"We have known for some time that Down syndrome is associated with a range of neurodevelopmental and behavioral outcomes," said Dr. George T. Capone, a study coauthor. "We hypothesized that the association between developmental function and behavior was not random; rather, the two are related in such a manner that distinct behavioral clusters can be identified."
The study underscores the point that children with Down syndrome are not all alike, he explained, which has "direct implications for our understanding of brain organization and possibly the relationship between genotype and phenotype in young children with the diagnosis." Dr. Capone said that further research is clearly warranted.
He and his colleagues were not particularly surprised by the findings, he added, because "it has long been our observation that children with Down syndrome and maladaptive behavior differ from their typical peers with the diagnosis." These differences are obvious and measurable both to parents who respond to validated behavioral questionnaires and to neurodevelopmental pediatricians who use a DSM classification to identify behavior and mental health disorders.
Increased vigilance, screening, and evaluation for atypical development and behavior problems have recently received greater emphasis in the American Academy of Pediatrics’ updated "Health Supervision for Children with Down Syndrome" guidelines (Pediatrics 2011 128:393-406).
"Our study findings support the existence of well-delineated behavior clusters in children with DS, and in our clinic we have witnessed educational success when these issues are recognized and addressed. Pediatricians can do families a great service by recognizing that a coexisting neurobehavioral condition may be present," said Dr. Capone of the department of pediatrics at Johns Hopkins University, who is also director of the Down syndrome clinic at the Kennedy Krieger Institute, both in Baltimore. With proper evaluation and treatment, he noted, children with DS and disruptive behaviors or ASD can benefit from a combination of medication and behavior management, in addition to an educational program emphasizing functional communication and social skills development.
Dr. Capone said he had no relevant financial disclosures.
