Foreword

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The Editors of Current Problems in Pediatric and Adolescent Health Care are delighted that a developmental pediatrician with a special interest in Down syndrome, Dr. Eileen F. Kasten, agreed to write the Foreword for this issue.

Down syndrome is one of the most widely recognized congenital disorders. One in 800-900 live births is of a baby with Down syndrome¹, ² and 80% of babies with Down syndrome are born to mothers under 35 years of age. The constellation of physical and cognitive features has been well described and is usually identified in the newborn period. Increasingly ultrasound and maternal and fetal markers allow identification prior to delivery. Early diagnosis of Down syndrome and detection and treatment of associated medical problems has led to a much longer lifespan and much improved functional abilities. Integration into the typical classroom and the opportunity for work activities as adults has expanded the horizon for persons with Down syndrome. Parents who give birth to a baby with Down syndrome should be encouraged to have realistic expectations but generally should treat their child with Down syndrome just as they would treat their other children.

Much work is being done to improve the functional abilities and health of persons with Down syndrome. While genetic manipulation is a hope for the future, research is seeking best ways to enhance communication and educational abilities of persons with Down syndrome. Medications are being evaluated that may enhance cognitive abilities, improve problem behaviors or decrease the rate that some older adults with Down syndrome lose their cognitive abilities.

In this issue, Dr. Baum and her colleagues have comprehensively described the diagnosis of Down syndrome, the medical complications that might be anticipated and the ongoing health surveillance that is generally recommended. Although specialty clinics for the care of children with Down syndrome and occasionally for the care of adults with Down syndrome exist, the primary care clinician can manage most health care needs for the person with Down syndrome. The primary care provider in the local community is also the best-placed person to assist the family as they navigate the educational system and find social and work activities for the adolescent and adult with Down syndrome. This issue of Current Problems in Pediatric and Adolescent Health Care should prove an excellent resource for the primary care practitioner providing services for the patient with Down syndrome.

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References 

1. Jones KL. Smith's recognizable patterns of human malformation. In: 6^th edition. Philadelphia: Elsevier Saunders; 2006;p. 9
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2. National Institutes of Health. Facts About Down Syndrome. www.nichd.nih.gov/publications/pubs/downsyndrome.cfmAccessed August 18, 2006
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