Children With Down Syndrome and Autism: The Challenges of Co-Occurring Diagnoses

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There is little known about the dual diagnosis of Down syndrome and autism spectrum disorder. The medical community has only recently recognized that Down syndrome children can be paired with other disorders such as autism or obsessive compulsive disorder. Parents of these children often have their concerns dismissed unless severe symptoms are present. This can cause intervention to become delayed.

While a delay will not impair those with Down syndrome it can be detrimental to those that have autism. For this reason if a parent senses that her child may have a dual diagnosis it is important that her concerns are voiced to a doctor.

Typically, children with Down syndrome and autism begin to show impairments and a regression as they get older. These issues can be overlooked by others because the child is already seen as having a cognitive disorder. However, these children perform well below their peers that only have Down syndrome.

The medical community does not currently have an agreed set of criteria for diagnosing autism in Down syndrome children. However, those with a dual diagnosis perform lower on cognitive tests and are more likely to have certain characteristics and conditions. These include being more preoccupied with how their bodies move, limited diet and sensitivity to food textures, increased hyperactivity, sleep disturbances, more behavioral problems and self injurious behavior.

The diagnosis of autism is made based on a set of behaviors, but these behaviors are more likely in those that have a learning disability or a cognitive disability. Thus, Down syndrome is likely to be the underlying cause of autism in these children.


It is not possible to cure Down syndrome or autism spectrum disorder, but improvements can be made in children with a dual diagnosis. Treatments include early intervention, medication, therapies and discrete trial teaching.

Early intervention is very effective in socializing those with autism. This is why it is important for parents of children with Down syndrome to voice concerns to their doctor if they believe their child has autism as well. Early intervention makes these children more social and able to work on areas in which they have deficits such as speech.

Medication will not make a vast improvement for those that have a dual diagnosis. However, it can make certain conditions more manageable. They include hyperactivity, self injurious behavior, sleep disturbances and behavioral problems.

Children with Down syndrome and autism benefit from therapies. Speech therapy can help these children learn to communicate more effectively by using PECS and sign language. These individuals will also work on oral motor skills in speech sessions. Physical therapy can help these children with their coordination. It can also assist them in learning to participate in physical activities. Occupational therapy teaches children with a dual diagnosis skills that will make them more functional such as writing, putting on their shoes and brushing their hair.

Discrete trial teaching can help children with a dual diagnosis to accomplish their learning goals. In these trials learning is broken down into steps, and each step must be mastered before the child moves onto the next. Repetition, prompting and reinforcement are all used in discrete trial teaching.

Families of children with Down syndrome and autism spectrum disorder are often strained. Divorce is more likely for those that have a child with a dual diagnosis. For this reason, it is important to talk openly with one another and get help if needed.