When Children Have a Dual Diagnosis of Down Syndrome and Autism

As diagnoses of autism rise, healthcare professionals and caretakers have noticed that the symptoms of the disorder often overlap with the symptoms of Down syndrome.

Years ago, doctors did not associate the conditions because of the perception that individuals with Down syndrome who presented with behavioral and developmental challenges did so because of their genetic composition. In recent years, however, more children with Down syndrome are being dually diagnosed. A dual diagnosis isn't easy for parents to cope with, but it does relieve them from the stress of not knowing the right help to obtain for their children.

Diagnosing autism in children with Down syndrome is complicated because many such children exhibit the following behaviors:

• Lack of speech and communication
• Poor hearing or vision
• Poor social skills due to lack of speech or lack of opportunities for natural inclusion
• Sensory problems, low muscle tone
• Other medical problems that diminish their natural level of attention to their environment

One parent of a child who received a dual diagnosis of Down syndrome and autism at about age 3 observed that he didn’t make eye contact or have more than five consistent words in his vocabulary. He also had trouble trying new foods or carrying out simple tasks such as brushing his teeth or hair.

This child went on to improve his language and communication skills, even becoming bilingual. He also became a hearty eater and now brushes his teeth and combs his hair enthusiastically. Like any other child living with Down syndrome, he faces challenges in his everyday life, but his parent questions if he actually had autism. Instead, the parent believes the child overcame a developmental stage typical for children with Down syndrome.

Other parents have different experiences, however, and accept that their children have both autism and Down syndrome.

Parents should take note of possible red flags indicating children with Down syndrome may also have autism. Their communication skills may be lacking, or they may have sensory difficulties, such as being uncomfortable with certain sounds, smells or textures. If children don't learn to manage their sensory reactions, parents should consider evaluating them for a dual diagnosis.

Other signs that a child with Down syndrome has autism include repetitive behaviors or poor eye contact, although some children with Down syndrome alone have these symptoms. Early intervention services are the key to improving these behaviors.

When raising children with special needs, parents must constantly adapt to new challenges, including an unexpected accompanying diagnosis. Parents of children with Down syndrome or special needs of any kind must face their challenges to make way for their triumphs. Awareness about a child's condition is part of that arduous but rewarding process.