Autism vs Down Syndrome

Although autism and down syndrome have some similarities, they are different syndromes. In both syndromes, there are delays in functioning, differences in disability, and differences in intellectual disability. Even though it is a huge misunderstanding, autism and down syndrome are generally accepted as the same disorder. Only the families with these children are the ones who can distinguish between the two disorders. The difference between autism and down syndrome continues to be the subject of various studies.

Autism is a developmental disorder that usually begins to be diagnosed in the first 3 years of life and continues throughout life, which can be expressed as the inability of the person to establish an appropriate verbal and non-verbal relationship with his/her environment. Today, the diagnosis can be made early with some simple diagnostic tests.

Basically, we, as human beings, are composed of genes. These are connected to each other by chromosomes. Our physical and personal structures are composed of these genes and chromosomes. That’s why all of us are different from each other. Because these genes and chromosomes connect each other differently. However, from time to time during this transformation, something abnormal happens that cause Down Syndrome. When the embryo couldn’t develop as it is supposed to be and there is an extra chromosome, that baby is born with Down Syndrome. Down Syndrome is when the cells in the baby’s body have an extra chromosome instead of 46, that is, 47 chromosomes. Down Syndrome is not a disease but a genetic disorder.

Children with autism have difficulty in social communication as the biggest problem. Although children with autism seem to have completed their physical development normally, the physical characteristics of the disorder are more pronounced in children with Down Syndrome. Although the nature and degree of disability in children with autism are not clear, the family never has clear information about the child’s capacity and potential.

Nevertheless, the cases are clearer in children with Down Syndrome and the family is clearly aware of the situation. Families of children with Down Syndrome have lower stress levels compared to other types of disability and they draw a more positive picture regarding their children.

Autism, which has a mysterious nature, causes behavioral problems in which there is no social interaction and connection, and there is helplessness about the solution. Interaction and the faces of the people around them do not matter to these children. Children with Down Syndrome can be easier to be guided because they are open to communication and social environments compared to children with autism. Children with Down Syndrome have much more positive personality traits, which is not the case with children on the autism spectrum.

The difference between autism and Down Syndrome shows its most important distinction during pregnancy. While Down syndrome is a disorder that can be identified during pregnancy, autism is a disorder that cannot be detected during pregnancy. Autism is a disorder that appears with symptoms before the age of 3 and can be diagnosed after the age of 3. And it slowly begins to show itself.

While autism is more common in boys than girls, there is no gender discrimination in Down Syndrome, and it is a disorder that can be observed equally in boys and girls. On the other hand, when looking at the difference between autism and Down Syndrome, while genetic factors are effective in Down Syndrome, the exact cause of autism is not known and is not very clear.

Autism Spectrum Disorder

Autism spectrum, which is diagnosed in the first three years of life and continues for life, is a condition that can be easily diagnosed when it is noticed by the parents in the early period. The intervention process, which can be accelerated with effective treatment methods that can be applied within the control of the professional, shows its effect, especially in infancy. The most ideal of the precautions that can be taken during pregnancy is to start regular folic acid consumption. In fact, at least 3 months before getting pregnant, the need for folic acid should be met both with the foods in the nutrition program and with additional supplements by the mothers.

Although the exact cause of the autism spectrum cannot be proven, it is mostly thought to be genetic. In autism, which is more common in men than in women, the person experiences complexity in verbal and non-verbal communication. Other disorders that may accompany autism are attention deficit hyperactivity disorder and epilepsy, as the most common ones.

In order to be diagnosed with autism, whether in infancy or childhood, a person must have at least 6 conditions. While there are situations such as inadequacy in interaction in their social life, that is, not being able to make eye contact, instead of spending time with peers preferring to be alone, and not being able to reflect on their mimic and emotional expressions properly, constantly repeating the same words during communication and not being in imaginary or symbolic activities in order to draw attention.

One of the most important factors in the autism spectrum is intelligence. While most children with autism have an intelligence problem, some of them may also have moderate or mildly gifted intelligence. It is important that positive environmental conditions, effective family communication, early diagnosis, and special education start in the early period for children with autism, who need to start talking at the latest around the age of 5 on average.

