Health Screenings Every Child with Down Syndrome Needs — And How to Access Them in Northeast India

Children with Down syndrome are at higher risk for a specific pattern of health conditions. Many of these conditions — if identified early — are highly manageable and have little impact on quality of life. Left undetected, some can significantly affect development, health, and wellbeing. This guide explains what to screen for, when, and where to access these services in Northeast India.

The essential Down syndrome health screening schedule

Vision (Eyes)

Why it matters: 40–80% of children with Down syndrome have some form of vision problem. These include refractive errors (needing glasses), strabismus (crossed or misaligned eyes), cataracts (clouding of the lens — which can be present from birth), and nystagmus (involuntary eye movements). Many are treatable, especially when caught early. Untreated vision problems directly affect learning and cognitive development.

When to screen: First comprehensive eye examination by 6 months of age. Then annually throughout childhood and adolescence, or more frequently if a problem is identified.

Warning signs: Eyes appear crossed or misaligned; child does not track moving objects by 3 months; white or grey appearance to the pupil (possible cataract); rubbing eyes excessively; tilting head to see.

Hearing (Ears)

Why it matters: 75% of children with Down syndrome have some degree of hearing loss. The most common type is “conductive” hearing loss caused by recurrent ear infections and fluid in the middle ear (“glue ear”) — this type fluctuates, meaning a child may hear normally one week and poorly the next. Even mild, fluctuating hearing loss significantly affects speech and language development.

When to screen: Newborn hearing screen at birth (mandatory in most hospitals). Comprehensive audiological assessment by 3–6 months. Every 6 months until age 3, then annually.

Warning signs: Does not startle to loud sounds; does not turn toward voices by 3–4 months; speech development is delayed or unclear; says “what?” frequently; turns up volume very high.

Thyroid function

Why it matters: 15–20% of children with Down syndrome develop hypothyroidism (underactive thyroid). The thyroid gland regulates metabolism, growth, and brain development. Untreated hypothyroidism causes fatigue, slow growth, constipation, dry skin, and — critically — cognitive regression that can be mistaken for “just how DS is.” It is easily treated with a once-daily tablet (levothyroxine) that costs under ₹50 per month.

When to screen: At birth (newborn thyroid screening). At 6 months, 12 months, then annually throughout life. Blood test: TSH (Thyroid Stimulating Hormone) and free T4.

Heart (Congenital Heart Defects)

Why it matters: 40–50% of babies born with Down syndrome have a congenital heart defect (CHD). Most are identified in the newborn period or within the first weeks of life. Common types include ventricular septal defect (VSD), atrial septal defect (ASD), and atrioventricular septal defect (AVSD). Many require surgical correction. With appropriate treatment, outcomes are excellent.

When to screen: Echocardiogram (cardiac ultrasound) should be performed for every child with Down syndrome by 3 months of age, regardless of whether any symptoms are present. Some heart defects produce no murmur or symptoms in early infancy.

Dental health

Why it matters: Children with DS have delayed tooth eruption, smaller jaw structure, and higher rates of gum disease (periodontal disease). Poor dental health affects eating, speech, and can allow bacteria to enter the bloodstream (particularly concerning in children with heart conditions).

When to screen: First dental check by age 1 (at eruption of first tooth). Every 6 months thereafter. Note: teeth grinding at night (bruxism) is very common and can be managed with a night guard.

Where to access these services in Northeast India

Meghalaya

• NEIGRIHMS, Shillong — North East Indira Gandhi Regional Institute of Health and Medical Sciences. Comprehensive specialist services including paediatrics, ophthalmology, ENT, cardiology, and endocrinology. Accepts referrals from across Northeast India.
• Civil Hospital, Shillong — Government hospital with specialist departments. Free or subsidised care for BPL card holders.
• Nazareth Hospital, Shillong — Mission hospital with good paediatric services.
• Ganesh Das Hospital, Shillong — Government tertiary care hospital.

Assam

• GMCH, Guwahati — Gauhati Medical College and Hospital. All specialist services.
• GNRC Hospital, Guwahati — Private hospital with good paediatric neurology.
• Down Town Hospital, Guwahati — Private, good paediatric cardiology.

Manipur

• RIMS, Imphal — Regional Institute of Medical Sciences. Government tertiary hospital.
• Shija Hospital, Imphal — Private hospital with specialist paediatric services.

How Aadya Hope Foundation can help

We provide referral letters, pre-appointment preparation, and accompaniment support for families navigating specialist appointments in Shillong, Guwahati, and Imphal. We also help families understand their child’s reports and treatment plans, and connect with government schemes that subsidise care for children with disabilities.

Contact us for a free health referral consultation. We will help you prioritise which screenings your child needs most urgently based on their current age and health status.