Factors Influencing Development of Down Syndrome Children in The First Three Years of Life: Siriraj Experience
Pornswan Wasant MD*, Boonchai Boonyawat MD*, Samruay Tritilanunt MD**, Nithiwat Vatanavicharn MD*, Achara Sathienkijakanchai MD*, Pisanu Ratanarak MSc*, Onanong Malilum MSc*, Somporn Liammongkolkul MSc*
Affiliation : * Division of Medical Genetics, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok ** Division of Child Development, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok
Objective : To analyze factors influencing development of Down syndrome children in the first three years of life.
Material and Method: A cross-sectional study was conducted in 100 Down syndrome (DS) children attending
at the Genetics clinic, Department of Pediatrics, Siriraj Hospital between January 2002 and December 2005.
All individuals were three to six years of age. The data was collected from January to December 2006,
including general information and factors on the child and their families. The child developmental quotient
(DQ) was evaluated by Capute Scales Cognitive Adaptive Test/Clinical Linguistic & Auditory Milestones
Scale (CAT/CLAMS) at three years of age. Data were analyzed by descriptive statistic and multiple linear
regression with the significant level at p-value < 0.05.
Results : The mean development quotient (DQ) was 63.78 + 11.25 (range 32-91) with the majority being mild
developmental delay. The child and family factors contributing to developmental quotient (DQ) outcome were
birthplace, congenital heart disease, age at the first genetic counseling, regular follow-up in the Genetics
clinic, age at the first early stimulation program/speech training program, parental education/occupation,
and family income. Only family income and age at the first speech-training program were found to be indepen-
dently associated with developmental quotient (DQ) at the age of three years (p-value < 0.05).
Conclusion : Down syndrome is the most common genetic cause of mental retardation. Various factors contribute
to developmental quotient (DQ) outcome but the most important factors are family income and age at the first
speech-training program. Therefore, Down syndrome children with the above factors should be followed-up
and monitored closely for the optimal long-term outcome.
Keywords : Down syndrome, Development, Factors
