Assessment & Research

Prediction of the number of Down's syndrome infants to be born in England and Wales up to the year 2000 and their likely survival rates.

Nicholson et al. (1992) · Journal of intellectual disability research : JIDR 1992
★ The Verdict

Plan for a growing wave of clients with Down's syndrome who carry heavy medical loads from birth to midlife.

✓ Read this if BCBAs who write behavior plans for children or adults with Down's syndrome in medical or community settings.
✗ Skip if Practitioners who work only with autism or mild learning disabilities.

01Research in Context

01

What this study did

Yuwiler et al. (1992) ran a population model for England and Wales. They asked how many babies with Down's syndrome would be born each year up to 2000. They also looked at how many people with Down's syndrome would be alive at any one time.

The model used birth data, maternal age trends, and survival rates. It assumed current prenatal screening stayed the same.

02

What they found

The model said live-birth rates would climb above 20-year highs. By 2000, the total number of people with Down's syndrome would hit record levels.

In short, more babies and more adults with Down's syndrome were coming, even with screening in place.

03

How this fits with other research

Hickey et al. (2025) now gives real numbers that update the 1992 forecast. Their clinic chart review of 2,321 Coloradans shows the heavy medical load those extra births bring: 80% needed a NICU stay and over half later needed heart surgery or sleep studies.

Fullana et al. (2007) and Tenenbaum et al. (2012) fill in the hospital piece. Half of kids with Down's syndrome are admitted before age three, mostly for breathing problems. Adults land in hospital twice as often and stay longer than the general public.

Stancliffe et al. (2007) adds a sober note: adults with Down's syndrome who live with family die sooner than other adults with ID, mainly from heart or lung issues. Together these papers turn the 1992 head-count warning into a full care-plan: expect more patients, earlier and longer hospital stays, and higher midlife risk.

04

Why it matters

You will see more clients with Down's syndrome across the lifespan, not just kids. Build early screening for heart, thyroid, hearing, and sleep apnea into your behavior plans. Team up with medical providers to spot respiratory illness fast and to plan for longer hospital stays. When families ask about the future, you can give them real data: bigger cohorts, higher medical need, and proven ways to act early.

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Add a medical red-flag checklist (heart, thyroid, hearing, sleep, respiratory) to every Down's syndrome behavior plan and share it with the medical team.

02At a glance

Intervention
not applicable
Design
other
Population
down syndrome
Finding
not reported

03Original abstract

Using current demographic projection of maternal age-structure, age-specific fertility rates, and the availability, detection and utilization rates of prenatal diagnosis and subsequent termination rates, predictions are made of the likely numbers of births with Down's syndrome (DS) in England and Wales to be expected up to the year 2000. Further predictions are made of age-specific prevalence of the condition bearing in mind recent trends in survival. These figures show that, despite current screening policies based on maternal age alone, the observed live birth prevalence of DS will rise to levels higher than have been seen for 20 years. Together with consistently increased survival, this will mean that, throughout the next century, the population prevalence of DS will be higher than ever before. Work based in other countries has reached similar conclusions. As the prevention of all births affected by DS is not possible in the forseeable future, and some would argue that it is not desirable, society will need to provide for those affected.

Journal of intellectual disability research : JIDR, 1992 · doi:10.1111/j.1365-2788.1992.tb00569.x