Wednesday, June 19, 2024

Is Down Syndrome A Form Of Autism

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Brain Chemistry And Asd

The Dual Diagnosis of Down Syndrome and Autism

The neurochemistry of autism is far from clear, and very likely involves several different chemical systems of the brain. This information provides the basis for medication trials to impact the way the brain works in order to elicit a change in behavior. An analysis of neurochemistry in children with ASD alone has consistently identified involvement of at least two systems.

  • Dopamine: regulates movement, posture, attention and reward behaviors
  • Serotonin: regulates mood, aggression, sleep and feeding behaviors

Additionally, Opiates, which regulate mood, reward, responses to stress and perception of pain may also be involved in some children.

Detailed studies of brain chemistry in children with DS-ASD have not yet been done. However, our clinical experience in using medications that modulate dopamine, serotonin or both systems has been favorable in some children with DS-ASD.

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Help Your Child To Develop

Although it may take extra time for your child to learn and master skills, you may be surprised at how much he or she will be able to do. With encouragement, your child can learn important skills. You can help your baby learn to walk, talk, or eat by himself. You can help your child make friends and do well in school. Later you can help him or her learn job skills and maybe live independently.

To learn how to help your child throughout life, see Home Treatment.

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Asperger Syndrome Generally Involves:

  • Hypersensitivities
  • Difficulty with the give and take of conversation
  • Difficulty with nonverbal conversation skills
  • Uncoordinated movements, or clumsiness
  • Anxiety and depression

The tendencies described above vary widely among people. Many learn to overcome their challenges by building on strengths.

Though the diagnosis of Asperger syndrome is no longer used, many previously diagnosed people still identify strongly and positively with being an Aspie.

The Journey From Classical Autism To Autism Spectrum Disorder

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Till about the 1970s, the classical autism studies included all shades of ASD bundled under a generic term Autism.

Today, however, physicians, therapists, and researchers consider each of these five categories while referring to specific autism symptoms:

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What Is Asperger Syndrome

Asperger syndrome, or Aspergers, is a previously used diagnosis on the autism spectrum. In 2013, it became part of one umbrella diagnosis of autism spectrum disorder in the Diagnostic and Statistical Manual of Mental Disorders 5 .

Typical to strong verbal language skills and intellectual ability distinguish Asperger syndrome from other types of autism.

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Case Descriptions: A Closer Look At Two Toddlers With Down Syndrome And Autism Spectrum Disorders


A male child, age 26 months at the initial evaluation and 50 months at follow-up, A.B. met autism criteria on the ADOS-G, ADI-R and clinical judgement at both evaluations. Medically, he has a history of heart problems that have required monitoring, but no surgery. His motor milestones were delayed and he was reported to begin using words at 18 months and then lost their spontaneous use for a period of 8 months. He is currently functionally nonverbal and communicates by reaching, manipulating anothers hand, and vocalizing without coordinated eye gaze. His overall developmental quotient is estimated to be 45 and his nonverbal problem-solving skills are a relative strength on his MSEL profile.

A.B. presents as a lethargic, irritable child who is easily frustrated and cries in the context of challenges. During the ADOS-G at the time of initial evaluation, he rarely directed affect or vocalizations to others, did not use any gestures, did not integrate verbal and nonverbal behaviours to communicate intention, did not initiate or respond to joint attention, and did not initiate any showing or giving behaviours. His functional play was limited to cause-and-effect actions. At follow-up, he continued to show impairments in social and communicative behaviour .


Get Your Child Regular Medical Care

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You can help your child stay healthy by scheduling routine checkups. This will help to identify, manage, and monitor any diseases and health problems that people with Down syndrome have a higher chance of developing.

Doctors look for specific problems at various ages, such as cataracts and other eye conditions during a baby’s first year. These checkups are also a good time for you and the doctor to talk about any concerns you have. Many parents have similar concerns as their children grow, including:

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What Is Down Syndrome

Down syndrome , is also termed as trisomy 2. It is a genetic disorder which is triggered by the third copy of chromosome 21. People with down syndrome show mental equivalent of an eight and nine-year-old. However, some individual can lead a very normal life.

The condition is usually characterized by delay in growth, a poor muscle tone and a lower IQ.

The disorder occurs by chance and can be detected in the womb itself.

What To Think About

There are several controversial treatments for Down syndrome that either have not been proved helpful or have questionable benefit. Some treatments may even cause physical harm or have ethical implications. Talk with your child’s doctor before you try treatments that you and the doctor haven’t yet discussed.

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How Autism And Down Syndrome Are Similar

Meanwhile, they both share some traits.

