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It is virtually impossible to accurately portray the actual number of services that are required within the orthodox Jewish community when it is not legal to collect such data based upon religious or racial guidelines. We are only left to infer.

The handicapping features affects every aspect of a persons life from self image to the social interaction with the community and family. The handicap defines our boundaries and rather than encouraging the breaking of those boundaries actually nurtures increased limits on them.

The acceptance of this as a fact is the key limiting factor preventing unbounded personal success.

For example there are several studies that were able to sample the community based upon socio-economic status. In these studies it was shown that there is a correlation between higher socio-economic status and a positive course of functioning within the community.

People born with disability must first learn to cope with their disability before they can begin to learn to cope with the world around them. According to one study (DeWitt) there is a direct correlation between the length of time spent on the disability and the level of success in life.

There is a concept called the distorted interactive dynamic. This is the inability of the typical member of society to fully accept the disability of the person and therefore the highly limited conversation that pursues. It is a guarded and highly protected kind of discussion that prevents any form of spontaneity. This then is not only the problem of the person with the disability to overcome but rather a lifelong challenge.

A person with a disability must then define him/her self by how they are perceived by others for a significant portion of their lives.

These are simply some of the many imposed limitations that a person with a disability must confront as they navigate their lives.

It is difficult to see the person in the wheelchair. The wheelchair becomes the obstacle for us to overcome in order to see that there is indeed a human being sitting there before us.

The parent of a child with a handicap is suddenly comforted with the reality of hope which is after all the ultimate redemption. For it is only from the self that this hopelessness comes and it is only from our Creator that the redemption from this suffering will come to a sudden halt.

The character of the family is only found when a challenge arises. The arrival of a disabled baby is one of those challenges. This character building challenge empowers every member of the family to restate or increase his or her family commitment, involvement, and participation. It is an opportunity to reaffirm the entire dynamic of sibling and parental relationships.

It is the ultimate test of the self as an integral part of the whole. Finally it is a challenge to define and redefine the collective directions and abilities of the members of that family.

Siblings become more comfortable with a population previously unknown to them and these very same siblings in another setting will take the initiative to put others at ease. A natural next step resulting from being the sibling of a special needs child.

With all this said, what can I offer you to keep your own child?

If you will make up your mind that all hope is not lost then this is the beginning of our ultimate collective redemption.

There are those segments of the process that are observed, monitored, and regulated, and there are those aspects of the process over which we have absolutely no control and even less insight.

The only tools that the orthodox Jewish community has that works is prayer and psalms which we use to influence the outcome. And these tools work. They become, as the Baal Shem Tov (1698 – 1760, founder of the Chassidic movement) has said, “the windows to heaven.”

When G-d sends us a child with Down syndrome, He’s also sending us the special instructions as to how to properly handle the situation.

As stated above just as there are no two people the same there are no two birthing experiences that are the same.

Every baby goes through a birthing process that is similar only in that every baby descends through a series of internal events ultimately presenting as an external being. It is here that all similarities end and the uniqueness of life begins.

This revealed and very unique infant now becomes the object of so much love and adoration. As soon as the baby is handed to the parents, the first thing they will do is join with every other parent in world history by fulfilling the “counting of the fingers and the toes” ritual.

When the birth is successful on every level and the child is the expected perfect package then there is an increased sense of closeness amongst the parents and siblings.

However what if, G-d forbid, your baby is born with a less-than-perfect result? How does that affect the increased closeness?

How many times have we heard that G-d does not make mistakes? Only humans make mistakes. Put this all another way, everything and everyone is perfect in the Creator’s eyes, it is our eyes that need correction.

Perhaps it is this inability to see this G-dly perfection that is present in the disabled child that is the same Divine punishment of blindness that the Sodomites experienced because they refused to heed G-d’s warnings not to harm Lot’s guests.

Unfortunately, the primary standard by which we measure acceptance is intellect. How many physicians have tried to fabricate their findings upon examination with manufactured information developed spontaneously to appease and soothe overly concerned parents of a child who has Down syndrome?

