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

Mental Wellness in Adults with Down Syndrome: A Guide to Emotional and Behavioral Strengths and Challenges (2nd Edition)

April 2021 | Dennis McGuire, PhD and Brian Chicoine, MD - Book (2021)

The PDF linked below is a copy of the second edition of Dr. McGuire and Dr. Chicoine's book originally published by Woodbine House Publishing in 2021. After Woodbine closed in 2022, the publishing rights reverted to the authors. Dr. McGuire and Dr. Chicoine chose to make the book available to readers as a free PDF. 

Mental Wellness in Adults with Down Syndrome PDF opens in new window

Second edition of Mental Wellness in Adults with Down Syndrome by Dennis McGuire and Brian Chicoine


Bienestar mental en los adultos con síndrome de Down opens in new window


Translation of the book into Spanish was made possible through the generosity of the Fundación Iberoamericana Down21 opens in new window and the Matthew Foundation opens in new window


Photos and images have been removed because permission to use them was not included with the authors' publishing rights. Except for a few deletions of text that referenced photos and images, the text of the PDF is the same as the version published in 2021. Additional resources are available in the Mental Health section of the Adult Down Syndrome Center's Resource Library.


Table of Contents

Chapter 1 - Mental Health Assessment

Chapter 2 - Assessing the Physical Health/Mental Health Connection

Chapter 3 - Family and Community Support

Chapter 4 - What Is Normal?

Chapter 5 - Concrete Thinking and Behaving

Chapter 6 - Visual Memory and Cues

Chapter 7 - Communication

Chapter 8 - Self-Esteem and Self-Image

Chapter 9 - Self-Talk Revisited

Chapter 10 - The Groove and Flexibility

Chapter 11 - Life-Span Issues

Chapter 12 - Sensory Processing Differences and Disorders

Chapter 13 - Social Skills

Chapter 14 - Mental Illness and Its Precipitants

Chapter 15 - Assessment of Mental Illness

Chapter 16 - Treatment Approaches for Mental Illness

Chapter 17 - Mood Disorders

Chapter 18 - Anxiety Disorders

Chapter 19 - Obsessive-Compulsive Disorders

Chapter 20 - Psychotic Disorders

Chapter 21 - Eating Refusal

Chapter 22 - Challenging Behavior

Chapter 23 - Self-Injurious Behavior

Chapter 24 - Tics, Tourette Syndrome, and Stereotypies

Chapter 25 - Autism

Chapter 26 - Alzheimer's Disease and Decline in Skills

Chapter 27 - Regression


Woodbine Book Description

Awards for the First Edition: 

2007 Independent Publisher Award: Bronze Medalist in Psychology/Mental Health Category

2006 Best Book Awards, Psychology/Mental Health Finalist

2006 ForeWord Magazine's Book of the Year Award: Finalist in Psychology Category

This thoroughly updated second edition of Mental Wellness in Adults with Down Syndrome is upbeat and accessible in tone, yet encyclopedic in scope. The size of the book reflects both the breadth of the authors' knowledge - acquired as cofounders of the first medical clinic dedicated solely to the care of adults with Down syndrome - and the number of psychosocial issues and mental disorders that can affect people with Down syndrome. It's the go-to guide for parents, health practitioners, and caregivers who support teens and adults with Down syndrome. 

Mental Wellness emphasizes that understanding and appreciating both the strengths and challenges of people with Down syndrome is the key to promoting good mental health. It shows readers how to distinguish between bona fide mental health issues and common characteristics of Down syndrome - quirks or coping strategies. For example, although talking to oneself can be a sign of psychosis, many adults with Down syndrome use self-talk as an effective problem-solving strategy.

The second edition includes new chapters on sensory issues (written by Dr. Katie Frank) and regression, expanded and now separate chapters on communication, concrete thinking, and visual memory, and an extensively updated chapter on Alzheimer's disease citing abundant new research. Other chapters cover a range of conditions and assessment and treatment options: 

  • What Is Normal?
  • Self-Esteem & Self-Image
  • Self-Talk
  • Grooves & Flexibility
  • Life-Span Issues
  • Social Skills
  • Mood & Anxiety Disorders
  • Obsessive-Compulsive Disorder
  • Psychotic Disorders
  • Eating Refusal
  • Challenging Behavior
  • Self-Injurious Behavior
  • Autism
  • Tics, Tourette Syndrome & Stereotypies

Find More Resources

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.

View Resource Library


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.