Nonetheless, many things remain elusive. Jason wanted to drive. "It's fun for boys and sexy for girls," he said in Count Us In. Count Us In. "You can get girls if you drive." He had announced that when he was old enough, he wanted a red Saab turbo convertible. Emily paused as she recounted this, deeply frustrated. "So how do you tell your kid that he's never "You can get girls if you drive." He had announced that when he was old enough, he wanted a red Saab turbo convertible. Emily paused as she recounted this, deeply frustrated. "So how do you tell your kid that he's never going to drive? I said, 'Your reaction time is slower than other people's.' I made it something physical. He's no dope. He shouldn't drive because he doesn't have the judgment, but how to say so?" Jason lives in a lonely demographic. He is too bright for most others with Down syndrome; they can't keep up with his verbal abilities, his puns, his games. But he is not bright enough for people without disabilities. "He has no peers," Emily said with a mix of enormous pride and terrible regret. going to drive? I said, 'Your reaction time is slower than other people's.' I made it something physical. He's no dope. He shouldn't drive because he doesn't have the judgment, but how to say so?" Jason lives in a lonely demographic. He is too bright for most others with Down syndrome; they can't keep up with his verbal abilities, his puns, his games. But he is not bright enough for people without disabilities. "He has no peers," Emily said with a mix of enormous pride and terrible regret.

Jason described a life for himself that included a family and a dog and a white picket fence; he has a sort-of girlfriend, who also has DS. Emily took him in for a vasectomy. Though many males with DS are infertile, some are not. "It only takes one sperm to do it," Emily said. "We did not want to leave the responsibility of birth control to a girl whose capacity we were unclear of. If he wants to set up housekeeping with somebody and have a marriage, I'll give him the wedding of the age. Being a good parent, though-I simply don't see how he could do it."

Charles's dream was that his son would live independently, so he set Jason up in an apartment of his own. Jason found his first job at Barnes & Noble, tearing the covers off magazines destined for recycling. He found it excruciatingly boring and kept making up ways to amuse himself. When his supervisor insisted that this was not his job, he replied, "I'm an independent adult person and I make my own decisions"-showing the very spirit that Charles and Emily had fostered, applied in exactly the wrong context. He was fired soon thereafter. His next job was at the White Plains Public Library. He developed his own idiosyncratic way of shelving videos, and unsurprisingly, the library staff wanted things done their way. Jason argued about it until they, too, had to let him go.

"He wants to open a store where he will tell people the inner messages of Disney movies," Emily explained. "You wait in line, he says, 'Next!' and you come up and say, 'Please, Jason, would you explain the inner meaning of The Hunchback of Notre Dame The Hunchback of Notre Dame?' He would say, 'The inner meaning is that it's what's inside people that counts, whether they're a good person, and that's more important than whether they're beautiful. That'll be fifty dollars, please. Next!' You cannot explain to him that people already know this, that they don't find it out at a store anyway. In some very, very basic ways, he's clueless." Emily threw up her hands. She told me mournfully, "The primary job of most parents is to make their kids think they can do anything; my primary job is to take him down. Reduced to a sentence, it's 'You're not smart enough to do what you want to do.' Do you know how much I hate having to say that?"

When Jason was twenty, his father was diagnosed with cancer, and three years later, he died. Jason became deeply depressed. Emily became depressed, too. Emily found Jason a therapist, then turned to Westchester Arc (the organization's name was originally an acronym for Association for Retarded Citizens), where Charles had served as president of the board. She wanted to qualify for ResHab, or residential habilitation, in which support staff come to a person's home and provide services and instruction in independent-living skills. She was tossed around in the bureaucracy until she finally broke down in tears in front of a committee and said, "My kid is destroying himself. I can't do all of this myself." Jason was finally given a caseworker who came in twenty hours a week. "That was a great help," Emily said, "but I started realizing that it wasn't enough. I had to bite the bullet and acknowledge that as smart as he is, he needs more structure and supervision. He just is not eating healthy meals at a regular time each day, or getting himself up and to work on time."

Emily decided that Jason needed to be in a group home. "It was a feeling of failure," she said. "We had worked so hard to make him the Down syndrome guy who didn't need it. But I had to look at what was best for him, and not at some ideal we had built up for ourselves." When Emily put Jason on the waiting list for a local facility, she found out that the wait was an impossible eight years. "Raising a kid like Jason," she said, "the kid is the least of the challenges. Jason was there to put his arms around me when the bureaucracies had nearly killed me." Services are seldom available to anyone who does not have the wherewithal to battle agencies. Doing so often requires education, time, and money-which is a painful irony given that these services are intended to benefit people who may be short on all three.

One day, Emily spotted a house for sale in Hartsdale, New York, and realized it would be a perfect group home. It had three bedrooms, enough for Jason and a companionable two friends; it was near the main bus stop, and across the street from a supermarket, a bank, and a pharmacy. Emily bought the house, then asked Arc to run it. The New York State Office of Mental Retardation and Developmental Disabilities now rents the house from Emily for the amount of her mortgage payment. Jason moved in with two of his best friends from the parties Emily had been throwing. The three receive Social Security disability checks that go straight to Arc, which spends the money to maintain and staff the house.

"They love one another," Emily said. "They call themselves the Three Musketeers." Jason has a job working for the local radio station, where he is happy. "I'm stepping back a little," she said. "The ultimate job is to appreciate him for who he is-and who he is, is really terrific. Anything he's accomplished, he's accomplished because he really stuck to it. Nothing comes easy to him." She paused. "He's kept a lot of dignity in the face of that. I really, really admire him tremendously. I'm also sad for him, because he's smart enough to know that almost everybody is accomplishing things that he's not, smart enough to realize that his life is different." job is to appreciate him for who he is-and who he is, is really terrific. Anything he's accomplished, he's accomplished because he really stuck to it. Nothing comes easy to him." She paused. "He's kept a lot of dignity in the face of that. I really, really admire him tremendously. I'm also sad for him, because he's smart enough to know that almost everybody is accomplishing things that he's not, smart enough to realize that his life is different."

Even if a child never acquires the skills needed for independent living, he accumulates experience and history. "He says to me that he wants this particular video," Emily said, "and I used to say to him, 'You are intelligent enough to watch something better than that.' I used to think that if I kept pushing, he would have a better life in the world. But now I think, 'Well, if that's what he enjoys, who am I to interfere?' So I don't buy things like The Brave Little Toaster, The Brave Little Toaster, but I don't give him a hard time if he wants to buy it for himself. You can have tulips and windmills coming out your ears, but you don't but I don't give him a hard time if he wants to buy it for himself. You can have tulips and windmills coming out your ears, but you don't ever ever get to the Uffizi, and that's it." get to the Uffizi, and that's it."

A couple of years later, Jason was depressed again, and Emily reflected with concern on her original attempt to make Jason the highest-functioning DS kid in history. She said, "With perfect hindsight would I have done it differently? His intelligence has enriched our relationship so much and I would never want to give that up, but I'll admit that lower-functioning Down kids are happier, less obsessed with how unfair it is. They have an easier time in many ways, but is that better? He takes such pleasure in words, in using his mind." I went to a reading at Barnes & Noble that Jason and his friend did when their book was reissued. Jason answered the audience's questions with fluency and poise. Emily was aglow and Jason was aglow, their pleasure in his intelligence a mutual delight. The parents of children with DS who had come to hear him were aglow, too, with hope. During the book signing, people approached Jason reverently. He and Emily were heroes, and Jason loved being a hero; I could understand his loneliness, but I could not miss his pride.

Once when I was at Emily's house, she called Jason and offered to take him and his roommates to The Pirates of Penzance The Pirates of Penzance. After a pause, I heard her say wistfully, "Well, okay, I guess I'll go on my own." The cliche is that people with Down syndrome are incredibly sweet-natured, and they are, but they are unsubtle in their thinking, and Emily's nuanced disappointment had not registered with Jason as it might with a typical child of six or seven. "He's not very introspective," she said. "He doesn't understand the origins even of his own feelings. So it's pretty much impossible for him to be outrospective and guess what's going on inside of me." A few years later she said, "Actually, in some ways he is the first kid with Down syndrome who is really introspective. It's not a boon to have Down syndrome and be introspective, because what you see when you look inside yourself are inadequacies. That's how deep he can look into himself. Jason was talking the other day about what he might have done if he hadn't had Down syndrome. I have never allowed myself that fantasy. It's too dangerous for me." the first kid with Down syndrome who is really introspective. It's not a boon to have Down syndrome and be introspective, because what you see when you look inside yourself are inadequacies. That's how deep he can look into himself. Jason was talking the other day about what he might have done if he hadn't had Down syndrome. I have never allowed myself that fantasy. It's too dangerous for me."

