What are the recommended health monitoring guidelines for children with Down's Syndrome in primary care?

Children with Down's syndrome require tailored and/or additional health assessments due to specific associated risks ². They are at an increased risk of conditions such as hypothyroidism ². Blood checks should be considered based on the monitoring needs for specific syndromes and clinical judgement ².

For young people aged over 14 years with a learning disability, including those with Down's syndrome, an annual health check should be offered in primary care if not already arranged by their specialist team ². During these annual health checks, and generally for children with learning disabilities, all aspects of the person's health, care, and wellbeing should be reviewed ². This includes asking about specific concerns or difficulties with daily living skills (e.g., eating, dressing, toileting, sleep) and their social situation ². Vaccination status should be reviewed, and any outstanding immunizations offered, as people with a learning disability should receive the same national immunization programme as the general population and are in a clinical risk group for annual influenza immunization ². Physical measurements such as weight, height, body mass index (BMI), pulse rate and rhythm, and blood pressure should be checked ². Healthy lifestyle and health promotion advice, including diet and exercise, should be offered ². All current interventions and medication should be reviewed, including adherence, adverse events, drug interactions, and response to treatment ².

It is important to ask about any safeguarding concerns, assess the risk of exploitation, abuse, or neglect, and refer to the local safeguarding team if concerns arise ². The child's communication needs must be taken into account and reviewed regularly ². Continuity of care with the same GP and other healthcare professionals is encouraged where possible ². Support needs and reasonable adjustments, such as extended appointment times, communication aids, and environmental adaptations, should be reviewed ². Liaison with the local multidisciplinary learning disability support team is recommended for advice on areas such as assessment and care coordination, behavioural assessment and treatment, epilepsy care, mental health, and support for children with complex health needs ². Professionals should also provide information and advice about keeping healthy as the person grows older, including screening services, dental, hearing, and vision health checks ².