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Down Syndrome
NM exam 2
26
Other
Graduate
10/30/2008

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Term
Definition of Down Syndrome
Definition
chromosome abnormality which occurs spontaneously and leads to motor and cognitive deficits (associated w/ advanced maternal age)
Term
Diagnosis of Down's
Definition
screening during pregnancy (maternal serum-alpha-fetoprotein); within days of birth (characteristic facial features, hypotonicity/flaccidity)
Term
Classification (in order of prevalence)
Definition
1. trisomy 21
2. mosaic - combo of normal and trisomy 21
3. translocation - breakage of 2 nonhomologous chromosomes w/ reattachment of broken pieces to other intact chromosome pairs
Term
delayed development influenced by:
Definition
moderate to severe congenital heart dz; degree of hypotonia; prolonged reaction time and greater variability in timing of muscle activation; delayed righting and equilibrium reactions
Term
sitting alone milestone for DS
Definition
10 mo. average (6-28 mo. range)
Term
creeping milestone for DS
Definition
15 mo. average (9-27 mo. range)
Term
Standing milestone for DS
Definition
20 mo. average (11-42 mo. range)
Term
walking milestone for DS
Definition
24 mo. average (12-65 mo. range)
Term
Neuropathology associated conditions
Definition
dec. brain wt (smaller brainstem and cerebellum), delayed cerebellar maturation, lack/delayed myelination, inc. in distance of synapses, signs in brain of premature aging (earlier onset of aging characteristics like dec. vision, dementia, alzheimer's, etc.)
Term
Cardiopulmonary associated conditions
Definition
40% have congenital heart dz, AV canal defects and ventricular septal defects usually repaired surgically within first year, patent ductus arteriosus, most to all infants with DS prior to 3 mo. of age are seen by pediatric cardiologist
Term
Hearing and vision associated conditions
Definition
anatomic changes of ear canal lead to conductive hearing loss, increased ear infections (delayed speech), congenital cataracts lead to vision impairments
Term
Musculoskeletal associated conditions
Definition
subluxation and dislocation (instability of patella-femoral joint, sublux of hip, dislocation of atlantoaxial joint - laxity of transverse odontoid ligament); inc. ligamentous laxity; absence of muscles (ie palmaris longus and facial muscles); foot deformities (pes planus)
Term
Musculoskeletal precautions
Definition
no strenuous gymnastics (no forward roll/somersaults), no contact sports, no diving, restricted use of trampolines
Term
Aging effects of DS
Definition
thyroid dsyfxn (usu. hypo-), CV disorder (mitral valve prolapse), obesity (sedentary lifestyle, excessive caloric intake, lack of social/community interactions), musculoskeletal (arthritis, hip instability, osteoporosis)
Term
Earlier signs of aging in DS
Definition
balance issues, motor tasks more difficult, dec. strength and endurance, vision and hearing decline, early onset of conductive hearing loss and visual impairment, alzheimer's, depression
Term
Recommendations for adults w/ DS
Definition
consistent exercise, good diet, community involvement, regular health examination
Term
Examination of oral-motor control (feeding in infants)
Definition
poor sucking and swallowing secondary to hypotonia; small space in mouth (short/narrow palate); hypoactive gag reflex (affects aspiration); chewing problems (eat softer foods)
Term
Examination of musculoskeletal system
Definition
1. joint and ligamentous laxity (defects of c.t. and abnormal protein structure of ligaments and tendons)-ROM
2. scoliosis of thoracolumbar region (delayed skeletal maturation and short stature)
Term
Examination of tone
Definition
hypotonia associated w/ lower wt. in cerebellum and brainstem, contributes to motor and speech delays, contributes to lessened degree of kinesthetic feedback
Term
Examination of sensory system
Definition
visual motor deficits, balance deficits including delayed postural responses to loss of balance
Term
Examination of motor performance
Definition
dec. spontaneous kicking, wide base of support for all activities, mov't in straight planes (lack rot. and control of mov't), coactivation of muscles for stability, latency of responses (postural and motor)
Term
Examination of social-emotional/play
Definition
look at toys but spend less time manually or orally exploring toys, have more aimless behavior, play less w/ toys
Term
Intervention for DS
Definition
inc. fxnal abilities, inc. amt and variability of mov't experiences, dec. reliance of extreme ROM by strengthening muscles, prevent and monitor secondary conditions, foster independence in mobility and self-care, find community resources for fitness activity/support groups/respite care
Term
PT services for DS
Definition
direct PT for short amts of time w/ specific goals; early intervention groups, special rec groups used to enhance mobility; assessment of work placements and living situations
Term
PT across the lifespan
Definition
0-3 y/o: EI
3-5 y/o: transition to school
5-12 y/o: set up fitness program or integrating child into sports/rec prog.
12-18 y/o: mobility in h.s., PT may be part of vocational training and work place eval., tranportation to/from work
Adult: intermittent eval of mobility and self-care skills in supervised or indep. living situation; changes in living situations due to aging parents; degen. of CNS and resultant mobility limitations
Term
Medical interventions
Definition
surgical repair of heart defects in infancy; hearing aids/glasses; pharmacology intervention as necessary for thyroid, arthritis, neurological dysfxn as pt ages
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