Children with Down syndrome generally still require frequent medical checkups (e.g., well-child visits) to ensure and maintain good health. Many pediatricians recommend vision and hearing tests at every visit. Many children with Down syndrome have sight problems and suffer from chronic ear infections (e.g., otitis media) in addition to hearing loss, which can compromise their ability to learn and use language. Identifying vision and hearing problems early may minimize their effect on learning and language skills.

Developmental delays continue in childhood. Children with Down syndrome may begin to walk and speak later than other children. It may also take longer for them to become toilet trained and to learn to feed and dress themselves.

Early-intervention services are generally recommended to continue from infancy up to school age. Physical therapy can continue to help increase muscle tone and coordination. Occupational therapy can be used to improve fine-motor skills, such as hand coordination. Speech therapy may help to improve language development. Therapists can also teach the parents of children with Down syndrome how to continue to improve these and other communication skills at home.

The U.S. Individuals with Disabilities Education Act (IDEA) guarantees educational services to children with Down syndrome who are 3 years of age and older. This includes free education that is appropriate for the child's level of development and an individualized education plan (IEP). These services are typically provided by the local school district.

Many school-aged children with Down syndrome can attend classes in regular schools. Some may still need special classes to help with any learning disabilities. There are also special programs available for the schooling of children with Down syndrome.

Children with Down syndrome can participate in activities (e.g., music, dance) and usually play sports, although medical problems may restrict some of these children from certain sports (e.g., football, diving). Many children with Down syndrome participate in the Special Olympics, a sports training and athletic competition for people with intellectual disabilities.

Schooling for children with Down syndrome may vary by state and school district. In some areas, classrooms are grouped by age regardless of education level. In others, children with disabilities may study separately in groups according to their ability level. Parents of Down syndrome children can educate themselves about their child's abilities and the programs offered within their districts.

Many adolescents with Down syndrome can still attend the same classes and schools and participate in the same activities as their age peers. They can often get after-school or summer jobs. Some continue their education through college, and many can look forward to living at least partially independently.

These adolescents generally have the same desires and interests as other adolescents. They can be concerned over romantic relationships and having their own families one day. Boys and men with Down syndrome are usually infertile. Girls with Down syndrome reach sexual maturity and experience menstrual periods, and many can become pregnant. However, a girl or woman with Down syndrome has an increased chance of having a child who also has Down syndrome.