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Down syndrome is commonly associated with mild to moderate intellectual disability. This may result in developmental delays as well as other problems that can make children, teens, and adults who have Down syndrome vulnerable to abuse, injury, and other types of harm. Depression and other mental health issues may also develop.

You can help manage and prevent these types of problems by being aware and helping your child learn how to avoid dangerous situations and maintain his or her self-esteem. Know what to expect as your child with Down syndrome grows and develops. Potential problems include:

• Difficulties dealing with hygiene. Issues related to hygiene become more pronounced as a child with Down syndrome approaches adolescence. You can help your child by establishing a daily routine to regularly tend to hygiene needs, such as showering or bathing and using deodorant. Hygiene is an important component of peer acceptance, especially when your child starts puberty.
• Sexual or physical abuse. Children with Down syndrome usually enter puberty and experience the related physical changes about the same time as other adolescents. But sexually developed teens with Down syndrome often do not have the same understanding of physical boundaries and are vulnerable to being sexually abused. Likewise, they may not understand when someone means to harm them physically. Carefully screen caregivers. Help your child avoid abuse by teaching him or her appropriate assertive behaviors and when and how to recognize threats. Teach your child to go out with a buddy rather than alone and how to respond to strangers. Help your child understand rules about giving out personal information such as his or her full name or address.
• Sexual activity and pregnancy. Adolescents and teens with Down syndrome have many of the same sexual impulses and feelings as others their age. Provide your teen with sexual education at a level he or she can understand. This should include ongoing discussions about love, mutual regard, kindness, and how to develop friendships. For more information, see the topic Talking With Children About Sex.
• Psychological problems. Adolescents with Down syndrome often have more than the usual amount of difficulties as they grow into adulthood. They may also have a hard time trying to sort out their feelings. They are prone to depression and other mental health problems. ¹ Many adolescents and adults work these issues out by talking to themselves ("self-talk"), which is sometimes misinterpreted as a serious mental disorder. Usually, this behavior is no cause for alarm. If the talk is self-demeaning or turns to signs of self-hatred, intervention is needed. Counseling and medicines may be helpful in these and other cases where the problems are not improving.