For most of recorded history, DS has not been compared to a holiday among windmills and tulips. The idea that "idiots" were amenable to amelioration originated with Jean Marc Gaspard Itard's attempt to educate the Wild Boy of Aveyron in the early nineteenth century. His theories were then developed by his pupil edouard Seguin, director of the Hospice des Incurables in Paris, who structured a system for assessing the intellectually disabled and was the first to recognize the merits of early treatment. "If the idiot cannot be reached by the first lessons of infancy," he wrote, "by what mysterious process will years open for him the golden doors of intelligence?" Seguin emigrated to the United States in the middle of the nineteenth century and established institutions for the care and education of the disabled, whom he enabled to participate in civic life, often through manual labor.

Yet even as Seguin was bringing about such transformation, others argued that the cognitively disabled were not merely stupid, but evil and corrupt. The language of accusing rectitude is reminiscent of the Imaginationist argument that women who bore dwarfs did so because of their lascivious nature: deformity and disability were interpreted as evidence of failure. Samuel G. Howe's 1848 Report Made to the Legislature of Massachusetts Report Made to the Legislature of Massachusetts articulates this pre-eugenic, dehumanizing vision: "This class of persons is always a burden upon the public. Persons of this class are idle and often mischievous, and are dead weights upon the material prosperity of the state. They are even worse than useless. Every such person is like a Upas tree, that poisons the whole moral atmosphere about him." articulates this pre-eugenic, dehumanizing vision: "This class of persons is always a burden upon the public. Persons of this class are idle and often mischievous, and are dead weights upon the material prosperity of the state. They are even worse than useless. Every such person is like a Upas tree, that poisons the whole moral atmosphere about him."

The first person to describe Down syndrome was John Langdon Down, in 1866. He referred to his subjects as Mongoloids Mongoloids or or Mongoloid idiots Mongoloid idiots on the basis that their faces, with slightly slanted eyes, resembled those of people from Mongolia. Down proposed that human evolution had gone from black people to Asians to white people, and that white people born with Mongolism were actually a throwback to their primitive Asian antecedents-a position then considered rather progressive insofar as it acknowledged evolution. on the basis that their faces, with slightly slanted eyes, resembled those of people from Mongolia. Down proposed that human evolution had gone from black people to Asians to white people, and that white people born with Mongolism were actually a throwback to their primitive Asian antecedents-a position then considered rather progressive insofar as it acknowledged evolution.

By 1900, the jobs that had been done by Seguin's trained individuals with mental retardation were being claimed by the great influx of immigrants, who did them more efficiently, and the institutions originally intended to educate the intellectually disabled were used to exclude them from an efficiency-oriented industrial society. Medical texts delineated how to classify someone an "idiot," an "imbecile," or a "moron"; eugenicists provided a spurious validation of the link between mental retardation and criminality, and laws favoring sterilization were instituted. of immigrants, who did them more efficiently, and the institutions originally intended to educate the intellectually disabled were used to exclude them from an efficiency-oriented industrial society. Medical texts delineated how to classify someone an "idiot," an "imbecile," or a "moron"; eugenicists provided a spurious validation of the link between mental retardation and criminality, and laws favoring sterilization were instituted.

As late as 1924, a British scientist published material saying that these children actually were biological members of the Mongol race; that view was finally challenged in the 1930s by Lionel Penrose, a British doctor who used blood tests to prove that white people with DS were genetically related to other white people and not to Asians. Penrose also established that the greatest risk factor for DS was maternal age, identifying thirty-five as the cutoff point at which risk escalated. Oliver Wendell Holmes wrote in a 1927 Supreme Court decision, "It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. Three generations of imbeciles are enough." The forced-sterilization law, applied to people with many disabilities and disadvantage but particularly focused on those with intellectual disabilities, was not repealed for almost fifty years. In 1958, a French geneticist, Jerome Lejeune, presented to the International Congress of Genetics his evidence that the condition was the result of a triplication of the twenty-first chromosome, of which there should be only two copies; the scientific name for Down syndrome is trisomy 21 trisomy 21.

The psychoanalyst Erik Erikson (inventor of the term identity crisis identity crisis), at the urging of his friend Margaret Mead, had sent his newborn son Neil to an institution within days of his birth in 1944 and kept his existence secret even from his other children, fearful that if anyone knew he had produced an "idiot" his reputation would be damaged. He had been told that his son would live no more than two years; in fact, Neil lived two decades. The view that a child with a disability was an unmitigated tragedy reached an apotheosis in Simon Olshansky's oft-quoted description of parents' "chronic sorrow." His was not the only such voice. The psychoanalysts Albert Solnit and Mary Stark lobbied in 1961 for a new DS mother to have "physical rest; an opportunity to review her thoughts and feelings about the wished-for child; a realistic interpretation and investment of the feared, unwanted child by doctors and nurses; and an active role in planning for and caring for the newborn child as she is able. These are the measures through which the mother can minimize or overcome the trauma of giving birth to a retarded child."

In 1966, the playwright Arthur Miller and his wife, the photographer Inge Morath, institutionalized their child with DS and told almost no one of his existence. In 1968, the ethicist Joseph Fletcher wrote in the Atlantic Monthly Atlantic Monthly that there was "no reason to feel guilty about putting a Down's syndrome baby away, whether it's 'put away' in the sense of hidden in a sanatorium or in a more responsible lethal sense. It is sad, yes. Dreadful. But it carries no guilt. True guilt arises only from an offense against a person, and a Down's is not a person." Willowbrook, that hell house of the 1960s and early 1970s, happened for a reason; parents who had been persuaded that their retarded children were not persons left them in repugnant conditions. that there was "no reason to feel guilty about putting a Down's syndrome baby away, whether it's 'put away' in the sense of hidden in a sanatorium or in a more responsible lethal sense. It is sad, yes. Dreadful. But it carries no guilt. True guilt arises only from an offense against a person, and a Down's is not a person." Willowbrook, that hell house of the 1960s and early 1970s, happened for a reason; parents who had been persuaded that their retarded children were not persons left them in repugnant conditions.

Yet even as prejudice against those with intellectual disabilities was escalating, a new movement to help the disabled was also unfolding. The argument that the disabled warranted benevolent treatment coincided with a larger post-Enlightenment shift in our conception of early education. Historically, this had been the province of mothers, and the notion that experts had something to add began only with the founding of the first kindergartens in early-nineteenth-century Germany. At the end of the nineteenth century, Maria Montessori applied lessons she had learned from her work among the intellectually disadvantaged in Rome to typical children. Soon nursery schools began to crop up in Europe. In the United States, they burgeoned when the New Deal subsidized teaching jobs, then spread further as the Second World War effort called mothers into the workforce. At the same time, attempts to curtail childhood mortality were also under way, directed especially at the poor. The new science of behaviorism rose up in opposition to eugenics and suggested that people are made, not born, and can be educated and shaped into anything. The emerging field of psychoanalysis was concurrently examining how early trauma could interfere with healthy development, and some of its adherents began to question whether the shortcomings of the poor and disabled might be the result of early deprivation rather than organic inadequacy.

The 1935 Social Security Act included a provision that the federal government would match state funds for treating the disabled. Investigators soon began to look at how a stimulating and enriching environment allowed poor children to transcend their apparent deficits. John Bowlby, the father of attachment theory, demonstrated that good maternal care was crucial to the development of the healthy child, an insight so obvious today that it is hard to remember how radical it was a mere sixty years ago.

Eugenics was finally discredited when it devolved into the Holocaust. Meanwhile, the influx of handicapped veterans at the end of World War II softened social prejudice against disabled people in general. In 1946, the US Office of Education set up a Section for Exceptional Children, which led to better education programs for people with special needs, but those children remained segregated from the larger society. In 1949, Ann Greenberg, the mother of a child with Down syndrome, placed advertisements in the World War II softened social prejudice against disabled people in general. In 1946, the US Office of Education set up a Section for Exceptional Children, which led to better education programs for people with special needs, but those children remained segregated from the larger society. In 1949, Ann Greenberg, the mother of a child with Down syndrome, placed advertisements in the New York Post New York Post seeking other parents who shared her concerns. A year later, they founded the Association for Retarded Citizens, now known as the Arc, and still one of the most prominent organizations in the field. Most parents thought of DS entirely in terms of nature: the child has a genetic anomaly and nothing can be done about it. Greenberg was among the parent activists on the side of nurture: the child has a genetic anomaly and there is work to be done. seeking other parents who shared her concerns. A year later, they founded the Association for Retarded Citizens, now known as the Arc, and still one of the most prominent organizations in the field. Most parents thought of DS entirely in terms of nature: the child has a genetic anomaly and nothing can be done about it. Greenberg was among the parent activists on the side of nurture: the child has a genetic anomaly and there is work to be done.

