632 Early Intervention of Visual Impairment may Protect Adaptive Behaviour in Down Syndrome?

Abstract

Down syndrome (DS) is one the most common genetic disorders. Little is known about the impact of visual disorders in DS on daily life. Our aim was to study the relation between the incidence of ocular manifestations and adaptive behaviour. Methods We performed a detailed medical history, including ocular disorders. We tested Hirschberg's corneal reflex method, observed eye movements during fixation of a slowly moving object, cover test, and assessed the Vineland Adaptive BehaviourScales, as well as the Coloured Progressive Matrices. 52 DS individuals with an age range of 19 to 52 years. Results. We observed a high incidence of ocular anomalies (refractive errors in 59.2%, strabism in 51%, motility disorders in 63.3% and congenital bilateral cataract in 16.2%), not differing with age. The occurence of visual disorders did neither lead to total lower adaptive level nor show an influence on cognition. Daily living skills were significantly lower in individuals with not corrected disorders, but these individuals showed a significant high co-morbidity of autism with childhood onset. We observed a majority of individuals with an adaptive functioning above the average. Hyperopia and the presence of refractive errors were significantly more frequent in individuals with an adaptive level above the average. Conclusions. Visual disorders lead to a poorer performance in adaptive behaviour in individuals with DS and also autism. This suggests that early intervention on refractive errors and visuomotor skills helps in the acquisition of daily living activities, which remain stable over the life-span. Therapeutic options for cataract need to be addressed early.