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Physical Education Class: Keeping Children With Down Syndrome Safe

written by: Anne Vize • edited by: Elizabeth Wistrom • updated: 8/2/2012

Safety tips for regular PE are important, but did you know there are some safety tips that apply especially for Down Syndrome kids? An important consideration for PE and sports for Down Syndrome kids is atlantoaxial instability - a condition that affects only some children with Down Syndrome.

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    What Is Atlantoaxial Instability?

    Atlantoaxial instability sounds like a long and complex condition. And for most teachers of Down Syndrome kids, it is something that just never comes up. After all, if there was anything we needed to know about that could affect our students with Down Syndrome, someone would have told us--wouldn't they? But often teachers of Down Syndrome kids don't know about atlantoaxial instability. What is it? Why is it important?

    Atlantoaxial instability is a condition that is rare and occurs only sometimes in Down Syndrome kids. It involves the top two vertebrae in the neck, which are the cervical vertebrae. These two are called the atlas and the axis--hence the name. The condition affects the joint in between these two vertebrae. In a child with atlantoaxial instability, the joint shifts and puts pressure on the delicate spinal cord that lies within the vertebrae. It can be detected with an x-ray.

    There is some discussion and disagreement in the medical world about who, when and how often x-rays should be done to detect atlantoaxial instability. In a child with Down Syndrome, there will usually be a key medical contact, such as the family doctor, who is a good starting point for discussions about atlantoaxial instability.

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    What Does It Mean for Teaching Down Syndrome Kids?

    From a teaching point of view, this is where the individual nature of working with children with special needs comes into play. You cannot make one general safety tip or rule that applies to all Down Syndrome kids. In most cases, it is better to talk about individual students and relate the issue to their IEP and individual planning. Information should be sought from the parents or caregivers, family doctor or pediatrician, or other relevant health care workers.

    It is possible with x-rays to determine if atlantoaxial instability exists and how it should be managed. It is not the role of teachers to decide if this condition is a risk for individual students.

    Teachers working with Down Syndrome kids need to be wary particularly of activities that could place the neck region at risk of trauma or injury. This could include activities such as contact sports, forward rolls or highly unpredictable sports that involve high speeds, large forces and weights, or the likelihood of collisions or impacts. This doesn't necessarily mean Down Syndrome kids should never do a forward roll; it does mean teachers should check first with a health care worker who fully understands the condition and the child to make sure it is safe. As with any physical disabilities or health conditions, find out first rather than after a safety issue or injury occurs.