I am going to explore a couple of areas where both the medical professionals and the general public get it wrong. We are going to start with hands and the palmar crease /single crease. According to wikipedia, only 45% of people with Down’s syndrome have a single palmar crease, so it is not as common as people/professionals (that I have come across) think. In the general population 10% of people will have a single crease on one hand and 5% of the population will have a single crease on both hands (again, according to wikipedia).
When Seren was born, the midwife examined her hands and although she didn’t say anything at the time, the action of checking Seren’s hands became a constant theme and remains a source of interest to medical professionals and well meaning members of the general public, friends or acquaintances who have read the “blurb”.
There are several physical characteristics that an individual with Down’s syndrome *might* display, and having a single palmar crease is one of them (also can be known as a simian crease, but this is an outdated term). Seren has a single crease on each hand and on examination, medical professionals nod and show me her hands telling me that it’s a sure fire sign she has Down’s syndrome, or at the very least that it is “the most common” marker of Down’s syndrome (it is not). Many assume I haven’t noticed her palmar creases before even though she is now over 3 years old. The fact that Seren displays so many of the textbook characteristics of her Trisomy 21 (triplication of the 21st chromosome, aka Down’s syndrome), does not bear a direct correlation to how she functions on the spectrum of ability. Just because she has the physical markers does not mean that she is going to be worse off cognitively or health wise. This was one of the first questions I asked when Seren was born, but only because I thought the professionals were trying to subtily tell me something as they took great delight in pointing out her “markers” as she has almost every single one, which is unusual in itself. Seren is in fact a very capable 3 year old, and is developing really well in all other areas.
So here’s the thing. While Seren’s hands are “textbook” (palmar creases, short palms, short fingers), she is actually in the minority. I have not come across any other child with Down’s syndrome so far who has hands like Seren. In many ways they are the “worst” (horrible way to explain it, but you get what I mean) that I have ever seen. Her short fingers and thumb mean she really lacks dexterity. She cannot isolate finger movement and has an under developed pincer grip. She gets by though, she just might have problems with zips and buttons for the rest of her life. We are working on her fine motor skills, so we remain hopeful to get her functioning to her best ability!
On that note, have a look for yourselves. Here are some of the FoD family who have kindly submitted photo’s of their children’s hands. All these hands belong to children with Down’s syndrome, yet not all of them have single creases, and some kids even have a palmar crease on one hand and typical creases on the other!