Doctors have a very difficult time admitting that they do not know something. They’ve been trained to never admit ignorance about a problem or concern of the patient. (This is slowly changing)

Diagnostics of disability is not a complete subject in medical school. Nor is presenting the facts compassionately to an already confused and upset postpartum parent.

Many, not all, rabbis are also ignorant of the infant and their potentials. These rabbis may even represent themselves to be experts at handling these situations. They are however very sophisticated at providing clandestine and fast action in order to soothe the immediate needs of the family never once answering the question as to what was the real intent of the Creator in all of this.

The family is no absolved of any wrong doing and can get on with their lives knowing that everything was handled according to halacha.

There are clearly times when a child born with a disability or handicap does not belong in the home. There are those situations where the personalities involved do not have the capacity to handle the situation as it is.

These are not and never are the situations where the child is born with something like Down syndrome.

I have often compared Down syndrome to the Cadillac of disability. That is of all of the forms of disability that a person could find that their child was diagnosed with, Down syndrome is the mildest and most manageable of them all.

So when a rabbinical decision is made to give up a child who was born with Down syndrome it is clearly a case of, “that’s the way I’ve always poskinned (adjudicated) so how could I possibly change now?”

The reason for this kind of thinking on the part of rabbinical decision makers is that they would have no answer for those whom he has already advised to give up their children many years ago if he would suddenly change and advise mothers to keep their children.

As harsh and as callous as this may sound it is indeed the facts as told to me by one of the biggest amongst those who give out such advice.

It is a very humbling and lonely experience to give birth to a disabled baby. And this baby will grow to become a constant reminder of that humbleness and vulnerability.

To reject this child is to reject the sense of vulnerability.

Having the inner strength to accept and the courage to overcome the fear of the unknown is what I would expect that these rabbis should begin to instill in these families at this most vulnerable moment.

By rejecting the old realities and perceptions of Down syndrome we can effect a change. Hope is the possibility for real change. Acceptance means that change will take place as long as hope is not lost.

The reason that these rabbinical decisions have been so easy to implement with family approval and full participation is that once hope is removed then the morale of the family is at its lowest point.

Sadly, many orthodox Jewish families continue to give their biological offspring away to institutions or up for adoptions.

True the community now has their own institutions and adoptive resources (all governmentally sponsored) yet these are all merely designed to make it easier to reject your own child.

These abandoned babies and their diverse disabilities offer for many, the first opportunity at self sacrifice. This may actually be the one and only time in these peoples’ lives that they are being offered the chance to be a humble human being.

Many of these babies are being given away by their own mothers and fathers without any honest concern for the siblings’ loss or the long term implications for the destructive and diverse nature of this decision of hopelessness.

That is to say certainly this decision was made with many hours of discussion as to how best to handle the situation but with few words wasted on how to best integrate the child and retain the wholeness of the family.

We must first recognize that there are many negative feelings that surface after the birth of any baby and how much more so when the result is a differently-abled baby.

Religious Jews, known for their great scholarship and self discipline have chosen, often, to hide behind the cloak of doing what they have always done. They try to maintain control and contain the situation rather than accept that they are vulnerable.

Yet it is that vulnerability that is the one thing we can share with the world that makes us whole again.

There is a well known Chassidic concept made known by the Baal Shem Tov, that explains that when a person dislikes something, a trait or a characteristic in another it is only because that person himself possesses these qualities.

Maybe these babies remind us of just how imperfect we are and just how vulnerable we can be. Maybe these babies remind us of how dependent we are on what others think and feel about us.

“The stone which the builders initially scorned turned out to be the corner stone.” (Tehillim)

This was Dovid HaMelech.

At first he was overlooked because he was so small and perceived to be weak and insignificant. Later he was able to demonstrate who and what he really was.

