Doctors Get Clearer Picture On Developmental Milestones For Kids With Down Syndrome

A man plays with his daughter, who was born with Down syndrome. (Michael S. Wirtz/The Philadelphia Inquirer/TNS)

Pediatricians don’t have much to go on when assessing when children with Down syndrome should walk, talk and reach other milestones. Now, a new study details the specific parameters for those with the chromosomal disorder.

Researchers analyzed 842 children and young adults with Down syndrome who visited the Boston Children’s Hospital Down Syndrome Program between March 2018 and March 2023 to assess their developmental progress.

He Recommendationspublished online this week in the journal Pediatrics, show striking differences compared with their typically developing peers.

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Most children with this chromosomal disorder can walk independently around the house by age 4½, follow one-step directions by age 5½, run and use stairs by age 8, and drink from an open cup by age 12. It is not until the teenage years that at least 75% of children with Down syndrome can follow two-step directions or use at least 50 words, signs, or pictures.

According to the Centers for Disease Control and Prevention, these are all skills that most children acquire by age 2 1/2, the study notes.

“The American Academy of Pediatrics recommends that children and adolescents with Down syndrome receive advance guidance regarding development and behavior. However, few tools offer specific guidance on developmental norms for children with Down syndrome,” Dr. Nicole Baumer and colleagues at Harvard University wrote in the paper. “Our goal was to estimate the age ranges in which children and adolescents with Down syndrome reach developmental milestones to facilitate developmental assessment by pediatricians.”

The study involved people with Down syndrome between the ages of 2 months and 24 years and was based on data collected from caregivers, physical therapists and electronic medical records. Researchers assessed the likelihood of reaching 25 different developmental milestones.

In a comment In an article published in Pediatrics alongside the study, Dr. Marilyn Bull of Indiana University School of Medicine said the findings will help doctors determine whether developmental delays are typical or warrant further evaluation. The research is also notable, Bull said, because it offers insight into what to expect in early adulthood.

“Currently, developmental assessment is predominantly based on clinical experience, but clinicians will now be able to systematically assess development across multiple domains at routine health surveillance visits,” Bull wrote. “These data illustrate that skill attainment spans a broader age range in individuals with Down syndrome than in neurotypical children and that clinicians can use them to effectively assess developmental progress.”

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