Down Syndrome Health Check List

Does your health care provider know that our kids need a few extra screenings at each visit?  Do they use the DS growth chart?  What are the recommendations?  Although this is from 1999, it still provides a great starting place for use by providers.  Do the research.  Get the best care for our kids.

Reprinted from Down Syndrome Quarterly , Volume 4, Number 3, September 1999 

Down Syndrome Health Care Guidelines (1999 Revision) Record Sheet

Sheet #1: Birth to Age 12 Years

Name: ________________________________         Birthday: ______________________________

 

Age, in years

Medical Issues

At Birth or at Diagnosis

6-mo

1

1-1/2

2

2-1/2

3

4

5

6

7

8

9

10

11

12

Karotype & Genetic Counseling

_____

Usual Preventative Care

_____

___

___

___

___

___

___

___

___

___

___

___

___

___

___

___

Cardiology

Echo

Audiologic Evaluation

ABR or OAE

___

___

___

___

___

___

___

___

___

___

___

___

___

___

___

Ophthalmologic Evaluation

Red reflex

_____

___

___

___

___

___

___

___

___

___

___

___

___

Thyroid (TSH & T4)

State screening

_____

___

___

___

___

___

___

___

___

___

___

___

___

Nutrition

_____

___

___

___

___

___

___

___

___

___

___

___

___

___

___

___

Dental Exam1

___

___

___

___

___

___

___

___

___

___

___

___

Celiac Screening2

___

Parent Support

_____

___

___

___

___

___

___

___

___

___

___

___

___

___

___

___

Developmental & Educational Services

Early Intervention

___

___

___

___

___

___

___

___

___

___

___

___

___

___

___

Neck X-rays & Neurological Exam3

X- ray

___

___

___

___

___

___

___

___

___

Pneumococcal Conjugate Vaccine Series

_______

Instructions: Perform indicated exam/screening and record date in blank spaces. The grey or shaded boxes mean no action is to be taken for those ages. 

¹Begin Dental Exams at 2 years of age, and continue every 6 months thereafter. 
²IgA antiendomysium antibodies and total IgA. 
³Cervical spine x-rays: flexion, neutral and extension, between 3-5 years of age. Repeat as needed for Special Olympics participation. Neurological examination at each visit. 
© Down Syndrome Quarterly, 1999. This record sheet may be printed out for individual use but may not be reproduced on any website without prior permission. 
 

Reprinted from Down Syndrome Quarterly, Volume 4, Number 3, September, 1999

Down Syndrome Health Care Guidelines (1999 Revision) Record Sheet

Sheet #2:  13 Years to Adulthood

Name: ________________________________      Birthday: ____________________________

Age, in years
Medical Issues	13	14	15	16	17	18	19	20-29
Usual Preventative Care	___	___	___	___	___	___	___	___
Audiologic Evaluation	___	___	___	___	___	___	___	___
Ophthalmologic Evaluation	___	___	___	___	___	___	___	___
Thyroid (TSH & T4)	___	___	___	___	___	___	___	___
Nutrition	___	___	___	___	___	___	___	___
Dental Exam1	___	___	___	___	___	___	___	___
Parent Support	___	___	___	___	___	___	___	___
Developmental & Educational Services	___	___	___	___	___	___	___	___
Neck X-rays & Neurological Exam2	___	___	___	___	___	___	___	___
Pelvic exam3				___	___	___	___	___
Assess Contraceptive Need3				___	___	___	___	___

Instructions: Perform indicated exam/screening and record date in blank spaces. The shaded boxes mean no action is to be taken for those ages. 

¹Begin Dental Exams at 2 years of age, and continue every 6 month thereafter.
²Cervical spine x-rays: flexion, neutral and extension, between 3-5 years of age. Repeat as needed for Special Olympics participation. Neurological examination at each visit.
³If sexually active.
© Down Syndrome Quarterly, 1999. This record sheet may be printed out for individual use but may not be reproduced on any website without prior permission. 


Be gentle.