The study was a retrospective study using case notes from Unit’s database of 5 years from January 2006 to December 2010. Children who had a clinical and cytogenetic diagnosis of down syndrome as per ICD-10 diagnostic criteria were included in the present study. Those who had perinatal asphyxia of HIE stage II and above, congenital hypothyroidism, congestive cardiac failure, renal failure, or epilepsy were excluded from the present study. Calibrated instruments were used to measure the height, weight and head circumference as per standard guidelines. The developmental history along with a detailed developmental assessment was performed on all children. Chromosomal analysis was performed on phytohaemagglutinin-stimulated cultures of peripheral blood using standard techniques [4]. Data were compiled on SPSS 12.0 for Windows (SPSS Inc., IL). ANOVA and student t-test were used for comparing variables.

TABLE I  Characteristics of Children with Down Syndrome

There was a definite delay in motor and verbal development in children with trisomy; however, there was only a developmental lag in achieving the social skill of reciprocal smile across all groups. The relative strengths in the syndrome are social and visuo-spatial skills, while verbal skills and motor planning are weak [9]. The generalized hypotonia in children with Down syndrome might be one of the causes for a delayed head control compared to turning over in the study children. The mean age of achievement of developmental milestones in children with translocation and mosaicism was better than that of children with trisomy. Compared to the previous report of development in Indian children with this syndrome [10], the motor and social development in children with trisomy was similar. Significant improvement (P<0.001) was seen in speaking. Children with trisomy spoke by 30.36 months vs 42.4 month in the earlier report [10]; probably due to early diagnosis, interventions, and improved socio-economic environment. In conclusion, the secular trends in development of Indian children with Down syndrome over the last three decades show similar motor and social development profile with improvement in language domain. Further studies need to standardize growth charts for Indian children with Down syndrome and evaluate the deviations in growth and development in these children.

Contributors: All the authors were involved in the concept, design and manuscript preparation. VMS did the cytogenetic analysis.

Funding: None; Competing interests: None stated.

1. Mekes J, Falk R. Chromosomal anomalies and continous gene syndromes. In: Menkes JH, Sarnat HB, Maria BL, Editors. Child Neurology, 7th edition, Philadelphia, PA: Lippincott Wilkins, 2005. p. 227-57.

2. Cronk C, Crocker AC, Pueschel SM, Shea AM, Zackai E, Pickens G, et al. Growth charts for children with Down syndrome: 1 month to 18 years of age. Pediatrics. 1988;81:102-10.

3. Silverman W. Down syndrome: cognitive phenotype. Ment Retard Dev Disabil Res Rev. 2007;13:228-36.

4. Morton CC. Cytogenetics. In: Dracopoli NC, Haines JL, Korf BR, Moir DT, Morton CC, Seidman CE, et al., Editors. Current Protocols In Human Genetics. New York: John Wiley & Sons; 1994. p. 10.2.110.2.2.

5. Clementi M, Calzolari E, Turolla L, Volpato S, Tenconi R. Neonatal growth patterns in a population of consecutively born Down syndrome children. Am J Med Genet Suppl. 1990;7:71-4.

6. Cronk CE. Growth of children with Down’s syndrome: birth to age 3 years. Pediatrics. 1978;61:564-8.

7. Myrelid A, Gustafsson J, Ollars B, Annerén G. Growth charts for Down’s syndrome from birth to 18 years of age. Arch Dis Child. 2002;87:97-103.

8. Al Husain M. Growth charts for children with Down’s syndrome in Saudi Arabia: birth to 5 years. Int J Clin Pract. 2003;57:170-4.

9. Fidler DJ, Hepburn S, Rogers S. Early learning and adaptive behaviour in toddlers with Down syndrome: evidence for an emerging behavioural phenotype? Downs Syndr Res Pract. 2006;9:37-44.