What is Down’s syndrome
First called Mongolian or Mongolian dementia, Down syndrome is now generally known as trisomy 21, also known as congenital stupidity in China, and is one of the most common serious birth defects. Down’s syndrome was first diagnosed in 1866 by the British physician Don John B. Hoffman. John? Langdon first published the condition at the Society. In 1965, who officially named the disorder “Down syndrome”. It encompasses a range of genetic disorders, the most representative of which is trisomy 21, which causes high levels of abnormalities including learning disabilities, intellectual disabilities and handicaps.
The prevalence of Down syndrome is not directly related to ethnicity, standard of living, etc. It is estimated that 1 in 660 births has Down syndrome, making it the most common chromosomal variant. Advanced maternal age increases the risk of Down syndrome in infants. Families at potentially high risk are often offered genetic counseling and genetic testing such as “amniotic fluid diagnosis”.
There are basically three types of Down syndrome
1. Trisomy of the 21st chromosome pair: chromosomal translocation causing variation of the 14th chromosome pair Standard type of trisomy of the 21st chromosome pair: also known as trisomy 21, one extra chromosome of the 21st chromosome pair and forty-seven chromosomes in the cell, accounting for 90-95% of people with Down syndrome.
2. Chromosome translocation type: 5-6% of all cases. One of the extra chromosomes in the cell may be attached to other chromosomes, especially the fourteenth or twenty-first chromosome pair. 5-6% of people with Down syndrome are in this category.
3. Anechromatosis: 1-3% of the total. Not all cells in this category have 47 chromosomes, some have 47 chromosomes and some have 46 chromosomes.
Common complications of Down syndrome
People with Down syndrome have a higher chance of having organ malformations, but not all complications occur, and there are cases where there are no complications at all.
1. malformations of the digestive organs, such as congenital esophageal atresia, duodenal stenosis, lockjaw, etc.
2, congenital heart disease, the prevalence rate is up to 40%, especially the proportion of endocardial insufficiency is high, usually fatal if not treated early
3, cataract, the prevalence rate is 2%.
4. Acute leukemia, with a prevalence of 1%.
5. Indirect instability of the ring axis, prevalence 2-3%.
6. Thyroid disease, prevalence 3%.
7. Nodding epilepsy, prevalence 10%.
8, transient myelodysplasia.
9.Ocular anomalies, myopia, hyperopia, disorderly vision, etc. caused by corneal and crystal body anomalies.
10. Infiltrative otitis media, which tends to accumulate fluid in the inner ear and cause otitis, affecting the sense of hearing.
The seven characteristics of Down syndrome
1, mental retardation: for mild, moderate, mostly moderate mental retardation, its intelligence gradually decreases with age, age from 1 to 10 years, and its average intelligence quotient (IQ) decreases from 58 to below 40. Some experts believe that IQ is relatively stable during adolescence and decreases later. Most studies have shown that environmental factors are important in influencing IQ, and that patients raised in good environments have relatively high IQs. The degree of mental retardation can vary between different types of patients, with trisomies generally being the most severe and translocations the next most severe. Among the translocation types, those with balanced translocation have a lesser degree of intellectual involvement. As the children are quiet and docile, they provide better conditions for special education training. Although it is difficult to reach the level of elementary school grade 1-2 in terms of cultural skills, there can be significant improvement in adaptive ability and a certain degree of self-care and labor ability.
2. Language development disorders: The average age of children starting to learn to speak is 4-6 years old, 95% of them have articulation defects, slurred diction, stuttering and low voice; more than 1/3 of them have abnormal speech rhythm or even outburst sounds.
3. Behavior disorders: most of them have mild temperament, often giggle, like to imitate and repeat some simple actions, and can perform simple labor; a few patients are irritable, capricious, hyperactive, and even have destructive and aggressive behaviors; some show a tendency to flinch, accompanied by posture of catatonia.
4.Motor development delay: The difference between the motor function of the affected children and their normal peers may not be significant during the period after birth, but the difference increases with age. Motor development also varies widely among patients. Patients with congenital dwarfism can perform simple movements such as dressing and eating, but their movements are clumsy, uncoordinated, and their gait is unstable.
