Slide 1

Down syndrome is a genetic condition that occurs in the fetus, caused when a person is
born with an extra chromosome; chromosome 21. Thus people with down syndrome,
have 47 chromosomes rather than 46.
Down syndrome is the most common chromosome disorder. People with Down
syndrome will vary in appearance, temperament, and ability, as each one is a unique
individual. Down syndrome occurs approximately once in every 700 births, and is the
most frequent recognised cause of intellectual disability. This disorder occurs at
conception, however there has been no evidence to find how or why it occurs.

Slide 2

In most children with Down syndrome, the condition is recognised at, or shortly after,
birth. As many as 120 features have been described as being related to Down
syndrome, however, most people with the syndrome have no more than six or seven of
these. (HIT CLICKER) Most commonly, people with Down syndrome are found to have:
some characteristic physical features
some health and developmental challenges
some level of intellectual disability

Slide 3

Some of the physical characteristics of a person with down syndrome include a rounded
face, with a flat profile, and the eyes slanting slightly upwards, with some white or
yellow speckling around the rim of the iris. There is often a small fold of skin that runs
vertically between the inner corner of the eye and the bridge of the nose, known as the
epicanthus. The back of the head is also slightly flattened, and they tend to have short,
broad necks. (HIT CLICKER) The mouth cavity is slightly smaller than average, and the
tongue is often slightly larger. The hands tend to be broad with short fingers, and the
pinky finger may be slightly curved towards the other fingers. Their feet tend to be
stubby and wide spaced, specifically between the first and second toe. They also suffer
from reduced muscle tone. Those with Down syndrome usually weigh less at birth, and
their ultimate height is commonly shorter than other adults.

Slide 4

Most children with Down syndrome will experience some delays in all areas of
development, including gross and fine motor skills, personal and social development,
language and speech development, and cognitive development. This diagram shows a
comparison between the development of children who have Down syndrome with those
who do not. A way to think of this development is to use the analogy of cars travelling
along the road. The child without an intellectual disability travels along the road at an
average speed, picking up skills and knowledge as they go. The child with Down
syndrome travels along the same road, picking up the same skills and knowledge, but
they travel at a slower speed, arriving at each stop later than the other child, and
staying there for a longer period. So, students with Down syndrome are able learn all of
the skills a child without Down syndrome can, it will just take them a longer time to
develop those skills.

Slide 5

This graph outlines some of the average variations in development in the early years
between a child with Down syndrome, and one who does not have Down syndrome, or
an intellectual disability. So, as you can see, examples include that a child with Down
syndrome will not speak their first word until nearly 2 years of age, which is almost one
year after other children. And, children with Down syndrome will not be able to dress
themselves until they are nearly 8, which is nearly 4 years later than other children. So,
again, children with Down syndrome will develop the same skills as children who do not
have Down syndrome, it will just take them a longer time to do so.

Slide 6: Medical conditions

Children with Down syndrome may have a range of medical conditions, and there are
conditions that are more common in children with Down syndrome then in other
children. These conditions include Heart conditions, glue ear, respiratory problems,
sensory disorders, loss of sight, orthopaedic problems, and gastrointestinal problems

Slide 7 Support and therapy

Due to these medical conditions and their physical and intellectual disability, children
with Down syndrome may require additional support, including professional therapy.
This may include a speech and language therapist to refine their speech, a physical
therapist to assist in building motor skills and muscle strength, and an emotional and
behavioural therapist to help them respond to feelings of frustration.

Slide 8 Common behaviours

Due to their slower development, and accompanied medical conditions, children with
Down syndrome can display behavioural concerns. Although there are no behaviour
problems that are unique to children with Down syndrome, and most of the people with
Down syndrome are able to develop and demonstrate good social skills appropriate
social behaviour, there are some behaviours that are quite common among children
with down syndrome. These are: tongue protruding, hyperactivity, wandering, and
aggressive behaviour. We will now look at each of these behaviours individually and the
strategies that can be put in place to prevent, or stop these from occurring.

Slide 9 Tongue-protruding

Children with Down Syndrome often have a habit of sticking out their tongue, due to the
combination of a larger than average tongue inside a smaller than average mouth. I
read the blog of Felixs mum (the little guy on the right), and she had a really good way
of explaining it:
Imagine going to the dentist and you have an anaesthetic in your mouth. For a few
hours afterwards, your mouth will hang open and your tongue will protrude. Your tongue
will feel huge, and if you try to talk, you might sound funny, and you may even drool,
because your tongue feels so heavy, that you cant control it. This is similar to the lack
of muscle strength people with Down syndrome experience; this is how they feel all the
time.
A way to try to stop this habit is to ask or remind, the child to keep their tongue in their
mouth. A simple tongue-in, may work, and the system of rewarding the child for doing
so has been shown to be effective in stopping the habit. However, this will need to be in
conjunction with the parents of the child, as the child will need to be constantly
reminded to put their tongue in, not just when at school.

Slide 10 hyperactivity

Children with Down syndrome have difficulty channelling their attention into one activity
for any period of time. Children who are hyperactive often have little sense of time
sequence, so a fixed routine will assist to settle these students. Short spans of time
working, broken up by allowing the children to participate in physical activity, will allow
children to burn their energy when need, and be focused on the task when asked. When
working, it is also important to attempt to avoid restrictive, confusing or overstimulated
places, as this will distract them from the task. For those who went to Belvoir, Sue made
a specific point about keeping the classrooms as bare as possible so as to not overstimulate some of the children, for this exact reason.

