Occupational Therapy for Children with Down Syndrome to Enhance Development for a Fulfilling Life

• Occupational therapy supports holistic development for childrenwith Down syndrome.This includes movement, life skills, language, and learning.
• Occupational therapy is an integrated care approach involving assessment, goal-setting, collaboration with a multidisciplinary team, and designing individualized activities.
• At Samitivej Children's Hospital, occupational therapists teach parents brief, consistent home exercises to enhance self-care and daily living skills.

Children with Down syndrome often face challenges in movement, communication, and learning. However, with proper care and developmental stimulation from an early age, they can develop and fully utilize their potential.

Common challenges in occupational therapy include

• movement difficulties : Weak gross motor muscles cause delayed sitting, standing, or walking, while unstable fine motor skills affect grasping small objects or writing.
• daily living activities : Difficulty performing basic tasks such as dressing, using utensils, or brushing teeth.
• language and communication : Challenges understanding multi-step instructions, reliance on gestures over speech, and unclear pronunciation.
• attention and learning : Short attention spans limit sustained focus during learning.

Role of occupational therapy in caring for children with Down syndrome

Occupational therapy for children with Down syndrome involves a comprehensive, holistic process including systematic assessments, collaborative goal-setting with families, working alongside a multidisciplinary team, and designing individualized interventions. This continues with teaching and guiding parents to extend therapy at home, covering movement, hand use, cognition, emotion, learning, and daily life skills. Coordination with families, teachers, and professionals helps children gradually increase independence and live confidently.

Integrated care approach

1) Comprehensive assessment
Observe gross and fine motor skills through play, hand use, ADLs (eating/drinking, using utensils, dressing), attention/participation, and classroom skills using observation, standardized tools, and interviews with parents and teachers.
2) Collaborative goal-setting with family

Set measurable, achievable, and meaningful daily life goals such as

• being able to put on and take off socks independently 4 out of 5 times.
• writing a nickname within the lines within one month.
• sitting and engaging in table activities for 5 minutes without reminders.

3) Treatment planning with multidisciplinary team
Parents collaborate with pediatricians, rehabilitation doctors,physical therapists, speech therapists, psychologists, special education teachers, and schools to ensure coherent, effective therapy plans..

4) Design individualized interventions

• Gross motor and balance
  - Bear crawling, walking on lines, and dancing to music to strengthen the core and shoulders.
• Fine motor and hand use
• - Squeezing, pinching, and twisting sponges, clay, or bottle caps.
• - Two-handed activities like threading laces, tearing, and pasting.
• - Coin sorting, line tracing, coloring, and cutting along lines.
• - Household tasks like watering plants, pouring water into bottles, and folding clothes.
  - ADLs (daily routines)
• Dressing and undressing, using spoons, buttoning, zipping, tying shoelaces, and handwashing.
  - Sensory processing
• Playing with sand trays, playdough, finger painting, and blowing bubbles.
  - Learning promotion
• Storytelling, matching and categorizing games, following 1-2 step instructions.

Note: These activities are preliminary ideas. Occupational therapists adjust difficulty to match each child's goals and abilities for ongoing progress.

5) Provide parents with home program guidance for continued practice
Examples include

• Task Analysis: Break tasks into steps, practice one step at a time, gradually reduce assistance, and immediately praise success.
• Visual Supports: Use pictures or icons to indicate steps, timing, and methods.
• Adaptive equipment: Thick-handled spoons, two-handled training cups, etc.
• Set practice time: brief but consistent, 10–15 minutes daily.

6) Follow-up for evaluation and plan adjustment

Regularly review progress, update reports for families and schools, and adapt activities to the child's age and advancing skills.

Occupational therapy for children with Down syndrome requires collaboration among all involved parties to develop personalized therapy plans that meet each child's unique needs, enhancing independence and daily living abilities.

Developmental and Learning Potential Promotion Center at Samitivej Children's Hospital International

The Developmental and Learning Potential Promotion Center at Samitivej Children's Hospital International has a comprehensive expert team including pediatricians specializing in child development and behavior, child and adolescent psychiatrists, psychiatric nurses, speech and language therapists, developmental psychologists, and clinical psychologists.

Our team provides holistic care for children with special needs such as those on the autism spectrum, children with developmental delays, genetic conditions including Down syndrome, and children facing emotional and learning difficulties.

We aim for every child to progress continuously and grow balanced physically and mentally, aligned with their individual developmental stage.

Information provided by the Special Children CenterSamitivej Hospital