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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

The silent struggles of those with invisible disabilities
2016-12-13

Description: Dr Magteld Smith, invisible disabilities Tags: Dr Magteld Smith, invisible disabilities 

Dr Magteld Smith, researcher and deaf awareness
activist, from the Department of Otorhinolaryngology
at the UFS.

December is International Disability Awareness Month. Despite equality before the law and some improvements in societal attitudes, people with disabilities are still disadvantaged in many aspects of their lives. They are more likely to be the victims of crime, sexual abuse, are more likely to earn a low income or be unemployed, and less likely to gain qualifications than people without disabilities.

Demystifying disabilities is crucial

Dr Magteld Smith, a researcher at the University of the Free State (UFS) School of Medicine’s Department of Otorhinolaryngology, says that often people think the term “disability” only refers to people using a wheelchair, etc. However, this is a misperception because some individuals have visible disabilities, which can be seen, and some have invisible disabilities, which can’t be seen. Others have both visible and invisible disabilities. There is an ongoing debate as to which group has the greatest life struggles. Those with visible disabilities frequently have to explain what they can do, while individuals with invisible disabilities have to make clear what they cannot do.

Invisible disability is an umbrella term that captures a whole spectrum of invisible disabilities and the focus is not to maintain a list of specific conditions and diagnoses that are considered invisible disabilities. Invisible disabilities include debilitating fatigue, pain, cognitive dysfunctions, mental disorders, hearing and eyesight disabilities and conditions that are primarily neurological in nature.

Judging books by their covers
According to Dr Smith, research indicates that people living with invisible disabilities often suffer more strained relationships than those with visible disabilities due to a serious lack of knowledge, doubts and suspicion around their disability status.

Society might also make serious allegations that people with invisible disabilities are “faking it” or believe they are “lazy”, and sometimes think they are using their invisible disability as an “excuse” to receive “special treatment”, while the person has special needs to function.

Giving recognition and praise
“One of the most heartbreaking attitudes towards persons with invisible disabilities is that they very seldom enjoy acknowledgement for their efforts and accomplishments. The media also seldom report on the achievements of persons with invisible disabilities,” says Dr Smith.

Society has to understand that a person with a disability or disabilities is diagnosed by a medical professional involving various medical procedures and tests. It is not for a society to make any diagnosis of another person.

Dr Smith says the best place to start addressing misperceptions is for society to broaden its understanding of the vast, varying world of disabilities and be more sensitive about people with invisible disabilities. They should be acknowledged and given the same recognition as people with visible disabilities.

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