  • Developmental delays
  • Independence
  • Need for love and support

People with both conditions will have delays. Learning skills like talking, riding a bike, doing chores, and managing money might take longer. Thus, its important for people to be patient. Never blame someone for needing more time. Setting too-high expectations isnt fair to them. Instead, meet them where they are.

Also, independence will be harder. They might not be able to be fully independent. Instead of pushing them into something they arent ready for, help them. Find whats realistic and not too stressful. Help them learn at their own pace.

Above all, people with both conditions need love and support. It isnt always easy to be disabled. Thus, they need to be surrounded by helpful people. Its important to give them a safe environment where they can learn without feeling ashamed.

Was Aspergers Linked With Nazism

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Some prominent historians have argued that Hans Asperger was complicit in Hitlers regime of euthanasia in his bid to create a genetically fit German population.2 Psychiatrists and other physicians were involved in a Nazi programme that murdered children who were seen as either physically or mentally “inferior” or “undesirable.” Asperger, along with some of his colleagues, attempted to mould certain autistic children into “productive” citizens. He was also responsible for sending others to the Spiegelgrund clinic, where they were starved or given lethal injections. Asperger’s complicity in the death of neurodiverse children has fueled some calls to further abandon the Asperger’s label, even in a colloquial sense.

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Lack Of Acceptance By Professionals

Problem: There is sometimes a lack of acceptance by professionals that ASD can coexist in a child with Down syndrome who has cognitive impairment. They may feel an additional label is not necessary or accurate. Parents may be told, This is part of low functioning Down syndrome. We now know this is incorrect. Children with DS-ASD are clearly distinguishable from children with Down syndrome alone or those who have Down syndrome and severe cognitive impairment when standardized diagnostic assessment tools such as the ABC are used.

Result: Parents become frustrated and may give up trying to obtain more specific medical treatment or behavioral intervention.

Clinical Research: Down Syndrome Autism Often Coexist

Regression risk: Children who have both autism and Down syndrome are more likely to lose language and other skills than children who have Down syndrome alone.

Nearly 40 percent of people with Down syndrome also meet the criteria for an autism spectrum disorder, suggests a U.K. study of nearly 500 children, published in Autism Research1.

The study found that 38 percent of children with Down syndrome meet a screening test cutoff for either classic autism or another pervasive development disorder on the autism spectrum.

In keeping with the elevated prevalence of autism in males, the study shows that boys with Down syndrome are significantly more likely to meet the criteria for an autism spectrum disorder than girls with Down syndrome.

The study assessed whether children show signs of autism by asking their caregivers to fill out the SocialCommunication Questionnaire , which consists of yes-or-no questions about social and communicative deficits and repetitive and restricted behaviors.

The researchers note that the SCQ does not provide a clinical diagnosis. For example, using the SCQ and an additional questionnaire, a 2010 study initially estimated that 42 percent of children with Down syndrome have an autism spectrum disorder. However, after assessing some participants using more rigorous in-person tests, it downgraded the estimate to 18 percent2.

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Babies And Young Children

Your child will likely take more time than other children to reach certain milestones. But his or her achievements are just as significant and exciting to watch. Be patient, and encourage your young child as he or she learns.

  • Walking and other motor development milestones. You can help your baby and young child strengthen muscles through directed play. As your child gets older, you can work with a physiotherapist and your doctor to design an exercise program to help your child maintain and increase muscle strength and physical skills.
  • Self-feeding. Help your child learn to eat independently by sitting down together at meals. Use gradual steps to teach your child how to eat. Start with allowing your child to eat with his or her fingers and offering thick liquids to drink.
  • Dressing. Teach your child how to dress himself or herself by taking extra time to explain and practice.
  • Communicating. Simple measures, such as looking at your baby while speaking or showing and naming objects, can help your baby learn to talk.
  • Grooming and hygiene. Help your child learn the importance of being clean and looking his or her best. Establish a daily routine for bathing and getting ready. As your child gets older, this will become increasingly important. Gradually add new tasks to the routine, such as putting on deodorant.

Risk Factors For Social Withdrawal

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When children’s play and communication skills are developing very slowly due to learning disability, there is a risk that their development becomes arrested, or ‘stuck’.

For example, a child may sit and just roll a car back and forward, or line up bricks or sit and flap an object because he or she does not know how to play more creatively. Progress will only be made if someone – parent or sibling or teacher – plays with the child and shows him or her how to play in more rewarding and advanced ways. Even if play is not more advanced, if someone plays with the child, taking turns in a simple activity such as rolling a ball or running balls down a runway, this will prevent the child developing the habit of engaging in a repetitive activity that does not lead to any learning or progress.

