Lignes directrices GLOBALES sur les soins médicaux pour les adultes atteints du syndrome de Down
The new GLOBAL Medical Care Guidelines for Adults with Down Syndrome (GLOBAL Adult Guideline) provide first in-kind, evidence-based medical recommendations to support clinicians in their care of adults with Down syndrome and was supported by generous donations from the Down syndrome community. To ensure this life-changing resource is kept up-to-date, please consider making a donation today!
As Published in JAMA

The first in-kind GLOBAL Adult Guideline was peer reviewed, edited, and published in the Special Communication section of the print and online October 2020 issue of JAMA, the Journal of the American Medical Association. Exclusive access to the full article here!
“We are so pleased that the quality of our guideline rose to the occasion of being published in JAMA, and we are deeply grateful to our families and self-advocates for pushing us to work on this difficult project,” says Michelle Sie Whitten, President & CEO of the Global Down Syndrome Foundation.
Full GLOBAL Guideline




The GLOBAL Adult Guideline provides an important tool in a primary care setting, augmenting both evaluation and care previously based solely on a person’s age, gender, clinical symptoms, or the presence of known risk factors and other comorbidities.
Copying, posting, or altering this document is prohibited. However, providing a link to the full guidelines on GLOBAL’s website is permissible. Free individual downloads and printing is also permissible.
Family-Friendly GLOBAL Adult Guideline




The Family-Friendly GLOBAL Adult Guideline provides the same important information covered in the Full GLOBAL Guideline in a family-friendly format with helpful pull-out quotes, definitions of medical terms, large photos and font, and is color coded by medical topic.
Copying, posting, or altering this document is prohibited. However, providing a link to the full guidelines on GLOBAL’s website is permissible. Free individual downloads and printing is also permissible.
Additional GLOBAL Adult Guideline Resources
The GLOBAL Adult Guideline is a technical resource for clinicians. The toolkits (for example, the checklist and diabetes toolkit) are family-friendly. GLOBAL will be creating additional toolkits, so please check back to get the most recent updates.
Copying, posting, or altering these documents is prohibited. However, providing a link to the toolkits on GLOBAL’s website is permissible. Free individual downloads and printing is also permissible.




Second Edition GLOBAL Adult Guideline Workgroup
Authors

Peter Bulova a suivi une formation de premier cycle à l'université de Brown. Il a effectué son internat et son internat en chef et a obtenu son diplôme de médecine à l'université de Pittsburgh. Il est professeur de médecine interne générale et enseigne aux étudiants en médecine, aux résidents et aux boursiers de l'université de Pittsburgh. Le Dr Bulova participe actuellement à des recherches sur la maladie d'Alzheimer chez les adultes atteints du syndrome de Down, siège au NIH National Down Syndrome Registry Data Access Review Committee et est un réviseur ad hoc pour plusieurs revues, notamment le Journal of Intellectual Disability Research et l'American Journal on Intellectual and Developmental Disabilities. Le Dr Bulova est également membre du conseil d'administration du Down Syndrome Medical Interest Group et intervient au niveau national sur la prise en charge des adultes atteints du syndrome de Down.

Depuis 1990, le Dr Capone travaille au Kennedy Krieger Institute, où il est actuellement directeur de la clinique et du centre de recherche sur le syndrome de Down. Il s'intéresse à un large éventail de sujets concernant les personnes atteintes du syndrome de Down, notamment les soins de santé, le développement et le comportement neurologique, la santé mentale et les essais de médicaments pour le sommeil chez les enfants et les adultes. Le Dr Capone vit à Towson, dans le Maryland, avec sa femme Mary et son fils Daniel.

Brian Chicoine, M.D. is the co-founder and Medical Director of the Advocate Medical Group Adult Down Syndrome Center in Park Ridge, Illinois. The Center has served over 6000 adolescents and adults with Down syndrome since its inception in 1992. Dr. Chicoine graduated from Loyola University of Chicago Stritch School of Medicine. He completed his Family Medicine residency at Lutheran General Hospital where he is now a faculty member. He has published many articles regarding health of people with Down syndrome. He has co-authored two books “Mental Wellness of Adults with Down Syndrome,” and “The Guide to Good Health for Teens and Adults with Down Syndrome” published by Woodbine House Publishing.

