Down syndrome is a genetic condition. It is not an illness or disease.
Our bodies are made up of millions of cells. In each cell there are 46 chromosomes. The DNA in our chromosomes determines how we develop. Down syndrome is caused when there is an extra chromosome. People with Down syndrome have 47 chromosomes in their cells instead of 46. They have an extra chromosome 21, which is why Down syndrome is also sometimes known as trisomy 21.
Although we know how Down syndrome occurs, we do not yet know why it happens. Down syndrome occurs at conception, across all ethnic and social groups and to parents of all ages. It is nobody's fault. There is no cure and it does not go away.
Down syndrome is the most common chromosome disorder that we know of. One of every 700-900 babies born worldwide will have Down syndrome, although this number is lower in Australia - see Down syndrome population statistics. Down syndrome is not a new condition. People with Down syndrome have been recorded throughout history.
People with Down syndrome have:
- some characteristic physical features
- some health and development challenges
- some level of intellectual disability.
Because no two people are alike, each of these things will vary from one person to another.
A test for Down syndrome can be carried out before a baby is born. Down syndrome is usually recognised at birth and is confirmed by a blood test. It was named after Dr John Langdon Down who first described it.
What does it mean to have Down syndrome?
Most of the young people growing up with Down syndrome today will lead quite ordinary lives in the community. Some people with Down syndrome may not need much help to lead an ordinary life, while others may require a lot of support.
Having an intellectual disability
Down syndrome is the most common cause of intellectual disability that we know of. Everyone who has Down syndrome will have some level of intellectual disability. There will be some delay in development and some level of learning difficulty. Because everyone is unique, the level of delay will be different for each person.
When a baby is born, there is no way to tell what level of intellectual disability the child may have. Nor can we predict the way in which this may affect a person's life. However, we do know that having Down syndrome will not be the most important influence on how that person develops and lives their life. Instead, what happens after birth will be much more important and family, environmental, cultural and social factors will shape their life, just like everyone else.
For many people with Down syndrome, speaking clearly can be difficult. Although a lot of people with Down syndrome speak fluently and clearly, many will need speech and language therapy to achieve this. Very often, people with Down syndrome can understand a lot more than they can express with words. This often means that their abilities are underestimated, which can make them feel frustrated.
Some people with Down syndrome will find it very difficult to develop language skills and speak clearly. This may be made worse by hearing loss.
Living an ordinary life
People with Down syndrome are not fundamentally different from anyone else. They have the same needs and aspirations in life that we all do, including:
- a good place to live
- meaningful employment
- the opportunity to enjoy the company of friends and family
- having a role in our community.
However, achieving these goals is harder for people with Down syndrome than it is for everyone else. Many people with Down syndrome are likely to need some level of support to help them achieve the kind of life that most people take for granted.
Having Down syndrome will not be the most important influence on how that person develops and lives their life.
In the past, many people with Down syndrome have not had the opportunity to develop to their full potential. Often, they have been separated from the rest of the community, living in segregated settings such as care institutions. Low expectations were placed on them and there were limited opportunities for learning and personal growth.
Today we recognise that growing up in families and communities, with the same rights and responsibilities as everyone else, is vital to the development of people with Down syndrome.
To be a part of a community you have to be in it. This means that people who have only experienced life in a segregated setting may find it difficult to be included in the general community. Life for people who grow up being included in families and communities will be very different than it has been for those who have always lived in care facilities.
Encouraging children with Down syndrome to go to a school with their peers from their community has many benefits. It opens the way for a smooth transition to adulthood and encourages meaningful inclusion in the community.
People with Down syndrome need opportunities to reach their full potential, like we all do. When given these opportunities, they become valued and productive members of their families and the community.
To be a part of a community you have to be in it.
Being an individual
One of the greatest challenges that people with Down syndrome face is the attitudes of other people who do not understand what it means to have Down syndrome. Despite much change, many people still don't see the individual person. Instead they just see 'Down syndrome' and expect everyone with Down syndrome to be more or less the same.
People with Down syndrome are very different from each other, just as we are all different. Every person with Down syndrome is unique, with their own talents, abilities, thoughts and interests. And, like everyone else, people with Down syndrome have strengths and weaknesses. While one person may read very well but find basic mathematics difficult, another might be a first-class cook and live independently in the community, but will have to work hard to speak clearly. Family passions, culture, interests and skills are also likely to be shared by people with Down syndrome, as they may be by other members of the family.
People with Down syndrome do not all look alike. In fact, people with Down syndrome look more like other people in their own family than they look like others with Down syndrome. Although there are some physical features associated with Down syndrome, there is large variation in how many of these features an individual may have. For some people, one feature may be very prominent while in another it may not exist at all. Importantly, the physical characteristics of Down syndrome that a person may have do not tell us anything about that person's intellectual ability.
Another common misconception is that all people with Down syndrome are happy and affectionate. People with Down syndrome experience all the same emotions as everyone else. They get happy, sad, embarrassed, frustrated, thoughtful and fall in and out of love, just as we all do. They may, however, find it difficult to express their feelings in words. This can lead to frustration and the expression of feelings through behaviours.
Some medical and health matters
As recently as the 1950s, life expectancy for people with Down syndrome was as low as 15 years of age. In recent times, progress in medical and social sciences has very much improved the health and the quality of life enjoyed by people with Down syndrome. In Australia today, most people with Down syndrome will enjoy a long and healthy life.
There are some common health issues and some more serious medical conditions that are more likely to occur in people with Down syndrome than in other people. People with Down syndrome often have lowered general immunity compared to the general population. This means that they may be more susceptible to infections and common illnesses, especially in early childhood. However, a diagnosis of Down syndrome does not mean that someone cannot have a healthy life. Some people with Down syndrome are very fit and healthy, while others experience a range of health issues.
Regular health checks may be required for specific issues. Living a healthy lifestyle is important, including keeping fit and getting regular exercise.
Even with a healthy diet, there can be a tendency for both children and adults with Down syndrome to become overweight. An active lifestyle with plenty of physical activity helps to counterbalance this tendency and encourages general health and fitness.
A small percentage of people with Down syndrome will require a high level of living support. This may be because of complex health issues or a greater degree of intellectual disability.
The most important influence on early development is daily interaction and activities within the family.