Activities for Children With Down Syndrome

Start from how the child learns

Children with Down syndrome vary as much as any other children, but there is a learning profile that shows up often enough to plan around. Three parts of it decide which activities land.

• Seeing beats hearing. Visual memory is a relative strength; auditory short-term memory, holding a spoken sentence in mind long enough to act on it, is a relative weakness. Anything shown as well as said works better than anything only said.
• Understanding runs ahead of speech. Most children with Down syndrome understand far more than they can say, often for years. An activity that lets the child answer by pointing, matching or doing shows what they know; one that needs a spoken answer hides it.
• Low muscle tone. Hypotonia makes holding a crayon, sitting up at a table and standing on one foot all cost more effort. Children tire and stop, and it looks like losing interest. It usually is not. Shorter goes, better seating, and activities that do not depend on a steady hand.

Everything below follows from those three. The games page covers the same profile as it applies to a screen; this page is the wider list.

Matching and visual learning Visual

This is the strength, so it is where to start on a bad day and where to hang new learning on a good one.

• Sort the laundry. Socks into pairs, then by colour, then by whose they are. Real objects, real purpose, and it is matching.
• Picture lotto. A board of six pictures and a pile of matching cards. Start with identical pictures, move to picture and outline, then picture and word. The shadow matching worksheets are the middle step of that, printed.
• Matching on a screen. The shadow matching game with the written words switched on, because for this child the written word is a support rather than an obstacle. The matching games for toddlers page puts the three matching games in order.
• Visual schedules. Not an activity so much as the frame for all of them: a strip of pictures showing what happens next. A child who cannot hold "first bath, then story" in their head from hearing it can read it off a strip all evening.
• Memory pairs, face down, with four cards to begin with. It is the one card game where a visual memory strength shows up as winning.

Fine motor Hands

Small, strong fingers come from squeezing, pinching and threading, not from worksheets. Pencil control is the last thing to arrive, not the first thing to practise.

• Playdough: roll, squash, pinch off pieces, hide beads in it and dig them out. The pinch is the point.
• Threading large beads on a shoelace, then pasta, then smaller beads. Stiff laces with a taped end are less frustrating.
• Stickers. Peeling a sticker off its backing is a two-finger pinch with a visible reward. A sheet of stickers and a piece of paper is a full activity.
• Tongs and tweezers moving pom-poms from one bowl to another. Sort by colour and it is a matching activity as well.
• Tearing paper into strips, then into small pieces to glue. Cheaper than any toy and a real workout for the fingers.
• Drawing on a slope. A ring binder laid on the table with the paper clipped to it. The angle puts the wrist in a better position and the child tires less.

On a screen, nothing that drags. The games here are all single taps for exactly this reason, and the games page explains why.

Speech and language Talking

The gap between what the child understands and what they can say is the thing to work with, not against. Give them ways to answer that do not need speech, and keep modelling the speech.

• Sign and say. A key-word sign (Makaton or a similar system) alongside the spoken word for the important words of the day: more, finished, drink, help. Signing does not delay speech; the evidence points the other way. It gives the child a way to say the word before the mouth can.
• Books with the words visible. Point at the word as you say it. Many children with Down syndrome learn to recognise whole written words early, and reading then supports their speech rather than the other way round. The word matching game is that, with photos.
• Songs with actions. Rhythm, repetition, a gesture for every line. "Wind the bobbin up" teaches more vocabulary than a flashcard session.
• Choices, not questions. "Apple or banana?" holding both up, is answerable by pointing and models both words. "What do you want?" is not.
• Expand what they say. Child: "dog". Adult: "big dog. The big dog is running." One step up, never a correction.
• Oral motor play: blowing bubbles, straws, whistles, party blowers. Lip and tongue strength affects clarity, and this is the fun version of the exercises.

Gross motor and balance Body

Low tone and loose joints mean balance, core strength and coordination all need more practice than they get by accident.

• Obstacle courses across the living room: cushions to climb, a chair to crawl under, a line of tape to walk along. Change it every day and let the child build it.
• Animal walks. Bear walk, crab walk, frog jumps. Weight through the arms builds shoulder stability, which is where handwriting eventually comes from.
• Balance: standing on a cushion, walking on a curb, stepping stones made of paper plates.
• Swimming, if it is available. Water supports the body, so the child can move in ways they cannot on land, and the resistance builds tone.
• Ball games with a big soft ball: roll, catch, kick. Sitting and rolling it back and forth is also turn taking.
• Trampolines and swings for the joy of it and for the core. Watch the neck: some children with Down syndrome have instability of the upper neck joints, and forward rolls and trampolines should be cleared with their doctor first.