When John F. Kennedy became president, he established a commission to study mental retardation and its possible prevention. Reintegration of the disabled into the larger society was spearheaded in part by his sister, Eunice Kennedy Shriver, whose 1962 article in the Saturday Evening Post Saturday Evening Post about their sister Rosemary emphasized that even families of prominence and intelligence can have retarded children. She observed with sadness the poor living conditions to which most people with mental retardation were consigned. Her vision of change took meaningful form in the wake of the civil rights movement's rethinking of social inequalities. Black people had for so long been described as constitutionally inferior, and when they rose up against that characterization, they opened the door for other marginalized people to do the same. Head Start, founded in 1965, was dedicated to the idea that people lived in poverty not because inherent deficits qualified them for nothing better, but because they had not received appropriate and constructive early stimulus. Head Start combined health, education, and social services and trained parents as active partners in the treatment of their children. about their sister Rosemary emphasized that even families of prominence and intelligence can have retarded children. She observed with sadness the poor living conditions to which most people with mental retardation were consigned. Her vision of change took meaningful form in the wake of the civil rights movement's rethinking of social inequalities. Black people had for so long been described as constitutionally inferior, and when they rose up against that characterization, they opened the door for other marginalized people to do the same. Head Start, founded in 1965, was dedicated to the idea that people lived in poverty not because inherent deficits qualified them for nothing better, but because they had not received appropriate and constructive early stimulus. Head Start combined health, education, and social services and trained parents as active partners in the treatment of their children.

By the end of the 1960s, insights from Head Start were being applied to people with intellectual disabilities, and in particular to children with Down syndrome. It became clear that people with DS showed a wide range of functioning, and that it was absurd to predict a newborn's abilities simply from his diagnosis. It seemed to follow that writing such people off at birth was unfair, and that their capacities should be maximized, both to give them a better life and to avoid later costs. Early intervention was better value for money than remediation. In 1973, Congress passed, over President Nixon's veto, the Rehabilitation Act, which stated, "No otherwise qualified handicapped individual in the United States shall, solely by reason of his handicap, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance." Even with the budget cuts of the Reagan years, programs for disabled children remained in force; this population had become entrenched and drew broad public sympathy. The cause reached a triumphal apogee with the passage of the Americans with Disabilities Act in 1990, which extended the 1973 protections beyond the confines of federally funded programs. Parents, with support from disabled people themselves, had capitalized on changing ideas about humanity. They had validated lives long considered worthless. If racial minorities and the poor deserved support and respect, then so did people with Down syndrome and related conditions. If help to these other groups was best given early, then so, too, was aid to people with intellectual disabilities. be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance." Even with the budget cuts of the Reagan years, programs for disabled children remained in force; this population had become entrenched and drew broad public sympathy. The cause reached a triumphal apogee with the passage of the Americans with Disabilities Act in 1990, which extended the 1973 protections beyond the confines of federally funded programs. Parents, with support from disabled people themselves, had capitalized on changing ideas about humanity. They had validated lives long considered worthless. If racial minorities and the poor deserved support and respect, then so did people with Down syndrome and related conditions. If help to these other groups was best given early, then so, too, was aid to people with intellectual disabilities.

Early intervention (EI) is now a federal program for infants with any of a broad range of complaints-low birth weight, cerebral palsy, Down syndrome, autism-and it has vastly raised levels of functioning in all these groups. EI services provided before a child turns three may include physical therapy, occupational therapy, nutrition counseling, audiology and vision services, nursing support, speech-language therapy, and instruction on assistive technology, as well as support and training for parents who are having trouble coping. It entails a strong focus on sensory stimulation of all kinds. Hospitals are required to tell parents about these services. EI is available to people at every socioeconomic level, sometimes through home visits and sometimes in special centers. These early services are also a form of parent training and may help families to feel optimistic about keeping their children at home. The quality of services for children with particular disabilities varies enormously from state to state; New York, for example, has especially good EI services for DS, and anecdotes tell of people moving to the state specifically to access them.

EI is the full expression of the nurture-over-nature argument-the ultimate triumph of psychoanalysis, civil rights, and empathy over eugenics, sterilization, and segregation. It grew out of a strange nexus of federal politics, parent activism, and psychology; it was a result of changing understandings of nondisabled children and new theories of general early education. It continues to evolve today, as many forms of engagement are grouped under that now-ubiquitous rubric.

Change in both treatment and acceptance of people with DS, however, continues to be driven by parents. By demanding that physicians treat their children's physical ailments as respectfully as they would those of nondisabled children, they have brought about an astonishing increase in life expectancy for people so diagnosed. If early intervention early intervention is ultimately a vague and ever-evolving umbrella term for a broad range of protocols, it has nonetheless been the organizing phrase for a radical rethinking of the lives of disabled people. Where science and biological cure have been stalled, the social model of disability has achieved wild triumph. Many specific techniques are invaluable in addressing particular needs, but the long and short of it is that disabled children, like nondisabled children, thrive on attention, engagement, stimulation, and hope. is ultimately a vague and ever-evolving umbrella term for a broad range of protocols, it has nonetheless been the organizing phrase for a radical rethinking of the lives of disabled people. Where science and biological cure have been stalled, the social model of disability has achieved wild triumph. Many specific techniques are invaluable in addressing particular needs, but the long and short of it is that disabled children, like nondisabled children, thrive on attention, engagement, stimulation, and hope.

When Elaine Gregoli's daughter, Lynn, was born in 1970, a few years before Jason Kingsley, the obstetrician announced to the baby's father, "Your daughter is a Mongoloid idiot." Elaine, just twenty-three years old, already had a son, Joe, two and a half, and she decided not to have more children. She had never heard of EI. "Lynn was a baby a very long time," Elaine said. "She didn't sit up till she was twelve months old; she didn't walk till she was almost two." Elaine went to an agency, YAI, where a doctor gave her some little exercises to do with Lynn. When Elaine returned two years later, the agency asked her whether she'd like to work there part-time, because they had a severely handicapped little girl with seizures, and they wanted a nurse around. "So Lynn was in the first preschool program that Brooklyn ever had, for two hours, twice a week, and I was right there to learn what I could," Elaine said. She became increasingly interested in the brand-new field of early intervention, and Lynn's school asked her to run their program.

Like Jason Kingsley, Lynn was immensely nourished by the nascent EI movement. She competed in the Special Olympics as a gymnast and an ice-skater. Her motor skills were always better than her cognitive skills, so Elaine mainstreamed her in recreational programs, but not in educational ones. She was in a regular Girl Scout troop, and in a swimming program with typical kids. "But she always was with the younger kids," Elaine said. "She was ten, and she was with six-year-olds. You keep her where she can succeed."

Sometimes, Elaine recalled, she needed to be reminded that her son needed equal praise for his accomplishments. Lynn didn't walk until she was almost two, but she was so small that she looked much younger. "Everybody would come to our house and go, 'She's walking!'" Elaine recalled. "My son came up to me one day and said, 'Mom, look!' He walked back and forth in front of me. He said, 'I know how to walk, too.' After that, I told people, 'When you come into my house, you look at and you praise both my children.'"

Despite the attention Lynn's condition demanded, Joe's relationship to his sister was generally positive. Elaine remembers the story of a schoolmate who said to Joe that his sister was retarded. It was hurled as an insult, but Joe didn't notice that; he just said, "Yes, she is," and got into a conversation about what it meant. "I'd wanted Joe to know that word, so it wouldn't be a shock to him," Elaine said. "It really was an eye-opener, that he realized that. It was like saying she had brown hair and brown eyes." Many years later, when Joe and his wife were expecting each of their sons, their obstetrician suggested that they go to a geneticist. Joe agreed, but said each time that he wanted to have the baby even if he had Down syndrome. "I was surprised at that," Elaine said. "That was when I knew that Joe really didn't feel she was a negative." schoolmate who said to Joe that his sister was retarded. It was hurled as an insult, but Joe didn't notice that; he just said, "Yes, she is," and got into a conversation about what it meant. "I'd wanted Joe to know that word, so it wouldn't be a shock to him," Elaine said. "It really was an eye-opener, that he realized that. It was like saying she had brown hair and brown eyes." Many years later, when Joe and his wife were expecting each of their sons, their obstetrician suggested that they go to a geneticist. Joe agreed, but said each time that he wanted to have the baby even if he had Down syndrome. "I was surprised at that," Elaine said. "That was when I knew that Joe really didn't feel she was a negative."

As an adult, Lynn works in a cafeteria, earning minimum wage, and she lives in a community residence; when I met the Gregolis, she had been there about ten years. Lynn reads on a first-grade level; she can do basic math with a calculator. Elaine said that she often wonders how much higher Lynn's functioning might be if she had had early intervention as it is now practiced. When I met Elaine, she and Lynn were fresh from a trip to Disney World with Joe and his wife and two young children. "Lynn was the aunt," Elaine said. "She took them on every ride; she bought them shirts; she really did great. Her nephews just love her. They play with her; she plays with them; she really enjoys them. I would love for Lynn to be a teacher, or a doctor. And she's a cafeteria worker. But for her, it's perfect. She loves that paycheck, and she goes to the bank and cashes it and puts it in her checking account. Writes her own checks. That's a big thing for her. So I've learned to love it, too."

