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I suggest you give a copy of this list to your pediatricain.
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Health Care Guidelines for children with Down Syndrome
Childhood (1 - 12 years)
Based on 1999 Down Syndrome Health Care Guidelines
Down Syndrome Quarterly (Volume 4, Number 3, September 1999, pp 1-16)

  • TSH and T4-Thyroid Function Test (annual).
  • Echocardiogram by a pediatric cardiologist if not done previously.
  • Behavioral Auditory Testing (every 6 months to age 3, then annually).
  • Lateral cervical spine x-rays (neutral view, flexion, extension) to rule out atlanto-axial instability. Radiologist to measure atlanto-dens distance and neural canal width (at 3-5 years, then as needed). * Dr. Menezes, University of Iowa Hospitals and Clinics Neurologist, suggests every 2-3 years.
  • Pediatric and neurological exam with evaluation for spinal cord compression: deep tendon reflexes, gait, Babinski sign.
  • Use Down Syndrome Growth Charts and head circumference charts with others. (See Link).
  • Eye examination (annually, or as indicated).
  • Screen for celiac disease, IgA antiendomysium antibodies and total IgA (between 2 and 3 years).
  • Question about obstructive sleep apnea; ENT exam (as needed).
  • Dental exam (2 years; follow up exams every 6 months after). Twice daily brushing.
  • Reinforce need for subacute bacterial endocarditis prophylaxis (SBE) for cardiac problems (as indicated).
  • Brief vulvar exam for girls.
  • Well child care: immunizations; pneumococcal vaccine (2 years).
  • Evaluation by speech/language pathologist.