Even the poor are not exempted from the mitzvah of giving tzedukah. So how much more so is a person obligated to give spiritual charity through encouragement and often by simply being and trying. (Rambam, Laws of Gifts to the Poor 7:5)

Torah law declares that every Jew can help someone else in some way.

You can try to exempt yourself by simply declaring that you don’t have enough strength to do so, however this is simply the Yetzer Hora (the Evil Inclination) seducing you.

If you have a baby and you are trying to find a way out of accepting the responsibility of caring for that baby by searching around for a way out then you are actively exempting yourself from your obligation to properly provide for this gift. This is you taking an active role in rejecting a gift given to you by Hashem.

Moshe Rabbeinu spoke with a speech impediment and Yaakov Avinu walked with a limp and Yitzchak Avinu was blind and yet they each still had something to offer Klal Yisroel.

We are taught of the many challenges and hardships of the Yidden in Mitzrayim. We learn how they met those challenges by hard work, and by maintaining their own unique way of dress and retaining the language of their people.

These are not tales of yore to be read once a year in the comfort of our air conditioned homes completely detached from the pain and suffering experienced by our brethren. Yet that is how it actually works until we are challenged as an individual and then we come to the realization of the totality of our true attachment to the community at large current and past.

We will then rely upon the community whether we accept or reject this newborn. Our search for comfort in the rabbinical, medical, and social work fabric will afford us many choices.

Running always sounds so comforting. Yet running does not diminish the pain or doubts and will not provide the opportunity for this child to grow up at home with a mommy and a daddy and siblings all their own.

“More than the calf wishes to suck does the cow wish to suckle.” (Pesachim 112b)

You have no feeling for this responsibility? It does not matter, so long as the mission is accomplished and accomplished properly.

“…for they have turned their back to Me, and not their face.” (Yermiyahu 2:27)

This means that one should never turn to Hashem with their back and not their face. One may turn with his back while the face is at least not turned elsewhere. The worst condition of this is when the “face” is involved in an opposite movement.

Everyone has value and if Hashem in His infinite wisdom chose to give you this gift trying to back out is simply not the answer. Your entire purpose for existence could be merely to accept this child and rear this child and not back out.

The easy path is not always the answer. Your dreams of a simple, easy, and comfortable life may not be fulfilled in this lifetime yet your expectations not being completed does not provide enough rationale to give up.

This child will grow to give tzedukah in some way. This child will however simultaneously be at the mercy of whomever you have chosen. Yet you will know every waking hour that you do not have any input into the life force of this perfect little neshamah.

Simply put our obligations are to approach the Holy One, Blessed be He, in sincere supplication that He grant us the strength to overpower our Yetzer Hora. We daven (pray) each day that we will be granted the strength to overcome the evil inclination who interferes with our acceptance of our own child and that when we are faced with a challenge that we will not listen to the other side but rather have the strength, courage, and conviction to succeed.

When we offer sincere prayers soliciting help from Hashem to guide us we will be answered as long as we stay the course. The truth will be revealed and our connection to G-d will be strengthened by facing the challenge and not backing away from the problem or Hashem.

May Hakadosh BaruchHu grant us to choose truth, to realize the simcha of helping another, and to have the ability to give tzedukah and may we all see the ultimate and true light immediately.

From the age of two until the age of four is when the child begins to organize and categorize the world. This is the time language begins.

Once the child is adept at making order which occurs at about the age of four the child also masters organizing skills and becomes adept at recognizing and using symbols.

At the intuitive stage the child begins to reason. This intuitive reasoning is dependant upon coincidence for explanation. This phase is referred to as the intellectual level of moderately mentally retarded.

This is not an exact science. The series of stages of development, however, do offer an insight into the ability to reason and be abstract. It also explains at what stage variations might occur. The child with mental retardation rarely attains an advanced level of conceptualization or reasoning.

It is very common for parents to talk about their teenagers as children. These same parents then will also refer to their young adults who have Down syndrome as “children” as well.

