Down Syndrome

What is it?

Down Syndrome is a genetic disorder where the body has more copies of chromonsone 21 than usual. There are three main types:

  • Trisomy 21 is the most common type, affecting around 94% of people with Down’s syndrome. Every cell in the body has an extra copy of chromosome 21.
  • Translocation is where an extra piece of chromosome 21 attaches itself to another chromosome. It affects around 4% of people with Down’s syndrome. In this situation, there are only 46 chromosomes in each cell but one of them has extra material attached.
  • Mosaicism is the least common type, affecting around 2% of people with Down’s syndrome. Only some of the cells have an extra copy of chromosome 21, which can mean people with mosaic Down’s syndrome experience less delay with some aspects of their development. (NHS, 2015)

Down Syndrome occurs in approximately 1 in 1000 births in the U.K. (In The US closer to 1 in 700) although the risk may increase with the age of the mother.

How can we recognize it?

Down Syndrome children usually look more like their families than each other but some common characteristics may occur. Some children may have a small, flat nose and a small mouth with protruding tongue. Eyes may slant upwards and outwards and hands may be broad with short fingers. Most children have weak muscle tone and experience cognitive delay, although this can range from mile to severe. Many children with Down Syndrome experience a delay in developing speech and language.

Down Syndrome
Down Syndrome Condition as a Concept Background

What are the associated health or behavioural problems?

Some health problems associated with Down Syndrome could be:

  • Around 50% of children with Down Syndrome will also have a congenital heart defect
  • Hearing and vision problems such as glue ear or short-sightedness.
  • 1 in 10 children will experience problems with their thyroid gland function leading to lethargy, weight gain and slowed reactions.
  • Increased risk of infections due to under development of the immune system

Some behavioural problems may include:

  • Approximately 1 in 10 may also suffer from Autism or other disorders on the autistic spectrum.
  • Some children with Down Syndrome may exhibit obsessive tendencies or have problems with attention and impulse management.

Information adapted from Genetics Home Reference: Down Syndrome (2015) and NHS (2015a)

Many parents can be scared at the thought of raising a child with Down Syndrome – this short video clip focuses on what the children can do, rather than what they cannot.

How can we support learners in the classroom?

As with Sotos Syndrome, many of the strategies that prove useful in supporting learners with Down Syndrome as also useful for the average learner therefore implementing these practices in your classroom could lead to better outcomes for all students as well as promoting the inclusion of students with SENDs.

I have worked for years as a gymnastics coach, specializing in preschool, women’s artistic and SEND gymnastics. Children with Down Syndrome can benefit massively from gymnastics-like activities in developing muscle tone and co-ordination. Atlanto-axial instability (the spinal cord bones in the neck) can affect many individuals with Down Syndrome so it is essential to be aware of this when planning lessons to avoid damage. When working with children with Down Syndrome in the school where I am currently placed the school has been focusing on consistency across the school when it comes to behaviour expectations and teaching children the skills they need when they leave school to become independent members of society.

One of the most successful gymnasts with Down Syndrome

Teaching strategies we can use:

  • Children with Down Syndrome learn well through visual and hands-on activities, as do many other children, so plan lots of visual and practical material in your lessons
  • Model behaviour and encourage peer modelling – also be aware of that children can copy bad behaviour as well as good!
  • Lots of overlearning, review and repetition
  • Be aware that children with Down Syndrome can often suffer from hearing disorders and fatigue due to narrow ear canals and weak muscle tone – be sure to plan activities with these in mind and appeal for support from medical professionals if you think this could be affecting learning.
  • Learning through small steps with explicit success criteria and low risk of failure
  • Make sure classroom routines are consistent and structure of day is explicitly explained (e.g. visual timetable)
  • Be aware of position within the classroom and potential distractors in the environment
  • Model visual support for tasks e.g. mind maps, visual organisers to give children tools they can use independently to support their own learning
  • Be aware of neck instability and low muscle tone when planning P.E. lessons, especially if including gymnastics skills such as the forward roll.
  • Activities should include areas each individual child needs to work one such as fine and gross motor skills, language skills and self-help skills

(Faragher and Clarke, 2013, Tingey, 1987)

‘It’s okay to go slow’ A Japanese documentary (with English subtitles) following a young boy with Down Syndrome through the first 6 years of his life.

Some general principles for supporting SEND learners in the mainstream classroom

  • Be consistent in your behaviour expectations
  • Have high expectations for all your learners – not impossible expectations but never give up on a child simply because they have a special educational need or disability.
  • Ask for help – there are lots of organizations offering support and training for those working with SEND children and lots of information available to help you best support the learners in your classroom.
  • Use visual support and focus on giving children the tools they need to become independent learners.

Watch the video below for a message from a young woman with Down Syndrome where she talks about the importance of not placing limits on what someone can do based simply on them having a special educational need or disability.


Faragher, R. and Clarke, B. (2013) Educating learners with Down Syndrome: Research, Theory and Practice with Children and Adolescents, Routledge: London

Genetics Home Reference (2015) ‘Down Syndrome’

NHS (2015) ‘Down’s syndrome – Causes’ (Accessed 22/11/15)

NHS (2015a) ‘Down’s Syndrome – Complications’ (Accessed 23/11/15)

Tingey, Carol, Down Syndrome: A Resource Handbook, Pro Ed: London

Further reading

More about Down Syndrome

Video that could be used to help children in the class understand a classmate with Down Syndrome

Well at School

Reading with Children with Down Syndrome


Tips for teaching children with Down Syndrome

General teaching strategies for supporting children with SENDs

I hope some of this information proves useful to you in your future classroom!



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