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Children with Down Syndrome have poor muscle tone, which means low muscle strength and limited muscle co-ordination The centre of the tummy can sometimes protrude because of poor muscle tone. Muscle strength improves in time as the child develops. Joints also tend to be rather loose because of slack ligaments. Problems connected with poor muscle tone can be treated or eliminated using Vojta or Bobath exercises. Many DS children suffer from low levels of immunity. They can also suffer with impaired vision, including short sight, long sight, squint or nystagmus. The can be inflammation of the eyelids or absent tear ducts. Hearing disability tends to be light or moderate, possible causes being too much wax in the ear canal, chronic middle-ear inflammation, liquid build-up in the middle ear, deformation of the ear ossicle, nasopharynx blockage, inflammation of the upper airways, polyps or Eustachian tube malfunction. Other problems include malfunction of the thyroid gland, although this can be successfully anticipated and cured. Children with DS tend to have certain congenital disorders, including congenital heart or digestive tract disorders.

Regarding the outward appearance of DS children, they tend to have a rounder head with eyes of normal shape but narrow and slanting eyelids. Other features include a thicker and bulkier neck, smallish ears and sometimes narrower ear canals also. The roof of the mouth also tends to be narrower and tooth growth is delayed. Our DS children don’t have a greater tendency to tooth caries than other children, but there is greater risk tendency to paradentosis. The children’s arms are somewhat shorter, their hands are small and they have shorter fingers. Most children have a single crease across the palm and on the feet there is a greater space between the big toe and the other toes. Because of overall weakness of ligaments, DS children can tend to have flat feet. The complexion tends to be pale and skin is often dry and can develop fissures, particularly during cold weather. Often it is wrongly stated that they typically have an over-large tongue (macroglossia), although in fact it is only apparently larger in relation to the relatively smaller oral passage. Tongue protrusion is actually caused by inadequate muscle tone and can be successfully treated using Castillo – Morales therapy. True macroglossia (over-large tongue) is in fact rare among DS children.

Mental limitations. Mental limitations are present in all children with Down Syndrome, regardless of the type., and in some cases they can be severe. However, unlike previously-held notions that regarded DS children as suffering from serious or very serious mental retardation, results of current American research indicate that the ability of most DS children ranges from mild to moderate disability. Although it was formerly believed that their mental ability declined with age, studies of a group of DS children over several years indicate nothing of the kind. ( S. Pueschel, Parents Guide to Downs Syndrome: Toward a Brighter Future, 1991 ). The most common defect is lack of concentration.