Pediatric Medical Guidelines
The American Academy of Pediatrics publishes a guideline for families and physicians to navigate the health needs of children with Down syndrome. The guidelines were recently updated to include prenatal guidance, building upon previous versions that provide age-based care and treatment.
- The current version (“Health Supervision for Children Down Syndrome”) was published in Pediatrics (Vol. 149, Issue 5, May 2022). An electronic version can be accessed here: https://publications.aap.org/pediatrics/article/149/5/e2022057010/186778/Health-Supervision-for-Children-and-Adolescents
- TSH and T4-Thyroid Function Test (annual).
- Auditory testing (every 2 years).
- Cervical spine x-rays (as needed for sports); check for atlantoaxial dislocation.
- Ophthalmologic exam, looking especially for keratoconus & cataracts (every 2 years).
- Clinical evaluation of the heart to rule out mitral/aortic valve problems. Echocardiogram-ECHO (as indicated).
- Reinforce the need for subacute bacterial endocarditis prophylaxis (SBE) in susceptible adults with cardiac disease.
- Baseline Mammography (40 years; follow up every other year until 50, then annual).
- Pap smear and pelvic exam (every 1-3 yrs. after first intercourse).
- If not sexually active, single finger bimanual exam with finger-directed cytology exam.
- If unable to perform, screen pelvic ultrasound (every 2-3 years).
- Breast exam (annually).
- General physical/neurological exam. Routine adult care.
- Clinical evaluation for sleep apnea.
- Low calorie, high-fiber diet. Regular exercise. Monitor for obesity.
- Health, abuse-prevention, and sexuality education. Smoking, drug and alcohol education.
- Clinical evaluation of functional abilities (consider accelerated aging); monitor loss of independent living skills.
- Neurological referral for early symptoms of dementia: decline in function, memory loss, ataxia, seizures, and incontinence of urine and/or stool.
- Monitor for behavior/emotional/mental health. Psych referral (as needed).
- Continue speech and language therapy (as indicated).
Resources: National Down Syndrome Society