During my time as a special educator, I encountered numerous children who required care, affection, and early intervention. Some were from poor families where even basic medical care and developmental guidance were lacking. I still recall a young boy who could not walk because his muscle tone was low—his parents, not knowing about the advantages of early therapy, could not afford it. There was another child with major speech delays because he had untreated hearing problems. These are early years, and they are pivotal, but so many kids blew past the window of care and had life-altering physical and cognitive setbacks.

Down Syndrome (DS) is a genetic disorder that impacts people differently, affecting their physical, intellectual, and emotional growth. Early childhood, especially the first five years, is an important time for children with DS because it lays the groundwork for their health, mobility, learning, and socialization in the future. This article discusses why the early years are important and how focused interventions can make a big difference in the quality of life for children with Down Syndrome.

Down Syndrome results from a complete or partial extra copy of chromosome 21, causing variations in physical traits, muscle tone, mental ability, and medical conditions. Each of the three forms of DS—Trisomy 21 (95%), Translocation (3%-4%), and Mosaicism (1%)—involves different levels of delays in development and medical issues. People with DS tend to experience increased loss of mobility and secondary medical problems over time, so early intervention becomes imperative.

Down Syndrome (DS) is a genetic disorder resulting from the presence of an extra copy of chromosome 21. Although developmental delay is evident in children with DS, intervention during early stages can significantly influence their development, health, and quality of life. The most critical years are the first five years because these form the bases of cognitive, motor, and social development.

The First Five Years of Development

Year 1: Sensory and Motor Skill Development

During their initial year, babies with DS also have low muscle tone (hypotonia) that can put back motor developmental milestones such as holding their heads up, turning over, and sitting without help. Physical therapy early on in life improves muscle strength and coordination. Sensory stimulation, touch, and listening are very much necessary in ensuring that they engage with the surroundings. Frequent medical checkups to keep up with heart ailment and eating difficulties are extremely important.

Year 2: Improving Motor and Communication Skills

Most toddlers with DS by age two begin crawling and pulling to stand. Walking, though, might still be delayed because of balance problems. Speech development is also initiated, but expressive language development could be slower. Speech therapy is crucial in enabling them to communicate well. Facilitating social interaction through play could enhance cognitive and emotional development.

Year 3: Achieving Independence in Daily Activities

By age three, DS children usually begin to walk, but with a broad gait. They start to refine motor skills such as holding tiny objects and eating with utensils. Programs of early childhood education incorporating interactive learning and play structured to stimulate problem-solving skills and social interaction assist them in gaining these skills. Occupational therapy may aid in the development of self-help skills such as dressing and feeding.

Year 4: Enlarging Social and Emotional Competencies

Four-year-olds with DS develop greater independence and emotional sensitivity. They begin to learn about routines and are able to follow simple commands. Yet, they continue to have difficulty with attention and impulse control. Structured preschool programs offer critical cognitive stimulation, while therapy helps increase attention span and flexibility within the group. Peer interaction, encouraged by matching and group activities, promotes social skills.

Year 5: Preparation for School and Long-Term Progress

By age five, children with DS are ready for structured learning environments. They may have stronger receptive language skills than expressive language, meaning they understand more than they can verbally express. Early reading programs, speech therapy, and individualized education plans (IEPs) help prepare them for mainstream or specialized schooling. Strengthening motor coordination through activities like climbing and drawing enhances both academic readiness and physical independence.

Why Early Intervention Matters for Kids with Down Syndrome?

The first five years set the tone for a child's future development. Early intervention therapies—physical, speech, and occupational—reduce delays and facilitate skill development. Routine medical surveillance ensures the prompt management of frequent health issues like heart disease, thyroid disease, and vision or hearing loss. Moreover, an inclusive and supportive environment allows children with DS to gain confidence and autonomy.

What Role Do Parents Play In Early Care And Support?

Parents are the biggest champions of their child's health. Educating families about DS, giving them emotional support, and introducing them to services like support groups and therapy centers can go a long way in the progress of a child.

Community programs, inclusive schools, and public awareness campaigns reduce stigma and provide an enabling environment where children with DS can grow and develop. Facilitating acceptance and offering customized learning opportunities enable children with DS to join mainstream society confidently.

