Children with Down syndrome: causes and signs, possible level of education. Teaching Children with Down Syndrome

Children with Down syndrome, of course, in terms of intellectual development differ from their healthy peers. The article will tell you how the development and education of children with Down syndrome takes place, what features this process has.

The birth of a baby is a long-awaited and desired event. But is it always like this? And what if a child is born with an incurable serious illness, in which he will outwardly differ significantly from his peers and lag behind them in mental development? For many parents, the diagnosis of Down's syndrome, found in a tiny child, sounds like a terrible sentence.

Previously, it was considered that all children with Down syndrome are not amenable to learning, since they are characterized by a severe degree of mental retardation. As modern studies show, indeed, almost all patients with this disease have lags in intellectual development. However, the intellectual level of patients within this group varies significantly and can vary from a slight lag to a severe one.

Development Features

But still, many children with Down's disease are able to learn to walk, talk, write, read and do almost everything that their healthy peers can. But in order to achieve this, parents need to provide their sick children with appropriate educational programs and an adequate living environment.

With the diagnosis of Down syndrome, the development of the child has its own characteristics. So, speech appears late and remains underdeveloped throughout life, speech understanding is difficult, vocabulary is very modest, sound pronunciation in the form of dyslania or dysarthria is often observed.

Such difficulties in mastering speech are due to a decrease in hearing acuity, a small oral cavity, and reduced muscle tone. Also, sick children have narrow and small ear canals, which negatively affects the ability to listen. Great importance in the development of speech is given to tactile sensations inside the oral cavity. Patients can hardly recognize their sensations, having little idea where to place the tongue to pronounce sounds.

Visual perception in children with this diagnosis is also imperfectly developed. Small patients prefer to avoid complex visual configurations and fix their attention, as a rule, only on single visual images. Children are not able to search and find details, carefully consider specific objects.

Despite such a severe intellectual defect, the emotional sphere remains preserved. Down children can be friendly, obedient, affectionate. They are able to love, be offended, embarrassed, but at the same time they are stubborn, angry, irritable. Many babies are curious and have a good imitative ability, which is of great importance for instilling work processes and self-care skills. The level of skills that children with such a diagnosis are able to achieve can be different and depends on genetic factors and the social environment of the baby.

The 21st extra chromosome, which is the cause of the development of downism, causes the occurrence of some physiological features, in view of which the development of the child is much slower than in healthy babies.

Learning features

Many various techniques allowing to develop and effectively train down children. But parents should set themselves up for the fact that teaching children with Down syndrome is a rather complicated process that takes a lot of time. The earlier classes were started with the baby, the higher the chances of success. The main didactic principle of teaching such patients is the involvement of various channels of perception (sense organs). The learning process should go slowly enough, and the classes themselves should be pleasant and interesting for the child.

early help. It should be provided from the moment an appropriate diagnosis is made until the admission of a small patient to an educational institution. Its main goal is to ensure the maximum realization of the child's capabilities, to prevent the development of secondary disorders, and to include the baby in the general educational flow.

Preschool education. Down babies can become students of a compensatory type preschool created for children with intellectual disabilities. The curriculum includes the following main areas: social development”, “Health”, “Formation of activity”, “Physical development and physical education”, “ Aesthetic development" and " cognitive development". All classes are conducted by qualified teachers, based on generally recognized methods of teaching and developing children with intellectual disabilities.

In modern times, integrated learning in educational institutions (both school and preschool) is becoming increasingly popular, which provides for the joint education of healthy children and children with disabilities, providing the latter with social adaptation and special conditions. When a child-down visits integrated groups in kindergartens, individual curricula are developed in accordance with his capabilities, which undoubtedly gives positive learning outcomes.

Schooling. Education of patients diagnosed with Down syndrome can take place in special correctional schools, where classes are organized according to a special program for children with intellectual disabilities. Also, schoolchildren can study in integrated classes, where, just as in kindergarten, for each student, in accordance with his level of development, a separate curriculum is developed.

Down syndrome is a common genetic disorder. For every 600-800 newborns, there is 1 child suffering from this disease. The disease was first described by John Langdown Down in 1866 and got its name from the name of this famous professor. Only after almost a century (in 1959), the French scientist Jerome Lejeune managed to identify the cause of the syndrome, which is the presence of an extra chromosome.

Rehabilitation of children with Down syndrome is undoubtedly a difficult and lengthy process. The task of parents is to help their child as much as possible and create conditions for him in which he would feel the same as everyone else - a full-fledged member of society. And then, of course, the baby will be able to achieve great success.

Although the number of chromosomes in a living organism is usually directly proportional to the level of its development, in humans extra chromosome can cause a number of problems. A newborn with 47 chromosomes needs to be surrounded by a special attitude, since the risk of developing pathologies in his body, including Down syndrome, is very likely. And yet this does not mean that a child with this diagnosis is completely lost to society.

It would be more correct to say that this incurable disease is a serious challenge for parents and the baby himself, but those who persevere will be rewarded

Diagnostics

Doctors consider it necessary to determine the presence of Down syndrome even at the stage of gestation - this will allow the mother to mentally prepare for the fact that her child will be unusual or even refuse to give birth. There are a number of invasive (penetrating) techniques that allow you to count number of chromosomes in a child's DNA still on early stages gestation - for this, an analysis of the fluid from the umbilical cord is taken, a biopsy is performed, non-invasive methods can be used as alternatives - a special ultrasound (screening) or the isolation of the child's DNA from the mother's blood.

Invasive techniques show a high accuracy of the result and are mandatory for women with a predisposition to this disease and are also recommended for pregnant women under the age of 30.

The accuracy of non-invasive diagnostic methods is questionable, however, other methods are not available to women after 35, since an attempt to intervene in the uterus can be fatal for pregnancy.

Reasons for the appearance of chromosome 47

This disease is a gene mutation, but even such complex phenomena must have own reasons occurrence. The reasons for the birth of a special child have not been precisely established - only groups of people have been identified who have such children more often. Accordingly, even the presence of all the described reasons - not a guarantee, but only an increased risk of having a baby with disabilities, because the specificity of gene mutation is still not fully understood.

