Guidelines for Teachers of Students with Down Syndrome

Physical and Medical Characteristics

Physical and Medical Conditions Implications Strategies


Frequent colds, upper respiratory infections and small ear canals resulting in impacted wax,can cause varying degrees of temporary or permanent hearing loss.

Loss of hearing can vary as much as 40 db from one day to the next.

Hyperacusis, ie. over-sensitive to loud


Significant and/or permanent hearing loss.

Delayed speech and language development.

When the hearing is affected the student will not hear well in the classroom situation.

The student may not hear sirens in the yard or teacher instruction when outside.

Inconsistent responses to instructions from day to day

Inconsistent speech patterns.

The student may place hands over ears or want to withdraw from situations where there is a lot of loud noise, ie.concerts, assembly.

Student may wear hearing aids.

Sit the student appropriately so he/she can see and hear the teacher (ie close to the speaker) and not be looking into bright light coming in from a window.

Give instuctions clearly, simply and ‘face-to-face’.

Use language appropriate to the student’s level of development.

The student may use signing.

Seat the student towards the back of the room and comfort when necessary.

Consideration will need to be given to carpeting, curtains and furnishings, to ensure the classroom is acoustically appropriate.


Above average incidence of impaired vision.

Increased susceptibility to eye damage from exposure to the sun.

The student may display behaviours, such as, tilting the head back or working far too close to a book.

The student may wear glasses which he/she may have difficulty keeping on.

Gradual deterioration of the eye tissue.

Suggest the student’s eyes are checked.

Ensure appropriate seating in the classroom.

Check if student has glasses.

Request information about vision from parents.

Ensure adequate protection from sun exposure, ie. hat, UV cream, approved sunglasses.

Immune System

Underdeveloped immune system. May be more susceptible to illness, particularly upper respiratory infections.

May be frequently on anti-biotics which may affect behaviour and toileting.

Respond to individual needs.

Heart Defects

Heart defects, many of which are now operable, are found in up to 40% of students.

May have a ‘pigeon chest’ ie breast bone sticking out  – which is no need for concern in relation to IMPLICATIONS and STRATEGIES

Student may be slow in movements.

May tire easily.

May be less-able to fully participate in physical activities.

Obtain accurate, updated medical information.

During physical activity, allow the student to opt out when the end of his/her level of endurance has been reached.

Neck Instability

Increased mobility of the first two neck bones causes neck instability. It is recommended that the student obtain an x-ray before engaging in activities such as tumbling, trampolining, somersaulting or horse riding. Check that an x-ray has been taken. This can be done at the age of 5 years and again at the age of 10 years.

Fine Motor Skills

Poor dexterity.

Difficulty with handwriting, cutting and other manipulative activities.

Student can experience poor manipulation skills, eg. difficulty with self-help skills, such as buttoning clothing.

Sketchy handwriting, oversized or undersized writing.

Student may need to be physically stable when carrying out manippulative activities.

Activities should include games and songs that practice isolating fingers and developing muscle strength in arms, wrists,hands and fingers.

Student should access ‘Key Steps’ program.

A structured handwriting program may be necessary.

The student may be too small for classroom furniture…consider placing a box under feet.

Gross Motor Skills

Varying degrees of poor muscle tone.

Poor motor planning.

The student may be ‘flat’ footed.

Student may be floppy and loose jointed.

Difficulties with co-ordination and gait.

Difficulty with accessing equipment…

“Where do I put myself to get over?”

Students may not have the same stamina as their peers and therefore may have difficulty keeping up when walking/jogging is required.

The student may wear orthotic devices in his/her footwear.

Should be encouraged to participate in physical activity along with his/her peers.

Student should participate in the “Fun and Games” program if there is one in the school.

The student may need to be taught how to access playground equipment.

Verbal and physical guidance will assist the student to gain confidence.

Model or “talk” the students through the problem.

Allow the student to rest when and where it is appropriate.

Ensure devices are placed in the correct shoe after Phys.Ed. or swimming, etc.


Due to the broad range of physical characteristics and intellectual abilities, students with Down syndrome may display varying degrees of intelligible speech.

Implications Strategies
 Signing may be appropriate for the student with Down syndrome,

ie. signing is used to augment speech and language development.

The student may not be able to indicate his/her personal needs.

The student may show frustration associated with the inability to communicate.

The student may use gesture as a form of expression.

 Signing resources, ie. story books and signing dictionaries

If a student is not being understood, say to the student, “Show me”.

Provide opportunities for the student to communicate with adults and peers.

Encourage the student to participate in activities that involve ‘turn taking’ and sharing.

Encourage the student to use social greetings and manners, eg. “Good Morning”, “Help me” and “Please”…and to communicate at routine times, eg. at lunch.

