A question about people with Down Syndrome. [Details inside].

As this site shows, they do not always have their mouths open. i think they are open a lot, because they lack the self-awareness to think about keeping them closed.

They have physical abnormalities. According to the internet:

People with Down syndrome typically have short, stocky bodies with thick hands and feet. Their hands also commonly have a “simian crease”, which is a crease in the palm that runs completely from one side of the hand to the other. In addition, they typically have broad, short heads with small low-set ears, small concave saddle-shaped or flattened noses, relatively large ridged tongues that roll over a protruding lower lip, loose joints, and low muscle tone that contributes to poor motor skills. Frequently, their eyes have an East Asian-like appearance due to an epicanthic fold . This is a fold of skin over the inner corner of each eyelid, which makes the eyes appear to slant upward. Because of this eye characteristic, Down syndrome was referred to as Mongoloidism when it was first described in 1866 by the English physician John Langdon Down. However, this term was misleading because Down syndrome can occur in any human group, not just Asians. As a result, Mongoloidism has been rejected as a synonym for Down syndrome. It wasn’t until 1959 that it was discovered that Down syndrome individuals have an irregular number of chromosomes.

This is related to a common tendency for the tongue to protrude. There are many possible contributing factors (from here):

• Children with Down Syndrome have a weak suckle as infants and learn to control the flow of liquid by protruding their tongue .

• Individuals with Down Syndrome have a smaller, higher arched hard palate which means that the tongue is contained in a smaller than average space.

• There is lower than average tone in the muscles of the tongue. This makes it appear larger because it is floppier. Tongue movement depends on the actions of a variety of muscles in the mouth and it plays a role in swallowing, breathing, chewing and speaking. Individuals with Down Syndrome have difficulty with producing and co-ordinating the necessary movements to control the tongue.

• During normal development, the tongue grows at a different rate to other parts of the face such as the jaw, which in the early years, normally results in the tongue having a high, forward position in the mouth. This, combined with a smaller oral space and low tone in the tongue, may result in the tongue protruding.

• The muscles of the tongue constantly correct and readjust the tongue’s position in the mouth, based on the sensory feedback it receives. Many children with Down Syndrome have difficulty receiving and integrating sensory information and may not develop these skills as quickly or completely. Consequently, they may not be aware that their tongue is protruding.

• Tongue protrusion may also result from an inability to move the jaw separately from the tongue. This is a skill that develops over time and is dependent on jaw stability. Without this stability the tongue protrudes as the jaw lowers.

• Tongue protrusion may develop due to airway compromise such as large adenoids or tonsils, which are common in individuals with Down Syndrome.

• The ability to self-correct a protruding tongue requires some degree of insight and motivation to change. Depending on a child’s age and developmental level, this self-monitoring may not develop fully, or may develop much later.

• Many children with Down Syndrome have delayed motor development and therefore may not have the stable base from which oral-motor skills can develop.

• Upper respiratory tract infections, which block the child’s nose, may cause them to breathe through their mouth rather than their nose. In mouth-breathing the jaw lowers and the tongue is no longer contained within the mouth. These infections may develop as a result of middle ear infections, which are common to individuals with Down Syndrome. This develops due to a dysfunction of the Eustachian tube, which is located at the back of the throat and is connected to the middle ear (its function is to equalise air pressure on both sides of the eardrum). If there is low tone in the muscles surrounding the entrance to the tube, fast-flowing fluid may enter the middle ear, causing an infection over time.

As my niece has aged, she has had a lot of pain in her mouth. She recently lost a lot of weight because eating became so painful. She is nearly 30. There are only a few foods she is able to eat without pain. I believe a lot of it also has to do with a fear of gagging. Many adults with Down’s have an esophageal dysfunction That might make it harder to breathe through the nose.

Maxillary horizontal and transverse displasia which results in constricted nasal airway. You have to breath, so they breath through their mouths. You have to open your mouth to breath that way. Etc. Etc.

It is called open mouth posture, @rebbel. People with Down syndrome have a smaller and more narrow upper jaw, a higher arch in the roof of their mouths and weaker muscle tone in the facial muscles. It often results in poor motor skills and the open mouth with a protruding tongue you may be noticing in people with Down syndrome. The human body is amazing and beautiful, isn’t it?

Thank you all very much for your responses!
I realized I could easily look this up somewhere on the net, but with some questions I prefer your personal input, because it is, well…., personal.
Thanks!

I just got this picture on facebook today. I don’t know if you can see it if we don’t have a facebook connection. I hope so though.

Beautiful, @Judi. Simply beautiful.