Clinical Scenario: Down Syndrome

iDevice icon Martha's story
  • Martha is a 4 1/2-month-old baby with Down Syndrome. She has 2 older sisters. Her mother is presently on maternity leave and is at home during the day.

Physiotherapy assessment

  • General observation
    • visually alert and focuses on faces
    • visually tracks objects horizontally and vertically
    • cooes and smiles
  • Muscle tone
    • low to normal
    • able to move and control head and limb in antigravity positions
  • Range of motion
    • full, with hypermobility of joints
  • Gross motor skills
    • In supine: maintains head in midline for extended periods of time; turns head to either side and returns to midline; tucs chin in; brings hands to midline; maintains midline hand position with fingers interlaced; kicks legs in air with pelvis beginning to come off the support surface
    • In prone: tolerates position well; elevates head to 45 degrees; weight-bears through flexed arms with elbows behind shoulders
    • Pull to sit: initial head lag; head comes in line with trunk at about 30 degrees of elevation
    • Supported sitting: requires lower trunk support; maintains head in midline; beginning to bear weight through arms in forward lean support
    • Supported standing: not bearing weight through lower limbs


  • Based on what Martha can do, identify one gross motor goal you would set for Martha, in collaboration with her family, that you would expect her to achieve in the next 3 months.
  • Prepare 1 fun activity that you could teach to her mother that will help Martha achieve this goal.
  • Do you know medical conditions that are common in infants and children with DS and should be taken into consideration?

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