In general, experts point to such factors that allegedly increase the likelihood of a down birth:

• late conception age. First of all, it is more and more difficult for the mother to give normal offspring with age - it is believed that after 35 years of age, a gene mutation in a woman in labor becomes much more likely. However, men should not relax either, just the “threshold” for them is a little higher - it is 45 years old. In general, experts point to such factors that allegedly increase the likelihood of a down birth

• Heredity. This moment is even more confusing, since even ideal heredity does not guarantee anything - down can be born in a family where the parents are young and completely healthy, and none of the relatives has ever had this syndrome. Moreover, a completely opposite situation is also possible, when healthy children can be born to two down children - there is no direct transmission of the mutation; however, it must be taken into account that a sick boy is usually sterile from childhood, although not always.

However, doctors insist that the fact of fixing such diseases in the same family earlier may indicate a general tendency to gene mutation. This is not a reason to abandon children, but only a reason to once again consult with doctors before conception.

• Incest. Human reproduction, which requires the obligatory participation of two people, is organized in such a way that the child receives different genes and is adapted to more factors of the outside world. During sexual contacts between close relatives, the sets of genes received from both parents are very similar, so the mutation mechanism is turned on, trying to “invent” adaptability to a larger number of external stimuli. The result in most cases are serious violations - in particular, Down's syndrome.

• Increased solar activity. It is believed that the formation of the disease can also be affected by a cosmic cause, which can be resisted in only one way - by carefully checking the forecasts of solar activity when planning conception. This theory requires large-scale comprehensive confirmation, and yet it is recognized as scientific. She is one of the reasons why downs are called "sunny" children.

Characteristics of the patient

Children with Down syndrome are very similar to each other due to the similarity of the gene code, but they still look different, because everyone also looks like their parents. At the same time, they differ from the parents of small patients some signs that adults may not have at all, for example:

• Highly flat face and a strongly flattened nose.
• Slightly oblique incision of the eyes and a small fold of skin near the inner corner of the eye. In combination with the previous sign, an appearance is obtained that is vaguely reminiscent of a Mongoloid.

• The skull appears shortened, the occiput is oblique and flat. In the structure of the outer ear, various anomalies are often noted.
• The mouth is usually quite small compared to the tongue, so these children often stick out their tongue, or, more generally, they almost always keep their mouth slightly open.
• Muscles are characterized by a weakened tone, and the joints fix the position less reliably.
• On the inside of the palm there may be a transverse fold, an anomaly of the little finger is often observed in the form of unnatural curvature.

If an unusual appearance has little effect on normal life, then another problem is the internal pathologies that regularly accompany Down syndrome. Nowhere is it indicated how many years “sunny” children live, because their life expectancy largely depends on the degree of development of such comorbidities.

In general, the life expectancy of downs is comparable to the life expectancy of healthy people diagnosed with similar pathologies, namely:

• Congenital heart disease (typical for 2/5 downs).
• Disorders of internal secretion.
• Pathologies of the skeleton - both serious (absence of one pair of ribs, deformity of the chest or pelvis), and simply noticeable (short stature).
• Respiratory pathologies caused by impaired structure of the nasopharynx and other upper respiratory tract.

• Improper functioning of the gastrointestinal tract, impaired fermentation.
• Sensory organs disorders - reduced hearing abilities, visual pathologies (glaucoma, strabismus, cataracts).

However, not all features of children with Down syndrome are necessarily bad. For example, they are also called “sunny” children for their beautiful, especially shining eyes, as well as for their amazing sincerity of a smile.

It should be noted that such an appearance cannot be called deceptive - downs are really distinguished by their kindness, which could set a worthy example for many healthy people.

General features of development

Since Down syndrome is a genetic pathology, modern science is still very far from learning how to correct it. Nevertheless, methods have been developed that are designed to successfully resist various manifestations of the disease, bringing the condition of a sick child closer to the norm of a healthy one.

Since the diagnosis can be made during pregnancy, it is important to conduct a full diagnosis in infancy for the associated disorders described above. With the constant supervision of specialists and a properly built course of medication differences from a healthy baby will no longer be so obvious.

An important point is the slow development of the child - both mental and physical. The lag behind normal children by months is noticeable already in infancy, because a down child will be able to hold his head only at the age of about three months, by the age of his best achievement will be able to sit down on his own, and only by the age of two will he learn to walk on his own.

However, these terms are indicated for those children who, despite the syndrome, were brought up in the same way as normal ones. If the diagnosis was made in time, specially created programs will significantly speed up the process.

The task of achieving a decent level of development in a child with Down syndrome does not seem impossible, it just takes a little more effort. Of course, it’s worth starting with exercises aimed at developing fine motor skills, because this is progress not only for the muscles, but also for the brain. Massage is also considered a very effective way to improve the physical condition of a sick child.

Learning literally everything is a little more difficult than with other babies, so parents will have to make more efforts to teach the child to speak.

In order to deliver a clear, correct speech, experts recommend paying more attention to songs and poems.

Very important overcome the psychological barrier, which may arise in a child when he realizes that he is different from other children. If there is any violation of speech, it must be eliminated as soon as possible - it will be easier to establish normal communication in kindergarten. Elementary self-care skills will help the child not depend on the help of others, which will also help increase self-confidence.

The specifics of physical development

For children with Down syndrome, the path to big-time sports is practically cut off - they are distinguished by a weak physical development, and in general weigh a little. Wherein physical education is almost more important for them than for healthy children, for this is the only way to strengthen a weakened organism.

In general, health problems have a pronounced external manifestation, because the popular symptoms of the syndrome are extremely weak skin pigmentation, an abundance of rashes, excessive dryness and roughness of the skin, a tendency to crack in the cold.

Perhaps, the heart and the circulatory system as a whole are most often affected by developmental pathologies. Heart disease is noted in almost half of all those suffering from Down syndrome, murmurs are heard in the heart rhythm, a characteristic phenomenon is impaired valve operation.