Until her retirement in 2008, Elaine Gregoli served as assistant director of YAI/National Institute for People with Disabilities-the same agency she visited when Lynn was two. At YAI, part of Elaine's job was to tell other parents about EI. "All parents want to help their kids," she said, "even if they're distracted by poverty or drug addiction. Since early intervention is free, they go for it, and they mostly end up repeating things with their kids after the social worker leaves." The organization offers psychological counseling and respite care for families of people with disabilities; it serves twenty thousand people a day. Elaine also counseled parents who had a prenatal diagnosis of DS. "They're four months pregnant and have to make a decision within a week or two about whether to abort," she said. "I'll tell them all the good things and some difficulties. The parents may never accept what happened to them and yet accept their child. They're two separate things, the parental loss, and the actual person they will almost always end up loving."

The two key movements in educating disabled children after they have graduated from EI are mainstreaming mainstreaming and and inclusion inclusion. Unlike EI, these two approaches affect nondisabled children. In the 1970s and 1980s, parents advocated for mainstreaming, so that disabled students could be taught mostly in dedicated classrooms within ordinary public schools. The 1990s brought a shift to inclusion, which educates disabled children in the same classrooms as their nondisabled peers, often with a special assistant. The most recent major piece of legislation in this area is the Individuals with Disabilities Education Act of 1990 (IDEA), which requires that all children with disabilities receive a free, appropriate public education in the least restrictive possible environment. This integrating of disabled children into regular schools has changed the appearance of the American classroom. Children with intellectual disabilities are usually educated in some mix between special-ed and heterogeneous classrooms unless their disabilities are too extreme for that to be viable; they may go to special schools only after every attempt has been made at achieving the least restrictive environment.

There are two essential questions in the debate about these philosophies: what is better for the child with a diagnosis, and what is better for the typical children (those without such a diagnosis). Some parents complain that disabled children in the classroom are a distraction and slow down learning for the rest. Conversely, Michael Berube, codirector of the Disability Studies program at Penn State, whose son has DS, argues that inclusion's benefits are "truly universal"-because being in a classroom with people with disabilities breaches the widespread distrust of and discomfort with people who are unwell and makes those who are able-bodied more humane. Children with DS who are included have good models for language development, learn behavioral norms, and tend to realize more of their potential than they would in an environment predicated on their limitations. Integrated education prepares people with DS for supervised employment, freeing them from the sheltered workshops of times past; it helps more of them to live relatively independently. Public schools are often required to be inclusive; fights still occur to incorporate these policies in private schools.

The pitfall is that people with DS who are in inclusion programs are often cut off from their peers, and people without DS are willing to go only a certain distance in building relationships with people who have the condition. "If the school superintendent and the principal and the teachers all buy into it and educate themselves, I think inclusion works beautifully," said Arden Moulton, one of the founders of the National Down Syndrome Society (NDSS). "But it also depends on the child. Some children shouldn't be in inclusion programs, just like some kids shouldn't be at Yale." Betsy Goodwin, NDSS's cofounder, said, "The purists end up with lonely kids. Teen years are hard enough. You can't expect a normal teen to have his best friend have a disability. It just isn't the way it works." shouldn't be at Yale." Betsy Goodwin, NDSS's cofounder, said, "The purists end up with lonely kids. Teen years are hard enough. You can't expect a normal teen to have his best friend have a disability. It just isn't the way it works."

Betsy Goodwin was young and fit and didn't expect complications when her daughter, Carson, was born with Down syndrome in 1978 in New York. At the time, patients in private practice were generally counseled to institutionalize, and patients in clinics were instructed to take the baby home. In Betsy's view, this is because doctors who had personal relationships with their patients were ashamed of what they saw as their failure. Her obstetrician said, "Why don't you have a healthy baby, and we'll forget about this one?" Barton Goodwin had been open to the possibility of leaving Carson behind; he feared that he would lose Betsy to the world of disability. Betsy was also frightened, but more frightened of the alternative. She called her childhood friend Arden Moulton, a social worker, and said that the doctors wanted her to institutionalize her child. Arden said that was the last thing Betsy should do. However, the lack of resources for DS babies and their families quickly became clear. A few months later, Betsy, until then an interior decorator, decided to start an organization for parents in her situation and asked Arden to help her. "I was a professional," Arden recalled, "and she had the perspective of a parent." That is how, in 1979, the National Down Syndrome Society was established.

The first project of the NDSS was to organize a conference for scientists working on any aspect of trisomy 21, as there had never before been such a gathering and the work was diffuse. At that time, total research in the United States on DS was about $2 million annually; it is now approaching $12 million, which is still low for a condition that affects so many people. Betsy went to Washington to meet with the head of the NIH, who told her that with amniocentesis, there would soon not be anyone born with Down syndrome. "I don't know whether he'd met anyone Catholic," she said drily, twenty-five years later.

Betsy became pregnant again when Carson was two, and she considered amniocentesis. She wasn't sure whether she'd have had an abortion if she'd known that Carson would be born with DS. "I wasn't sure why I was doing it," she said. "To terminate? I honestly can't say. I wanted, at least, to know. But for some reason, he kept getting in the way of the needle, so we never obtained a good read. The amnio goes into twenty-two weeks, and a baby can survive at twenty-four, so it was becoming very unpleasant for me. I finally said to Barton, 'You can divorce me tomorrow, but I'm not going to go on with this process. I'm going to have what I have.'" Betsy's son was born typical, as was another son a few years later. "My three kids get along great," Betsy said. "That was another warning of the obstetrician: it's going to ruin your marriage, and any kids you have subsequently will suffer. I really think, almost to a one, the siblings of kids with Down's grow up to be more sensitive and thoughtful-maybe even more fulfilled-than the rest of the population." I'm going to have what I have.'" Betsy's son was born typical, as was another son a few years later. "My three kids get along great," Betsy said. "That was another warning of the obstetrician: it's going to ruin your marriage, and any kids you have subsequently will suffer. I really think, almost to a one, the siblings of kids with Down's grow up to be more sensitive and thoughtful-maybe even more fulfilled-than the rest of the population."

The Goodwins loved New York City, but when Carson turned eleven, Betsy thought New York was not the place to foster independence in someone who couldn't form adult judgments. "So I came up with Greenwich, Connecticut, which has a policeman on every corner. It struck me as a very safe town for a young woman like her to be walking around." Carson has a warm personality and is socially comfortable. When her brothers were in high school, she loved to dance. "I used to see this arm come out of her bedroom, and she'd grab one of her brothers' friends and make them dance with her," Betsy said. "Some of them, to this day, as men, say, 'I never would have known that step if it weren't for Carson.'"

When I met Carson, she had recently lost her job at Whole Foods because she always seemed to put the tomatoes at the bottom of the bag. "She's never been a tomato fan," Betsy said. "I assure you that the doughnuts would be on top." Carson has trouble understanding that other people think or feel differently-her mother's preference for John Coltrane over Britney Spears, for example, baffles her. She knows that her Down syndrome makes her different, even though she doesn't grasp exactly how. That is why, Betsy explained, her dancing gives her so much joy: "She loves anything that makes her an equal."

In the last three decades, NDSS has grown up alongside the child who inspired it; since Carson was born, it has awarded millions of dollars in scientific grants and has also supported social scientists focused on better educational strategies for people with intellectual disabilities. Once a year, NDSS organizes a conference at which scientists present their work to parents. The society has set up an annual Buddy Walk, which takes place in two hundred locations around the United States. People with Down syndrome walk with a friend to raise money and awareness; Buddy Walk events now bring in about a half million dollars a year to the organization. They also build community for people with DS and their families.

The National Down Syndrome Society has had to steer its way through treacherous waters. Some parents are concerned that an organization that researches ways to cure or ameliorate the symptoms of DS is not providing the affirmation that people with the syndrome need. Antiabortion disability activists have long argued that selective termination devalues the lives of disabled people; some have tried to persuade the NDSS leadership to take a strong position against abortion. NDSS would like to see more people keeping children with DS, but not because they are forced to do so by law. need. Antiabortion disability activists have long argued that selective termination devalues the lives of disabled people; some have tried to persuade the NDSS leadership to take a strong position against abortion. NDSS would like to see more people keeping children with DS, but not because they are forced to do so by law.

Until Ronald Reagan signed the Baby Doe Amendment in 1984, which classed the neglect or withholding of treatment for disabled infants as child abuse, parents and physicians could essentially let such infants die if they wished. The Princeton ethicist Peter Singer has espoused the right of women to choose abortion through the end of pregnancy and to commit infanticide on newborns if they so choose. He has defended this position with the utilitarian argument that most women who eliminate an unwanted child will produce a wanted one, and that the loss of happiness of the child who is killed (whose life would have been unsatisfactory) is outweighed by the happiness of the healthy child who follows. Although Singer's position is extreme, it reflects the pervasive devaluation of people with Down syndrome and the assumption that their lives are displeasing to others and to themselves. One mother described being asked by a psychiatrist how she got on with her son with Down syndrome; when she replied, "Terrific," he said that there was no need to be defensive. Marca Bristo, who chairs the National Council on Disability, said, "Singer's core vision amounts to a defense of genocide."

