Improving Balance in Children with Down Syndrome

For many people, maintaining balance while walking or standing is automatic. Their bodies and brains easily interpret input from their muscles and joints, their eyes, and the vestibular system (inner ear) to help them remain on their feet.

For children with balance issues — such as those with Down syndrome — this system does not always run fluidly and can put them at greater risk of falls.

Reasons for balance difficulty vary, but may include:

• Impaired muscle tone
• Too much or not enough flexibility
• Impaired motor control
• Vision difficulties
• Vestibular issues
• Decreased endurance

Children with Down syndrome often have a number of these factors that contribute to their balance issues. A skilled evaluation by a physical therapist may be valuable in determining whether the child could benefit from a course of physical therapy to improve their balance.

There are a number of ways that balance can be improved during everyday play and activity engagement for all ages. The information below is categorized by age group to improve balance from a number of angles. Please keep in mind that every child is different and may require modifications to best address their needs.

Improving balance in young children

• Practice the specific activity that is challenging to improve motor memory and control.
• Core strengthening can help with body awareness and movement. Exercises on the yoga ball, animal walks, and climbing-based activities can be beneficial.
• Glasses should be worn if recommended. Vision plays a role in balance and children are visually dominant in the early years of life.
• Use visual tracking activities such as “Look and Find” books, playing “I Spy,” visual scanning and matching games, catching, throwing, and kicking different sized balls or balloons.
• Exposure to lots of different movements like swinging and bouncing assist in vestibular system adaptation and growth. Playgrounds are great places to work on this.
• Experiencing different tactile sensations through the feet can make the small muscles in the feet stronger and learn different textures. Walking barefoot on sand, grass, gravel, carpet, and uneven surfaces can be helpful.
• Orthotics with lace up sneakers, if recommended, can improve overall alignment. This can help get muscles moving in better ways to assist in balance during play.

Improving balance in older children and teens

• Same as above, but more advanced.
• Core strengthening activities can be achieved through a yoga ball, planks, crunches or sit-ups, squats, etc.
• Specific balance challenges can include standing on one foot, standing with one foot in front of the other, walking on lines and uneven surfaces. Try these activities with eyes open and closed.
• Orthotics with lace-up sneakers, if recommended, are beneficial to maximize alignment and performance.

If you are interested in learning more, please reach out to a physical therapist near you or talk to a physical therapist in the Trisomy 21 clinic.