Medical Care in Down Syndrome: A Preventive Medicine Approach

by Rogers; Paul

• ISBN13: 9780824786847
• ISBN10: 082478684X
• Format: Hardcover
• Copyright: 1992-06-12
• Publisher: CRC Press

Summary

This reference provides contemporary information on all aspects of Down syndrome, investigating health concerns by age group and by organ system. The text sets out to identify and correct problems before they interrupt developing skills. It includes preventive medical checklists with summaries of appropriate medical intervention; supplies background information about history, genetics and epidemiology; outlines clinical management strategies; establishes guidelines on how to inform parents of the diagnosis and conveys practical suggestions on the handling and care of the infant; and offers a detailed review of the medical literature. Appendices provide information including growth charts and financial checklists.

Table of Contents

Preface	p. v
Introducing Down Syndrome
Introduction	p. 3
History of Down Syndrome	p. 6
Chromosome Studies	p. 13
Epidemiology	p. 21
References	p. 25
The Development of the Child with Down Syndrome: Implications for Effective Education	p. 29
Introduction	p. 29
The Dynamic Process of Development	p. 31
Measuring Development in Terms of IQ	p. 32
The Wide Range of Development	p. 34
Development in the First Five Years	p. 35
The Early School Years	p. 41
Teenagers	p. 44
Effects of Down Syndrome on Development	p. 46
Why These Delays?	p. 46
What Can We Do To Improve the Children's Progress?	p. 52
Not Just Delayed	p. 54
Designing Early Intervention and Education Programs	p. 58
The Challenge	p. 62
References	p. 62
Preventive Medicine by Age Groups
The Neonate	p. 71
Neonatal Diagnosis	p. 71
Specific Medical Concerns	p. 78
Genetic Counseling	p. 81
Parent-Infant Attachment	p. 82
Down Syndrome Preventive Medicine Checklist: Neonatal	p. 83
References	p. 83
The Infant: Two to Twelve Months	p. 85
Medical Problems in the First Year	p. 86
Down Syndrome Preventive Medicine Checklist: Two to Twelve Months	p. 93
References	p. 93
The Child: One Year to Puberty	p. 97
Respiratory Infections and Middle Ear Effusions	p. 97
Airway Obstruction	p. 98
Cardiac Problems	p. 99
Orthopedic Problems	p. 99
Thyroid Difficulties	p. 102
Growth and Nutrition	p. 103
Dental Considerations	p. 104
Ocular Considerations	p. 105
Family Education and Support	p. 105
Annual Down Syndrome Preventive Medicine Checklist: Age One Year to Puberty	p. 112
References	p. 113
The Adolescent	p. 115
Puberty	p. 115
Medical Problems in Adolescence	p. 118
Annual Down Syndrome Preventive Medicine Checklist: Adolescent	p. 119
References	p. 120
The Adult	p. 121
Medical Concerns in Adults	p. 123
Management of Psychiatric and Behavior Disorders	p. 129
Office Management of Specific Psychiatric Disorders	p. 132
Management of Behavior Disorders	p. 134
Support for the Family	p. 138
Down Syndrome Preventive Medicine Checklist: Adult	p. 141
References	p. 142
What We Know About Preventive Medical Care
The Ears	p. 147
The Ear at Risk	p. 148
Hearing Losses	p. 152
Evaluation and Treatment	p. 153
References	p. 153
The Heart	p. 157
Endocardial Cushion Defect	p. 159
Ventricular Septal Defect	p. 161
Other Defects	p. 162
Pulmonary Artery Hypertension and Pulmonary Vascular Disease	p. 163
Management	p. 164
Access to Cardiac Care	p. 164
References	p. 166
The Gastrointestinal System	p. 169
Duodenal Obstruction and Other Upper Gastrointestinal Anomalies	p. 170
Lower Gastrointestinal Anomalies	p. 172
Inflammatory Bowel Disease	p. 172
Is There Evidence for Malabsorption in Down Syndrome?	p. 173
References	p. 175
The Musculoskeletal Systems	p. 179
The Spine	p. 179
The Lower Extremity	p. 183
Arthropathy	p. 184
References	p. 185
The Endocrine System	p. 189
Thyroid Dysfunction	p. 190
Gonadal Function	p. 194
References	p. 198
The Central Nervous System	p. 201
Brain Structure and Function	p. 201
Sleep	p. 206
Seizure Disorders	p. 206
Behavior Disorders	p. 208
Moyamoya Disease	p. 211
Aging and Alzheimer's Disease	p. 212
References	p. 217
The Ocular System	p. 225
Refractive Errors	p. 226
Strabismus	p. 226
Nystagmus	p. 227
Blepharoconjunctivitis	p. 228
Cataracts	p. 228
Keratoconus	p. 229
Retinal Pathology	p. 231
Optic Nerve Hypoplasia	p. 231
Conclusion	p. 232
References	p. 232
The Immune System	p. 235
The Immune System	p. 235
Hematological Diseases	p. 241
Autoimmunity	p. 244
Purine Metabolism	p. 244
At Risk Immunologically	p. 245
References	p. 246
Dental Care	p. 251
Periodontal Disease	p. 251
Dental Anomalies	p. 252
Dental Caries	p. 252
Dental Management	p. 254
References	p. 255
Is Obesity Inevitable?	p. 257
Who?	p. 258
When?	p. 258
Why?	p. 260
What Can be Done?	p. 263
References	p. 265
Miscellaneous Medical Problems	p. 267
Dermatological Diseases	p. 267
Genitourinary Disease	p. 268
Enzyme Levels	p. 269
Dual Diagnosis	p. 269
References	p. 271
Controversial Therapies	p. 273
Facial Surgery	p. 274
Megavitamins	p. 275
DMSO	p. 275
Siccacell Therapy	p. 276
Benda's Thyroid/Pituitary Therapies	p. 276
Summary	p. 277
References	p. 277
Legal and Financial Advice	p. 281
The Future
The Future in Down Syndrome Research	p. 289
Human Chromosome 21 and Murine Trisomy 16	p. 289
Improving the Quality of Life	p. 290
References	p. 293
Growth Charts for Down Syndrome	p. 295
Specific Medical Recommendations	p. 303
Books About Down Syndrome for Professionals and Parents	p. 311
Parent Support Organizations	p. 317
Preventive Medicine Checklist: Neonatal Through Adult	p. 329
Financial Checklist for Families	p. 332
Using Computers to Stimulate Developmental Skills	p. 335
Index	p. 339
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