The first five years of a child's life form the foundation of their overall growth and success. For children with Down Syndrome, these five years are particularly crucial in treating developmental delays, building motor skills, managing health issues, and developing emotional well-being. Through prompt interventions, family support, and exposure to quality healthcare and education, children with DS can lead meaningful lives and reach their full potential.

Polycystic Ovary Syndrome (PCOS) is often dismissed as a reproductive or cosmetic issue—a condition marked by irregular periods, acne, and weight fluctuations. But the hormonal and metabolic underpinnings of PCOS go much deeper. New findings presented at ENDO 2025, the annual meeting of the Endocrine Society, now highlight a troubling link: PCOS may significantly increase the risk of vascular events in women with thrombotic disease, and these events are occurring at increasingly younger ages.

The research, presented by a team from Riverside University Health System Medical Center and supported by national health data, suggests that the combination of PCOS and thrombotic disease creates a more dangerous cardiovascular profile, one that might be going under-recognized in clinical settings.

The analysis drew on records from the National Inpatient Sample (NIS), evaluating over 205,000 women hospitalized between 2016 and 2022 for thrombotic, atherosclerotic, or cerebrovascular diseases. The goal was to see how outcomes differed based on the presence or absence of comorbid PCOS. The findings were both significant and sobering:

Women with both PCOS and thrombotic disease had higher stroke rates (14.81%) compared to those without PCOS (11.91%).

A greater percentage of women with PCOS were under the age of 50 at the time of their vascular event compared to those without PCOS across all categories—thrombotic, atherosclerotic, and cerebrovascular.

Also Read: Your Home May Look Clean, But These 8 Spots Are Dirtier Than You Think

Despite the younger age of presentation, in-hospital mortality rates were similar between women with and without PCOS, suggesting the seriousness of these events in younger populations is not being offset by age-related resilience.

Dr. Alexander Lim, DO, who presented the findings, noted, “We found that cardiovascular events in women with PCOS were more likely to occur at an earlier age. The risk tends to decrease with age, possibly due to underdiagnosis of PCOS in older women or survivorship bias.”

Why Metabolic Difficulties Due To PCOS Lead Vascular Complications?

To understand why PCOS might elevate vascular risk, it's crucial to look at its underlying pathology. PCOS is not just a hormonal disorder—it’s also deeply metabolic.

Women with PCOS frequently exhibit insulin resistance, even if they are not overweight. This insulin resistance is a precursor to type 2 diabetes, hypertension, nonalcoholic fatty liver disease, and dyslipidemia—all conditions that significantly increase the risk of both arterial and venous thrombotic events.

Despite this, clinical management of PCOS often remains centered on cosmetic symptoms (like acne and hirsutism) or fertility concerns, rather than addressing the long-term metabolic and cardiovascular consequences. This treatment gap may explain why vascular events in women with PCOS catch both patients and providers off guard.

Why Current Testing May Be Failing Women?

Another striking aspect of the new research is that women with PCOS who experienced recurrent thrombotic events (strokes, heart attacks, pulmonary embolisms) often showed normal results in standard coagulation tests. This was identified in a diagnostic review by a coagulation management team and later verified through a national data set analysis using TriNetX, a large health research network.

Between 2013 and 2018, researchers used the TriNetX platform to analyze PCOS patients aged 15–75, excluding those with known thrombotic disorders, smoking history, or HIV. They found that thrombotic events occurred at significantly higher rates in women with PCOS compared to matched controls, even though clinical tests failed to detect abnormalities in coagulation.

What this suggests is that standard coagulation assays may not be sensitive enough to detect the unique thrombotic risk profile in PCOS, raising concerns about diagnostic error or delayed interventions.

This is the first large-scale study to systematically evaluate the rate and clinical presentation of thrombotic events in women with PCOS using national data and validated diagnostic algorithms like SPADE (Symptom-Disease Pair Analysis of Diagnostic Error).

By comparing outcomes 90 days prior to major thrombotic events, the researchers identified consistent symptom patterns—including subtle indicators—that could serve as early warning signs for intervention. However, the precise biological mechanisms behind thrombosis in PCOS remain poorly understood.

The message is clear: PCOS isn’t just a reproductive disorder—it’s a systemic, vascular-risk condition that can dramatically impact a woman’s health long before menopause. Clinicians need to think beyond fertility and skin health and recognize that young women with PCOS may be walking around with unrecognized cardiovascular vulnerabilities.

