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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

Childhood obesity should be curbed early
2017-03-15

Description: Child obesity Tags: Child obesity

Serious intervention by parents is required to deal
with childhood obesity. Prof Louise van den Berg and
a group of final-year PhD students worked on a study
about the prevalence of obesity in six-year-olds in
South Africa.
Photo: Supplied

If your child is overweight when they start school at the age of six, unless you do something about it at that point, the indications are they are going to be overweight teenagers and obese adults. This is according to University of the Free State’s Prof Louise van den Berg.

Evidence has shown that overweight children and teenagers have a greater risk of developing lifestyle diseases such as type 2 diabetes, hypertension and cardiovascular disease later in life, and dying prematurely.

Obesity is a global pandemic rapidly spreading among adults and children, in developed and developing countries alike.

Dr Van den Berg worked with Keagan Di Ascenzo, Maryke Ferreira, Monja-Marie Kok, Anneke Lauwrens, all PhD students with the Department of Nutrition and Dietetics, to conduct the study. Their research found that children who are overweight by the time they turn six should be screened for weight problems.

Why six-year-olds?
Children who are overweight between the ages of two and five are five times more likely to be overweight when they are 12. There are two periods in a normal life cycle when the body makes new fat cells. The first is in the uterus and the second is around the age of six. The second phase lasts from the age of six to puberty.

The study assessed the prevalence of obesity in six-year-olds as part of a campaign in South Africa to raise awareness of the problem among parents and educators.

A total of 99 children were chosen from seven schools in Mangaung, the capital city of Free State. The schools were chosen from quintile four and five schools, which when measured by their own resources and economic circumstances, are well resourced and serve largely middle-class and wealthy communities.

The children’s weight, height and waist circumference were measured and used to calculate a body mass index score and waist-to-height ratio. Both these figures are good predictors for future lifestyle disease risks such as type 2 diabetes, hypertension and cardiovascular disease. A person with a good waist-to-height ratio can wrap a piece of string equal to their height around their waist at least twice.

When the children had a higher body mass index, they also had an increased waist to height ratio. The study found one in four children from the schools surveyed were overweight when they started primary school.

Nipping the fat in the bud
Although there are many factors that play a role in preventing childhood obesity, parents’ perceptions of their children’s weight play an important role. A recent study found that more than 50% of parents underestimate the weight of their obese children. These parents remain unaware of the risks their children face and are not motivated to take any action.

At least half of the parents whose children are overweight struggle to recognise their children’s weight problems fearing that they will be labelled or stigmatised. By the time they turn six overweight children should be referred to dieticians and nutritionists who are qualified to guide their parents in getting them to eat well and be more physically active at pre-primary and primary school.

The high prevalence of weight problems among six-year-olds found in this study is an urgent call to healthcare professionals to step up and empower parents, educators and children with the necessary skills for healthy dietary practices and adequate physical activity.

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