5. Growth disorders: Maternal gestation period is shorter in patients with congenital dwarfism, with an average of 262 to 272 days. At birth, the height is l~3cm shorter than normal newborns, the head circumference is basically normal, the biparietal diameter is in the normal range, the anterior-posterior diameter is relatively short, and the occipital area is flat. Most of them have a short head shape. The fontanelle and forehead sutures are wide and close late, and the third fontanelle (the sagittal suture above the posterior fontanelle is widened) often appears. Most children with this disease sleep deeply in the first few days after birth, sucking and swallowing very slowly, or even completely unable, so it is very difficult to wake up and feed. 80% of children with this disease have generally low muscle tone.
6, special appearance: wide distance between the eyes, the two eyes are oblique, the inner canthus, low ear position, low nasal bridge, wide and thick tongue, mouth often half open or tongue sticking out of the mouth, deep and many tongue cleft, thick palm and short thick fingers, short last finger often bent inward or two knuckles, 40% of children have through palm. In the metatarsal pattern, the tibial arch of the ball area of the thumb, the distance between the thumb and the second toe finger is large, and the joint ligaments are lax or see low muscle tone.
Developmental characteristics of self-control in children with Down syndrome
1. Children with Down syndrome have a low level of motivation for self-control
It has been pointed out that all people are born with the motivation to develop their abilities, and although it does not initially rely on external reinforcement, the feeling of happiness in early life reinforces the degree of approaching success. That is, when a child succeeds in a task, they show a pleasant reflection, and this pleasant feeling can motivate him to seek newer and better skills. The behavioral curves of persistence and success in regular children and children with Down syndrome have been studied and found that children with Down syndrome have a lower rate of success in their efforts than regular children. It has also been shown that children with Down syndrome perform work at a lower level and at a slower pace, do not often show enjoyment in their work, and prefer to take on easy challenges. Children with Down syndrome show great variability in cognitive ability test items, they lack persistence and avoid learning opportunities, and low scores on many test items are due to their refusal to try rather than to their poor performance. Therefore, it is very important to enhance the self-control of children with Down syndrome and to stimulate “motivation”.
2. The growth environment and level of care for children with Down syndrome are different from those of ordinary children
Due to the physical and psychological defects of children with Down syndrome, their growth environment and the level of care they receive are different from those of ordinary children. Children with Down syndrome have difficulty integrating into the general social community, they have little access to kindergarten and schooling, and are often neglected from normal education due to the differences they exhibit in their Et life. Children with Down syndrome and their parents have little opportunity to communicate with each other due to the lack of communication options. Lack of social role modeling is also an important factor in the development of self-control in children with Down syndrome. Children with Down syndrome have difficulty finding role models and objects to imitate because they have little exposure to ordinary children and their environment, and therefore, they have difficulty responding well cognitively. Many studies testing mother-infant relationships have found that mothers of children with Down syndrome may spend a great deal of time with unsatisfactory results. They are used to taking care of everything and doing everything themselves, which in turn reduces the problem-solving skills of children with Down syndrome and affects the development of the child’s persistence qualities.
3. Children with Down syndrome have a poorer ability to control their emotions
Ordinary children, under the influence of school education and the gradual and strict requirements of parents, as they get older, their ability to control and regulate their emotions will increasingly develop. Children of early school age are to some extent able to control some of their desires and obey the needs of their activity tasks. Children with Down syndrome, on the other hand, are poor and slow in developing emotional control. Their ability to regulate and control their emotions is still more governed by the needs and passions of the organism. They have difficulty regulating their emotions and behaviors according to socially desirable behavioral norms or moral standards, and they have difficulty coordinating their emotions with the changing environment and practical needs, and changing the desires and demands that have arisen.
How to improve self-control in children with Down syndrome
Capturing the critical period of self-control development The study of the critical period has important implications for child development, as it illustrates the optimal period for individual learning. Research has shown that self-control in children aged 3 to 9 years tends to increase with age, and the critical age for development is between 3 and 5 years. Studies have found that children’s self-control develops rapidly between the ages of 3 and 4 and slows down relatively between the ages of 4 and 5. Physiological studies have also shown that inhibition develops rapidly in children between the ages of 4 and 5, and that delayed inhibition in the cerebral cortex lays the foundation for the central nervous system to control individual activities. Children with Down syndrome develop self-control more slowly than normal children because of their own deficits. However, through analysis, it is easy to see that the development of self-control in young children is mainly in early childhood. Therefore, we need to seize the critical period of early childhood to intervene and correct the self-control of children with Down syndrome at the right time.
