31 for 21: DAY 22 :: Hypotonia

Many people ask me how Down syndrome affects Jack.  Although there are many differences between children with Ds, because they are all uniquely individual; there are often similar characteristics that most kids with Ds share.  One of these traits, for example, is low muscle tone.

Down Syndrome Fact of the Day #22:

Individuals with Down syndrome generally have decreased muscle tone, or hypotonia.

Hypotonia is a medical term used to describe decreased amount of resistance to movement in a muscle.  In lay terms, muscle tone is the way in which our muscles react to gravity.  It is not a measure of strength or weakness (so you can't increase your muscle tone by lifting weights!).  There is no perfect or completely normal tone, and there is a range from low to high.  Many of us have generally low muscle tone, which is why we often slouch.  Children with Down syndrome generally have quite low muscle tone.  Jack’s hypotonia has always been defined by professionals as “mild” but even so, we have physical therapy every other week to help him reach gross motor milestones that are less challenging for typically developing children with higher tone.

Symptoms of hypotonia include problems with mobility and posture, breathing and speech difficulties, lethargy, ligament and joint laxity and poor reflexes.  This is why many kids with Down syndrome (including Jack) have flat feet and a bit of a sway-back posture.  Children with Ds are usually hyperflexible due to their lower tone and ligamental laxity.  When Jack is tired or sick, you may also notice that he feels a bit “floppy” when you pick him up.  This was more apparent when he was an infant. 

To understand the physical demands placed on children with Down syndrome by low muscle tone, many professionals say to imagine cooking dinner while wearing socks on your hands.  That would be quite challenging, wouldn't it?!?!  Well, thanks to regular physical and occupational therapies, Jack is becoming more and more independent and likewise less frustrated completing daily activities. 

The take away message about hypotonia here is that developing general motor milestones is important for children with low muscle tone, and absolutely achievable; it just sometimes takes them longer.  For caregivers, it is important to encourage ALL skills that other children are doing, but sometimes we have to modify or just provide a little extra help for them to gain proficiency in these skills.  Like any child, practicing these skills helps to build muscle and lays the foundation for later development.