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Diagnosis of Autism Amongst Children with Down Syndrome

In the past, people were of the view that autism was rare amongst individuals with Down syndrome. However, when research increased, it was discovered that autism is 10 to 25 times more common in people with Down syndrome than in the general population.  Hence, some children go through a dual diagnosis – a diagnosis of autism and Down syndrome – which poses a bigger challenge for them. In addition, the diagnosis of Down syndrome in autistic children might take place at a later stage due to their overlapping symptoms. 

A study, consisting of children with a dual diagnosis, proposed that the average age of autistic children when diagnosed was 14.4 years, though the children start showing symptoms of autism at an early age. A delay in the diagnosis of both conditions might become a little difficult to cater to. Children going through a dual diagnosis face trouble in coping with education and development, as compared to the ones who are prone to a single condition. Moreover, the condition of the child becomes worse if any one of them is not detected and the expectations from the child remain the same. If a child is expected to outperform or be charming, then that might create frustration for the ones concerned and would lead to a poor relationship between the child and the expectations from their surroundings.  

Children with a dual diagnosis are affected by a genetic predisposition in families. They go through some serious health-related issues that are not found in children with Down syndrome only. The probability of autism diagnosis increases if the child has experienced severe illness in the early years, such as epilepsy, infantile spasms, infections, visual or hearing impairments, and any sort of brain injury. It is not necessary that every child with Down syndrome who goes through these medical problems will eventually become autistic; rather some brain damages or sensory deprivation leads to certain severe learning disabilities or development issues that are similar to autism. 

There are two groups of children with Down syndrome- one which is diagnosed with both the conditions correctly, and the other which is wrongly diagnosed. The first group displays deficits in emotional and social skills when interacting with other children, parents, or adults. This social impairment can be observed among children who experience a learning disability of moderate to mild severity in the first group. Whereas the second group goes through more severe levels of disability that result from brain damage and impairment in their development areas. Furthermore, the group that is wrongly diagnosed exhibits a range of repetitive, obsessional behaviors, and may typically flap their hands, resist change and have limited communication skills. However, they interact affectionately with the people around them. As they show positive behavior towards communication and social skills and work on improvement, their autistic behaviors tend to decrease. However, they might continue to show some obsessional behaviors when anxious, as it is common in children with Down syndrome. Moreover, if they do not improve those skills, then there is a possibility that they might move further along the spectrum. 

Small Steps Big Dreams in Dubai, UAE aims to provide equal opportunities to autistic children, so as to make their development process smoother. The current focus of autism therapy in Dubai is on improving and polishing their skills to provide a successful career path for them and relieve their parents of some stress. There is a way for more research for the diagnosis of autism and Down syndrome, both, and to identify therapies or treatments to support their development and enhance their learning abilities. However, both conditions are linked with the child’s development in their early years. The proportion of autistic symptoms in children with Down syndrome varies across the studies, possibly because of different diagnostic measures or the sample size taken into consideration. It is a matter further complicated by how children with a dual diagnosis exhibit complex symptoms, such as an increased tendency to display compulsions. However, it must be noted that, at times, children with Down syndrome often show behaviors that are related to Autism Spectrum Disorder (ASD) even though they may not have ASD. 

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