Down syndrome: Testing during early childhood (ages 1 to 5)

Down syndrome can cause a variety of health problems related to physical and mental functions. Your child should have regularly scheduled exams by a doctor to identify signs of any problems. The sooner health issues are recognized, the better they can be managed.

The American Academy of Pediatrics recommends doctors who care for children with Down syndrome pay special attention to certain health issues between ages 1 to 5, such as:¹

• Growth and weight gain. At each visit, your child should be weighed and measured. These measurements should be plotted on growth charts that have been adjusted for children with Down syndrome.
• Ear problems. Children with Down syndrome have a 50% to 70% risk for developing ear problems. For this reason, they should have hearing tests every 6 months until age 3, after which they should be tested every year. A hearing specialist (otolaryngologist) should examine your child if there are indications of hearing problems.
• Eye problems. Your child's eyes should be thoroughly examined every year. Young children with Down syndrome are at about 50% risk for developing nearsightedness or farsightedness. The exam should be done every 2 years by an eye doctor who specializes in children (pediatric ophthalmologist) or who is experienced in caring for children with disabilities.
• Thyroid function. Children with Down syndrome have an increased risk for thyroid disease and should have a blood test to screen for related problems every year.
• Dislocation of the neck bones (atlantoaxial dislocation). Your child should have X-rays to evaluate bones in the neck. This should be done between ages 3 and 5 to look for signs of loose ligaments that may lead to dislocation. These may be done only once. The need for additional X-rays is controversial. However, more may be needed if your child wants to participate in Special Olympics or if you have noticed symptoms that concern you, such as neck soreness.
• Sleep apnea. You may be asked questions about your child's sleeping habits, including most common positions and whether he or she snores or is restless.

The Down Syndrome Medical Interest Group (DSMIG) recommends blood testing for celiac disease between the ages of 2 and 3 years.²

References