Ask the professional

Dear Etty:

Our 3 and-a-half-year-old daughter has out grown her baby chair and we were wondering if you have any experience with the chairs called Tripp Trapp.  They are wooden chairs that grow with the child.  Our daughter is very hypotonic.

Do you recommend these chairs for children with Down syndrome? If not do you have any other suggestions for sturdy and practical high chairs for children older than 3 years of age?

Thank you very much. I look forward to your answer.

By the way, do you also know of any special beds that are good for children with Down syndrome who have sleep apnea.  Our daughter spends most of the night sitting up with her head back and crashing forward, and she moves around a lot at night.  At the moment she is still in a baby cot but has really outgrown that.

Any advice will be warmly received.

Naomi Willems

Dear Naomi,

There are pros and cons to the Tripp Trapp as with anything in life. The pros include a cute design, not handicap looking, as it is not a handicap chair. It can adjust to the height of the child as the child grows. The chair itself is a highchair and is at table height. The Tripp Trapp comes with accessories for safety to secure the child in, but one very important con is that it does not have enough support for a child that has extreme tone issues (hyper or hypotonicity). It also does not have its own tray.

The chair I have recommended in the past was called the PosiTot. I have received excellent reviews from all the parents who have used it. Its pros include bright colors and cute design. It is extremely adjustable in almost any imaginable direction such as back tilt, seat depth, foot rest etc… for a perfect ergonomic position. Its cons include the chair height itself, it is low and the chair does appear slightly handicap looking. The parent feedback in both was that the PosiTot was great for therapy sessions especially when trying to teach your child a new skill such as feeding, fine motor or cognition. Your child is comfortably contained and sitting with out the need to concentrate on holding herself upright. The Tripp Trapp was great for daily living as it allowed the child to be more social and join the family because of its table height. Based on your child’s needs, an appropriate decision can be made. One further point the PosiTot can be paid for by insurance.

As to the Sleep Apnea and special bed to assist your daughter to sleep, I researched online and conferred with Ruthi Fruendlich an extremely experienced Speech Therapist, and was only able to find a pillow for an adult, with little or no proof of its success. I am more concerned that you treat the sleep apnea rather then look for a compensation. As I am not privy to more information I am assuming it is Obstructive Sleep Apnea verses Central Sleep Apnea, the type of Sleep Apnea children with Down Syndrome are prone to. A good ENT should be consulted, as mild OSA can be helped by clearing Congestion and sleeping on ones side and, more severe OSA can be helped by removing adenoids and tonsils. Helping OSA will allow your child to sleep better and concentrate better in the day time. I hope the information was helpful. Thank You for you for your question.

Happy to be able to still respond,
Etty Terebelo.

Dear Etty,

I just had a Downs baby. I’m doing okay (I think). Because she is still an infant, therapy will not begin for months. She needs to be significantly delayed in New Jersey in order to qualify. What can you suggest I do in the interim?

Northern New Jersey

Dear S.G.,

First of all, Mazel Tov!

Second, your ‘Downs’ is first and foremost a cute baby with a diagnosis of Down syndrome.

Now, to answer your excellent question, there are lots of things you can do:

One of the easiest, but most important, is enormous amounts of ‘tummy time’. This cannot be stressed enough. This will allow your baby to get good head control, after which the body will follow.

You can also give your baby a deep pressure massage using a lotion. Start on her belly and chest area using circular motions. Move to arms or legs starting at shoulder or hips and moving towards finger or toes. Massage palm of hands and fingers, soles of feet and toes. This will help with body awareness for motor planning. As children with Down syndrome frequently have low tone around the mouth, massage around the mouth areas as well. This might help with addressing a tongue that protrudes.

Constantly talk to her throughout the day. Tell her what you are doing, i.e. washing dishes, folding laundry, etc.

Hold her in the position as shown so as not to splay legs or hips (no need to use both hands). The child also sees what you see when held this way.

When playing with toys with her, use bright colors and pictures with clear faces; these are more stimulating.

Doing these things will certainly give your baby an edge. You sound motivated and on the ball.

Keep up the good work,


Left by Naomi Willems - Wednesday, July 21, 2010

Dear Etti Thank you so much for your reply. We did end up buying the tripp trapp as could not find anything else we thourght would be suitable and even though I must admit to begin with we were a bit hesitant if this was the right thing or not,we are now really delighted with the chair. Our daughter is now 4, she can climb up and down by her self (we wanted something that she could be independant), and she loves being at the table with us. She sits very nicly on it, with her back straight. The only 2 things we are a bit concerned we have to watch out for are that a) she does not push herself back i.e away from the table and b) she does like sometimes to stand up on the chair and reach across the table, and if anything is around it may go flying across the room. In fact my husband liked it so much he bourght one for him self. Thank you again, and about the bed. The sleep Apnea has really improved alot we got that seen too but she does like to still sleep sitting up and is still banging her head around when she falls, so we are still looking for a bed solution if anyone has any ideas for a 4year old. Thank you very much Regards Naomi Willems

This article first appeared in issue #14 of Down Syndrome Amongst Us

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