Children with Down syndrome may have behavior problems that could interfere with development and learning. There may be a chance that their behavior becomes disruptive to the family, school, or could be harmful to the child or adult with Down syndrome, as well as others. While evaluating a child with Down syndrome who may have behavior concern, it is important to figure out if it is related to medical problems such as:

• Vision or hearing deficits
• Thyroid function
• Sleep apnea
• Anemia
• Constipation
• Depression
• Anxiety

The behavioral challenges in children with Down syndrome are usually not different from those seen in typically developing children, but they may occur at a later age and last somewhat longer. When evaluating behavior in a child or adult with Down syndrome, it is important to look at the behavior in the context of the individual’s developmental age, not only their chronological age. Some behavior problems are also due to frustration with communication and can be controlled by finding ways to help the child communicate better.

Common Behavior Concerns in kids with Down Syndrome

These are some of the common behavior problems in children with Down syndrome:

1. Wandering/Running off

Children with Down syndrome may run or wander off without a word. For their safety, it is crucial to have good locks and door alarms at home. Write in a plan and share with school about what everyone should do in case the child leaves the classroom or playground. At home, you can put a stop sign on the door as a reminder to the child with Down syndrome to check before leaving the house.

2. Stubborn behavior

Sometimes, a child may display stubborn or oppositional behavior as a way of communicating frustration or lack of understanding. This may be due to his communication/language problems. Children with Down syndrome become very good at distracting parents or teachers when they are challenged with a difficult task.

3. Attention Problems

Children with Down syndrome can have ADHD but they should be evaluated for attention span and impulsivity, based on developmental age and not chronological age alone. An expert can help diagnose attention problems and help with behavior altering measures. Anxiety disorders, language processing problems, and hearing loss can also present as problems with attention.

4. Obsessive or Compulsive behaviors

These can be as simple as always wanting to sit in the same chair at the table or repetitive behaviors such as dangling beads or belts when not engaged directly in an activity. This is more common in younger children with Down syndrome, and while the number of compulsive behaviors is no different than those in typical children at the same mental age, the frequency and intensity of the behavior is often more in children with Down syndrome.

5. Autism Spectrum Disorder

Almost 5 to 7 percent of children with Down syndrome experience autism. This diagnosis is usually made at a later age than in the general population, and regression of language skills may also occur later. The interventions strategies are the same as for any child with autism and it is important to be identified as early as possible so that the child can receive appropriate therapeutic and educational services.

Intervention strategies for treating behavior problems in children with Down syndrome are variable. They depend on the child’s age, severity of the problem, and the setting in which the behavior is most commonly seen. Chronic problems may need the intervention of a behavioral specialist who works with children and adults with special needs.