1. Use games to correct the self-control of children with Down syndrome
Research shows that young children persist longer in certain interesting activities than in boring ones, and uninteresting activities are easy to distract young children and break behavior rules. However, “games were used to develop self-control in young children, and the results showed that game training can improve self-control and that the types of games used to train young children in self-control should be different at different ages. A study of children’s false beliefs noted that children in general and children with Down syndrome were able to engage in spontaneous pretend play and developed the ability to engage in complex interactive pretend play before they passed a false belief task. Many psychologists and clinicians have attempted to use play to intervene and treat children’s maladaptive behaviors. Play helps children express and complete their emotional conflicts in a collaborative relationship with the therapist, who interacts with the child through the metaphorical language of play. Children with Down syndrome have poorly developed self-control due to little access to toys and little communication with their peers. Therefore, in the correction of self-control for children with Down syndrome, games should be introduced appropriately, starting with simple, easy-to-implement tasks that can arouse their interest, and slowly moving to activities that require more willful effort, thus gradually developing their self-control skills.
2.Use the “trigger” effect to develop self-control
Children’s self-control behavior is largely influenced by environmental factors. The purpose of young children’s activities is mostly linked to their immediate needs, interests and desires. Research has found that triggers can have a positive effect on the development of self-control in children. Educators need to make good use of this tool to develop self-control in young children. Children who are intellectually backward have single interests and hobbies, and their material interests dominate. Cultivate the “motivation” of children with Down syndrome, give them appropriate incentives, so that they can experience the joy of success, so as to trigger the desire for success of children with Down syndrome, prompting them to pursue higher goals, thereby enhancing their ability to self-control.
3.Enhance the ability of “delayed gratification” of children with Down syndrome
”Delayed gratification” is considered to be one of the most important skills in self-control and is seen as an essential component of social interaction and emotional regulation. Psychologists believe that delayed gratification is a sign of psychological maturity. Specifically, it refers specifically to a choice orientation that willingly forgoes immediate gratification for a more valuable long-term outcome, as well as the ability to demonstrate self-control while waiting. The ability to delay gratification in normally developing children around age 4 is thought to predict cognitive and social competence in young adulthood. Delayed gratification ability encompasses many factors, and studies of children with intellectual disabilities have reported difficulties in making choices. Language comprehension may contribute to this difficulty. In order to make a decision to wait, children must know the meaning of the word “wait” and some concepts of time. Therefore, patiently teaching children with Down syndrome some relevant language and using examples to make them fully understand can be helpful in the development of delayed gratification.
4. Give full play to the role of “family
The family plays a very important role in the correction of self-control of children with Down syndrome. Children with Down syndrome rarely have the opportunity to be accepted by the outside world, and the group with which they have the closest relationship is the family. A child with Down syndrome belongs to the family and has the highest expectations from parents and siblings. An Australian study showed that there is a relationship between the temperament of children with Down syndrome and maternal parenting behaviors. Parents of children with Down syndrome who are overly coddling and protective of their children develop poorer self-control. Other parents are overly authoritarian and strict, not allowing any emotions and behaviors that violate the social requirements of the child to appear, confining the affected child to a narrow space, in which case the child will show repression, withdrawal and even aggressive behavior, which are poor control characteristics. Children’s motivation to control develops through the caregiver’s guidance of the child’s understanding of the behavior-effect relationship. The caregiver provides an emotionally positive environment for the child and shares the child’s goals so that they become mutual, which can be accomplished by the parent taking the initiative, i.e., the parent assisting the child in developing skills and inspiring the child to attempt higher level tasks through inspirational methods. Family members have to gradually adapt to the routine of the affected child and choose the appropriate educational methods according to their characteristics.
Of course, the transformation of a child with Down syndrome from a dependent individual to a more self-controlled individual is a gradually changing and difficult process. However, we believe that through patient guidance and cultivation, the self-control ability of children with Down syndrome will be significantly improved.