Children with T21 (Down Syndrome): team support :: Kingston and Richmond NHS Foundation Trust

On this page…

Departments:
Paediatrics (babies, children and young people)
Children's community nursing

Last Updated: 20 February 2026

This offers information about our Multidisciplinary Team (MDT) approach to caring for children with Trisomy 21 (Down Syndrome).

We are dedicated to supporting your child’s development and wellbeing through a coordinated approach.

About Trisomy 21 (Down Syndrome)

Trisomy 21 (T21) is also known as Down Syndrome.

It is a genetic (family history) condition that affects physical development, learning and health.

Every child with Trisomy 21 is unique and has their own strengths and difficulties.

About a Multidisciplinary Team (MDT)

An MDT (Multidisciplinary Team) is a group of professionals from different healthcare and education specialities.

Our MDT approach ensures that all aspects of your child’s development and health are supported.

Your child’s MDT may include the following specialities.

Paediatrician: oversees general health, growth and development.
Geneticist: provides genetic (family history) counselling and information.
Physiotherapist (PT): helps with movement, strength and coordination.
Occupational Therapist (OT): supports daily living skills, sensory processing and independence. (Sensory processing means managing information from our senses, such as sight, sound, taste, balance etc).
Speech and Language Therapist (SLT): assists with communication, social interaction and feeding skills.
Educational Psychologist: provides strategies to support learning.
Specialist Nurse: offers guidance on medical and developmental needs.
Dietitian: advises on nutrition and healthy eating.
Social Worker: provides parent and care-giver support and access to community services.
ENT Specialist and Audiologist: monitors hearing and ear health.
Ophthalmologist: checks and manages vision (sight) needs.
Cardiologist: assesses and treats heart conditions (which are common in children with T21).

Some MDT specialities in detail

Physiotherapy (PT)

Children with Trisomy 21 may have poor muscle tone and delayed motor (muscle movement) development.

Physiotherapy aims to do the following.

Improve strength, balance and coordination.
Support development of whole-body motor skills such as sitting, crawling, standing and walking.
Improve posture and overall mobility.
Provide exercises and strategies to promote independent movement.
Prevent musculoskeletal issues and support long-term physical health.

Occupational Therapy (OT)

Children with Trisomy 21 may have difficulties with motor (muscle movement) skills, sensory processing and daily activities.

OT aims to do the following.

Support development of fine and gross (whole body) muscle movement skills to enhance coordination.
Assist with daily living activities such as dressing, feeding and toileting.
Address sensory processing challenges to improve focus and wellbeing.
Provide adaptive strategies and equipment to support independence.
Work on handwriting, play skills and school readiness.
Collaborate with parents, caregivers and educators to implement strategies at home and school.

Speech and Language Therapy (SLT)

Children with Trisomy 21 may experience difficulties with speech, language and communication. They may also have difficulties with feeding and swallowing.

The SLT aims to do the following.

Support early communication skills, including gestures, vocalisations and social interaction.
Assist development of play and social interaction.
Enhance understanding and use of language, including work on vocabulary and sentence formation.
Help with speech clarity and pronunciation.
Assist with alternative communication methods such as Makaton, pictures and symbols. (Makaton is a language learning programme that uses signs, symbols and speech.) These alternative methods can include high-tech communication devices, if this is right for your child.
Address feeding and swallowing difficulties to ensure safe eating and drinking.
Provide parents with strategies to encourage language and feeding development at home.

Support you can expect

You can expect the following support from our MDT.

Regular health checks to monitor growth and wellbeing.
Early intervention services to improve development.
Therapies tailored to your child’s needs. These include physiotherapy, occupational therapy, speech and language therapy etc.
Support in education through school programmes and additional learning resources.
Guidance for parents and caregivers to help navigate medical, social and emotional difficulties.

Health Visiting (HV) team

Children with Trisomy 21 are more likely to experience common health problems. They may also experience delays in reaching developmental milestones.

The Richmond-based [CHECK] Health Visiting team from Central London Community Healthcare NHS Trust (CLCH) will carry out regular assessments. These will track developmental milestones, and identify delays or conditions particular to Trisomy 21.

The team aims to do the following.

Monitor growth and development to ensure quality of life and developmental progress.
Give guidance on immunisations, and encourage families to follow the appropriate immunisation schedule.
Work closely with the multi-disciplinary team (MDT) of specialists to ensure coordinated care.
Offer families emotional support as they adjust to the T21 diagnosis and cope with feelings of stress or grief.
Support parents in advocating for the rights and needs of their child.

How you can get involved

Wherever possible, we encourage you to do the following.

Attend all scheduled MDT appointments to ensure coordinated care.
Encourage play and learning activities suited to your child’s needs.
Get in touch with support groups and networks for families of children with T21 (see More information, below).
Work closely with educators and therapists to implement strategies at home and school.
Advocate for your child’s needs and ensure they receive help from all available support services.