[The early rehabilitation in children with Down. Paying special attention to shuffling and comorbidities of developmental disorder].

Objective: There have been many reports on the effects of early rehabilitation in children with Down syndrome, which have demon- strated that early intervention improves motor skill acquisition and prevents a shuffling gait in these children. With regard to the mental development and mental health of these children, they are known to be friendly and social but some experience difficulties with nursing. Recently there have been a few reports on comorbidities of developmental disorders in Down syndrome. In the present research we studied both the motor and mental developments in children with Down syndrome, paying special attention to the shuffling gait and the comorbidi- ties of developmental disorder.

Methods: Clinical records of 121 children with Down syndrome (age, 1-11 years; mean age, 3.8 years), who visited the Yokohama rehabilitation center, were investigated.

Results: Despite early intervention, we found that 14 patients (11.9%) exhib- ited a shuffling gait. Concerning the comorbidities of the psychiatric developmental disorder, 21 patients (17.4%) had autism spectrum disorder (ASD)-like characteristic. The children with a shuffling gait appeared slow with regard to motor developmental milestones. They also had ASD-like characteristics.

Conclusions: Children with Down syndrome needed early rehabilitation not only for its motor skill effects but also for mental support. In spite of early intervention, those with a shuffling gait needed special care owing to the comorbidities such as ASD-like characteristics. More research is needed to establish the prognosis of Down syndrome.