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20 October 2025 | Story Andre Damons | Photo Supplied
Down Syndrome

As South Africa marks Down Syndrome Awareness Day on 20 October, it is worth pausing to celebrate the incredible children who light up our lives and the parents who walk this journey with them. Down Syndrome is the most common chromosomal disorder, causing intellectual disability. 

According to Down Syndrome South Africa, one in every 600 babies born in developing countries has Down syndrome. Data on the prevalence in South Africa remain limited, however, earlier estimates suggest about one in every 770 births. Although Down syndrome is not curable, children with the condition have many abilities and strengths. It is, therefore, vital that families engage in interventions that help children reach their full developmental potential. 

Dr Olive Khaliq, Senior Lecturer in the Department of Paediatrics and Child Health at the University of the Free State (UFS), says most interventions rightly focus on the child, but there is growing recognition that parents are just as central to their children's progress. The home is the first and most consistent environment where development occurs. Parenting a child with Down syndrome can, however, be influenced by the social context. 

 

Empowering programme 

“In South Africa, cultural beliefs and community attitudes often shape how families cope and seek support. Some parents fear disclosing the child's disability due to fear of being judged or the long-standing myth that Down syndrome is a curse or a punishment.  

“This can lead to isolation or delays in accessing interventions that could make a difference. Empowering parents with knowledge and practical tools are therefore essential, not only for their children's development, but also for their own well-being,” she says. 

A remarkable example of such empowerment is the Developmental Resource Stimulation Programme (DRSP), a home-based programme designed by Dr Dorothy Russell from the Department of Paediatrics and Child Health. The DRSP, designed for children with Down syndrome from birth to 42 months, combines structured play and guided parent-child interaction, helping parents to stimulate their child's cognitive, fine-motor, gross motor, and language development using everyday household items such as teaspoons, tumblers, and face cloths. Previous quantitative research shows that children whose parents participated in the programme made measurable developmental gains. 

 

Feedback from parents 

In 2024, Drs Khaliq and Russell, together with Prof Gladys Kigozi-Male, Associate Professor in the UFS Centre for Health Systems Research and Development, received an interdisciplinary grant from the UFS to explore the experiences of parents regarding the DRSP. They engaged 31 parents of children with Down syndrome in individual interviews and focus group discussions. According to Kigozi-Male, findings revealed overwhelmingly positive experiences. Parents reported feeling more capable and more connected with their children. “One parent shared: ‘It [the DRSP] helped me to become closer to her, and to know her better, and to know what she’s capable of … my child can do anything that we wanted her to do …  she’s capable of everything, and that if we follow this programme, she [will] become very strong and capable,” said Prof Kigozi-Male.   

Another parent reflected on the knowledge gained: “… the knowledge that I didn’t have before …  as a mother of a Down syndrome baby – but for any mother …  I have learned so much, and it is what any mother should know …” Parents also noted visible improvements in their children’s development, particularly in muscle strength, crawling and walking with one parent explaining “It really changed a lot …  my child's neck was not okay, so the programme taught us how to train the neck muscle. Even when they started walking or crawling, it really helped a lot …” 

Another parent highlighted how the programme strengthened their confidence as caregivers saying “… I don't think we would have come this far without the programme because it helped us understand my child … Without the programme I don't think he would have been so strong because we wouldn't have known how to help him ...”

The DRSP, explains Dr Russell, is just one example of what can happen when parents are treated as active partners rather than passive recipients of care. Going forward, it is important that parents' voices continue to shape how interventions are designed and delivered. Their lived experiences are powerful sources of knowledge on what works in real settings.  

“As we commemorate Down Syndrome Awareness Day, let's remember that inclusion begins with understanding, and understanding grows when we listen to families, parents, and children who remind us that every life matters,” concluded Dr Khaliq. 

News Archive

Doll parent project exposes learners to real-life issues of responsible reproductive health
2016-11-01

Description: Doll parent project  Tags: Doll parent project

Princess Gaboilelwe Motshabi,
Princess Gabo Foundation, Maki Lesia,
School of Nursing, Zenzele Mdletshe,
Internationalisation office, Masters of
Education students from Rutgers University
and study leader.


With the alarming rate of teenage pregnancies in secondary schools, a concerned teacher approached University of the Free State (UFS) School of Nursing in 2013, and in 2015, the Reproductive Health Education Project (RRHEP) was established in collaboration with fourth-year Midwifery students, the Princess Gabo Foundation and the UFS Community Engagement Directorate.

Empowering learners to make responsible reproductive health choices was the primary objective, which got final-year nursing students involved in the Doll-Parenting Project as part of their Service Learning Module. To simulate parenting, boys and girls in Grade Eight were given dolls to take care of as their “baby” for a given period of time. After an information session with parents and guardians, the project took off at Moroka High School in Thaba Nchu and Lekhulong High School in Mangaung. The Princess Gabo Foundation, an NGO operating in the Thaba Nchu community, which supports maternal health programmes, provided the dolls, kangaroo wraps, and diaries in which learners recorded their daily experiences of caring for a baby.

Teen parenting – a challenging experience

Learners were required to calculate how much it would cost to care for a baby, the cost of buying nappies, formula milk (if not breast feeding), doctor’s visits, and medicine. The project was supported by teachers in various subject classes, and learners were encouraged to express themselves through writing of poems or essays about how it feels to be a teen parent.

Dr Delene Botha, lecturer at the School of Nursing, said there was a need to establish a sustainable research project that would attract funding. By adding some of the missing components and drawing on other disciplines such as Sociology and Psychiatry, the project was expected to be extended to meet the needs of other stakeholders including teachers, parents and the community at large.

With cellphones and data provided by the Community Engagement office, the “parenting practice” involved receiving SMS messages from nursing students during odd times of the day to remind them about the needs of the baby; such as wet nappies, the “baby” not feeling well and to be soothed.

Sensitising learners yields success

In evaluating their performance, appointed “police learners” became the eyes and ears of the community to observe and report on how “parents” treated their “babies”. Statements from participants and feedback showed Incidences of negligence and the feeling of embarrassment from being a teen parent. The report indicated that learners felt that having a baby while still at school was not a good idea. The project concluded with a debate on the subject.

As part of the programme, a group of postgraduate Education students from Rutgers University in the US, visited Chief Moroka High School and received first-hand information from their interaction with the learners from which they created digital stories of their Community Engagement experience and took these back with them.

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