Abstract
In this study, we investigated the relationship between gross motor development and timing for starting weaning in children with down syndrome (hereinafter: DS children), together with the effects of the timing for starting functional therapy for eating on subsequent acquisition of eating function, with the aim of examining support systems at regional care and guidance centers.
Subjects comprised 62 DS children of 3 years or younger at the initial examination who were examined at the outpatient clinic for dysphagia at a regional care and guidance center. The course of gross motor development was acquired from the medical records of the subjects, whereas age at initial exam, eating and swallowing function at initial exam and information regarding timing for starting weaning were acquired from their dysphagia clinic records. Subjects were divided into four groups according to age at initial exam, as 19 subjects were boys aged ≤ 18 months (EB), 24 subjects were girls aged ≤ 18 months (EG), 10 subjects were boys aged ≥ 19 months and ＜36 months (LB), and 9 subjects were girls aged ≥ 19 months and ＜36 months (LG). Because no difference was noted between boys and girls for eating and swallowing function at the initial exam, the relationship with eating and swallowing function at initial exam and with the period of acquisition of eating and swallowing function were investigated in the EB/EG group and LB/LG group.
Gross motor development delay was observed in DS children but weaning was started at the same time as typically-developed children. As a result, weaning was started for many DS children before they could sit stably, so coordination with physiotherapy appears necessary for oral ingestion in a stable posture.
There was no difference in the number of months required to acquire eating and swallowing function due to age at initial exam, suggesting that starting instruction from the early stage could speed up function acquisition. Furthermore, as the function acquisition rate was high for some items in the EB/EG group, early intervention also appears effective from the standpoint of reliably acquiring functions that are learnt early. It appears best to give advice on function acquisition in accordance with weaning period development, and our results indicated that information regarding eating should be given directly after examination at the center and a system for providing continuous support should be refined.
