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)
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TSH
and T4-Thyroid Function Test (annual).
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Echocardiogram
by a pediatric cardiologist if not done previously.
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Behavioral
Auditory Testing (every 6 months to age 3, then annually).
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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.
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Pediatric
and neurological exam with evaluation for spinal cord compression:
deep tendon reflexes, gait, Babinski sign.
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Use
Down Syndrome Growth Charts and head circumference charts with others.
(See Link).
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Eye
examination (annually, or as indicated).
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Screen
for celiac disease, IgA antiendomysium antibodies and total IgA
(between 2 and 3 years).
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Question
about obstructive sleep apnea; ENT exam (as needed).
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Dental
exam (2 years; follow up exams every 6 months after). Twice daily
brushing.
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Reinforce
need for subacute bacterial endocarditis prophylaxis (SBE) for cardiac
problems (as indicated).
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Brief
vulvar exam for girls.
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Well
child care: immunizations; pneumococcal vaccine (2 years).
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Evaluation
by speech/language pathologist.