Terry Harville earned a PhD in Biochemistry and Molecular Biology, before earning his MD at the University of Florida. He completed a residency in Pediatrics and Fellowship in Pediatric Immunology, Rheumatology, and Transplantation Biology; also at the University of Florida. Dr. Harville joined the faculty of Duke University, where he pioneered hematopoietic transplantation in patients with rare forms of Combined Immunodeficiencies. Subsequently, he joined the faculty of Arkansas Children’s Hospital and the University of Arkansas for Medical Sciences, as Director of Pediatric Rheumatology and Immunodeficiencies. He was asked to take over the Directorship of the Transplantation Laboratories in order to provide better transplantation services in the state of Arkansas. Dr. Harville has more than 160 published abstracts, book chapters, and peer-reviewed manuscripts. Autism Spectrum of Disorders and other diseases of Neuro-atypicality, including Down syndrome, have been amongst his research and clinical care emphases. He also is considered an expert in the diagnosis of immunodeficiency disorders and autoimmune disorders, including celiac disease.

Barry Martin est professeur adjoint de médecine interne générale à la faculté de médecine de l'université du Colorado, où il reçoit des patients pour des soins primaires et des consultations. Il est certifié en médecine familiale et a plus de 20 ans d'expérience dans la fourniture de soins de santé primaires aux adultes handicapés, en particulier aux personnes souffrant de troubles du développement et du syndrome de Down. Il a été directeur médical de l'ancienne Denver Adult Down Syndrome Clinic. Il est actuellement directeur médical de la clinique pilote de Denver Health et de GLOBAL pour les adultes atteints du syndrome de Down. Le Dr Martin est membre du National Down Syndrome Congress et du Down Syndrome Medical Interest Group.

Le Dr McGuire est un spécialiste de la santé comportementale des personnes atteintes du syndrome de Down. Il possède plus de 30 ans d'expérience dans les domaines de la santé mentale et des troubles du développement. Il est l'ancien directeur des services psychosociaux de l'Adult Down Syndrome Center à Chicago, dans l'Illinois. Il a contribué à la création de ce centre, qui accueille chaque année plus de 4 000 patients. Le Dr McGuire donne des conférences lors d'événements organisés dans le monde entier et est le co-auteur de deux ouvrages importants : Mental Wellness of Adults with Down Syndrome et The Guide to Good Health for Teens and Adults with Down Syndrome (2011), tous deux publiés par Woodbine House. Il a reçu de nombreux prix, notamment le prix de la recherche Theodore D. Tjossem du National Down Syndrome Congress en 2003 et le prix scientifique de la Journée mondiale du syndrome de Down en 2010. Le docteur McGuire continue de recevoir des couples, des familles et des particuliers dans un cabinet privé de la région de Chicago. Le docteur McGuire est titulaire d'un doctorat de l'université de l'Illinois à Chicago et d'une maîtrise de l'université de Chicago.

Dr. McKelvey leads a multidisciplinary clinic that provides comprehensive services for adolescents and adults with Down syndrome. He is interested in public health issues that take into account the growing number of people with genetic syndromes and the complex interplay of medical and social needs in this population across lifespan. Dr. McKelvey has published original research investigating the etiology of osteoporosis in individuals with Down syndrome and has worked as Principal Investigator on clinical trials involving cognitive aspects of Down syndrome. He is actively researching nutrition, autoimmunity and the role of inflammation as it relates to dementia. He is interested in biomarkers and genetic changes which predict the early onset of common diseases in Down syndrome and also have implications for treatment of disease in the general population.
*In loving memory of Dr. Kent McKelvey, who dedicated his life to caring for adults with Down syndrome. His leadership and belief in GLOBAL gave us the confidence to create this important guideline. We are forever grateful.