For women living with PCOS, this means that a heart-healthy lifestyle—including regular cardiovascular screening, metabolic management, and awareness of symptoms like chest pain, migraines, and swelling—needs to be part of long-term care, not just pregnancy planning.

Last August, Erica Kahn was enjoying a peaceful evening stargazing in Arizona’s Glen Canyon National Recreation Area. The 33-year-old Massachusetts resident was on vacation, photographing the night sky. Bats flitted through the air, but she didn’t give them much thought, until one of them flew straight at her face.

In the chaos, the bat became lodged between her camera and her face. She screamed instinctively, and part of the bat ended up in her mouth. She still doesn't know exactly what part of the bat it was, but she estimates the contact lasted a few seconds. “It seemed longer,” she said.

The bat eventually flew away. Though she wasn’t sure if she’d been bitten, her father, a physician who was traveling with her, advised her to get treated for potential rabies exposure.

Scrambling for Health Insurance

The problem? Just weeks earlier, Kahn had been laid off from her job as a biomedical engineer and had decided to forgo COBRA coverage, which would’ve let her stay on her former employer’s health insurance plan. The cost, around $650 a month, felt too steep for someone young and healthy.

She figured she could risk going uninsured for a while and quickly sign up for a plan if something happened. That decision turned out to be costly.

After the bat incident, Kahn purchased a private health policy for $311 a month from a Florida-based company called Innovative Partners LP. She even called them to confirm that emergency services or accident-related care would be covered. Feeling reassured, she went to a hospital in Flagstaff the next day and began her rabies vaccination series.

The Treatment and the Shock

Kahn received four doses of the rabies vaccine over 14 days. Her first visit also included three injections of rabies immunoglobulin, a vital treatment that boosts the body’s ability to fight off the deadly virus. She continued her treatment at different clinics in Arizona, Colorado, and Massachusetts.

Then the bills arrived.

Across all four facilities, Kahn was charged a total of $20,749. The bulk of that, $17,079, came from Flagstaff Medical Center, which billed $15,242 for the vaccines and immunoglobulin alone.

To her shock, her insurance company denied all claims. Their explanation? The treatment occurred during the policy’s 30-day waiting period, and the company ruled that the services did not qualify as accident-related or life-threatening under their terms.

Appeals, Confusion, and Mounting Debt

Kahn tried to appeal the decision. She got a doctor at Flagstaff Medical Center to sign a letter supporting her claim, but she struggled to reach doctors at the other facilities. The insurance company gave her conflicting information about where to send appeal paperwork. In July, she learned that the insurer had not received any formal appeal.

Health policy expert Sabrina Corlette, from Georgetown University, reviewed Kahn’s situation and suggested the policy she purchased was likely a “fixed indemnity” plan, as reported by the Washington Post.

These limited plans pay only a set amount per day for care, regardless of actual costs, and are not required to meet the standards of the Affordable Care Act (ACA). Corlette added that even if Kahn had purchased a more comprehensive plan, treatment that began the day after enrollment might not have been covered.

“This is why it’s so important to be insured before something happens,” Corlette said. “It’s not just about coverage, it’s about timing.”

A Harsh Lesson in Hindsight

Back when Kahn lost her job, she was still within the 60-day window to opt into COBRA. Had she done so and paid the premium, her coverage would have applied retroactively to the day she was laid off. She didn’t realize this until much later.

Now re-employed and covered under her new job’s insurance, Kahn is still chipping away at the debt from her run-in with the bat. She negotiated one $706 bill down to $420 and set up a $10-a-month payment plan for a separate $530 charge. But over $19,000 remains unpaid.

You may be cleaning your house well, however, there may still be spots, corners, and places that you could be missing. But, what makes germs stick in these corners longer than other spots? Well, there could be certain reasons, that determine the duration of a germ, including:

Surface Types: solid surfaces like counters or textured surfaces

Living Habits: How often do you clean or disinfect surfaces

Lifestyle Practices: Washing hands and bathing regularly

Cleaning Procedures: What you use to clean, whether it is using bleach or alcohol based cleaning supplies

What Are The Top 8 Dirtiest Spots In Your House?

Kitchen

As per the National Sanitation Foundation (NSF), areas where food is kept, stored or prepared have the most bacteria as well as fecal contamination than any other place in your home.