Slide 11 Wandering

Many children with Down syndrome do not understand danger or risk. Most wanderers
don't feel lost, or experience fear when they lose sight of their parent. It is very hard to
teach these children to stay near an adult with all of the exciting temptations around
them. Strategies that can be used in school to prevent students with Down syndrome
from wandering off is the use of visual aids, such as placing stop signs on the doors and
gates of the school, and outlining expectations of where the students are, and are not
allowed to enter. At Belvoir, they had quite a sever system, of sectioning off the school,
and having each room, and area locked. If the school is able to, locks and alarms are
effective. It is also important to have a plan of action for the teachers and school in the
case that a child did wander out of the school grounds.

Slide 12 Aggressive behaviour

Aggressive behaviour by children with Down Syndrome is commonly an attempt by

them to communicate how they are feeling, as their language and communication skills
are not quite developed. They may be feeling frustrated, upset, bored, angry, or
annoyed.
Aggressive behaviour for a child with Down syndrome can include hitting someone,
biting someone, yelling or screaming, or the destruction of objects. All of these
behaviours are often signs that the child is attempting to communicate an emotion. This
behaviour is particularly common among children under the age of 10 as they are often
still struggling with their language skills. Children who have Down syndrome also do not
have the ability to empathize with others, so are often quite surprised by the negative
reaction their behaviour causes. If we all remember Peters outbursts of violence, which
we saw when he got angry, or to excited. And the scene where he kicked one of his
friends in the face, and seemed a bit confused when everyone was telling him he was
wrong.
When this behaviour occurs, it is best to not show too much reaction, as this may
incidentally reinforce the behaviour. Instead, try to re-direct the attention of the child.

Slide 13 Children with Down syndrome in the classroom

Things to know when teaching a child who has down syndrome:

They are visual learners.

They are hands-on learners.
They understand a lot more than they can say.
They work best one-on-one.
They are able to follow classroom rules and routines if they are clearly outlined.
They will need help to remember instructions.
They will need time to process one skill before moving on to another.
They have poor memory.
They have a fear of failure.
Teacher expectations of behaviour, attitude and ability need to remain high so as to act
as encouragement.

Slide 14 Teaching strategies

If in your classroom you have one, or numerous students with Down syndrome, the
following strategies should be implemented in your teaching: The use of visuals, explicit
teaching, experiential activities, and making modifications to the environment,
activities, assessments, and the curriculum.

Slide 15 Visuals
All children with Down syndrome can benefit from visual support, as they are strong
visual learners. Children with Down syndrome have a better chance of understanding
information or instruction when they SEE it, rather than HEAR it. Because visual
supports are concrete symbols, they assist children in processing the language,
organising their thinking, and remembering information. Visual supports are also

effective in aiding memory, giving reassurance or confirmation, and improving an

understanding of words, routines and situations. Visual cues can be used in the
classroom to outline instructions, rules, routines, expectations, or the structure of a
lesson, or whole school day.
Slide 16 Explicit Teaching

When teaching students with Down syndrome, the teacher should ensure that they use
explicit teaching. This involves breaking down tasks into a step-by-step process, and
using modelling and scaffolding to ensure the student understands the activity and what
they are required to do. Students with Down Syndrome are errorless learners, meaning
that they will continue to repeat the same mistake. For this reason, students should be
reinforced for their achievement at each step of the task. If a child learns a skill
incorrectly, it will require considerable rehearsal to relearn that skill. To avoid this failure,
teachers need to do all they can to ensure the student understands what is expected of
them.

Slide 17 Experiential learners

Students with Down syndrome are experiential learners, meaning they learn best when
using concrete materials, relating their learning to real-life experiences, participating in
hands-on activities, and using a range of materials. Hands-on materials should be
used in the classroom whenever possible, such as throwing a soft ball to students when
you want them to answer a question, or including physical objects in a lesson. It has
also been found that students with Down syndrome, like other students, learn best when
what their learning relates to them, and they are able to retain learning best when
physically doing it. Hands-on materials should also be used as exercise for these
students, as, because they lack proper muscle tone, their hands will need to be
stretched, and slightly exercised before writing (squeezing a stress ball or pushing
palms together can do this).

Slide 18 Modifications
For most students with Down syndrome, modifications will need to be made to the
classroom, activities, and curriculum. However, these are dependant on the specific
child, as all children are different, and all have different needs. Once the teacher has
built a relationship with the child, and understands their abilities, and needs,
adaptations can be made.
Examples of possible adaption include the environment, such as creating designated
quiet areas, and ensuring the room is not over-stimulating, the manner in which you
teach, such as by offering more visuals, and ensuring you make explicit instructions,
differentiation to the curriculum, the difficulty of tasks, the time you allow for tasks
to be completed, the opportunity for additional practice, the type of assessment
students partake in, and the level of support provided. Most children with Down
syndrome in a mainstream setting will be offered an aid, who will work one-one-one with
them, and provide the additional support and input the child may need.
So an example I have is of a girl I went to Kindergarten with. She was my age, so started
Kindergarten with all of us. She participated in the same activities, but had an aid who
helped her socialise, and participate in activities. She repeated Kindergarten four times,
until they believed she was ready to go to school. At school, she participated in the
class, did similar work than everyone, but had an aid, and lots of visuals to help her. She
kept at that level and progressed through the years.
Slide 19 In my classroom

So if there was a child with Down Syndrome in my classroom, I would first build a
relationship with that child, as you would any student. I would try to understand what
they know, what they dont know, and find out their abilities and strengths. Based on
that knowledge, I would then make adoptions to the classroom, curriculum, and class
work. Regardless of the childs ability, I would definitely implement the four effective

teaching strategies just discussed, which were visuals, explicit teaching, experiential
activities, and necessary modifications, because these strategies have been shown to
work for all children, not just those with a disability. These strategies ensure that your
instructions are clear, and that all students are aware of their expectations. They allow
students to be interactive, and engaged in their learning, and they ensure the learning
is best suited to them.