The lungs are usually formed correctly, deviations are relatively rare and are superficial. At the same time, due to pathologies of the neighboring heart, high blood pressure is recorded in the lungs of downs. Scientists also believe that the disease provides increased susceptibility to pneumonia.

Weak muscle tone is especially noticeable on the abdomen - it sticks out noticeably, compared to the chest, which could be a normal variant for middle-aged and older people, but looks rather strange in an infant. Often, the feature is also complemented by an umbilical hernia, but you should not worry about it - it goes away by itself over time.

Rest internal organs practically do not change under the influence of chromosome 47, except that the genitals may differ in a slightly smaller size than in other children of the same age and complexion; boys are usually infertile.

Feet and hands - a little irregular shape appear shortened and extended. On the hands, the pathology of the little finger, curved forward (if you fold your arms at the seams), is clearly visible, on the legs thumb is even more isolated than in healthy children. The lines on the palms are drawn especially clearly, on the feet there is also a skin fold that is uncharacteristic for most people.

Due to the passivity of the tendons, there is an increased likelihood of flat feet, therefore, to orthopedic insoles need to get used to from childhood

The uncoordination of movements is typical for downs - one gets the impression that they do not control their body very well, but this is how it is, however, it is. Since the musculoskeletal system is weakened, the likelihood of injury increases.

The described violations are very common among children with this disease, but they do not necessarily have a pronounced character. Individual items may not appear at all or be superficial, not interfering with life.

The formation of the psyche

Although many ordinary people tend to draw parallels between Down syndrome and mental retardation, experts point to the completely different nature of these phenomena. Downs have a problem with their inability to take a broad perspective and focus, but they are able to devote considerable effort to solving one small but very complex problem.

Although their level of education is usually criticized because of such absent-mindedness and detachment, there are cases when famous scientists in the field of mathematics grew out of a “sunny” child.

Babies with this disease seem indifferent to what is happening around them. In infancy, already three months after birth, a healthy child begins to recognize his mother and rejoices at her, being frightened of the others, but it seems that the downy does not care who calls him, touches him or even picks him up. In the future, the child does not show interest in communication - he hears the appeal, but cannot concentrate on the answer, therefore he usually does not react.

Wherein intellectual development stops at about seven years of age t - unless, of course, contribute to the further development of a small patient. By this point, he usually already speaks, but knows not so many words. The patient does not differ in special attention, his memory works rather poorly.

Characteristic are prolonged bouts of crying, despite the fact that there are no visible reasons for this.

Although concentration and attention are generally impaired, there are things that literally fascinate children with Down syndrome. These include, in particular, freely bouncing balls, although a sick child, unlike a healthy one, does not at all show excitement or desire to play himself. In general, babies with this diagnosis tend to focus on things that do not require any reaction from them.

Psychodiagnostics shows that the key problem of the disease is the lack of personality formation. If the child feels comfortable, his behavior can be perceived as a very big oddity, which still does not interfere with normal communication and other forms of human interaction.

preschool stage

Although many parents are afraid of the moment when an unusual child will have to be sent to kindergarten, this step is necessary, because only here children will be able to acquire the necessary skills to interact in society. Socialization is allowed in the most ordinary preschool children's institution, but on condition that educators will be aware of the characteristics of the baby and will be able to educate him according to the appropriate programs.

In particular, to strengthen the musculoskeletal system active play required, which also stimulate communication and the development of higher nervous activity. At the same time, the baby is more clumsy than healthy children, and prone to injuries, which teachers must take into account. Alternatively, exercise therapy can help.

Used to improve hearing sensitivity music games and lessons which also develops personality and physical activity. Since speech disorders are common, the presence in preschool a qualified speech therapist is a must.

A full-fledged upbringing of a personality is impossible without a properly constructed psychology. Children with Down syndrome are encouraged to interact with others in literally everything - even toys here often involve predominantly shared rather than individual use.

At the same time, even conditionally correct, but too stereotyped behavior of specialists is unacceptable - it is possible to reveal the personality only with an individual approach to each child.

School years

A child with Down syndrome may well study in an ordinary school - the qualification level of education for such children usually involves graduating from an educational institution of this type. It is noted that preliminary education in kindergarten helps such a child to get used to the new conditions, but here it is extremely important to show maximum understanding on the part of teachers and classmates.

At the same time, the baby likely to study much worse than most of his comrades. Down does not sit still, he does not know how to react quickly and focus, he does not remember information well.

People who create a training program for such a child will have to solve a number of difficulties:

• Speech problems have a deep mental implication, that is, the child cannot formulate his thought not only out loud, but even in his head. He thinks, but, in a sense, he does not speak his native language well, so he cannot be judged by his ability to express thoughts both orally and in writing. Because of this, it is quite difficult to objectively assess the level of his knowledge.

• Children with Down syndrome have a very underdeveloped thought process - it is quite difficult for them to draw their own conclusions. Such a child literally needs to show everything on his fingers, because on his own he can only count or rewrite.
• Creating your own logical chains, even simple ones, or abstract thinking is too difficult for such kids. In addition, the solution of the problem for them is strictly tied to specific conditions, but they can no longer draw parallels and reorganize by solving a similar, but still not the same problem.

• Memory is very limited, a “sunny” child needs much more time to thoroughly remember information.
• A special student is very distracted by any extraneous phenomena, and even gets tired very quickly, so ideally, you need to build the learning process in such a way that not a single task is too long and exhausting.
• The perception of information is fragmentary, individual facts or characteristics of a phenomenon are considered as unrelated, which hinders the discernment of patterns.

• Even complaisance and goodwill can interfere normal learning children with Down syndrome! Although they are very obedient and willing to complete tasks, and also have non-confrontational behavior, such children are not at all inclined to get upset because of their own omissions. This has a positive effect on their mood, but completely kills any stimulus, because without being upset or afraid of anything, the child simply does not see the point in trying and doing better.

