This is a summary of the Health Care Guidelines for Individuals with Down syndrome and can be placed in the front of a family's medical record book or in the front of a medical chart for rapid consultation. The original version was prepared in 1989 by Dr. Allen Crocker.
| Concern | Clinical Expression | When Seen | Observed Prevalence | Management |
| Congenital heart disease | AV canal defects, auricular or ventricular septal defects, Tetralogy of Fallot | Newborn or first year | 40-50% | Cardiac consultation,echocardiography,surgical repair, SBE prophylaxis |
| Hypotonia | Reduced muscle tone,increased range of joints, motor function problems | Throughout life;improvement with maturity | All | Guidance by physical therapy;early intervention;adapted physical education |
| Delayed growth | Typically at or near the third percentile for general population | Throughout | All | Use DS growth charts, early nutritional support; check thyroid, heart |
| Developmental delays | Some global delay, variable degrees; specific language problems | 1st year, continues | All | Early intervention, educational planning, speech/language therapy |
| Hearing concerns | Serious otitis media, small canals, mostly conductive impairment | Check by 6 months; review regularly in early years | Up to 50% at some times, ? 10% sensorineural | Audiology, tympanometry, ENT consultation |
| Ocular problems | (1) refractive errors, (2) strabismus, (3) cataracts | Eye exam by 6-12 months, then follow-ups | (1) 50%, (2) 35%, (3) 5% | Look for cataract; ophthamologic consultation |
| Cervical spine abnormality | (1)Atlantoaxial instability, (2) potential neck or long-tract signs | X-ray by 3 yrs; repeat in middle childhood | (1) 10% +/- (2) 1-2% + | Neurologic, orthopedic help; possible restriction, fusion |
| Thyroid disease | Hypothyroidism (rare hyper-), decreased growth & development | Some congenital; most 2nd+ decade; check at 2-3 years, repeat | 15% | Endocrine consult, replacement therapy as needed |
| Overweight | Excessive weight gain | Preschool and adolescent years | Common | Lifestyle adjustment, including diet and activity |
| Seizure disorders | Primary generalized (also hypsarrhythmia) | Any time | 5-10% | EEG,neurologic consultation |
| Emotional problems | Inappropriate behavior, depression, other emotional disturbances | Mid to late childhood, adult life | Common | Family guidance, aid in transitions, mental health assistance |
| Premature senescence | Behavioral changes, functional losses | 5th,6th decades | No Credible Observations (increased rate) | Special support |
Additional variable occurrences include congenital obstruction, Hirschsprung disease, leukemia, alopecia areata, keratoconus, hip dysplasia, diabetes mellitus, missing teeth, obstructive sleep apnea, and mitral valve prolapse.