Guide the other students to wait for the student with Down syndrome to respond and discourage them from talking for the student.


The student with Down syndrome may have a language delay.  However, the receptive language of the student is often more developed than his/her expressive language.

Implications Strategies
The student’s language may not be as sophisticated as his/her peers. Gain eye contact and gove clear, simple instructions to the student.

Use consistent language structures.  This will need to be supported by the whole school community including relief teachers during recess, lunch and extra curricular activities.

 Short-term memory means that the student may have difficulty retaining instructions and may forget them over a period of time.

The student may be unable to retain multiple instructions.

The student may have poor listening skills and elicit only parts of what has been said.

 Give instructions in small stages, eg….”Get the book” … wait for the student to carry out the instruction, then … “Go to the table…”.

It may be necessary to model what is required.

 The student may have difficulty understanding the general level of language used in the classroom.

The student may use limited, expressive language structures, eg. 2-3 word sentences.

 Encourage the other students to talk with the student with Down syndrome.

Spend five minutes each day talking with the student.

Make the most of special occasions to elicit language, eg. birthdays

Extend sentence structures by modelling a more complex structure, eg. student … “red truck” adult … “yes, a big red truck”.

A ‘communication book’ between home and school is a useful tool for ‘coversation starters’.


Students with Down syndrome should be expected to conform to classroom and school rules the same as their peers.

Behavioural Characteristics Implications Strategies
 The student may display disruptive behaviours due to developmental immaturity.

The student may take longer to learn the classroom and school routines, ie. returning to the class when the bell goes.

He/she may get over excited.

The student may have a range of attention seeking and task avoidance behaviours.

 The student’s behaviour may disrupt the other students.

Routines may need to be re-established at the beginning of each term.

Rules will need to be explained individually when on excursions.

Behaviour management will require a time commitment above what might normally be expected.

The individual student with Down syndrome may, from day to day, display inconsistencies in behaviour and abilities.

 Consideration must be given to the developmental level of the student and expectations matched accordingly.

Curriculum materials and activities should also match the developmental needs of the student.

Rules should be limited in number, simple and demonstrated to the student and be in black and white terms, eg. “No kicking … time out”.

It cannot be assumed that the student will know what is expected by appropriate behaviour.  It will be necessary to state what the ‘appropriate’ is, eg. “No touching Mary, sit with hands in your lap.”

The student must be made aware that his/her behaviour has made the teacher displeased and angry, eg. through the tone of voice and body language.


Descriptive praise is the most useful, ie. student’s name … like, “John, lovely sitting”.

When the student is able to understand a more complex language structure, ‘normal’ phrases will be appropriate.

 The student may have difficulty with a change of routine at home or school.  The student needs adequate preparation before a change of routine.  A ‘communication book’ with parents will be useful in communicating information and in preparing the student for changes in routine.

The use of a simple daily/weekly timetable will also be useful, eg. “It’s two more sleeps until swimming starts”.

 The student may have underdevolped social skills.  The student may not know how to initiate communication or play with his/her peers.  Emphasis will have to be placed on the student learning appropriate social skills.
 The student may have difficulties recognising and staying within physical boundaries, ie. the playground.  The need to implement appropriate supervision in the school yard.  The use of a ‘buddy’ system will be useful in encouraging the student to return to class after bell times.

The provision of appropriate play equipment will encourage the student to stay in the playground, eg. buckets and spades for the sandpit, balls, hoops, bats and balls.  The student may need to be taught how to use the equipment.

Consideration may have to be given to placing security devices on the gates.

A response plan is needed in the event that the student leaves the school grounds without permission.

It will be necessary to ‘walk’ the student around the school boundaries several times.  It may also be necessary to repeat this procedure at the beginning of each term.

Specific Learning Difficulties

As with all students, the student with Down syndrome has strengths and weaknesses in various areas.  In some curriculum areas, the student may be able to do the same work as the rest of the class.  In other areas, the student may have some specific learning difficulties and require a more structured teaching approach.

Specific Learning Difficulties Implications Strategies
 The student may have difficulty in generalising the skills taught.  The student may be able to carry out a task in a 1:1 situation or at home, but may not be able to do so in the classroom.  Teach the same skill in a variety of situations, eg. the student may be able to draw a face in art lesson, but may not be able to do this in a different lesson.  Communication between all personnel involved in the student’s program, will ensure consistent expectations.
 The student may experience developmental delay in some or all areas.  The student may experience difficulty in ‘keeping up’ with his/her peers in some or all of the curriculum areas.  The student may require an individual, negotiated curriculum.
 The student may have short-term auditory memory.  The student may only be able to follow one or two-stage directions at a time.  Give only one or two directions at a time.
 With long-term memory difficulties, the student may often retain inappropriate information, and have difficulty in retaining appropriate information.  Inappropriate responses to questions may be given.  Reinforce the appropriate responses.
 The student may have poor motor planning.  The student may be slower to carry out tasks involving gross and fine motor skills.  If more time is required to complete a task, the student may need to begin first or receive instructions first.
 Poor visual scanning may be evident.  Random visual scanning may occur.  Visual scanning (left to right, top to bottom) will need to be taught, generalised and maintained.