Moya Peterson est professeur de clinique au centre médical de l'université du Kansas, dans les écoles d'infirmières et de médecine, au sein du département de médecine familiale et communautaire. Elle a fondé et dirige la clinique spécialisée pour les adultes atteints du syndrome de Down. Elle enseigne également dans le cadre du programme d'études supérieures de l'école d'infirmières, et une grande partie de son enseignement porte sur les personnes handicapées et en particulier sur les adultes atteints du syndrome de Down. Le Dr Peterson a obtenu son doctorat en 2006, avec une thèse sur les adultes atteints du syndrome de Down et les préoccupations de leurs familles concernant les questions de santé à l'âge adulte. C'est cette thèse qui a été à l'origine de la création de la clinique lorsqu'elle a constaté qu'il n'existait pas de prestataires de soins de santé spécifiques pour les adultes atteints du syndrome de Down dans le Midwest.


Carl V. Tyler Jr. is a clinician-researcher and professor at the Cleveland Clinic. His life work has been devoted to improving the health and health care of persons with developmental disabilities through clinical care, research, and professional and community education. His clinical training in psychiatry, family medicine, and geriatric medicine provided a rich clinical foundation and framework to understand the difficulties and complexities in providing health care to this population. Following medical school and residency training, Dr. Tyler completed two academic fellowships at Case Western Reserve University; the first focused on aging and disability while the second was a 3-year NIH-sponsored fellowship in practice-based research design and methodology. Dr. Tyler is also the Director of the Developmental Disabilities-Practice-Based Research Network.

Michelle Sie Whitten is the Co-Founder, President & CEO of the Global Down Syndrome Foundation. GLOBAL is dedicated to significantly improving the lives of people with Down syndrome through Research, Medical Care, Education and Advocacy. As a direct result of Michelle & GLOBAL’s impactful government advocacy, NIH budget for Down syndrome has gone from one of the least funded to quadrupling in the last four years. In addition, Michelle served as a co-author and architect of the 2020 GLOBAL Guideline as published in JAMA. She has been recognized for her dedication to improving the lives of people with Down syndrome over the past decade, including: 17 ICON Awards, Denver Business Journal's Most Admired CEO, 2 National Down Syndrome Congress President’s Awards, Arc Thrift Stores’ inaugural Distinguished Disability Leadership Award and NewsED Civil Rights Award.
Prior to her career in the non-profit sector, Michelle was a cable TV pioneer in East Asia working for Liberty Media Corporation and Starz Encore. For her work during that time, she received the 40 Under 40 Achievement Award, the Real Women: Outstanding Entrepreneur Award and the Women in Cable & Telecommunications Walk of Fame Award. Her academic career was focused on international security and diplomacy and she holds a Masters degree and business certificate from Harvard University. She graduated Magna Cum Laude with a Bachelors degree from Tufts University and studied Mandarin Chinese and Women Studies at Peking University. Michelle is married to Tom, a British curator of Chinese contemporary art and they have two children, Sophia, who happens to have Down syndrome and Patrick, who is typical.

Bryn Gelaro joined the GLOBAL team in 2015 as a consultant and is currently the Senior Director of Adult Initiatives and Special Projects. She is a Licensed Social Worker with a background in behavioral health for adults with adults with Down syndrome. Her work includes furthering GLOBAL’s adult care initiatives, serving as an executive committee member and co-author of GLOBAL’s Medical Care Guidelines for Adults with Down syndrome, and managing the development and operations of GLOBAL’s efforts to open a World Class Medical Clinic for adults with Down syndrome. In addition, her role oversees many of GLOBAL’s exciting international projects, including work with Albania, Uganda, and Iceland. Bryn has spoken to parents, educators, and medical professionals at conferences across the nation, including the National Down Syndrome Congress, the Down Syndrome Medical Interest Group, and the Down Syndrome Affiliates in Action. She coauthored research on Down syndrome in Uganda and was a contributor to the Prenatal Testing and Information about Down Syndrome Pamphlet (2nd Ed). Bryn earned her Bachelors of Science in Psychology from the Pennsylvania State University in 2012 and holds a Masters in social work from the University of Chicago’s School of Social Service and Administration in 2015. She completed her Master’s graduate field training at the Adult Down Syndrome Clinic in Chicago, where she facilitated social skills groups, completed assessments, conducted therapy, and occasionally tried to keep up in Zumba class with teens and adults with Down syndrome.

