Rehabilitation Needs and Assistive Technology Provision in Children with Down Syndrome: A Real-World Cross-Sectional Study

Background: Down syndrome (DS) is aommon chromosomal disorder, with  an estimated prevalence in Italy comparable to other European countries (approximately 1 in 1,000 live births). It is associated with a broad spectrum of motor, cognitive, and functional impairments that frequently require long-term rehabilitation interventions, assistive technology, and social support. However, real-world data describing the complexity of healthcare needs in children with DS remain limited. This study aimed to characterize rehabilitation needs, assistive technology provision, and access to disability-related services in children with DS.

Methods: This retrospective cross-sectional study included children with DS referred to a territorial rehabilitation and assistive technology service. Demographic characteristics, rehabilitation services, economic benefits related to severe disability, and assistive device prescriptions were collected. Associations between demographic and clinical variables were explored through bivariate analyses. Data were retrospectively collected between January and December 2025.

Results: Twelve children with DS (mean age 7.98 ± 4.91 years) received 56 assistive device prescriptions. The small sample reflects the restrictive inclusion criteria, as only children requiring assistive technology and specialized rehabilitation services within a single territorial healthcare network were eligible. Ten children were classified as having profound disability and received economic benefits according to the Italian Ministerial Decree of September 26, 2016. Six accessed physiotherapy services in accredited rehabilitation centers. Females represented 64.3% of prescriptions and showed a different geographical distribution across healthcare districts (p=0.0123). Age was significantly associated with sex distribution (p<0.0001) and with the type of prescribed assistive devices (p<0.0001). Orthotic footwear was the most frequently prescribed device (50.0%), whereas wheelchairs and symbolic communicators were mainly prescribed in adolescents. Physiatrists issued most prescriptions (73.2%), with significant differences according to device type (p=0.0003).

Conclusions: Children with DS exhibit complex rehabilitation needs requiring integrated multidisciplinary care. The age-related evolution of assistive technology requirements highlights the importance of individualized rehabilitation pathways and coordinated healthcare planning to optimize functional outcomes and participation.