Early Intervention for Down Syndrome

Get the help you need during the early developmental years of a child with Down syndrome.
National Down Syndrome Society

The first years of life are a critical time in a child's development. All young children go through most of their rapid and developmentally significant changes during this time. During these early years, they achieve the basic physical, cognitive, language, social and self-help skills that lay the foundation for future progress, and these abilities are attained according to predictable developmental patterns. Children with Down syndrome typically experience delays in certain areas of development, so early intervention is highly recommended. It can begin anytime after birth, but the sooner it starts, the better.

What is early intervention?

Early intervention is a systematic program of therapy, exercises, and activities designed to address developmental delays that children with Down syndrome or other disabilities encounter. These services are mandated by a A federal law called the Individuals with Disabilities Education Act (IDEA) requires that states provide early intervention services for all children who qualify, with the goal of enhancing the development of infants and toddlers and helping families understand and meet the needs of their children. The most common early intervention services for babies with Down syndrome are physical therapy, speech and language therapy, and occupational therapy.

When should early intervention start?

Early intervention should begin shortly after birth, and usually continues until the child reaches age three. An amendment to IDEA in 2004 allows states to have early intervention programs that continue until the child enters, or is eligible to enter, kindergarten. The sooner early intervention begins, the better, but it's never too late to start.

How can early intervention benefit a baby with Down syndrome?

Development is a continuous process that begins at conception and proceeds stage by stage in an orderly sequence. There are specific milestones in each of the four areas of development (gross and fine motor abilities, language skills, social development and self-help skills) that serve as prerequisites for the stages that follow.

Most children are expected to achieve each milestone at a designated time, also referred to as a "key age," which can be calculated in terms of weeks, months, or years. Because of specific challenges associated with Down syndrome, babies will likely experience delays in certain areas of development, but they will achieve each of the same milestones as other children, just on their own timetable. In monitoring the development of a child with Down syndrome, it is more useful to look at the sequence of milestones achieved, rather than the age at which the milestone is reached.

MILESTONE: GROSS MOTOR

Sits Alone
Range for Children with Down Syndrome: 6 to 30 Months
Typical Range: 5 to 9 months

Crawls
Range for Children with Down Syndrome: 8 to 22 months
Typical Range: 6 to 12 months

Stands
Range for Children with Down Syndrome: 1 to 3.25 years
Typical Range: 8 to 17 months

Walks Alone
Range for Children with Down Syndrome: 1 to 4 years
Typical Range: 9 to 18 months

MILESTONE: LANGUAGE

First Word
Range for Children with Down Syndrome: 1 to 4 years
Typical Range: 1 to 3 years

Two-Word Phrases
Range for Children with Down Syndrome: 2 to 7.5 years
Typical Range: 15 to 32 months

MILESTONE: SOCIAL/SELF-HELP

Responsive Smile
Range for Children with Down Syndrome: 1 to 5.5 months
Typical Range: 1 to 3 months

Finger Feeds
Range for Children with Down Syndrome: 10 to 24 months
Typical Range: 7 to 14 months

Drinks from Cup Unassisted
Range for Children with Down Syndrome: 12 to 32 months
Typical Range: 9 to 17 months

Uses Spoon
Range for Children with Down Syndrome: 13 to 39 months
Typical Range: 12-20 months

Bowel Control
Range for Children with Down Syndrome: 2 to 7 years
Typical Range: 16-42 months

Dresses Self Unassisted
Range for Children with Down Syndrome: 3.5 to 8.5 years
Typical Range: 3.25 to 5 years

What are the types of early intervention therapies? How does each type address specific aspects of a baby's development?

infant is expected to gain head control and the ability to pull to a sitting position (with help) with no head lags and enough strength in the upper torso to maintain an erect posture. Appropriate physical therapy may assist a baby with Down syndrome, who may have low muscle tone, in achieving this milestone.

Before birth and in the first months of life, physical development remains the underlying foundation for all future progress. Babies learn through interaction with their environment. To do so, an infant must have the ability to move freely and purposefully. The ability to explore one's surroundings, to reach and grasp toys, to turn one's head to follow a moving object with one's eyes, to roll over, to crawl in pursuit of a desired objective--all of these behaviors are dependent upon gross as well as fine motor development. These physical, interactive activities foster understanding and mastery of the environment, stimulating cognitive, language, and social development.

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