In fact, more than 75% of dish sponges and rags have Salmonella, E. coli, and fecal matter compared with 9% of bathroom faucet handles.

The elements in kitchen that needs to be cleaned frequently include:

• Cutting boards
• Coffee maker
• Refrigerator, especially where uncooked food is kept
• Kitchen sinks and counter tops

What can you do? Use disinfectant wipes on faucets, refrigerator surfaces and counter tops. You can also damp sponges in microwave for a minute to kill bacteria.

The World Health Organization (WHO) also recommends washing your hands for at least 20 seconds before and after you touch raw meat or unprepared food.

ALSO READ: Dirtiest Things That You Touch In A Restaurant That Could Cause Food Poisoning

Knobs, Door Handles, Switches

These surfaces are touched continuously. While, it may miss out from daily cleaning, however, if you come to think about it, these places may be touched more than you would ever keep a count of.

NSF also found that bathroom light switches, refrigerator handles, stove knobs, and microwave handles were the dirtiest places in the house. You can use disinfecting wipes once a week to ensure they are clean and safe to use.

Your Makeup Corner

The place where you keep your makeup, and even your make up bag is one of the dirtiest places and this can infect your eyes, or cause skin infections.

A 2020 Lancet study shows that viruses can also get on makeup applicator from your hands and could make way to your eyes, nose, and mouth.

The best way to deal with it? Change the way you store your makeup. Make sure all the products are stored clean and dry. Clean your makeup brushes, wash them once a week with regular soap and water, or use an alcohol spray. Some doctors also recommend replacing cosmetics every 6 months.

Bathroom

Of course it is one of the dirtiest places in your home. This is where you scrub off dirt from your body and thus, becomes a breeding ground for bacteria.

There is also a lot of moisture in the bathroom, an environment that helps germ grow.

Where should you pay special attention? Shower tub, drains, faucets, floor around the toilet seat, bath towels, and toothbrushes.

ALSO READ: Your Towels Are Making You Sick— How Often Should You Wash Them?

Make sure you flush the toilet with its lid on.

Laundry

Leaving damp laundry in the washing machine, even if for just 30 minutes, can create the perfect environment for germs to grow. Always move clothes to the dryer right after the wash cycle ends.

If you’ve forgotten a load for a while, it’s best to rewash it. When using a laundromat or shared laundry room, wipe the washer drum with a disinfectant wipe before use.

Also, avoid folding clean clothes on public surfaces without wiping them down first. Washing clothes in warm or hot water, notes UNICEF, especially items worn in public, is more effective at killing viruses and bacteria than cold water.

Home Office & Living Room

NSF found that remote controls, keyboards, phones, and tablets are often shared among family and guests, and they’re germ hotspots. It also found mold, yeast, and even Staphylococcus on remotes and game controllers in multiple households.

A 2018 study published in the International Journal of Environmental Research and Public Health found that carpets can trap up to eight times their weight in dirt, sometimes making them dirtier than a city sidewalk. Viruses can survive for up to 3 days on plastic surfaces like remotes and keyboards.

Wipe down these items regularly with disinfectant wipes or a soapy cloth, and always wash your hands after returning home before touching any surfaces or electronics.

Pets

Your furry friends can bring germs indoors, especially if they spend time outside. Pet bowls, as per NSF, rank as the 4th germiest item in the home, with toys close behind. Studies have found staph, yeast, and mold on pet items.

Some helpful hygiene tips:

• Wash bowls daily with warm, soapy water
• Soak toys and bowls in diluted bleach weekly
• Clean hard toys with hot water regularly
• Wash soft toys once a month
• Wipe your pet’s paws before they come inside.

While your pet may not get sick, the germs they carry can easily transfer to your hands or face.

Personal Items

Every time you return home, you might be unknowingly bringing in bacteria and viruses, on your shoes, phone, wallet, or even headphones.

In a study by NSF of 22 homes, fecal bacteria, yeast, and mold were found on:

• Phones
• Keys
• Wallets and cash
• Lunchboxes
• The bottoms of purses

Since many of these items are made of plastic or metal, some viruses can live on them for up to 72 hours.

Disinfecting wipes work well on most of these surfaces. For electronics, consider using wipes specifically made for tech gear to avoid damage.