Achieving independence then, is a significant goal in the life of a person with Down syndrome. Unlike other teenagers, the retarded adolescent receives very little assistance from his peers in his/her struggle for independence.

There are precious few opportunities for social contact on a regular basis for adolescents with Down syndrome and typical teens. A more suitable solution would involve older siblings.

Older siblings provide a built in role model for the adolescent to emulate to form friendships and partner with at every stage of development. These older brothers and sisters demonstrate fundamental interactive social behaviors provided they have been raised in the same or similar environment. Thus the familiarity of this long term relationship will offer the retarded sibling benefits by continuing the development of appropriate socialization skills with those whom they admire so much in the first place.

By the age of five or six the intellectual differences among children is so great that it is impossible to offer any predicable survey with accuracy. As a result, scientists can only proffer opinion based on their examination of data rather than know for certain based on their observations.

At the age of five or six it would certainly be no great trauma to reintroduce a mentally retarded child to their biological family since the age and developmental levels have not fully developed yet.

However if the living arrangement reaches the early to mid teen age years and there is an attempt to disrupt the existing living arrangement then it is necessary to fully investigate the motives of the requesting (biological) family seeking a reversal of the current living arrangement.

Many agencies mission varies from year to year as the governmental funding and provisions change. One only need review any of myriad of agencies serving the orthodox Jewish community to see any 2 to 5 year period and how this pattern is revealed.

Our mission has remained steadfast. Our objective unchanged.

To improve the acceptance rate of our children within the community, to provide them with a warm, loving, and stable home environment, and to educate them within the community educational system side by side with the typical children in the community.

1) When a mother gives birth to a normal healthy baby it is a well documented fact that there is a significant incidence of “postpartum depression syndrome,” that is a mood condition. This is a well documented depressive disorder which occurs after a live birth. So how much greater is this condition to be expected to manifest as a syndrome after the birth of a baby born with a disability, such as Down syndrome?

2) There is a lack of accurate, comprehensive information about Down syndrome in general and specifically within the orthodox Jewish community. Many texts are available in secular libraries and as for those who have internet these venues are there to be explored as well. And finally there are the stores outside of the community offering a wide range of materials from simple to follow to text book style with clinical observations. And there is little for the orthodox Jewish family in Hebrew or Yiddish or in a style that respects the modesty of the readers offering information from an orthodox Jewish perspective.

3) To come to a decision to keep a baby with Down syndrome is a stressful, tiring and very emotional life event. It is a diagnosis that evokes fear and shock and it is not easily overcome.

How tragic is a family facing such a situation. The parents do not wish to reject the baby. But rather than deal with all of the unknowns inherent in the syndrome they make a life long decision based upon myth.

To condemn a family to a life apart from their own flesh and blood simply because the parents at that moment could not properly process the available information seems severe. Because they are not able to absorb the full ramification of their decision at that moment when contrasted against the backdrop of the confusion of feelings that could not be fully processed defies logic.

Many of the parents who do take their babies home may not come to terms with either the child or the syndrome. Maybe not for a long time or maybe never.

That is to say that many parents are able to eventually accept their child however they cannot accept the child’s condition; or, even with all of the possible support, advice, information and help, they are never able to quite get beyond the handicap in order to see the child.

Unfortunately by the time the parents overcome their personal, financial, and religious bias(es) directed at the baby with Down syndrome a significant period of time may have elapsed.

The child with Down syndrome develops slower than their siblings do. Even so it is simply not possible to predict with any accuracy any persons lifetime potential and especially not a newborn baby with Down syndrome.

Most parents have at least one of the following three fundamental instinctive feelings when confronting their newborn with Down syndrome;

1) A feeling of protectiveness toward their helpless baby who is even more vulnerable than a baby born without the syndrome.

2) A parallel revulsion at the thought of a baby born with an abnormality and,

3) Denial, which is seen via the ordering of repeated chromosomal studies, follow up studies, can continual questioning of the diagnostic process.

Even though these feelings of revulsion and denial are quite normal and common, taking into consideration the circumstance, it is the acceptance and expression of those feelings that is not so common.

