Early intervention services should begin shortly after birth to help children with Down syndrome develop to their full potential. These programs offer parents special instruction in teaching their child language, cognitive, self-help, and social skills, and specific exercises for gross and fine motor development. Research has shown that stimulation during early developmental stages improves the child's chances of developing to his or her fullest potential. Continuing education, positive public attitudes, and a stimulating home environment have also been found to promote the child's overall development.

Because children with Down syndrome respond well to their environment, those who receive good medical care and who are included in community activities can attend school, make friends, find work, participate in decisions that affect them, and make a positive contribution to society. Just as in the normal population, there is a wide variation in mental abilities, behavior, and developmental progress in these children. Their level of retardation may range from mild to severe, but most function in the mild to moderate range. Due to these individual differences, it is impossible to predict future achievements of children with Down syndrome.

Because of the range of ability in children with Down syndrome, it is important for families and all members of the school's education team to place few limitations on potential capabilities. It may be effective to emphasize concrete concepts rather than abstract ideas.

Teaching tasks in a step-by-step manner with frequent reinforcement and consistent feedback has been successful. Improved public acceptance of children with disabilities, along with better opportunities for adults with disabilities to live and work independently in the community, has expanded goals for individuals with Down syndrome.

drowning Drowning is the second leading cause of injury-related death for children aged one through 15 years, accounting for 1,003 deaths in 1998. Boys are more likely than girls to drown, and blacks are more likely to drown than whites. In 1998 black children aged five through 19 years drowned at two-and-a-half times the rate of whites. However, black children aged one through four years had a lower drowning rate than white children, largely because drownings in that age group typically occur in residential swimming pools, which are not as accessible to minority children in the United States.

Children most often drown in swimming pools. According to the U.S. Consumer product Safety Commission, among children younger than five years old, about 320 fatal drownings in 1991 and nearly 2,300 nonfatal near-drownings in 1993 occurred in residential swimming pools. Between 60 percent and 90 percent of drownings among children under age four occur in residential pools; more than half of these occur at the child's own home. Sixty percent fewer drownings occur in inground pools with four-sided isolation fencing than in inground pools without four-sided fencing.

Alcohol use also is involved in between a quarter and half of all adolescent deaths associated with water recreation; it is a major contributing factor in up to half of drownings among adolescent boys.

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