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For people with Down syndrome, family members, caregivers and professionals.

Common Characteristics of Adolescents and Adults with Down Syndrome

September 2022 | Brian Chicoine, MD - Medical Director, Adult Down Syndrome Center

"If you have met one person with Down syndrome, you have met one person with Down syndrome" is a sentiment often shared in the Down syndrome community. We certainly know this idea applies to health care. In our efforts to support individuals with Down syndrome in their health journeys, we strive to understand and appreciate each person’s unique qualities, abilities, interests, and strengths.

At the same time, there seem to be several behavioral characteristics that many (but not all) people with Down syndrome have in common. Recognizing and appreciating these common characteristics is also an important aspect of our approach to health care.

Three common behavioral characteristics are:


Many people with DS talk to themselves (self-talk). It is used to review the day, process stress, solve problems, and entertain oneself. Although self-talk sometimes is misinterpreted as psychotic behavior, typically it is not pathologic. However, a change in self-talk can be a sign of physical, mental, or social stressors and should be investigated. 


"The groove"

People with DS have a tendency towards repetition or sameness, often referred to as “the groove.” It frequently results in developing routines. These routines can be very functional and improve the performance of daily activities and occupational tasks. Although obsessive compulsive disorder is more common in people with DS, most of the time the groove is not an indication of a problem.


Interaction between physical and mental health

This is not unique to people with DS; but, due to impaired communication skills in many people with DS as well as other factors, physical health problems often present as behavioral or psychological changes. In assessing any behavioral or psychological change in a person with DS, it is very important to assess for possible underlying physical health problems.


Being aware of common characteristics such as self-talk and “the groove” can reduce diagnosing a common beneficial behavior as a pathologic condition. These common characteristics can also be used favorably to help adolescents and adults with DS develop healthy habits and behaviors. Many individuals with DS use self-talk to guide themselves to develop healthy habits. Once habits are learned, “the groove” can help individuals maintain and consistently repeat the behavior. Similarly, understanding the interaction between physical and mental health in adolescents and adults with DS can reduce over-diagnosis of mental health issues and under-diagnosis of underlying physical health problems. In addition, when there is co-occurrence of mental and physical health problems, not diagnosing and treating the physical health problem will typically result in poorer outcomes.

If you have met one person with Down syndrome, you have met one person with Down syndrome. However, being aware of characteristics that many people with Down syndrome have in common can be helpful when supporting individuals with Down syndrome in optimizing their health.

These characteristics are described in greater detail in the 2nd edition of our book Mental Wellness in Adults with Down Syndrome: A Guide to Emotional and Behavioral Strengths and Challenges. A free PDF version of the book is available in our Resource Library. 

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We offer a variety of resources for people with Down syndrome, their families and caregivers and the professionals who care for and work with them. Search our collection of articles, webinars, videos, and other educational materials.

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Please note: The information on this site is for educational purposes only and is not intended to serve as a substitute for a medical, psychiatric, mental health, or behavioral evaluation, diagnosis, or treatment plan by a qualified professional. We recommend you review the educational material with your health providers regarding the specifics of your health care needs.