By 2000, the resistance to prenatal screening from the disability rights camp had crystallized. Disability scholars Adrienne Asch and Erik Parens, in their seminal discussion of the problem, wrote, "Prenatal diagnosis reinforces the medical model that disability itself, not societal discrimination against people with disabilities, is the problem to be solved. Prenatal genetic testing followed by selective abortion is morally problematic and it is driven by misinformation." A few years later, Asch wrote, "Researchers, professionals, and policymakers who uncritically endorse testing followed by abortion act from misinformation about disability, and express views that worsen the situation for all people who live with disabilities now and in the future." Leon Kass, chairman of the President's Council on Bioethics under George W. Bush, has argued that we "treat" prenatally diagnosed illnesses by "killing" rather than tending to those who would develop them.

Preventing births of any subclass of people devalues them. A society in which fetuses with Down syndrome are routinely aborted clearly believes that DS is a grave misfortune. This does not mean that anyone hates or wants to slaughter people with DS; indeed, many people who would choose to terminate a DS pregnancy would also go out of their way to be kind to a living person with the syndrome. But I know from personal experience how kind sympathy can be a noxious prejudice; I do not care to spend time with people who pity me for being gay, even if their sympathy reflects a generous heart and is offered with egregious politesse. Asch claims that women abort disabled fetuses because of the woeful lives that would come of their pregnancies; that such woe is the product of chauvinism; that such chauvinism could be resolved. Janice McLaughlin, at the University of Newcastle, wrote, "Mourning the choice the woman is compelled to make is not the same as saying she is wrong or an active participant in discrimination. Instead, it points to the ways in which she, too, is a victim." But the acts of those women do not merely reflect the society; they create it. The more such pregnancies are terminated, the greater the chance that more will be terminated. Accommodations are contingent on population; only the ubiquity of disability keeps the disability rights conversation alive at all. A dwindling population means dwindling accommodation. would choose to terminate a DS pregnancy would also go out of their way to be kind to a living person with the syndrome. But I know from personal experience how kind sympathy can be a noxious prejudice; I do not care to spend time with people who pity me for being gay, even if their sympathy reflects a generous heart and is offered with egregious politesse. Asch claims that women abort disabled fetuses because of the woeful lives that would come of their pregnancies; that such woe is the product of chauvinism; that such chauvinism could be resolved. Janice McLaughlin, at the University of Newcastle, wrote, "Mourning the choice the woman is compelled to make is not the same as saying she is wrong or an active participant in discrimination. Instead, it points to the ways in which she, too, is a victim." But the acts of those women do not merely reflect the society; they create it. The more such pregnancies are terminated, the greater the chance that more will be terminated. Accommodations are contingent on population; only the ubiquity of disability keeps the disability rights conversation alive at all. A dwindling population means dwindling accommodation.

Of the 5,500 children born with DS in the United States each year, about 625 are born to women who had prenatal diagnosis and chose not to terminate. One doctor assured Tierney Temple Fairchild, who had a prenatal diagnosis, "Almost everything you want to happen will happen. It's just going to happen at a different schedule." This is untrue. A great deal does not happen on any schedule for people with DS. The remark was nonetheless helpful to the family in deciding to keep their child, and they didn't have amnio in subsequent pregnancies. "I had a choice and I chose life," Fairchild wrote. "Does that make me pro-choice or pro-life? Our political parties tell us we can't have it both ways. I chose life, but I am thankful I had the choice."

Like deafness and dwarfism, Down syndrome may be an identity or a catastrophe or both; it may be something to cherish or something to eradicate; it may be rich and rewarding both for those whom it affects directly and for those who care for them; it may be a barren and exhausting enterprise; it may be a blend of all these. "I've never seen a family who chose to have the baby and then were really sorry," Elaine Gregoli said. There is a strong movement to connect expectant mothers with a prenatal Down's diagnosis with families bringing up children with DS. Many parents have written memoirs expressing the rewards of raising such children, contending that there is less to complain of in Down syndrome than in the attitudes of the world. Of course, people who dislike having children with DS don't tend to write memoirs; neither do those of low socioeconomic status, for whom the obstacles to good treatment may be daunting.

My own observation is that some parents manufacture an affirmative construction of their child's disability to disguise their despair, while others have a deep and genuine experience of joy in caring for disabled children, and that sometimes the first stance can generate the second. I met disability activists who insisted that everyone's joy was authentic, and I met psychologists who thought no one's experience was. The truth is that while some people fall at either end of this spectrum, most are scattered across its wide span.

Deirdre Featherstone didn't want children, so she was delighted to learn that she was infertile. When she became pregnant in 1998, however, she felt she was stuck, and she decided to let things unfold. She was thirty-eight but not inclined to seek amniocentesis. "I believe certain things are not your business," she said. "If that baby is supposed to be inside alone for nine months, then you need to leave it alone. You don't go sticking things into their environment." Her husband, Wilson Madden, wanted to do amnio. "I wanted to give him that because he likes to plan," she said. "But the night before, I said, 'What if we found out something?' He said, 'I don't think that would make any difference.' I said, 'Well, if I find out there's something wrong, this kid's out of here, because, as you well know, I don't want to be anyone's mother. I don't even have the courage to be the parent of a regular kid. I'm perfectly ready to have an abortion if there's anything wrong. You aren't. So you'd better stop pushing the amnio.'"

They didn't have the test. "Thank God, because it would have been the biggest mistake of my life," Deirdre said. "You can't assess what you don't know." The day before her daughter, Catherine, was born, Deirdre, who is a jeweler and stylist, was supposed to be accessorizing a fashion show. She worked that afternoon, reviewing the outfits, then went home and had Thai food. When she began to heave in the night, Wilson realized she was in labor; she insisted it was just the takeout. A midwife delivered Catherine at home at ten the next morning and told her to see a pediatrician straightaway. The pediatrician confirmed visually that Catherine had Down syndrome. "I already knew that Catherine was the nicest person I was ever going to meet," Deirdre said. "It was harder for Wilson. It's probably always harder for the father, because they haven't had a physical relationship with the child for nine months." The pediatrician sent them for genetic screening the next day to confirm the diagnosis. "I had tears coming down my face, and she reaches up," Deirdre said. "She has one tear coming out of her eye, and she wipes my face. Twenty-three hours old."

Catherine was born into a very different world from the pre-EI one Lynn Gregoli and Carson Goodwin had entered, and Wilson felt that they had to look into every available mode of treatment. Deirdre said, "One of the things that made the early period difficult was that she would have therapy three times a week for speech, then occupational therapy, then physical therapy, and also craniosacral therapy. Her schedule was so full, it was hard for me to leave the house. That was probably the only difficulty, besides adjusting to the fact that somebody else is depending on you to live. I said to Wilson, 'If this is more than you can handle, you're free to go. I won't hold it against you and I won't think you're a bad person. But you can't stay upset forever.'" Wilson explained, "It never occurred to me to leave. But I was slower to get into the whole thing than Deirdre." one Lynn Gregoli and Carson Goodwin had entered, and Wilson felt that they had to look into every available mode of treatment. Deirdre said, "One of the things that made the early period difficult was that she would have therapy three times a week for speech, then occupational therapy, then physical therapy, and also craniosacral therapy. Her schedule was so full, it was hard for me to leave the house. That was probably the only difficulty, besides adjusting to the fact that somebody else is depending on you to live. I said to Wilson, 'If this is more than you can handle, you're free to go. I won't hold it against you and I won't think you're a bad person. But you can't stay upset forever.'" Wilson explained, "It never occurred to me to leave. But I was slower to get into the whole thing than Deirdre."

Deirdre surprised even herself. "I was so sure I was the parent who was not going to be able to deal with a child who was in any way different," she said. "I was just relieved to love her. She was very lovable. All my friends had these children they thought were perfect, and then they've had to come to terms with their children's limitations and problems. I had this baby everyone thought was a disaster, and my journey has been to find all the things that are amazing about her. I started off knowing she was flawed, and all the surprises since then have been good ones. She's one of the nicest, kindest, most thoughtful, sensitive people that I've ever met. She's funny. She always highlights the positive; I don't know how much of that is personality or if that's Down syndrome. When she makes up her mind that she's not doing something, that is that, which is also typical of Down syndrome."

The mother of a child with special needs inevitably becomes a soothsayer. "Somebody I know called me up in tears, saying, 'I just found out my kid has DS; what should I do?' I said, 'What do you want to do?' She said, 'It's my baby, and I want to have it.' I said, 'I'll tell you what, it's the best thing that has ever happened to me. And had I had the information, I would have made this big, big mistake by not having her. You've met my kid, we have a really good time.'" Recounting this to me, Deirdre added, "Down syndrome is easy, or at least Catherine is easy. Autism is probably a different experience. Would I make her life easier? Any way I could. Would I blink and turn her normal? No, I wouldn't. She may, at some point, have a different opinion and want to get facial surgery or some other normalizing procedure, whatever's out there by the time she grows up. Would I endorse her doing so if that's what she chose? If it comes up, I will, but I hope that I'll have raised her with enough personal strength and self-esteem to be happy in who she is."