Turn taking and social play Together

Many children with Down syndrome are socially motivated and use that to good effect, sometimes to avoid the hard bit of a task. The activities that work are the ones where the social part and the learning part are the same thing.

• Rolling a ball back and forth is the first turn-taking game and never stops being useful.
• Simple board games with a clear turn: a dice and a track, snakes and ladders with a small board. Tic-tac-toe on this site was built for this, with Maggie and the cat as the pieces and an easy computer that lets the child win most of the time.
• Pretend play with a script: shop, doctor, tea party. The script gives the child the words; the repetition lets them lead next time.
• Waiting games. Ready, steady, go, with a long pause before go. Musical statues. Learning to wait is the skill that makes school possible.

Daily living Everyday

The most useful activities are the ones that are not activities: a child who helps get dressed, lay the table and put the shopping away is doing matching, sorting, fine motor and language at once, with a reason.

• Getting dressed, with the clothes laid out in order and the child doing the last step of each one: pulling the sock up the last inch, pushing the arm through. The clothes shadow matching sheet is the vocabulary for it.
• Laying the table with a place mat that has the plate, cup and fork drawn on it. Matching, again.
• Putting shopping away. Cans with cans, fruit in the bowl. Sorting with a purpose.
• Cooking from a picture recipe: three or four photos in order. Pouring, stirring and tearing lettuce are all fine motor practice that ends in lunch.
• Hand washing and tooth brushing with a picture strip on the wall showing the steps. Do the whole thing hand over hand at first, then let the child do the last step alone, then the last two.

Sensory activities Calm

Some children with Down syndrome are sensory seekers, some avoid, and many are both depending on the day. Sensory activities are there for regulation, which means they are also the ones to reach for when nothing else is working.

• Trays of rice, dried pasta, water, shaving foam, with cups and spoons. Hiding small toys in them adds a finding game.
• Heavy work: carrying the shopping, pushing a loaded box, wearing a backpack with a book in it. Deep pressure through the joints is calming for a lot of children.
• Music and movement, which for many children with Down syndrome is the reliable way in.
• A feelings check-in. Not sensory, but it belongs here: the feelings check-in lets the child point at a face and then at what would help, and quiet time or a hug are two of the options.

For adults with Down syndrome

This site is built for children, but the search for activities does not stop at eighteen, and the principles do not change: visual, practical, social, and pitched at the person rather than at an age. Activities that work well for adults at home or in a day setting:

• Cooking from picture recipes and real shopping lists, with the person doing as much of it as possible.
• Jobs with a visible result: sorting post, watering plants, folding laundry, feeding a pet. Purpose matters more than the task.
• Walking groups, swimming, dance and bowling, for fitness and for the company.
• Music: choirs, drumming circles, or just a playlist and a kitchen.
• Games with clear turns: dominoes, Uno, bingo, and yes, the tic-tac-toe here, which has no age on it anywhere for exactly this reason.
• Art and crafts with a finished object at the end: cards, painted pots, simple weaving.

What to avoid is anything labelled for toddlers. An adult handed a baby toy has been told something, and it is not "here is something to do".

Five rules that apply to all of it

1. Show it, then say it. Every instruction has a picture, a gesture or a demonstration attached.
2. Short and often. Five minutes three times a day beats a fifteen-minute session that ends in refusal.
3. Succeeding most of the time. Pitch it so the child gets it right, then make it slightly harder. This is the idea behind errorless learning, and it is why the games here have no way to lose.
4. The last step first. Do the whole task with the child and let them finish it. Then let them do the last two steps. Backward chaining, and it means every attempt ends in "I did it".
5. No age labels. Choose by what the child can do, and never hand a ten-year-old something marked "ages 2 to 4". They can read the box.

What this page is: general information written by the person who builds these games, drawing on what the Down syndrome education charities publish, not by a therapist. The child's speech and language therapist, occupational therapist and physiotherapist know what applies to them, and the neck caution under gross motor is a question for their doctor.