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Down Syndrome Abstract
of the Month: Dec 1999

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Medical Aspects of School-aged Children with Down Syndrome

Leonard S, Bower C, Petterson B, Leonard H
Dev Med Child Neurol 1999 Oct;41(10):683-8

Division of Epidemiology, TVW Telethon Institute for Child Health Research, West Perth, Western Australia.

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Current and comprehensive information about the medical issues affecting children with Down syndrome (DS) is of value in counselling parents who are considering prenatal diagnosis and in planning services for people with DS as they age, especially given the continued improvements in their survival. Parents of school-aged children (mean age 11.37 years, 57.3% male, 42.7% female) with DS were identified by linking registers from the Disability Services Commission and the Birth Defects Registry. Less than half the children had cardiac and bowel conditions. More than half had ear conditions and more than three quarters had eye conditions. Ear, nose, and throat professionals were the specialists seen most often and the rate of tympanostomy tube insertion was nearly 17 times that of the general childhood population. Children with DS were over five times more likely to wear glasses than other children. These findings suggest that chronic, non life-threatening conditions impose a burden on families but do not threaten quality of life.

My comments:

The biggest problem with studies such as this one is that these surveys end up being biased toward the group that responds, rather than the group that is solicited in the first place. However, this study had a good base to start with, and a very good response rate to their initial survey request (80%). Also, several of the statistics arrived at in the study match previous statistical reports.

The children studied were ages 5 to 17 years of age. Besides the findings mentioned in the abstract above, here are some other interesting numbers:

  • 33% of children with DS reportedly had a congenital heart defect, with the most common being a septal defect. 17% of the total group required surgery for the heart defect.
  • 18% reported constipation. 0.1% had Hirschsprung disease. 0.1% had celiac disease.
  • 48% had "glue ear," which is thick fluid in the middle ear cavity that won't drain. 10% of the total had documented hearing loss. 46% of all children had surgery for an ear condition, mostly for placement of tympanostomy tubes.
  • 30% of the children had near-sightedness, 27% had "lazy eye" (strabismus). 54% of girls and 40% of boys were prescribed glasses.
  • 14% had disease of the thyroid. 0.1% had diabetes.
  • Of the 211 children with DS, 3 children had leukemia, 2 had hip disorders and 2 had AAI.
The authors also looked at the rate of medical events for the year of 1996:
  • In the 5 to 9 years of age group, 40% had one or more ear infections. In the older ages, only 24% had one or more ear infections for the year.
  • 36% of the children were in the hospital for any reason in 1996. Of those admitted to the hospital, 25% were for dental procedures, 25% for ear surgery, 29% were for respiratory problems, 10.5% for eye problems, and the rest (9.5%) were for other problems. In the youngest age group (5 to 9 years), admission for respiratory problems was the most common cause.
This report bears out the number of medical problems that can be associated with Down syndrome.

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