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Down Syndrome and Deaf-Blindness
and vision impairments can impact the mental health of
thosewithDownsyndromeintheformofanxiety,
depression, apparent loss of cognitive skills, agitation,
and aggression. Vision or hearing loss can be
frightening, and when combined with intellectual
disability, sensory losses can be more traumatic and
it may be more difficult to develop compensatory skills.
Early Intervention
Interventions to assist the child with vision
impairment can include corrective lenses, contact
lenses, sunglasses, special spectacles designed to fit
the facial features of children with Down syndrome,
magnification, enlargement, teaching of eccentric
viewing, head tilting or gaze shifting, appropriate use
of lighting, and rest after concentrated close work,
with the intervention dependent upon eye condition
(Smith & Lovack, 1996). There is evidence that
children with Down syndrome may have sensory
awareness deficits (Kumin, 2003), yet children with
severe vision impairment and moderate intellectual
disability can benefit from tactile forms of communication,
including braille (Chen & Downing, 2006;
Creech & Golden, 2009; Robinson, 2009). Research
into techniques for tactile communication for children
with impaired vision and other impairments have
concluded that tactile input should be used to
support information received through other senses in
order to help them link gestures and abstract
symbols (Chen & Downing, 2006; Rowland &
Schweigert, 2000). Research has also concluded
that augmentative and alternative communication
methods can be used effectively with preschoolers
with Down syndrome (Branson & Demchak, 2009).
Yet more research is needed that specifically
includes children who have impaired vision and
hearing and Down syndrome.
Despite the difficulty in assessing hearing in young
children with Down syndrome, refined audiology
testing has resulted in early interventions, such as
fitting of hearing aids and introducing speech and
language therapies and multisensory teaching
methods, sign language, and increased use of visual
cues, gestures, pictures, and reading (Kumin, 2003).
There is much evidence of the advantages of
early intervention services for children with Down
syndrome. Although there is a history of controversies
related to specific therapies such as vitamin and
mineral therapies, cell therapies, and Doman’s
102 | AER Journal: Research and Practice in Visual Impairment and Blindness
treatment of brain injury (Foreman, 1988; Jacobson,
Foxx, & Mulick, 2005), physical therapy, early
education, social work, nursing, occupational therapy,
speech therapy, audiology, and vision therapy have
resulted in feelings of improved morale and support
for parents (Pueschel, 1990). There is also evidence
that children with Down syndrome can directly benefit
from early therapeutic interventions. This is especially
the case if programs are comprehensive;
provided over a sufficient period of time and with a
selected number of qualified professionals; and are
initiated with very young children, involve parents,
and are structured yet flexible and adapted to the
individual needs of each family (Van Hooste & Maes,
2003).
Health and
Educational Services
Early intervention services vary from community to
community. For children with Down syndrome who
have additional hearing and vision impairments,
services may include:
N Services related to vision impairment such as
play groups, early intervention education with
teachers of children with vision impairment,
developmental daily living skills instruction,
and developmental orientation and mobility;
orthoptists (specialists who assess and
provide therapy to those with binocularity or
ocular motility difficulties) and pediatric ophthalmologists
and optometrists may also be
available
N Services related to hearing impairment such
as audiology and speech therapy, hearing-aid
specialists, and teachers of those who have
hearing impairments
N Services related to intellectual disability can
include special education services, respite
care, occupational therapy, music therapy,
specialized play groups, and parent support
programs
N Services related to physical disability can
include physical therapy, horse-riding for people
who are disabled, and nursing services
N Services for children who are experiencing deafblindness
or deaf-blindness and intellectual
disability may include the assistance of service
coordinators, family specialists, social workers,