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Developmental Characteristics Of Screen

Significantly more screen-positive than screen-negative children were diagnosed with autistic disorder or PDD-NOS . Screen-positive children had more severe cognitive impairment and a lower mean developmental quotient, with a mean difference in developmental quotient between groups of 11.0 . Scores on the Vineland Adaptive Behavior Scales did not differ between screen-positive and screen-negative children however, parents of only about 75% of clinically evaluated children completed the Vineland Adaptive Behavior Scales.

Find Resources And Support

Your doctor or local hospital can refer you to community resources to help you learn what to expect and how to care for your baby who has Down syndrome.

You may also want to think about joining a support group. Talking and sharing with other parents of children with Down syndrome can help you manage difficult feelings. It can also help you know what kinds of challenges to expect, as well as help you to discover the joys other parents have experienced with their children.

Families of children who have Down syndrome may need other types of resources, such as:

  • Financial assistance. Children with Down syndrome have special needs that may create more expenses for the family.
  • Estate planning. Become familiar with tax issues and estate planning to ensure that your child will have proper care and necessary resources available if you die.
  • Family counselling. This therapy involves regular sessions with a qualified counsellor who has experience working with families who have children with Down syndrome.

It’s also important to take time for yourself. Common frustrations and frequent highs and lows can all lead to exhaustion. Take good care of yourself so you have the energy to enjoy your child and attend to his or her needs. For more information, see the topic Caregiver Tips.

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Autism Vs Down Syndrome: How Can We Differentiate

Autism and downs syndrome are both developmental conditions that occur in both children and adults. They may present in one individual although the causes, symptoms and treatments for both are entirely different.

AutismThis is a condition that affects the behaviour of a child characterized by impaired communication, poor social interactions, impaired body movement and seizures.

It is caused by a number of factors which include

  • Abnormal brain development. The inability of the body to metabolize phenylalanine amino acid a condition known as phenylketonuria due to the absence of enzymes required for the metabolic process.
  • Viral infections of the pregnant mother such as toxoplasmosis that is passed unto the unborn fetus during pregnancy.
  • Inflammation of the brain after birth as a result of an infection caused by bacteria, virus or fungus.
  • Neurodevelopmental conditions of genetic origin that affect nerves and neurons such as fragile X syndrome and tuberous sclerosis.
  • Immunological problems with a compromised immune system and the occurrence of autoimmune disorders.
  • Vaccines such as the influenza vaccine.

There are different types of autism which include

Different types of Down syndrome include

  • Trisomy 21 which is the most common type of Down syndrome.
  • Mosaic Down syndrome where an individual has either two or three copies of the extra chromosome 21.
  • Robertsonian translocation that occurs with chromosomal rearrangements with improper fusing

Are There Any Child Characteristics That Could Serve As Risk Factors For A Comorbid Autism Diagnosis

What Is Mosaic Down Syndrome?

One hypothesis is that children with Down syndrome who are lower functioning may present with more significant social and communicative impairments than those with higher functioning. The present sample is too small to evaluate this conclusively however, for the three children who met criteria for an autism spectrum disorder, we observed very little variability in their developmental skills. All three children, at the chronological ages of 5258 months, obtained mental ages of 2728 months on the MSEL. All three fell within the lower 20% of the IQ distribution of this sample of children with Down syndrome. Further studies, with larger sample sizes, will be necessary to elucidate this hypothesis.

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How Consistent Are Ados

The psychologists on the team reviewed all data from the participants developmental history, standardized testing and laboratory measures, and determined that two children presented with comorbid autism and Down syndrome. One of these children exceeded the cutoffs for autism on both the ADOS-G and ADI-R , and the other exceeded cutoffs for spectrum on the ADOS-G and communication on the ADI-R . These two children will be described in more detail below.

The third child who was classified as having autism spectrum by the ADOS-G was not classified as having a clinical diagnosis of autism. Her developmental delay was significant and she had very poor motor skills and difficulty initiating movements. Her difficulties in joint attention, imitation, play and coordination of nonverbal behaviours were attributed by the clinicians to her overall cognitive and motor impairments. Notably, she demonstrated a reciprocal social smile, directed her facial expressions towards adults, and shared affect during play, providing evidence of dyadic social interaction.

How Common Is Autism

There are quite widely varying estimates in the UK and USA because there are no objective measures of autistic spectrum disorders. In the 1970s the estimates of the incidence of autism were 4-5 autistic children per 10,000 children. Currently estimates vary from 18.7 per 10,000 to 91 per 10,000. Since the 1970s, there has been an increased recognition of ‘milder’ social impairments such as Asperger syndrome, which are now part of the autistic spectrum disorders and this accounts for some increases but not all. There does seem to be evidence for a genuine increase in the numbers of children now having autism and autistic spectrum disorders. Of all individuals with a diagnosis of autistic spectrum disorder, some 50% have learning disabilities.

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