Down syndrome is associated with a characteristic physical appearance, mental retardation, and specific birth defects or health conditions. The facial features, in addition to low muscle tone (called hypotonia), are often the first signs that alert a physician to a potential diagnosis of Down syndrome. These features include an up-slant of the outer corners of the eyes, small skin folds over the inner corners of the eyes, a small nose with a flat nasal bridge, a flat profile, and a large, grooved tongue that often protrudes from the mouth. Other physical characteristics can include a short neck, excess skin on the back of the neck, short hands with a single palmar crease, a wide gap between the first and second toes, and short stature. There are many individuals without Down syndrome who may have one or more of these features. It is only when the features occur together and the appropriate genetic test (chromosome studies) confirms clinical suspicion that a diagnosis of Down syndrome is made.
All individuals with Down syndrome have mental retardation, usually mild to moderate. The degree of learning disability may not be immediately apparent, since social ability generally exceeds scholastic ability. Early intervention programs are important for giving people with Down syndrome the best chance to maximize their learning potential.
Certain birth defects and health conditions are more common in individuals with Down syndrome. The most common birth defect is a congenital heart defect, affecting 40 percent to 50 percent of newborns with the condition. Although many can be repaired with surgery, congenital heart defects remain the major cause of early death among affected persons. Individuals with Down syndrome have an increased chance of experiencing hearing loss, vision problems, and thyroid disease, as well as an increased susceptibility to infections. Because of such concerns, specific guidelines for the health care of individuals with Down syndrome have been developed.