Is the appearance of children with Down syndrome associated with their development and social functioning?

The appearance of 111 children with Down syndrome, aged six to 14 years, was rated by their class teachers as part of a larger study on factors associated with their development, social life-style and family functioning. There were no significant associations between measures of child development, communicative or independent functioning, social life, behaviour problems or with parental stress, parent-child relationships or quality of family life. Typical features of Down syndrome are not major correlates of development and social functioning, and no support could be found to justify routine cosmetic surgery aimed at ameliorating such features.