However, the right approach works wonders. Experts point out that the peculiarities of the child's behavior should not irritate the teacher - it's not the kid's fault that he is like that.

At the same time, praise is still able to motivate any student, and a general positive attitude, despite all the mistakes, helps the child not close, but move on, albeit slowly, towards the final goal.

Rehabilitation

Ever since society stopped considering children with Down syndrome as outcasts, people have been able to clearly see the effect of the thesis mentioned above that a good attitude can allow even such a child to achieve certain heights. Little by little, even celebrities with such a diagnosis began to appear - they do not have such big names, but they stand out strongly compared to many healthy people.

You just need to treat the child well, not hiding that he is unusual, but also without focusing on it as a problem. Support and proper patient education, teaching how to behave in society and what to do in private - that's all that is needed.

The society is gradually beginning to change its attitude towards such children towards a more balanced one, so the diagnosis is not a sentence, but only an increased need for a friendly environment.

For more interesting facts about children with Down syndrome, see the following video.

A child with Down syndrome is in dire need of communication. Very often, the surrounding world is negatively opposed to such children, which causes trauma to their psyche and affects their socialization in society. The main task of the parents of such a baby is not only to create a favorable atmosphere for him within their family and strengthen his confidence in himself and his abilities, but also to choose for him that educational institution where they can see an ordinary person in him, not notice his slight deviations and help you adapt to the world.

How to choose a school for a unique child

Not in everyone educational institution are ready to accept a child with Down syndrome, and in many, unfortunately, even teachers are biased towards such children and do not want to see them among their students. That is why the main criterion in choosing a school should be the attitude towards such children of the teaching staff and students of this institution. You can appreciate this, of course, only when you visit the institution. The first visit is best done by the parents themselves, without the child. Already at a preliminary conversation with the leader and the alleged mentor of the baby, parents can determine the degree of their loyalty to children with disabilities.

If the first conversation was successful, then you can come to school with your child. It is not necessary to immediately get acquainted with teachers and children, you can just wander through the corridors and classrooms, see everything that interests the child, talk about why you came to this beautiful and large building.

And only at the third visit, if the child likes the atmosphere and wants to return, you can get acquainted with the students and teachers, observe the reaction of the child and his opponents. Only under the condition of complete mutual understanding and the absence of stiffness and insecurity of a child with Down syndrome when communicating with new people in an unfamiliar place, we can safely say that the choice of an educational institution is completed and the place is determined.

Adaptation of a child with Down syndrome at school

For successful adaptation of a child in an educational institution, parents must tell the teacher and staff about all his deviations in detail. Some of these children may have hearing problems, others with vision - everything needs to be said in advance, since this is what can cause misunderstanding, both on the part of the child and on the part of others.

It is also necessary to discuss all the features of the curriculum in advance. Children with Down syndrome are a little behind their peers in development, so they need a simplified program, or an individual approach to their learning. An important role in the progress of such children is played not only by the professionalism of the teacher, but also by the participation of his parents in the learning process, their help and support.

Currently, a new category of children is coming to schools I and II - children with Down syndrome. This material is devoted to the reasons for this violation, the personality characteristics of these children and the tasks of the school in their education and development.

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Children with Down syndrome

Personality features, development prospects

Prepared

Tkacheva A.A.

What is Down Syndrome

The word "syndrome" refers to a combination of many features or features."Down Syndrome" is the most common form known to date. chromosomal pathology. First described in 1866John Langdon Down called "Mongolism". In 1959, the French professor Lejeune proved that Down syndrome is associated with genetic changes. Each cell contains a certain number of chromosomes. There are usually 46 chromosomes in each cell, half of which we get from our mother and half from our father. A person with Down syndrome has an extra third chromosome on the 21st pair of chromosomes, for a total of 47.

The most common form of Down syndrome is standard trisomy (complete tripling of chromosome 21 in all cells of the body). This form accounts for 94% of all cases of the disease.

Less often (approximately 4% of cases) there is a translocation (shift) of 21 pairs of chromosomes to other chromosomes.

The mosaic form (approximately 2% of cases) is the rarest form of Down syndrome, in which only some cells of the patient's body contain the triple 21 chromosome, and the patients themselves have a normal appearance and intelligence, but are at high risk of having a child with Down syndrome .

Down syndrome occurs in one in 600-1000 newborns. The reason why this happens has not yet been clarified. Children with Down syndrome are born to parents from all social strata and ethnic groups, with a wide variety of levels of education. Down syndrome cannot be prevented and cannot be cured. But thanks to recent genetic research, much more is now known about the functioning of chromosomes, especially about the 21st.

Research has identified four factors that affect the likelihood of Down syndrome in a child:

• older age of parents: mother over 35 years old, father over 45 years old
• too young age of the mother (under 18)

For women under the age of 25, the probability of having a patientof a child is 1/1400, up to 30 - 1/1000, at 35 years old the risk increases to 1/350, at 42 years old - up to 1/60, and at 49 years old - up to 1/12. However, because young women in general give birth to many more children, the majority (80%) of all people with Down syndrome are actually born to young women under the age of 30.

• consanguineous marriages
• and also, oddly enough, the age of the maternal grandmother.

Moreover, the last of the four factors was the most significant. The older the grandmother was when she gave birth to a daughter, the higher the likelihood that she would give birth to her grandson or granddaughter with Down syndrome. This probability increases by 30% with every year "missed" by the future grandmother.

The mechanism of this connection is not entirely clear, but it is hardly necessary to see something supernatural in it. After all, oocytes (future eggs) undergo the first division of meiosis even during the stay of the female embryo in the womb. It is during this division that the divergence of homologous chromosomes occurs - either correct or not. Girls are born with a ready-made full set of oocytes that have passed the first division of meiosis. Some of these oocytes already carry an extra chromosome 21: if these cells are destined to be fertilized, they will produce children with Down syndrome. And the number of such defective cells in the ovaries of a newborn girl, apparently, depends on the age of her mother.

