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Down Syndrome, behaviors, and excluding medical conditions.

Updated: Apr 19, 2021

Down Syndrome is a genetic condition causing delays in physical and intellectual development (National Association of Down Syndrome). Just like other children with disabilities, despite having delays that range from mild to severe, children with Down Syndrome should be encouraged to explore their skills and talents.

If you are a parent or caregiver of a child with Down Syndrome, you are aware that managing behaviors can be challenging, especially in school. The IEP Team may be discussing that “Johnny” needs a change of placement out of the general classroom. Depending on the level of intellectual disability and communication skills, the only way your child may be able to tell you something is wrong is to act out behaviorally. Johnny doesn’t necessarily need to move out of the general classroom. Johnny needs to see a doctor.

Children with Down Syndrome often have difficulty communicating symptoms they’re experiencing physically and emotionally. It is, therefore, important to exclude causes for the behaviors. Common medical conditions for individuals with Down Syndrome are: hearing problems (including ear infections), visual difficulties, Thyroid problems, Celiac disease, Constipation, and Obstructive sleep apnea (Brian G. Skotko, MD, MPP). Children with Down Syndrome also suffer from anxiety and depression just like neurotypical children.

As my website says, “Your child is not being difficult. Your child is having difficulties.” Find the root of the behavior. Maybe your child requires medication for constipation that needs to be administered at school in accordance with an Individual Health Plan, which is incorporated by the IEP. Maybe your child would benefit from seeing a counselor for depression. Maybe your child requires AT for alternative communication due to hearing difficulties as well as poor expressive language. Maybe your child needs an assessment to determine whether he/she has a comorbid ASD diagnosis and would benefit from ABA services in the classroom.

Remember, your child is entitled to a free and appropriate public education, in the least restrictive environment, in order to prepare your child for future employment, post-secondary education, and independent living. Feel free to contact me with questions.


Massachusetts General Hospital and Harvard Medical School have created “Down Syndrome Clinic to You” (DSC2U), which is an online resource for parents and providers specializing in Down Syndrome. Check it out: https://www.dsc2u.org



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