Adaptive and Behavioral Development in Children with Down Syndrome at School Age with Special Emphasis on Attention Deficit Hyperactivity Disorder (ADHD)

Down syndrome (DS) is the most common chromosomal anomaly occurring in live births (Capone et al, 2004; Menkes & Falk, 2005) and it has been described as a syndrome-complex of genetic origin with protean neurobiological consequences, and several characteristic neurodevelopmental and neuropsychological manifestations. Down syndrome is also considered to be the most common single cause of mild, moderate and severe mental retardation (MR) with over half of individuals with DS attaining an IQ of between 50 and 25 by the end of the first decade of life (Bittles & Glasson, 2004; Capone, 2004; Hanson, 2003; Menkes & Falk, 2005; Roubertoux & Kerdelhue, 2006; Van Cleve & Cohen, 2006; Vicari, 2006). Individuals with Down syndrome experience a reduced life expectancy, but within the DS population, life expectancy is increasing. Clinically, individuals with Down syndrome have typical physical and anatomical characteristics (Van Cleve &, Cohen, 2006). An issue of major medical importance is the participation and function on the health of individuals, communities and society. A holistic approach is now vital when assessing the individual, from body functions and IQ to learning abilities, attentional skills, daily activities and participation defined by the ICF as ‘the execution of a task or action’ with involvement in a life situation (WHO, 2001). Despite these shifts, there is limited investigation into the activity performance, participation, learning and behavior of children with DS, as measured by their adaptive functioning. The cognitive limitations of individuals with Down syndrome have an important influence on the level of functioning attained and a significant correlation between IQ and all areas of function has been noted. Relatively preserved visual–spatial and visual–motor skills are often noted, yet the influence of these skills on the activity performance of the child with DS is unclear (Fiddler, et al 2005; Vicari 2006; Vicari & Carlesimo 2006).