Deirdre never had to make her way through the gauntlet of prejudice that so determined Emily Perl Kingsley's early experiences. "People still give up their child. People still have abortions when they find out," Deirdre said. "I'm not here to judge it. You hate lima beans, I love lima beans. There's a lot of political correctness that I find ridiculous. But I'll take whatever's made it unacceptable to make fun of a child because she's different. I think we are less tolerant of prejudice than anywhere else or any other time." She described being at Catherine's public school in Tribeca one day when a five-year-old girl said, "I heard that when Catherine was inside you, you broke your egg, and that's why she came out funny." Deirdre said, "If you break your egg, then you don't have a baby at all." The little girl said, "You mean she's not broken?" Deirdre said, "No, she's not broken. She's a little different." Deirdre looked around the play area and said, "See that little girl over there? She has red, curly hair, and you have blonde hair. This little boy, he's black and his mom and dad are white, and they're Italian, and his sister is his sister, but they're not really related biologically." One of the parents nearby said, "I'm Korean and my husband's white." Another said, "I didn't marry a man, but my partner is a lady, so my child is also different." In this world of infinite variety, Catherine was just another variation on the idea that the only normality is nonnormality. "Sometimes I see somebody with a child with Down's, and I'll say, 'My daughter's in the same situation, she's eight,'" Deirdre said. "Nine times out of ten, people will say, 'Congratulations. Welcome to the club.' I think a lot of us feel lucky." still give up their child. People still have abortions when they find out," Deirdre said. "I'm not here to judge it. You hate lima beans, I love lima beans. There's a lot of political correctness that I find ridiculous. But I'll take whatever's made it unacceptable to make fun of a child because she's different. I think we are less tolerant of prejudice than anywhere else or any other time." She described being at Catherine's public school in Tribeca one day when a five-year-old girl said, "I heard that when Catherine was inside you, you broke your egg, and that's why she came out funny." Deirdre said, "If you break your egg, then you don't have a baby at all." The little girl said, "You mean she's not broken?" Deirdre said, "No, she's not broken. She's a little different." Deirdre looked around the play area and said, "See that little girl over there? She has red, curly hair, and you have blonde hair. This little boy, he's black and his mom and dad are white, and they're Italian, and his sister is his sister, but they're not really related biologically." One of the parents nearby said, "I'm Korean and my husband's white." Another said, "I didn't marry a man, but my partner is a lady, so my child is also different." In this world of infinite variety, Catherine was just another variation on the idea that the only normality is nonnormality. "Sometimes I see somebody with a child with Down's, and I'll say, 'My daughter's in the same situation, she's eight,'" Deirdre said. "Nine times out of ten, people will say, 'Congratulations. Welcome to the club.' I think a lot of us feel lucky."

As a mother, Deirdre is astonishingly patient. I witnessed her negotiating Catherine down from resistance on more than one occasion, capably steering her way around direct confrontations. Catherine tends to want to wear inappropriate clothes; she sometimes insists on a sundress when it's cold out. "I say, 'Why don't you wear pants under your dress, or over your dress.' Sometimes, she looks like she has furnished herself from a homeless shelter. She's good with that. So what am I going to say? I'm supposed to be building self-esteem, not knocking it down." It has been harder to maintain a sense of humor about the inevitable battles with the system, however. Wilson said, "It's important that she not be the slowest kid in the room. Maybe a hundred percent inclusion all the way is not the best. We're looking at a camp that caters to special-needs kids." Deirdre has a tigress's instinct when it comes to her daughter's education. "Her first kindergarten was not a fit at all. I requested a transfer on day two. Her education is just so important, it's more important than breathing. I had been to the board of ed, back and forth, and finally one day I hired a babysitter for Catherine for a week, and I packed a bag with my computer, a power pack, electrical cords, my cell phone, chargers, several days' worth of clothes, books. I went to the board of ed and said, 'I need to meet with the special-needs coordinator for this board of ed.' 'I'm sorry, she's not in. Can you come back?' 'No. I'm just going to stay. It's no trouble whatsoever. I have enough things for seven days, and I will sit here until she has time, but I don't want to rush her in any way.' I sat there, taking different things out of my suitcase, and making sure that everyone knows, oh, underwear, underneath that's the charger, and I'll get it out now, then put the underwear back in. After four and a half hours, somebody came out and said, 'Can we help you?'" Catherine was in a new school by the end of February. "I'm never unpleasant," Deirdre said. "But I make it clear that I do need certain needs met." went to the board of ed and said, 'I need to meet with the special-needs coordinator for this board of ed.' 'I'm sorry, she's not in. Can you come back?' 'No. I'm just going to stay. It's no trouble whatsoever. I have enough things for seven days, and I will sit here until she has time, but I don't want to rush her in any way.' I sat there, taking different things out of my suitcase, and making sure that everyone knows, oh, underwear, underneath that's the charger, and I'll get it out now, then put the underwear back in. After four and a half hours, somebody came out and said, 'Can we help you?'" Catherine was in a new school by the end of February. "I'm never unpleasant," Deirdre said. "But I make it clear that I do need certain needs met."

Five years later, I asked Deirdre how Catherine's education was going. "I was asking her about vocabulary words for school, and she said her new words were opportunity opportunity and and deficient deficient. I asked her for the definition of deficient, deficient, and she thought about that and finally answered, 'You, Mom.'" Deirdre burst out laughing. "I don't have a fear that everyone's going to find out I don't know what I'm doing as a mother because I've already admitted that. The question is how you educate yourself. Sometimes I think I'm a great mother. Sometimes I think I suck. I've never once in a million years said that I know what I'm doing being somebody's mother. I barely know what I'm doing being somebody's wife." and she thought about that and finally answered, 'You, Mom.'" Deirdre burst out laughing. "I don't have a fear that everyone's going to find out I don't know what I'm doing as a mother because I've already admitted that. The question is how you educate yourself. Sometimes I think I'm a great mother. Sometimes I think I suck. I've never once in a million years said that I know what I'm doing being somebody's mother. I barely know what I'm doing being somebody's wife."

People born with DS develop slowly and stop short of typical intellectual maturity, but their development usually runs on a steady course. Anyone who can relate to a typical child through various developmental stages can relate to a person with DS. DS babies are slow to make eye contact, slow to sustain it, and slow with imitative behaviors. They do not start to speak until they are two or three years old, and they do not make two- and three-word phrases until they are three or four years old. DS children often fail to grasp fundamental principles of grammar. I once asked someone who worked with people with DS why some are so much smarter than others, and she said, "Why are some people without DS so much smarter than others?" Though the parallel holds, some people do have "worse" DS than others. David Patterson, a geneticist working on trisomy 21, recently wrote, "It is virtually certain that genes on chromosome 21 do not work alone to cause the features we recognize as Down syndrome. They must work in concert with genes on other chromosomes. This is likely to be one of the reasons for the wide diversity seen in persons with Down syndrome."

People with Down syndrome are often warm and sociable, eager to please, and free of cynicism. Larger studies indicate that many people with Down syndrome are also stubborn, defiant, aggressive, and sometimes disturbed. In addition to the physical challenges that some people with DS face, many have behavioral issues, including ADHD and oppositional disorders; those with milder cases tend toward depression and pronounced anxiety. The popular image is not so much groundless as incomplete. The experience of living with DS is not easy. According to a large, recent study, these children generally have "less idealized views of themselves" and experience "repeated exposures to failure which contributes to uncertainty and 'learned helplessness,' which in turn has been linked to depression and other problems." disturbed. In addition to the physical challenges that some people with DS face, many have behavioral issues, including ADHD and oppositional disorders; those with milder cases tend toward depression and pronounced anxiety. The popular image is not so much groundless as incomplete. The experience of living with DS is not easy. According to a large, recent study, these children generally have "less idealized views of themselves" and experience "repeated exposures to failure which contributes to uncertainty and 'learned helplessness,' which in turn has been linked to depression and other problems."

People with DS are relatively low-energy and consistent in their behavior, which means that they are less demanding of caregivers than people with high-energy, chaotic disorders, such as bipolar disorder and autism. Both children and adults with DS are at heightened risk for physical and sexual abuse. Those with behavioral problems are more often placed out of the home by their families; they are less likely to fit in well in those settings, either, however, because they wear out paid support staff and are harder to take out in public. All of this, of course, exacerbates the symptoms that underlie their behavior.