Down Syndrome

Down Syndrome is a genetic condition in which a person is born with an extra copy of chromosome 21. This additional genetic material changes the level of development and causes features associated with Down Syndrome. We know that the human body is made up of 46 chromosomes that come from both parents equally. However, even though the exact reason for it is still unknown, people with Down Syndrome are born with 47 chromosomes instead of 46 chromosomes like the rest of the world. It happens because their 21st chromosomes are composed of 3 pieces instead of 2. 

One in every 691 children in the US is born with Down Syndrome, proving that it has become a common chromosomal condition. There are more than 400,000 people living with Down Syndrome in the USA. It is known that this rate is more than 6 million all around the world.

Children and adults with Down Syndrome share some common characteristics, but naturally, these individuals are more similar to their close family members. Although the probability of giving birth to a child with Down’s Syndrome increases as the mother’s age increases, 80% of births with Down’s Syndrome occur in mothers under 35 years of age because births occur more frequently at this age.

Behavior, mental ability, and physical development vary from person to person, of course, but many people with Down Syndrome are able to do their own tasks, live independently, and participate in fun activities on their own when they grow up. Children with Down Syndrome can continue their lives like an individual who completes their normal development with a good education. They can get a job when given the opportunity. They can reach a level where they can sustain their own lives. However, physical therapy, special education, and language therapy are needed. For these, it is necessary to get professional help in a planned and programmed way.

As a result of the inadequacy of the neurological systems of children with Down syndrome affecting the mental processes, many developmental processes such as their movements, perception of their environment, communication with the people around them, learning something new, making sounds, coordination, and speaking can be adversely affected. It is observed that individuals with Down syndrome are more passive, indifferent to their environment, quiet, or very cranky compared to normally developing babies. But on the other hand, they are no different from other babies in their first months of life.

Although the cognitive development of babies with Down syndrome follows the same order as children with normal development, their developmental speed is slower and delayed compared to their peers. While this retardation is less in some children, a very severe picture can be encountered in some children. When newborns are born, malnutrition, thyroid or growth hormone deficiency, severe heart problems, and similar problems can be observed in babies with Down Syndrome. In addition, the physical development (lengthening and weight gain) of babies with Down syndrome is slower than expected. This slow growth also negatively affects the developmental process of the child with Down syndrome. Reasons such as the child’s vision and hearing problems and the late recognition of this situation, and even the delay in the treatment of the child, also cause inadequacies in the learning process.

The first communication of a newborn child with those around him/her is through crying. Studies show that the crying of a baby with Down syndrome in the first year is different from other children in terms of both quantity and quality. It has been revealed that they cry longer, whine more and make less noise than children with normal development. Children with Down syndrome can be called good babies because they usually cry less until the sixth month, which causes the baby to communicate less with adults.

Even though there is a delay, babies with Down syndrome respond by smiling or making a noise when spoken to, as normally developing children do, show that they want to be held, enjoy fun games, and shout to attract the attention of those around them. It is a well-known fact that children with Down syndrome are more social, happy, affectionate, and friendly than others with disorders with mental deficits.

Generally, children with Down syndrome are described as cheerful, sympathetic, affectionate, social, lively, happy, and able to establish good relations with their environment. However, these children may also have emotional and behavioral problems. It is observed that these problems are more common than those with normal development but less than the groups diagnosed with intellectual disability.

Children with Down Syndrome can also show differences among themselves in addition to differences from the other children. Therefore, social and emotional development, cognitive development, and motor development are supported when special education is offered with a program suitable for the child’s needs.

In addition to deficiencies in attention and problem solving, some behaviors such as hyperactivity and behavior repetition are also encountered in Down syndrome patients. These behaviors can be prevented or minimized with the appropriate approaches of the parents before they appear in early childhood or before they become the child’s routine.