A mother may feel repulsed by her child and yet not talk about this very normal initial reaction to this highly unusual series of life events. This because there is a fear that it is not a normal feeling.

This chain of events creates an internal conflict that will only compound her already growing sense of confusion and inadequacy.

There are several mothers (fathers as well) who have accepted their children, who have admitted to me that at one point during this adjustment process they had wished that their baby were dead.

Now that kind of thinking is disturbing enough under any circumstance. So imagine how much more mentally disruptive it is for a mother to admit that she had detailed dreams as to how to best accomplish this end.

By not coping with stress properly the result is often to create more stress.

These same mothers with the passage of time (and some professional intervention) have openly admitted that they once had these thoughts and feelings and that they now understood that these were “quite normal reactions.”

They will further explain that they now can see that they were not bad people for having these thoughts and that they were able to follow their feelings of inadequacy and acceptance and deal with them.

Many parents ignorantly believe that all disabled children are the same. They are obviously not.

By researching Down syndrome and other handicaps a parent increases the opportunity to properly participate in the child’s growth. This investigating can and will reduce the misunderstandings, the uncertainties, and the inconsistencies that disrupt proper developmental decision making on behalf of the child.

Personal development is not a regular incremental process that occurs in equal measure in one and all. It is rather a series of stops and starts. Each child’s genetic code has a great influence on how he/she will develop. It is not then, only a matter of experience and teaching.

When the parents of a child with Down syndrome, who is living at home, receive counseling and the child receives the appropriate intervention and stimulation, then it is possible that there was significant progress.

Why couldn’t a child with Down syndrome, with a limited mental age be gradually reintroduced into his or her own family without any significant negative affect? Isn’t that what happens when a child is abducted or kidnaped or mistakenly placed in the wrong family?

The child is returned to the natural family.

Well it is most certainly the intent of the biological family at the time of the initial placement that would dictate the terms of such a situation. For then and only then would the child be properly prepared for a reuniting.

And secondly the amount of time that had lapsed between the initial separation and the desire for reunification is a very significant factor.

Well the process has begun. The barriers are beginning to crack. They have not in fact crumbled however they are beginning to crack.

As more schools begin to accept children and implement a Torah based classroom education for all children then we will see a communal wide benefit.

We need to increase the time spent developing and influencing character, personality, and tenacity to complete whatever is begun while simultaneously letting go of the idea that every child in order to succeed needs to be a genius with unlimited talent and the finest education that money can buy.

How many geniuses are so eccentric and unwilling to fully participate as they find comfort in a certain level of failure? Or how many exceptionally talented young people are there who can not make up their minds as to what it is they would like to do and which of their many talents they would like to focus? And finally how many over educated – unemployed people do we know?

The goal of an education is to build a solid foundation to fully participate in the life of this world. So isn’t it a better approach to have children and raise them to have a pleasant personality, good character traits, and the tenacity to complete whatever they begin?

This way we are not disappointed that our children are not geniuses, exceptionally talented, or that the level of education maybe didn’t meet up to our unrealistic expectations.

Treatment and care at home has continued to improve in quality and our schools and yeshivas at last must now once and for all step forward and accept the responsibility to educate all of our children who have gone through so much.

Now that we are beginning to keep our children at home we must face the challenge of educating them properly. No short cuts, no corners cut but rather a full acceptance of educational responsibility.

Maybe in the past there was a lack of understanding as to how to properly educate children with Down syndrome but today it is well known and understood.

We as a community have certainly had enough time to contemplate on the appropriateness of accepting special needs children into our schools as full equal student participants. Down syndrome is not contagious and there is no stigma to having a child in the school or the classroom.

It does not negatively reflect upon any of the other students in the classroom. And the fact that you personally cannot accept these realities has nothing to do with the fact that the children themselves are not in any way negatively impacted. Not socially, psychologically, not educationally.