Clinical picture

The most characteristic external signs of Down syndrome, according to which a presumptive diagnosis can be made immediately after the birth of a child, is:

• "flat" face - 90%
• thickened cervical skin fold
• brachycephaly (short head) - 81%
• slanted eyes
• semilunar skin fold at the inner corner of the eye (epicanthus).

Further examination of the child reveals:

• muscle hypotension (decrease muscle tone)
• increased joint mobility
• short and wide brushes, small arched palate, flat occiput
• deformed auricles, large folded nose.
• transverse palmar fold, as a universal sign of Down syndrome, can occur only in 45% of children born with this disease
• chest deformity, keeled or funnel-shaped
• pigment spots on the edge of the iris of the eyes (Brushfield spots).

Also, children with Downam syndrome may experience certain changes in the internal organs.

• combined, multiple, congenital heart defects, such as ventricular septal defect, atrial septal defect, large vessel anomalies, open atrioventricular canal
• on the part of the respiratory system - respiratory arrest during sleep due to a large tongue and structural features of the oropharynx;
• vision problems(congenital cataract, glaucoma, strabismus- strabismus)
• hearing loss
• thyroid disease (congenital)hypothyroidism)
• pathology of the gastrointestinal tract (intestinal stenosis, megacolon, atresia of the rectum and anus)
• anomalies of the musculoskeletal system (hip dysplasia, unilateral or bilateral absence of one rib, clinodactyly (curvature of the fingers), short stature, deformity of the chest)
• hypoplasia (underdevelopment) of the kidneys, hydroureter, hydronephrosis

The final diagnosis of Down syndrome can only be made after a study on the karyotype (chromosomal set) of the child.

The structure of mental underdevelopment of children with Down syndrome peculiar:

• speech appears late and remains underdeveloped throughout life, speech understanding is insufficient, vocabulary is poor, sound pronunciation is often found in the form of dysarthria or dyslania
• Difficulties in mastering speech in children with Down syndrome are associated with frequent infectious diseases of the middle ear, hearing loss, decreased muscle tone, a small oral cavity, and intellectual retardation.
• children with Down syndrome have small and narrow ear canals, which negatively affects auditory perception and the ability to listen, that is, to hear consistent consistent sounds of the environment, concentrate on them and recognize them
• in the development of speech are essential tactile sensations as inside the oral cavity, children often experience difficulties in recognizing their sensations: they have little idea where the tongue is and where it should be placed in order to pronounce this or that sound
• children with Down syndrome often speak rapidly or in separate word sequences, without pauses between them, so that words run into each other, in addition, at the age of 11-13, these children develop a stutter
• in the formation of the ability to reason and build evidence, children with Down syndrome experience significant difficulties. Children have a harder time transferring skills and knowledge from one situation to another. Abstract concepts in academic disciplines are inaccessible to understanding. The ability to solve practical problems that have arisen can also be difficult. Limited ideas, insufficiency of inferences that underlie mental activity make it impossible for many children with Down syndrome to teach separate school subjects.
• the profound underdevelopment of the speech of these children often masks the true state of their thinking and creates the impression of lower cognitive abilities. However, when performing non-verbal tasks (classification of objects, counting operations, etc.), some children with Down syndrome may show the same results as other pupils.
• features of visual perception: children with Down syndrome fix their attention on single features of the visual image, prefer simple stimuli and avoid complex visual configurations. This preference persists throughout life, children do not see the details, do not know how to look for and find them. They cannot carefully consider part of the world, they are distracted by brighter images. However, as a result of numerous experiments, it was found that it is better to operate with materials perceived visually than by ear.
• children with Down syndrome do not know how and cannot integrate their feelings - to simultaneously concentrate attention, listen, look and react and, therefore, do not have the ability to process signals from more than one stimulus at a single moment in time
• but, despite the severity of the intellectual defect, the emotional sphere remains practically preserved. "Downists" can be affectionate, obedient, benevolent. They can love, be embarrassed, offended, although sometimes they are irritable, vicious and stubborn
• most of them are curious and have a good imitative ability, which contributes to the inculcation of self-service skills and work processes.

The level of skills and abilities that children with Down syndrome can achieve varies greatly. This is due to genetic and environmental factors.

Thus, deep limitations of opportunities are naturally accompanied by a significant decrease in the quality of life. A child's severe illness also affects communication with peers, learning, labor activity ability to self-service. The child, unfortunately, is excluded from public life. All of the above determines the significance of the problem of social adaptation and correction of the corresponding contingents of children.

In the medical literature, Down syndrome is considered as a differentiated form of oligophrenia and, therefore, is also divided into degrees of mental retardation.

1. Deep degree of mental retardation.

2. Severe degree of mental retardation.

3. Medium or moderate degree of mental retardation.

4. Weak or mild degree of mental retardation.

The main directions of work on the adaptation of children with Down syndrome

The purpose of correctional work with children with Down syndrome is their social adaptation, adaptation to life and possible integration into society. It is necessary, using all the cognitive abilities of children, and, taking into account the specifics of the development of mental processes, to develop their vital skills so that, as adults, they can independently serve themselves, perform simple work in everyday life, improve the quality of their lives and the lives of their parents.

The achievement of the set goals is ensured by the solution of the following main tasks:

1. The development of the mental functions of children in the process of work and the earliest possible correction of their shortcomings.

2. Raising children with Down syndrome, shaping their correct behavior. The main focus of this section of the work is on the development of habits. Children need to develop the skills of cultural behavior in communicating with people, to teach them communication skills. They must be able to express a request, be able to protect themselves or avoid danger. Great attention must be paid to external forms of behavior.

3. Labor training, development of self-service skills and preparation for feasible types of household work. Self-care skills need to be developed.

Corrective education of severely retarded children can lead to significant positive changes in the development of the child, which should affect his future fate.

Sensory education is one of the areas of work for the social adaptation of children with Down syndrome.

