incontinence, swallowing troubles, and mobility changes (NDSS).
Down syndrome Atlantoaxial Instability
All children who wish to partake in sports that have Down syndrome should have a cervical spine X-ray, if there is a 4.5millimeter distance between the 1st and 2nd vertebra there should be a retraction from sports that are strenuous on the neck, people with atlantoaxial subluxation or dislocation and neurological signs should be restricted from all strenuous activities (Leshin).
Down syndrome and Autism
Toddlers generally tend to have repetitive motor behaviors and display a fascination with and staring at lights, ceiling fans, or finger. Receptive language problems and their spoken language may be highly repetitive or non-existent at times. In severe cases seizures, swallowing problems, constant movement of the eyes and extremely low muscle tone can occur. Children that are older tend to have a loss or inability to grow in their language and social skills, this can lead to irritability, anxiety, and an onset of repetitive behaviors. However, this is commons with single Down syndrome diagnoses within the ages of three to seven (Capone).
Down syndrome and ADHD
Attention Deficit Hyperactivity Disorder is said to be someone with “decreased attention
span, impulsive behavior and excessive fidgeting or other non directed motor activity.” However most children, especially children with Down syndrome show these signs throughout their childhood (NDSS).
Down syndrome and Diabetes
The most common type of diabetes with Down syndrome students is Type 1, dependent on Insulin. Students with Down syndrome have it the same effects as anyone else with Type 1 Diabetes. It is important to be familiar with students needs pertaining to the Diabetes and if/when something is not right (Shelby).
Down syndrome and Ear, Nose, and Throat Issues
Hearing loss that is mild or severe can affect a student’s development in their language and emotional skills and education. Hearing issues can be mistaken for stubbornness with children. It is important to make sure the students who have hearing aids are using them, also using simple sign language is beneficial. The facial structure of students with Down Syndrome can cause them the have inflammation of the mucus membranes in the nose and sinus membranes. This can cause blocking of the nasal passages, however sinus sprays and drops can keep the passages clear (Shott).
Down syndrome and Gastrointestinal Tract
Weight problems are often common with students with Down Syndrome. This can be caused by hypothyroidism, a lower rate of metabolism, and/or an overconsumption of calories with a lack of exercise (Skotko).
Down syndrome and Low Muscle Tone:
Students with Down syndrome can build muscle but may not be able to build it at the level of those without Down syndrome. Reduced tension of the muscles at rest requires the muscles to work more in order to move. Since, they have more instabilities in their joints, instructors need to make sure that the program is building supportive muscles around the joint incrementally. Due to their weak core muscles, It may be difficult for students to maintain a body position or change position. Pronation of the feet is very common, making balance movements more difficult. Some students have muscular imbalances that may cause them to favor one side over the other. For example, the right side may be stronger or weaker than the left or vice versa, creating a tendency to only hop or balance on one side.
Down syndrome and Mental health
Students with Down Syndrome often have a sensitivity to psychosocial and environmental stressors which can cause the children to have problems with anxiety, obsessive compulsivity, depression, difficulty sleeping, and social, cognitive, and coping skills (Munir).
Down syndrome and Vision
Vision problems are much more common in people with Down Syndrome. Nearsightedness, farsightedness, and difficulty changing the power to focus the eye. A child may have a difficult time getting use to wearing glasses however it significantly improves their eyesight and can better their eye alignment (Ledoux).