Michael Wells, BS, was the Research Coordinator for the Developmental Disabilities - Practice-Based Research Network (DD-PBRN). The DD-PBRN is a community-based participatory research network comprised uniquely of health care professionals, nurses, residential service providers, advocates and self-advocates. As Research Coordinator, Michael facilitates communication among these stakeholders, partner groups and prospective contacts or partners for future work. A major part of the coordinator role is dissemination of past, present and future work through academic lecture and poster presentations locally, regionally and nationally.
Expert Volunteer Contributors
Jarrett Barnhill (MD, DFAPA, FAACAP)
Donald Bodenner (MD, PhD)
Paul Camarata (MD)
Kamala Gullapalli Cotts (MD)
Rober H. Eckel (MD)
Anna Esbensen (PhD)
James E. Hunt (MD)
Seth Keller (MD)
Judy Lu Kim (MD)
Ira Lott (MD)
Michael McDermott (MD)
Joan Medlen (MEd, RD, LD)
Micol Rothman (MD)
Stephanie Santoro (MD)
Mary Stephens (MD, MHP)
Elizabeth Yeung (MD)
Joaquín M. Espinosa (PhD)
Joann Fontanarosa (PhD)
Gina Giradi (MS)
Allison Gross (MLS)
Janice Kaczmarek (MS)
Lina R. Patel (PsyD)
Michael S. Rafii (MD, PhD)
Karen Schoelles (MD, SM, FACP)

