Clinical Perspectives in the Management of Down Syndrome (Disorders of Human Learning, Behavior, and Communication)

The management of and attitudes toward children and adults with Down syndrome have undergone considerable changes in the course of the condi­ tion's long history (Zellweger, 1977, 1981, Zellweger & Patil, 1987). J. E. D. Esquirol (1838) and E. Seguin (1846) were probably the first physicians to witness the condition without using currently accepted diagnostic designa­ tions. Seguin coined the terms furfuraceus or lowland cretinism in contradis­ tinction to the goiterous cretinism endemic at that time in the Swiss Alps. Esquirol, as well as Seguin, had a positive attitude toward persons who were mentally ill or mentally subnormal. Esquirol pioneered a more humane treatment in mental institutions and Seguin created the first homes in France, and later in the United States, aimed at educating persons who were mentally subnormal. The term mongolian idiocy was coined by J. H. L. Down in England (1866). The term is misleading in several respects: (1) Down identified the epicanthic folds seen in many children with Down syndrome with the additional skin fold in the upper lid occurring particularly in people of Oriental (Mongolian) descent; and (2) Down also erred by assuming that Down syndrome represented regression to an ethnic variant of lower cultural standing. Such an interpretation might have been understandable at a time when the myth of Anglo-Saxon superiority was widely accepted by the British. Charles Darwin's then highly acclaimed theory of origin of the species may have contributed to such a concept. The management of and attitudes toward children and adults with Down syndrome have undergone considerable changes in the course of the condiƯ tion's long history (Zellweger, 1977, 1981, Zellweger & Patil, 1987). J.E.D. Esquirol (1838) and E. Seguin (1846) were probably the first physicians to witness the condition without using currently accepted diagnostic designaƯ tions. Seguin coined the terms furfuraceus or lowland cretinism in contradisƯ tinction to the goiterous cretinism endemic at that time in the Swiss Alps. Esquirol, as well as Seguin, had a positive attitude toward persons who were mentally ill or mentally subnormal. Esquirol pioneered a more humane treatment in mental institutions and Seguin created the first homes in France, and later in the United States, aimed at educating persons who were mentally subnormal. The term mongolian idiocy was coined by J.H.L. Down in England (1866). The term is misleading in several respects: (1) Down identified the epicanthic folds seen in many children with Down syndrome with the additional skin fold in the upper lid occurring particularly in people of Oriental (Mongolian) descent; and (2) Down also erred by assuming that Down syndrome represented regression to an ethnic variant of lower cultural standing. Such an interpretation might have been understandable at a time when the myth of Anglo-Saxon superiority was widely accepted by the British. Charles Darwin's then highly acclaimed theory of origin of the species may have contributed to such a concept Front Matter....Pages i-xix Front Matter....Pages 1-1 Common Medical Problems....Pages 3-14 Ear, Nose, and Throat Problems and Hearing Abnormalities....Pages 15-25 Ophthalmological Aspects....Pages 26-54 Cardiac Conditions....Pages 55-71 Dental Problems....Pages 72-79 Foot and Other Musculoskeletal Problems....Pages 80-92 Motor and Hand Function....Pages 93-101 Problems in Feeding....Pages 102-106 Nutrition Assessment of the Child with Down Syndrome....Pages 107-125 Developmental Assessment....Pages 126-138 P300 Latency and Cognitive Ability....Pages 139-146 Consonant Phoneme, and Distinctive Feature Error Patterns in Speech....Pages 147-152 Language Development and Intervention....Pages 153-164 Front Matter....Pages 165-165 Interdisciplinary Approaches....Pages 167-170 Development and Behavior....Pages 171-180 Down Syndrome and Leukemia....Pages 181-192 Issues of Family Interaction, Parenting, and Parent Groups....Pages 193-202 Sexuality, Reproduction, and Contraception....Pages 203-207 Alternative and Controversial Therapies....Pages 208-216 Back Matter....Pages 217-246 The editors of Clinical Perspectives in the Management of Down Syndrome have compiled a body of research which does more than categorize this historically misunderstood and misrepresented condition. Once believed to signify regression to an ethnic variant of lower cultural standing, Down syndrome has become the subject of interdisciplinary research. This volume approaches the condition from perspectives in fields such as psychology, dentistry, and rehabilitation; issues discussed within these disciplines reveal a wider range of potential understanding as experts examine Down syndrome individuals and the concerns which surround them, from alternative and controversial therapies to sexuality and reproduction