It is recommended to start physical therapy at the age of two months in babies with Down Syndrome. Exercises should be done under the care of a physiotherapist and should be practiced by the family at home with daily programs. With regular controls, the treatment of the child is organized and supported according to his/her condition. Children with Down Syndrome have lax facial muscles. Therefore, perception skills should be supported by including them in the program as well as muscle strength and motor skills during physical therapy.

It is a well-known condition that speech develops late in children with Down Syndrome. But with the right treatment, its effect can be minimized. With language therapy started in the early period, they can start speaking at an average of 2-3 years old. Although it is rare, some children with Down Syndrome speak too late after language therapy. The number of children who do not speak at all is very small.

  • Trisomy 21: It makes up the majority of the population with Down syndrome. It is the equivalent of the known definition of Down syndrome. It refers to an extra chromosome in the 21st chromosome. This is caused by wrong division. As a result, 46 chromosomes result as +1 and become 47 chromosomes.
  • Translocation: It makes up a small portion of the Down syndrome population. Chromosome 21 divides and attaches to another chromosome. Although it looks like 46 chromosomes in structure, there is 47 chromosome information as genetic information. These individuals also have the same characteristics as those with Trisomy 21. Although Down syndrome is not an inherited disorder, translocation is hereditary. If the mother or father is a carrier, it is quite possible that the child has a translocation type of Down syndrome.
  • Mosaic: It makes up a small part of the population with Down syndrome. The two structures in the DNA helix undergo different divisions, and one side continues with 46 chromosomes, while the other side divides to become 47 chromosomes. This results in the formation of a mosaic structure.

What Are the Physical Characteristics of Individuals With Down Syndrome?

  • They have a flat nose bridge and a flat face shape.
  • They have upward-sloping slanting eyes.
  • They are short-necked.
  • They have small and low-set ears.
  • They have large tongues that tend to stick out.
  • They have brush field spots. It means white-colored spots in the eye.
  • Their hands and feet are very small compared to the average and their peers. 
  • There is only one line on the palms. This is called the Simian line.
  • They have hypotonia.
  • They are always shorter than their peers whether in childhood or adulthood.  

Down Syndrome Is Not a Disease That Requires Treatment, It Is a Difference

From the moment they are born, the development and health problems of children with Down Syndrome should be followed closely. If possible, a professional should be preferred, and lifelong treatment of the individual should be provided by that professional. Thanks to these follow-ups in early childhood, it is possible for these individuals to lead healthy, happy, and active life.

At this point, families also have a big responsibility. The most beneficial action that families can take for their children is to have their annual follow-ups regularly and to ensure their participation in education and social life.

Differences Between Autism and Down Syndrome

Although there are similarities in the delays, disability, and mental degrees related to functional disorders on the basis of Down syndrome and autism syndromes, there are also differences in similarity when examined in detail. Although these disorders are perceived as the same, the distinction between the two is actually very clear.

Since mental development predominates with autism, these children are observed to have difficulties communicating. Although children with autism appear physically normal, physical changes are more evident in children with Down syndrome. The nature and degree of the disorder in children with autism do not show a clear feature, on the other hand, the cases can be observed more clearly in children with Down Syndrome.

It is more difficult to interact with a child with autism, but since communication with children with Down syndrome is easier, it is easier to direct them. In fact, the shyness of children with autism is not observed in children with Down Syndrome and they have very extroverted structures. Children with Down syndrome have more positive traits, but this is not exactly the case with children with autism.

The difference between autism and down syndrome manifests itself during pregnancy. While Down syndrome is a disorder that can be detected during pregnancy with some tests, autism is a disorder that occurs with symptoms before the age of three, not during pregnancy. And it slowly begins to show itself and develops with time.

While autism is more common in boys than girls, Down syndrome can be observed equally in both genders. Considering the difference between autism and down syndrome, we can say that while genetic factors are effective in down syndrome, the cause of autism is not known for sure.

Can Down Syndrome and Autism Coexist?

There are studies on this subject and according to the data of these studies, it shows that approximately 40% of children with Down Syndrome meet the criteria for autism spectrum disorder.

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