of Dr. Kent McKelvey Jr., who dedicated his life to caring for adults with Down syndrome. His leadership and belief in GLOBAL gave us the confidence to create this important guideline. We, and the Down syndrome community, are forever grateful.
GENEROUS COMMUNITY SUPPORTERS
KEY COLLABORATOR
The Ritter Family
Shawna Lucas
MULTI-YEAR SUPPORTERS
Adam’s Camp
Arc Thrift Stores
Bringing Up Down Syndrome (BUDS)
Broward Gold Coast Down Syndrome Organization
Designer Genes of North Dakota
Down Country
Down Syndrome Advocates in Action Nebraska
Down Syndrome Alliance of the Midlands
Down Syndrome Association of Atlanta
Down Syndrome Association of Central California
Down Syndrome Association of Central Kentucky
Association du syndrome de Down du centre de l'Oklahoma
Down Syndrome Association of Central Texas
Down Syndrome Association of Greater New Orleans
Down Syndrome Association of Greater St. Louis (Association du syndrome de Down du Grand St. Louis)
Down Syndrome Association of Greater Winston-Salem
Association du syndrome de Down de Jacksonville
Down Syndrome Association of Memphis & the Mid-South
Down Syndrome Association of Middle Tennessee
Association du syndrome de Down du Minnesota
Down Syndrome Association of Northeast Indiana
Association du syndrome de Down du nord-est de l'Ohio
Down Syndrome Association of Northern Virginia
Down Syndrome Association of South Georgia
Down Syndrome Association of Southern New Jersey
Down Syndrome Association of Wisconsin
Down Syndrome Coalition for El Paso
Down Syndrome Connections Las Vegas
Down Syndrome Connection of the Bay Area
Down Syndrome Family Connection
Down Syndrome Guild of Dallas
Down Syndrome Indiana
Down Syndrome Network of Montgomery County
Down Syndrome of Louisville
East Texas Down Syndrome Group
GraceSigns
IMDSA
Japan Down Syndrome Association
Congrès national du syndrome de Down
Alliance du syndrome de Down de Caroline du Nord
Rio Grande Valley Down Syndrome Association
Rocky Mountain Down Syndrome Association (Association du syndrome de Down des montagnes Rocheuses)
Sharing Down Syndrome Arizona
Southern Arizona Network for Down Syndrome
Virginia Down Syndrome Association
Dra. Macarena Lizama & Centro UC Síndrome de Down
BENEFACTORS
Burg Family Foundation
Société nationale du syndrome de Down
Rocky Mountain Down Syndrome Association (Association du syndrome de Down des montagnes Rocheuses)
KEY SUPPORTERS
Amy Van Bergen
Anna & John J. Sie Center for Down Syndrome
Charles Monfort
Association du syndrome de Down de Floride centrale
Down Syndrome Association of Central Ohio
Down Syndrome Association of Orange County
Down Syndrome of Louisville, Inc.
Institut Linda Crnic pour le syndrome de Down
The Napoleone Family
SUPPORTERS
ChapTer 21
Designer Genes of North Dakota
Les affiliés du syndrome de Down en action
Syndrome de Down Alabama
Down Syndrome Association for Families of Nebraska
Down Syndrome Association of Acadiana
Down Syndrome Association of Connecticut
Down Syndrome Association of Greater Cincinnati
Down Syndrome Association of Northern Virginia
Fun Coast Down Syndrome Association
The Family of Rya Gracyn Pierce
FRIENDS
Alan P. & Veronica C. Neuman Family
Charitable Fund
Alaska Down Syndrome Network
Chattanooga Down Syndrome Society
Club 21 Learning & Resource Center
David Egan et sa famille
Down Syndrome Association of Central Kentucky
Association du syndrome de Down du centre de l'Oklahoma
Down Syndrome Association of Delaware
Association du syndrome de Down du nord-est de l'Ohio
Down Syndrome Association of the Brazos Valley
Down Syndrome Association of Wisconsin, Inc.
Down Syndrome Family Connection
Down Syndrome Foundation of Southeastern New Mexico
Eastern Idaho Down Syndrome Family Connect
Families Exploring Down Syndrome of Brevard
Association internationale de la mosaïque du syndrome de Down
Kern Down Syndrome Network
Red River Valley Down Syndrome Society
Rio Grande Valley Down Syndrome Association
Sampson Collaborative Law
S.M.I.L.E. on Down Syndrome
Wisconsin Upside Down
OTHER HELPFUL RESOURCES
Down Syndrome Medical Care Centers in the U.S.
GLOBAL Webinar Series: Important Medical Updates
Immune Skin Conditions Clinical Trial
The purpose of this research is to better understand and treat immune skin conditions in people with Down syndrome.
Institut Linda Crnic pour le syndrome de Down
Improving the lives of people with DS through advanced biomedical research with an ultimate goal to enable precision medicine approaches to improve health outcomes in Down syndrome, including the development of new diagnostic and therapeutic tools.
Down Syndrome Medical Interest Group-USA
American Academy of Developmental Medicine and Dentistry
Special Thanks to 2020 GLOBAL Adult Workgroup
Authors
Peter Bulova
George Capone
Brian Chicoine
Terry Harville
Barry Martin
Dennis McGuire
Kent McKelvey
Bryn Gelaro
Moya Peterson
Amy Tsou
Carl Tyler
Michael Wells
Michelle Sie Whitten
Committee Members
Dr. Jarrett Barnhill
Dr. Donald Bodenner
Dr. Paul Camarata
Dr. Kamala Gullapalli Cotts
Dr. Robert Eckel
Dr. Anna Esbensen
Dr. James E. Hunt
Dr. Seth Keller
Dr Judy Lu Kim
Dr. Ira Lott
Dr. Michael McDermott
Joan Medlen
Dr. Micol Rothman
Dr. Stephanie Santoro
Dr. Mary Stephens
Dr. Elizabeth Yeung
Contributors
Dr. Joaquin Espinosa
Dr. Joann Fontanarosa
Gina Giradi
Allison Gross
Janice Kaczmarek
Dr. Lina Patel
Dr. Michael Rafii
Dr, Karen Schoelles