Sensory education is the initial stage of the learning process and is aimed at educating a full-fledged perception in a child with developmental anomalies, this is the basis for understanding the world around. The basis of sensory perception is the development of sensory sensation. Perception affects the analyzers of the child's feelings. The accumulation of sensory sensations about the world around contributes to the activity of the child's senses. The child begins to feel, positively perceive the surrounding reality through his practical activities,

Sensory perception develops the child's orienting activity in the surrounding world, because the child gets acquainted with the signs, and it is this activity that is disturbed in children with Down syndrome.

In order for the child to learn transmitted information, it is necessary to develop thought processes, including comparison, analysis, synthesis, generalization, classification.

The attitude of the state to the problem of "special" children

In domestic medical, pedagogical and psychological science, for many years, the position was affirmed about the hopelessness of this diagnosis for the further development of the individual. It was believed that a person with Down syndrome is not teachable, and attempts to treat this "genetic disease" were doomed to failure in advance. State policy, recognizing the value of a person in terms of his ability to work for the good of society, contributed to the fact that people in this category were classified as an "inferior minority", outcasts, outcasts. Therefore, the main concern of the state was to isolate them from society, placing them in a system of institutions of a closed type, where only basic care and treatment was provided as needed. Programs of psychological, pedagogical and social rehabilitation of people with Down syndrome have not been developed. It was generally accepted that neonatologists had to convince parents in the maternity hospital to abandon the child, citing the futility of any kind of assistance to such children. As a result, most children with Down syndrome, barely born, became orphans with living parents. Number social orphans with developmental disabilities, increasing from year to year, increased so much that a significant number of special closed-type institutions for isolating these children from society were overcrowded.

Such a state approach to solving the problems of "special" children in case of non-observance of the rights of the child, the absence in the country of laws on the civil rights of the disabled and on special education, led to a crisis situation both at the level of preschool and school education of children, vocational training and social and labor rehabilitation of adults with Down syndrome, so at the level of training for work with this category of the Russian population.

Attempts to change the current situation on the part of state and government structures in last years socio-political transformations in Russian Federation expressed in the adoption of a number of laws and regulations. These legal documents consider persons with problems in the intellectual, physical, psychological spheres as an object of special public care and assistance. And the attitude of society towards such people becomes a criterion for assessing the level of its civilization and development.

Plastic surgery for children with diabetes

In the last ten years, both in the press and in the medical literature, the problem of plastic surgery for people with Down syndrome has been discussed. In particular, in Germany, Israel, Australia, and occasionally in Canada and the United States, attempts were made to correct the facial features of these people with the help of such operations. Although the surgical procedure itself may vary depending on the individual needs of the child and the approach preferred by the surgeon himself, nevertheless, as a rule, the operation includes the removal of wrinkles between the nose and eyes, straightening of slightly oblique palpebral fissures, cartilage implantation in the area of ​​the bridge of the nose, cheeks and chin and removal of part of the tip of the tongue.

Supporters of plastic surgery believe that some shortening of the tongue will improve the speech capabilities of the child. In addition, in their opinion, after such an operation, children with Down syndrome will be better accepted in society, since, as a result, they will ooze less saliva, it will be easier for them to chew food and drink; they will be less likely to be exposed infectious diseases. Although some parental subjective observations indicate that people with Down syndrome benefit from such surgeries, more recent studies have not demonstrated big difference in pronunciation before and after the operation to shorten the tongue (the number of incorrect sounds did not decrease). An analysis of pronunciation assessments made by parents of children who underwent and did not undergo surgery also did not reveal a difference between these groups of children. Many issues related to plastic surgery on the face still remain unresolved and continue to be discussed in scientific circles. It is not entirely clear for whom such an operation is actually performed: for a child, for parents or for society. Should the child be involved in deciding whether surgery is necessary? What should be the indications for plastic surgery? What impact on the child will have an injury, without which no operation can do? Is it possible to avoid prejudice against a child with Down syndrome by correcting facial features? What will the results of the operation mean for the self-identification of the child and his idea of ​​himself? Should the degree of delay mental development be a criterion in deciding whether to undergo plastic surgery?

Other complications relate to the incorrect expectation that the child will be "normal" after the operation. This in some cases can lead to denial of the impairments he has. Currently, plastic surgery in the case of Down syndrome is controversial.

Early Assistance System

The formation of an early aid system in our country is today one of the priorities in the development of the system of special education.

Studies by foreign scientists have shown that systematic early pedagogical assistance to children with Down syndrome in a family environment with the involvement of parents in the process of correctional work allows us to bring not only the process of child development to a new qualitative level, but also largely determines the process of integration into society. At all stages of life, children with Down syndrome should, according to scientists, be under the patronage of specialists who organize the process of accompanying these people in the educational and social space.

Educational programs for children with diabetes

1. Early Educational Assistance Program for Children with Developmental Disabilities"Little Steps", developed at Macquarie University (Sydney, Australia, 1975), tested in the educational center of this university on the category of children with Down syndrome and other developmental disorders. This Program encourages children to interact more fully with the world around them.Developed at the Australian Macquarie University, it is successfully used in many countries and is recommended for use by the Ministry of Education of the Russian Federation.
   The methodology is presented in 8 books, which discuss the basic principles and techniques of teaching. The curricula of the program cover certain areas of development: gross motor skills, speech, motor activity, fine motor skills, self-service, social skills of the child. The method of teaching a child for each of the sections of the program allows you to gradually form any skill, ability, knowledge. The latest book contains a list of skills that determine the development of a child, and a series of checklists that allow you to test babies. Many children who have been trained in these methods have been able to attend integrated and inclusive classes in mainstream schools in the future.The conceptual provisions of the "Little Steps" program represent an innovative approach in the field of education of children with developmental disabilities:

• “All children can learn. A child with developmental disabilities learns more slowly, however, he can learn!
• Children with mental and physical disabilities need to master all the skills they need in games, communication with others, in achieving the greatest possible independence in order to integrate into society.
• Parents, like teachers, play the most important role.
• The effectiveness of learning largely depends on the age of the child. Classes should begin from the moment the diagnosis is established.
• The individual program of the child must satisfy both the needs of the child himself and the possibilities of his family.