We have all faced a myriad of personal and family challenges and yet this all boils down to, “these children who have perfect neshamas are searching out a way to take their rightful places in the Torah educational system.”

By our rejecting the old realities we can embrace change, hope and acceptance. This then is the challenge facing the community at large.

I was a 21 year old not yet college graduate who had ascended to the position of Assistant Administrator of this facility in a short 2 ½ years. The question is how?

There are two ways of viewing this ascent. The first is that I was some kind of administrative prodigy who was so skilled and insightful that this was the obvious choice and the alternative and much more realistic choice was that there simply wasn’t an interest level in people applying for these positions because much of the field was unregulated and the need to fill these positions was merely a selection process that was simply put “the best of the rest.”

When I first began working in the facility 2 ½ years earlier during the first two weeks on the job I made it a point to make daily rounds of the entire building and the various programs. This I did in order to familiarize myself with the facility and the various activities as well as to introduce myself to the various staffs and faculties.

On the very first evening that I was working in the facility I attended a very lively birthday party for a little girl named Debbie. Debbie, who was six years old, had Down syndrome and was a bright little girl who seemed to illuminate the entire surroundings like life itself in her joy of the moment.

Debbie was abandoned at birth by her birth parents and had been raised in institutions until she was five and then placed in this facility.

Debbie made me feel right at home at her party and I remained there for quite some time enjoying the singing and the snacks and the opening of the gifts that were purchased by the staff and her fellow residents.

After the party I continued on my rounds until the end of the shift.

One evening about two weeks later I was making new rounds that this time brought me to the swimming area. This was an indoor pool that was approximately 40 feet in length and about 25 feet wide and 4 feet deep everywhere.

As I entered the pool area I was greeted by shouting and laughter and I observed in excess of 50 children in the pool itself. There was one lifeguard on duty who was sitting casually pool side as the cadre of kids frolicked in the water.

The noise was deafening and the fun was unbounded as I called out to the lifeguard inquiring, “what are the regulations as to the number of children allowed in the pool at a time?”

The lifeguard responded with a casual shrug indicating that he had no idea. He then called out to me that there actually were no rules on the subject as far as he knew.

I called back to him to blow his whistle and to evacuate the pool.

“Sachel,” I thought should at least regulate these kinds of activities. And to have this number of mentally and physically handicapped children in the pool under limited supervision was not prudent.

As the children exited the pool I noticed an undistinguishable cluster of color reflecting from the bottom of the pool on my side. Having served as a lifeguard myself for five years I instinctively jumped into the water and pulled out what immediately became clear to me to be a child.

What took place in the next few moments would change my life forever.

As I pulled the child from the water I had no idea how much time had passed until I noticed the swirl of color. I called out to the lifeguard on duty to call the fire department and I immediately commenced mouth to mouth while simultaneously turning the listless little body trying to drain the water out of the stomach and lungs.

As I was beginning the second set of mouth to mouth series I realized that this little lifeless child in my care was none other than little Debbie the orphan whose birthday I had celebrated just two weeks earlier.

I was in a panic and had her breathing several times as the fire department arrived. They told me to continue administering mouth to mouth and as we entered the ambulance they eventually took over applying an oxygen mask.

As I held Debbie on my lap all the way to the hospital no one was talking and the silence was deafening yet I was lost in my own thoughts.

As the rear doors burst open and they ran with Debbie into the emergency room I just stood there soaking wet in all my clothes wondering what was going on. I approached one of the ER nurses to inquire as to Debbie’s condition and as she attempted to respond to me all she could do was cry and as the tears flowed down her cheeks all of a sudden I understood.

Debbie had actually died pool side prior to entering the ambulance however a credit to the fire department they tried everything to revive her.

As I turned and left the hospital devastated and exhausted I was completely lost.

Since Debbie was given away at birth her biological parents never found out of her passing or that she was buried more than 45 years ago.