Many treatments exist for the symptoms of DS, but none alleviates the condition itself. The extra chromosome cannot be suppressed or removed, though there is preliminary work on gene therapy to achieve this. Vitamin regimens have been in use to treat people with DS since the 1940s, as have off-label antihistamines and diuretics, though none of these has been shown to have any benefit; some, indeed, have been shown to have minor adverse effects. In addition, plastic-surgery protocols can normalize the appearance of people with DS. Such procedures include a sometimes pragmatic shortening of the tongue-which is said to reduce drooling, improve speech, and help people with DS to breathe better-and a wide range of cosmetic interventions such as nose jobs, removal of excess fat from the neck, and reshaping of the eyes to eliminate their slant. The National Down Syndrome Society and other groups object to these measures as unnecessarily painful and even cruel, the DS version of limb-lengthening, and also take umbrage at the prejudice against people who look as if they have Down's. They would like to use public education to change responses to a DS face rather than change its appearance.

Michelle Smith, a financial adviser at Wachovia Bank, is a perfectionist, and it is not easy for perfectionists to have children with disabilities. She has displaced her perfectionism onto mothering; if there is a perfect way to handle having a child with a disability, Michelle Smith has found it. She has even done a perfect job of renouncing perfection.

About fifteen weeks into her pregnancy, Michelle went for an alpha-fetal protein blood test. Her obstetrician said her results placed her at elevated risk for DS and offered her amnio. "I didn't even tell my husband that was an option," she recalled. "I went into complete and total denial. The person I had always been would have been the supercompetitive New York mom: the right clothes; the right barber; the right job. I would see disabled people and be so freaked out that I would just not look. But weird things happened during my pregnancy. I turned the TV on and just randomly saw a Touched by an Angel Touched by an Angel episode with the guy with DS. I was in Home Depot, eight months pregnant, and this Down syndrome little girl walked right up to me, with no mother or father with her, and put her hand on my stomach. I thought, obviously, somebody's trusting me with this pregnancy." episode with the guy with DS. I was in Home Depot, eight months pregnant, and this Down syndrome little girl walked right up to me, with no mother or father with her, and put her hand on my stomach. I thought, obviously, somebody's trusting me with this pregnancy."

At the delivery of Michelle's son, Dylan, the midwife thought his neck was a little thick. She looked up Michelle's blood test. An hour later, she told Michelle that her son had Down syndrome. "They put him on my stomach, and he gave me a spooky look, where I actually felt like he was the sage and I was the child," Michelle said. "I was intimidated by him, in this really beautiful way."

Michelle was determined not to look at things darkly, but at first it was hard; the baby stirred up all her own fears and insecurities. When she brought Dylan home from the hospital, she entered her apartment building through the back door because she was afraid of what the doorman might say. When she got in an elevator with Dylan, she would blurt out his diagnosis. "I felt everyone was staring," she said. "But it was just all about my my judgments." judgments."

As Michelle recounted it, her husband, Jeff, couldn't handle having a DS baby. "You have a conversation before you get married about children," she said. "Sometimes about money; sometimes, about religion. You rarely discuss what you'd do with a pregnancy with a special-needs kid." Jeff said that none of this would have happened if Michelle had just had the amnio. "Yes, it would have," Michelle said. "He would still be here." Jeff went through eight months of depression, and by the time he began to emerge, she had decided she wanted a divorce.

Immediately after the birth, Michelle began doing research on treatment for infants with DS. She read "Welcome to Holland," which helped her. "I read eleven books in the first two weeks," she said. "Then I met some other moms, who have been my saving grace. We have a group of four and we call ourselves 'the Down's moms,' and they're all women that I would be friends with anyway." They taught her how to navigate EI and everything that followed.

Michelle found an EI program located in the World Trade Center. Three months after Dylan was born, 9/11 happened. That was the end of the center. As she tried to figure out what to do next, Michelle felt the fighter in her coming to the surface. "The service coordinator for your agency is walking that fine line between giving you what you deserve, legally, and saving the state money. One of the other mothers said, when I had a bad meeting, 'Oh, you poor little neophyte. Here, pick yourself up.' So I hired a special-ed attorney to go to the second meeting with me. I don't know what you do if you're poor or uneducated with a Down syndrome kid, and you don't even know what you don't know." Three months after Dylan was born, 9/11 happened. That was the end of the center. As she tried to figure out what to do next, Michelle felt the fighter in her coming to the surface. "The service coordinator for your agency is walking that fine line between giving you what you deserve, legally, and saving the state money. One of the other mothers said, when I had a bad meeting, 'Oh, you poor little neophyte. Here, pick yourself up.' So I hired a special-ed attorney to go to the second meeting with me. I don't know what you do if you're poor or uneducated with a Down syndrome kid, and you don't even know what you don't know."

Dylan soon proved to have problems that EI could not address. He had recurrent intestinal crises that landed him in the hospital repeatedly-forty-one emergency room visits in his first eleven months. "I had a frequent-flier card in the ER," Michelle said. "I would call and admit myself." Dylan needed three major operations; physicians at Columbia gave him a 2 percent chance of survival. Jeff and Michelle lived in the intensive care unit with him for nine weeks straight. "He was on fourteen machines," Michelle recalled. "They brought in a fifteenth machine, the dialysis machine. I sat there, looking at him, thinking, 'Just go. It's okay. I can't do this, either.' I felt so guilty, saying that I couldn't handle watching my kid die. The priest comes in four times to read last rites. There were women on the second floor of that hospital who were so affected by my son, they came up daily and prayed over him, with rosary beads." As Dylan fought for his life, the Down syndrome became secondary. By this time, Jeff, also, had overcome his negative early response. His conversion came too late for the marriage, but not too late for his son. "It wasn't until we almost lost him that Jeff realized how much he loved him," Michelle said. "Now they're inseparable. Jeff adores this child."

Dylan emerged at a year old with twenty-two inches of his colon missing and a patched heart, but his physical health has been excellent since then. "He has a little gas problem; he's stinky, but who cares?" Michelle said. Dylan responded well to EI. "I was one of these people who would have been annoyed that my son's preschool had special-needs kids that might slow them down," Michelle said. "So I make myself perfectly charming to the other mothers. The woman who runs his nursery school believes in inclusion as a way of life. She called me the second week of school and said, 'He has a major gas problem. Make no mistake about it: he's already different. If he's now the smelly little kid with Down syndrome, people are not going to want to play with him.' That was brutally, beautifully honest. We found Beano, which is an enzyme that controls the gas." Michelle nonetheless expects Dylan's sweetness to carry the day. "My grandmother got this little puppy, and he was trying to figure this puppy out. He had his favorite puzzle piece in his hand, and he gave it to the puppy. He gives his favorite things away. He's heart-spontaneous." sweetness to carry the day. "My grandmother got this little puppy, and he was trying to figure this puppy out. He had his favorite puzzle piece in his hand, and he gave it to the puppy. He gives his favorite things away. He's heart-spontaneous."

Michelle has the zeal of a convert. "It was like I was trying to get FM on an AM radio in my old life. In a weird way, it was like this happened so I could see what I was capable of. Every single trait that I wasn't good at, I've had to develop because of him. I was living superficially and attached to my ego and my stuff and my image. I was very judgmental, critical-and how can I be judgmental of anything now? We're supposed to share all of our talents and gifts, but we have to know what they are first. Now, I have to help people, instead of just using my talents to make money."

Michelle consults with new parents, encouraging them to keep their children with DS. In the one case in which the couple gave up the child for adoption, she was devastated. I asked her about people who didn't share her dynamism, spirituality, and sense of purpose. "They all do," she said. "That's the wild thing with special-needs parents. This comes raging out of you. I feel such strength and courage in these women. I say to them all the time, 'I know you don't feel like you know what you're doing. Trust me. You are the perfect mother for this kid.'" She paused for a second and smiled. "You know, they probably want to smack me."

In about 95 percent of cases, Down syndrome is the result of a spontaneous mutation rather than a transmissible gene, and people who have DS seldom reproduce. Because DS was among the first major genetic anomalies for which prenatal testing existed, and because it is the most common genetic anomaly that can be detected in utero, it has been at the center of the abortion debate. Statistics range, but at present, about 70 percent of expectant mothers who receive a prenatal diagnosis of Down syndrome choose to abort. Ironically, outcomes for people with DS have improved more radically in the last forty years than have the outcomes for almost any other anomaly. People who would have languished in institutions and died at ten are now reading and writing and working. With adequate education and health care, many live more than sixty years; the national life expectancy for people with DS in the United States is around fifty, double the 1983 figure. People with Down syndrome are also interacting with a world that has many more accommodations for people with special needs. Supported employment means that many higher-functioning people with DS can find jobs; the general tolerance in society means that a person with DS arriving at a restaurant or a store with his family is more likely to be received graciously. In a recent study in Canada, parents of children with DS were asked whether they would pursue a cure if one were available. More than a quarter said they would not, and another third said they were not sure. arriving at a restaurant or a store with his family is more likely to be received graciously. In a recent study in Canada, parents of children with DS were asked whether they would pursue a cure if one were available. More than a quarter said they would not, and another third said they were not sure.

