Based on 1999 Down Syndrome Health Care Guidelines*  

Health Guidelines for Toddlers and Children with Down Syndrome

• TSH and T4-Thyroid Function Test (annual).
• Echocardiogram by a pediatric cardiologist if not done previously.
• Behavioral Auditory Testing (every 6 months to age 3, then annually).
• Lateral cervical spine x-rays (neutral view, flexion, extension) to rule out atlanto-axial instability. Radiologist to measure atlanto-dens distance and neural canal width (at 3-5 years, then as needed).
• Pediatric and neurological exam with evaluation for spinal cord compression: deep tendon reflexes, gait, Babinski sign.
• Use Down Syndrome Growth Charts and head circumference charts with others.
• Eye examination (annually, or as indicated).
• Screen for celiac disease IgA antiendomysium antibodies and total IgA (btwn 2 & 3 yrs).
• Question about obstructive sleep apnea; ENT exam (as needed).
• Dental Exam (2 years; follow up exams every 6 months after). Twice daily brushing.
• Reinforce need for subacute bacterial endocarditis prophylaxis (SBE) for cardiac problems (as indicated).
• Brief vulvar exam for girls.
• Well child care: immunizations; pneumococcal vaccine (2 years).
• Evaluation by speech/language pathologist.

For the complete Health Care Guidelines for Individuals with Down Syndrome, visit the Information and Resources section of the NDSS Web site.* "Health Care Guidelines For Individuals With Down Syndrome: 1999 Revision" (Down Syndrome Preventive Medical Check List) is published in Down Syndrome Quarterly (Volume 4, Number 3, September, 1999, pp. 1-16) and is reprinted with permission of the editor. Information concerning publication policy or subscriptions may be obtained by contacting Dr. Samuel J. Thios, Editor, Denison University, Granville, OH 43023; e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it . Granville, OH 43023 (email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it ).