Curriculum Guidelines

The Principal, teacher and the parent will be important contributors in determining an appropriate curriculum for the student, taking in the resources available in the school.  A student with Down syndrome may require a negotiated curriculum to ensure positive learning outcomes.

Curriculum Needs Implications Strategies
 The ‘social’ learning of the student needs to be emphasised, eg. turn taking, making friends.

Functional skills are a priority, eg. recognising the ‘girls toilet’ … eating recess at recess time and not his/her lunch … taking off jumpers in hot weather.

The toileting needs of the student may have to be considered.

The independence of the student must be fostered.

Adaptations in most curriculum areas.

 The student may be isolated and without friends at recess or lunch times.

The student may be ostracized by his or her peers for acting inappropriately.

Some students may not be fully toilet trained.

Others may have accidents as a result of medication or illness.

On excursions, students may have an accident because of the unfamiliar surroundings.

Independent work habits should be encouraged.

Modifications to the timetable may be necessary.

There will be a need for regular meetings for the people involved in the student’s curriculum.

Additional support and resources may be required.

To encourae their support, other class members may need to be informed of the curriculum needs of the student with Down syndrome.

Other teachers need to be informed of the student’s curriculum needs, in particular, the relief staff.

 One-to-one teaching of selected social skills, followed by small group then whole class instruction may be necessary.

When a student first commences school, these skills should be taught as a priority.  Support staff should be allocated to ensure these social skills are establlished within the first term of full-time attendance and revised after each holiday break.

It may be necessary to establish routine toilet timing, eg. visit the toilet before/after recess and lunch.

A contingency plan needs to be in place in preparation for accidents.

A verbal explanation, plus a walk to the toilet will be necessary to enable the student to plan how long it will take to get to the toilet.

The student with Down syndrome may not have the same muscle control as his/her peers.

Decrease the amount of direct supervision to encourage independent work habits.

At times it will be appropriate for the student to work with a small group.

Allow the student to join class activities and take part at his/her level. In the more formal part of the lesson, it may be necessary to adapt materials.

Appropriate activities could include … tracing, gluing, colouring, cut and paste, copying and model/independent writing.

Repetition of activities will be valuable, eg. only one worksheet in a week instead of three.

Have appropriate follow-up activities on hand for the student to access, eg. a box containing old activity sheets, glue sheets, glue sticks, scissors, colouring pencils, textas and familiar reading books.

A listening post can be a valuable resource.

The use of a computer as a tool to meet curriculum needs of the student should be explored.

At times it will be necessary for a 1:1 teaching structure so that the student receives additional tuition in the ‘basics’.  This can be achieved in the classroom or in a withdrawn setting.

It may not be appropriate for the student to attend ‘second language’ classes.

Increasing ‘on task’ behaviour will need to be emphasised in all curriculum areas.


* This student will learn and progress each year.

* Recording the ‘starting points’ and looking at the outcomes will emphasise the gains made

Celebrate success … however small.

Duty of Care

  • You will have to take on a greater responsibility for the welfare of the student with Down syndrome.
  • It is essential that the student with Down syndrome can access an appropriate Protective Behaviours Program.
  • Be aware of the Mandatory reporting procedures.
  • Ensure a high level of supervision in areas of risk… eg. toilets, school yard, excursions, swimming, moving between classes
  • Modifications may be needed in the toilet block, eg. a step up and taps that are easy to turn on.  Toilet procedures will need to be monitored and supervision adjusted according to the needs of the student.
  • Ear plugs are advisable for swimming.  If the student has a hearing loss, he or she will not be able to wear hearing aids in the water so an adult must be assigned to assist the student.
  • The student with Down syndrome may need supervision in dressing after swimming so this task will have to be managed.
  • On excursions, be very aware that the student may have a poor understanding of road safety and a poor concept of the boundaries involved, eg. in the park … demonstrate it.
  • During the hot weather, ensure the student is appropriately dressed, wearing suncream and a hat.
  • On camps, be responsive to the student’s developmental level, eg. you may have to assist with the bath/showering routine … also you may have to check that the student has changed socks after getting them wet.
  • Poor health may be a problem, so be responsive to the individual needs of the student.