1. Methodology for the formation of basic motor skills (ONE)

   Developed by Peter Lauteslager, a Dutch physiotherapist who specializes in motor development and specialized care for children with Down syndrome. It is used for children from 3 months to 3-4 years. It includes testing the levels of development of the child's basic motor skills and drawing up a program of classes with him. The technique implements a functional approach to stimulating the development of children, allows you to assess the dynamics of development and optimally plan classes. It is aimed at the habilitation of the child, prevents and corrects deviations in the motor development of the baby. It does not provide for the impact on the child, but interaction with him with the active participation of parents. The level of motor development is directly related to the primary research activities child and his inclusion in ordinary life- socialization. Testing gives a clear idea of ​​the successive stages of the formation of each motor skill, which allows specialists to correctly draw up a program for the child's motor development and develop recommendations for parents. Mastering motor skills provides the child with a certain level of independent existence, allowing him to consistently learn everything that ordinary children can do. The successful development of the child in the motor area moves him forward in the field of communication.

   3. "Step by step" ("Step by step")

   First of all, a child with Down syndrome should be taught the skills of self-care and behavior in everyday life, which not only ensure his independence and independence, but also serve to develop his personality, contribute to confidence and increase self-esteem. In Europe and America, for many years, a step-by-step methodology has been used to teach children with special needs. It is very effective for children with Down syndrome. The difficulties of social adaptation of such children are largely determined by the insufficient formation of elementary everyday skills in them. The main skills that ensure the independence of the child in any situation include self-care skills and housekeeping skills. And it is important to learn them in a timely manner. Any activity is based on basic motor and mental functions: concentration of attention, general and fine motor skills. These are preparatory skills. It is possible to teach one or another self-service skill only when the child has freely mastered the preparatory skills included in it. The process of learning to master skills should be purposeful, taking into account the peculiarities of psychophysical development and life experience, carried out against a positive emotional background with a wide use of incentives. The child needs time dedicated to skill development, learning and repetition. It is necessary to teach the independence and household skills of the child on the very simple material and in the most simple conditions.
   

   4. Socio-psychological model of Portage
   The technique was developed in the USA in the 70s of the last century, and is successfully used in many countries of the world. Portage's goal is to work with families with a disabled child, to help reduce disability barriers, and to socialize children. The family is visited by a home visiting specialist. A team consisting of project leaders, specialists who know the methodology and specially trained volunteers from among students, future doctors, psychologists and teachers participate in the process of child rehabilitation. During the visits, parents are taught structured teaching techniques to apply in their daily interactions with their child. Parents are taught to observe the child, plan for achievable goals, and encourage desirable behavior. Portage sections include infant stimulation, socialization, cognitive activity, development motor activity, speech, self-care skills. In the Portage methodology, all the skills, abilities and knowledge that a child should master as a result of targeted training are consistently described. It clearly defines what to teach, when to teach, and how to teach.
   5. Methodology for the development of speech and teaching reading by Romena Augustova
   This is a one-of-a-kind method for developing the speech of children with Down syndrome. The author, who has been engaged in the pedagogy of speech all his life, explains in a simple and accessible language in his book “Speak! You can do it”, how to teach a child with complex developmental disabilities to talk, how to communicate with such children, help them reveal their abilities and creative inclinations. Children who study according to the August method not only master well oral speech but also learn to read with passion.
   6. Hippotherapy
   Corrective riding - hippotherapy, is very effective and multifunctional for solving the problems of rehabilitation of children with Down syndrome. It develops the motor, sensory, emotional and psychological abilities of children. Communication with horses, caring for and caring for them increases the feeling of trust, patience, and reduces anxiety. Hippotherapy develops intellectual ability children, contributes to their social adaptation and better adaptation to life. Specially trained teachers own the method of conducting hippotherapy classes.
   7. Numicon system
   It is very difficult for a child with Down syndrome to gain knowledge from the field of mathematics, even its initial skills necessary in everyday life. "Numicon" is a set educational material and a specially developed methodology for working with it when teaching the basics of mathematics. The numbers in the set of visual material are represented by template shapes painted in different colors, which makes them accessible for visual and tactile perception. The set includes colored pins, a panel and task cards. The manipulation of the child with the details leads to the fact that actions with numbers become visual and tangible. This allows you to successfully teach children with Down syndrome the basics of mathematical knowledge.
   8. Lekoteka
   The word "lekoteka" literally translates as "storage of toys." In Russia, this new technique, developed by Swedish scientists for psychological support and special pedagogical assistance to parents raising children with severe developmental disorders and problems, is successfully applied. The service of the lecotheque forms in children the prerequisites for learning activities, supports the development of the personality of each child, conducting learning in the form of a game. Forms of work of the lekoteka: consultations for parents, diagnostic game sessions, therapeutic game sessions, group parent trainings. In the arsenal of lecotheques there are many toys and games for the development of children, special equipment, video libraries, music libraries. Children with Down Syndrome can attend classes at the Lecotheque from 2 months to 7 years of age.
   

Schooling

The school should

• teach basic disciplines: reading, writing, mathematics
• teach you how to get the job done
• to teach the ability to get along with people and know where to turn to find the answer to the question
• build independence and self-confidence
• develop self-care skills

Although social relations are an important aspect of life, children should be able to spend part of the day alone. They should learn to occupy themselves. Time spent alone is also good for development. It is during such hours that a child can learn the ideas that he has encountered, try to do something new on his own. He must have suitable toys and materials so that he does not get bored alone.

• ensure musical development children with diabetes

Movements help in the development of gross motor skills, teach to maintain balance. They are a means of self-expression. Rhythmic dances improve coordination of movements and make the movements themselves more graceful. Such activities give the child pleasure and give self-confidence for many years.

• sports development

Playing sports will contribute to the versatile development of the child, and using his physical abilities, he will be able to increase his overall level of adaptability to life, endurance, develop muscles, improve coordination of movements, the quality of general motor skills

As full-fledged members of society, people with Down syndrome can, just like their healthy peers, lead active image life: study, work.