Our existence is the one thing which is good in itself. Hashem gives us that one good thing, life itself. Sure everything is subject to accidents, illnesses, disabilities, and handicaps but we all share one universal handicap and that is the handicap of mortality.

After all even little Debbie the forlorn little smile that lit up the world around her was a gift from Hashem.

Our daughter Suri, who was born with Down syndrome was born with an atrial septal defect (ASD), and the most beautiful blue almond shaped eyes. Suri was able to recite all of the proper brochas over food, kiss the mazuzah on the door when entering or leaving a room, would not eat bread without washing first, and knew that Hashem was everywhere all before she reached the age of five.

Suri’s older brother Zalman once came into the room when he was age 9 and Suri was four and proclaimed that his sister’s eyes were not really like those oriental eyes but rather he observed that her eyes were more like rainbows. We were not sure what he was able to observe beyond the epicanthal folds.

All these years later it is easy to see what Zalman was able to observe all those years ago. I am certain that hidden deep behind those “rainbow shaped eyes” is the full rich hue of acceptance, kindness, and a complete expression of Ahavas Yisroel.

As we set out on the journey of making sense of the birth and early intervention we were also confronted with a myriad of special educational philosophies.

We realized early on that there were many opportunities for success and an equal number of potential disappointments.

For example almost every child with Down syndrome is delayed in their early development skills.

In Suri’s case it was delayed standing and walking, very delayed speech, open heart surgery, slow potty training and keeping up with pediatrician appointments for a variety of common childhood ailments.

The lack of encouragement that we faced on the part of the medical community is not as a result of mean spirited people of medicine it is rather a lack of understanding and knowledge about two basic areas of syndromes. Facts and Feelings.

As a new parent of a baby born with Down syndrome there is a sense of isolation and a need for reassurance and a bit of warmth.

Almost all physicians who spend up to 3 years in medical school, a one year internship, and up to three years in a residency only learn about one and a half to two hours about disability, syndrome, and handicap. Hardly the substance of an expert opinion.

A word of caution here. If your physician cannot say “I’m not sure” or “I really don’t know let me look it up” then you need to find another doctor. The exception is of course a practitioner who specializes in syndrome, disability, and handicap.

When discussing human educational developmental objectives and changes that are necessary for continued success keep in mind that a mind is like a parachute they only work when they are open.

In 1945 Professor Reuven Feuerstein developed a dynamic learning assessment that was initially used to assess recent arrivals to the land of Israel who had survived the Holocaust. These tests were especially unique in that they were absent any cultural or language bias. This mediated method of evaluation has proven remarkably adaptable and successfully demonstrates not merely scores of learning disabled and mentally retarded but rather observes how a child learns and acquires knowledge.

When John Langdon Down made his first observations as to the original 12 characteristics of the syndrome bearing his name it was obvious that there were more to come. Today most authorities have identified more than sixty clinical signs and several more recent studies have identified ninety and one Polish study identified over one hundred twenty. (Cunningham)

Today as we explore some of these characteristics we find universally that females are missing the twelfth rib and almost all people with the syndrome have a mouth that is disproportionately small, as is the skull in general, this accounts for the normal size tongue appearing to be oversized.

The tongue can be controlled with early intervention.

The air sinuses are usually underdeveloped causing frequent sinus blockages. The children will resort to breathing through their mouths and this is a commonly observable feature.

As a result of the small skull stature the ear canals are also narrow and this leads to frequent ear infections and a high incidence of hearing loss. (IBID)

The variety of therapies available to children who have Down syndrome is astounding. In the absence of solid medical research parents are vulnerable. Many parents will hear what they want to hear. They are searching for a quick fix and are exploited by unscrupulous practitioners promising a panacea placebo as a treatment.

Many new ideas that have been supported by studies should not however be overlooked. Parents need to make informed decisions.

Amongst the therapies that are legitimate medical practice there is exploitive unsupported treatments.

One example of this is the thyroid treatments that are often recommended and the unscrupulous use of thyroid treatment protocols that are not based upon diagnosis or medical fact.