The main didactic principle in teaching such children is

• the involvement of different channels of perception, that is, different sense organs. First of all, it is necessary to ensure the visibility of training, and to improve the result, connect touch, hearing and kinesthetic sensations.
• the process of assimilation of new knowledge should go in small steps, it is more expedient to break one task into several parts.
• classes should be made as interesting and enjoyable as possible for the child, noting his slightest achievements and successes

Modern research has shown a deep connection between the psychological situation in the family, the level of interaction between parents and the child, the effectiveness of early intervention programs, preschool and school assistance.

A favorable combination of the body's compensatory capabilities with properly selected programs at each stage of training, effective forms its organizations can largely and sometimes completely neutralize the effect of the primary defect on the course of the child's psychophysical development.

The future of children with Down syndrome is more promising now than ever and many parents have already overcome the challenges they face.

Konotopskaya Tatiana

You've been waiting for a baby for so long...
All nine months of pregnancy, you loved him, talked to him, listened to his every movement inside you, impatiently counted the days until he was born ...

And when he was born, like a bolt from the blue, there was a diagnosis made by doctors to your child - Down Syndrome...

It is difficult to describe the whole gamut of emotions that parents experience when they learn about the illness of their baby. This is fear, and resentment, and bewilderment, and unwillingness to believe in what is happening ...
Many begin to blame themselves for the illness of the child. Some people want to run away from him...
But did all those feelings that you experienced for your baby while waiting for him to be born, all the love for him disappear after you learned his diagnosis?

Try to calm down and comprehend what is happening.
First, you are not to blame. The appearance of an extra 21st chromosome in a baby is an accident from which no one is immune.

Secondly, "Down's syndrome" is not a sentence. Medical problems that can affect the development of a child do not occur in all children, and the very development of children with this syndrome, like healthy babies, depends on the influence of a wide variety of factors. This is the health of the child, and care for him, and the quality of education. And children growing up in a family have much greater chances for successful development and a full-fledged independent life.

How does a child with Down syndrome develop?

The development of children occurs in constant interaction with the environment. They are especially influenced by the people with whom they communicate. In this respect, children with Down syndrome are no different from other babies. Moreover, their development is even more dependent on the influence exerted in the early years.

In the first year of a child's life his main experience is the experience of communicating with people around him. He sees and hears everything that happens around, feels touches, smells ... The kid recognizes his loved ones, makes eye contact, smiles, babbles.

Children with Down syndrome practically do not differ from their peers at this age. During this period (as well as others) it is very important that the child feels contact with you: touch him, pick him up, talk to him. You will notice that the child is happy to make contact with you - he looks for you with his eyes around the room, smiles at you, joyfully gurgles.

Things are worse with motor development. Due to reduced muscle tone, most of these babies later begin to roll over, sit, crawl and walk. This limits their experience of knowing the world around them, which, in turn, causes a delay in mental development. The use of appropriate exercises in the first year of a baby's life will help to significantly reduce this lag.

An important milestone in a child's development is the formation of speech, which becomes the leading link in the further formation of its nervous activity. At the age of 2-3 months, babies usually “walk”, in the second half of the year they begin to pronounce individual syllables, and by the year, as a rule, they know about 5-10 words. Children learn to speak by imitating others. In addition, they must learn to understand the meaning of words. To do this, you need to pronounce the name of the action or object, pointing to them. Very soon, for the baby, this can turn into an exciting game in which he will poke his finger at all the objects for you to name them, or he will answer your questions himself.

In the same way, children with Down syndrome learn to understand the first words. But they start talking later, sometimes much later than ordinary children. These babies often have difficulty pronouncing words, so they often resort to sign language. In addition, another cause of delayed speech development may be hearing loss or hearing loss. Therefore, it is very important to regularly check it with audiometry.

How can you help your child?

First of all, surround him with your love and care, but do not limit his freedom with your overprotection. Do not look for any deviations in the behavior of the child, because all children show their feelings in different ways. Remember that his basic needs are no different from those of any other child.
Talk to the parents of children with Down syndrome, their advice will help you in your activities with the baby, and a positive experience will give you confidence. Be aware that there are organizations dedicated to helping children with Down syndrome.

Engage with your child on a regular basis, while using his strengths - good visual perception and visual learning ability. Show him various pictures, letters, written words, any other visual aids ...

Due to reduced muscle tone in such children, motor function is impaired, which can delay their further development. It must be remembered that all motor skills improve with training. Therefore, come up with new exercises, show them to your child, always praise him for his success. To strengthen the muscles of the hand, drawing, modeling with plasticine, designing, sorting are useful. small items, stringing beads.

Given that such children have a shorter concentration period compared to healthy ones, try to change activities during classes.

Be prepared for the fact that during training you will have to face difficulties in memorizing new concepts and skills, in establishing a sequence of actions, in the ability to reason and generalize ...
Try to expand your child's social circle, because another of his strengths is the ability to imitate the behavior of peers and adults, learn from their example.

Popularity is on the rise in recent years early educational assistance programs for children with developmental disabilities. This is due to the success of its application in various countries peace. The Small Steps program, developed at the Australian Macquarie University, is recommended for widespread use by the Russian Ministry of Education. It describes individual work with children, tells how to teach a child the skills of speech perception, develop his motor activity.

Many children who studied under this program were able to go to ordinary schools, where they study according to individual plans. By the way, studying in a simple school with ordinary children is also of no small importance for a child.
Firstly, he communicates with his peers, imitating them, learning how to behave in everyday situations, how to play football, ride a bike, dance.
Secondly, the child does not feel like an outcast, and for peers he is not a stranger. He is part of society! It is even better if peers take patronage over such children, or when they all work together in various circles.

Of course, not everything in raising a child will be easy for you. Daily intensive classes require a lot of work and patience. You can't always reach 100% desired result. But how much joy even small victories of your baby will bring to you! And with the desire and perseverance there will be a lot of them!

Good luck to you and baby!