Targeted abortion had been expected to eliminate most of the population with Down syndrome, but the proportion of people born with the condition in any given year has increased or remained constant since testing was introduced. Such children are not evenly distributed across the population. Eighty percent of Down syndrome births are to women under thirty-five who have not had testing, and many of these are poor, as wealthier people are more likely to seek prenatal testing even if they are not in a risk category. Studies suggest that among people who carry to term, those with fewer material advantages may be less perfectionist and ambitious for their children, and therefore more readily accepting of the permanent dependence of children with DS. Some agencies specialize in arranging adoptions of children with DS; the head of one said to me, "I wish I could show you a list of the people who've given up their babies to me. It would read like Who's Who in America Who's Who in America." More women choosing to have prenatal testing and abort fetuses diagnosed with DS brings the DS population down, while more women conceiving in later life brings it up. As people with DS who used to die at ten are living to sixty, the number of people on the planet with Down syndrome is increasing; the number in the United States may double between 2000 and 2025, to as much as eight hundred thousand.

The American College of Obstetricians and Gynecologists recommended in 2007 that all pregnant women undergo nuchal translucency in the first trimester, with the option of genetic counseling and amniocentesis or CVS in the second trimester for those with poor nuchal translucency results. Disability rights groups oppose this protocol; the conservative columnist George Will, who has a son with DS, called it "a search and destroy mission." Moderates have asked that people simply be better informed about the experience of parenting a child with Down syndrome. Stephen Quake, a Stanford professor who developed one of the new blood tests for DS, said, "It's a gross oversimplification to assume that these tests are going to lead to the wholesale elimination of Down syndrome births. My wife's cousin has Down syndrome. He's a wonderful person. It's not an obvious step that you would terminate an affected pregnancy." Nonetheless, activists worry that women who wish to keep a DS pregnancy may feel pressured to terminate as prenatal diagnosis gets easier. People without health insurance have a much harder time obtaining prenatal tests, and some worry that this will make DS into a poor man's condition. much harder time obtaining prenatal tests, and some worry that this will make DS into a poor man's condition.

In contrast, Michael Berube points out that having children with DS could become the province of the rich if prenatal screening becomes universal and insurance ceases to cover the medical and educational costs for those who keep such children. The existence of tests provides an imperative to use and act on them. One study said that women who do not use prenatal testing or who keep a pregnancy they know will lead to a child with a disability "were judged more responsible, more to blame, and less deserving of both sympathy and social aid subsequent to giving birth to a disabled child than were women to whom testing was not made available." These demographic suppositions seem to cancel each other out and point to the confusion around conditions such as DS, which can be considered both burden and luxury, sometimes by the same person. Michael Berube wrote, "So much depends on whether our technologies serve our social desires or our social desires are made to serve our technologies." In a newspaper interview, he added, "The fifteen million dollars spent on the new test for Down by the National Institute of Child Health and Human Development might have gone instead toward much-needed research on the biochemistry of people living with the condition."

Prenatal screening and support for people with DS should not be mutually exclusive, any more than cochlear implants have to engender the death of Sign, any more than a vaccine for an infectious disease should prevent our treating people who develop it. In the pragmatic economy of modern medicine, however, an ounce of prevention is usually held to be worth a ton of cure. As the techniques for prenatal diagnosis of DS have become more available, funding for research in the field has diminished. This seems particularly tragic because treatment for the major symptoms of DS, long considered impossible, is now a field full of promise. In 2006, Alberto Costa demonstrated that Prozac could normalize the compromised development of the hippocampus in mice that had a Down's-like condition. He later found that the Alzheimer's drug memantine boosted memory in similar mice, most likely by quieting neurotransmitter systems that he believes interfere with learning in DS. In 2009, William C. Mobley, chairman of neurosciences at the University of California, San Diego, showed that raising norepinephrine levels in the brains of these mice allowed them to learn at the level of typical mice. In 2010, Paul Greengard, of Rockefeller University, normalized learning and memory in such mice by lowering levels of -amyloid, which is also implicated in Alzheimer's disease.

Mobley said, "There's been a sea change in our ability to understand and treat Down syndrome. There's been an explosion of information. As recently as 2000, no drug company would possibly have thought about developing therapies for Down syndrome. I am now in contact with no less than four companies that are pursuing treatments." Commenting in the and treat Down syndrome. There's been an explosion of information. As recently as 2000, no drug company would possibly have thought about developing therapies for Down syndrome. I am now in contact with no less than four companies that are pursuing treatments." Commenting in the New York Times, New York Times, Craig C. Garner, codirector of the Center for Research and Treatment of Down Syndrome at Stanford University, said, "This was a disorder for which it was believed there was no hope, no treatment, and people thought, 'Why waste your time?' The last ten years have seen a revolution in neuroscience, so that we now realize that the brain is amazingly plastic, very flexible, and systems can be repaired." Craig C. Garner, codirector of the Center for Research and Treatment of Down Syndrome at Stanford University, said, "This was a disorder for which it was believed there was no hope, no treatment, and people thought, 'Why waste your time?' The last ten years have seen a revolution in neuroscience, so that we now realize that the brain is amazingly plastic, very flexible, and systems can be repaired."

As with the deaf and their implants, and dwarfs and their ELL, this is another scramble-not so much for identity, this time, as for science. If people with DS can be normalized, should we think more carefully about terminating DS pregnancies? Costa said, "The geneticists expect Down syndrome to disappear, so why fund treatments? It's like we're in a race against the people who are promoting those early-screening methods. If we're not quick enough to offer alternatives, this field might collapse."

Angelica Roman-Jiminez was twenty-seven when her daughter Erica was born in 1992. Erica was a first child, and there had been no thought of doing amniocentesis. But when the baby was born, Angelica knew that something was wrong. "I remember holding the doctor's arm and saying, 'Please tell me.' My husband, I could see it in his eyes." The doctor told Angelica that her baby had "mild Down syndrome"-though there is no way to tell the severity of Down's symptoms in a newborn.

The doctors offered the possibility of adoption, but Angelica was not interested; still, she wondered how to tell people. "I called my parents. I said, 'The baby was born with...,' and I couldn't finish the sentence. My father said, 'Well, does she have all her fingers? Does she have all her toes?' I said, 'Yes, yes.' He said, 'Whatever it is, we'll deal with it.' You always hear about unconditional love for your children no matter what. And there it was." Her priest said, "God gave you this child for a reason. Anything that I've seen come your way, you're able to tackle it, and this will be the same."

Not everyone had the grace to respond in kind. "A lot of our friends looked at it as a death," Angelica said. "I couldn't move from why why. 'Why did this happen to us?' But then you realize, 'Wait a minute, she's alive. She needs our love and attention.' I still wanted to do birth announcements, and I sent along a letter describing what our lives were now." Though she is Catholic, Angelica was working in a clerical job at Trinity Episcopal Church in lower Manhattan, and a coworker had a friend who had a child with Down syndrome. "She stayed on the phone with me for over an hour and told me which books to read. To stay away from anything earlier than the eighties. To join a parents support group. That was when I broke out of that 'Why?'" It helped that Erica was born the same year that Jane Pauley featured Jason Kingsley on her program. Images of people with DS were proliferating, as they had not even a few years earlier. Though she is Catholic, Angelica was working in a clerical job at Trinity Episcopal Church in lower Manhattan, and a coworker had a friend who had a child with Down syndrome. "She stayed on the phone with me for over an hour and told me which books to read. To stay away from anything earlier than the eighties. To join a parents support group. That was when I broke out of that 'Why?'" It helped that Erica was born the same year that Jane Pauley featured Jason Kingsley on her program. Images of people with DS were proliferating, as they had not even a few years earlier.

Within six weeks, Angelica had enrolled Erica in an early-intervention program. "When your child is born with a disability, all your high hopes and dreams are shattered. When she was one, I was always looking to see whether she was keeping up with the other children at the center. She was struggling with her grasp, her gross and fine motor skills. Then one day she had the coordination to pick up a Cheerio, and I wanted to jump for joy. A few years later, she needed ear tubes. Of course we wanted to do our best there, because if you can't hear, how is your language going to develop? So the doctor said, 'Well, she's not going to be perfect.' I felt, how dare he say that? He's never going to be perfect, either."

Speech development was ongoing. "She would point at what she wanted, and we would encourage her, 'Tell us what you want.' One time she had an evaluation for school, and the psychologist asked me whether Erica made her bed in the morning. I said, 'Well, no. We're in a rush. I'll just do it, and we'll go.' She checked off, 'Not given the opportunity.' Now I try always to give her the opportunity, whether it's zippering up her coat, tying her shoelace. She can write her name, address, and phone number."

Erica struggles with poor judgment, as do many people with DS. "We try to teach her, 'This is danger, this is not,'" Angelica said. "She's very trusting, without stranger anxiety. We've taught her that when she meets someone for the first time, she should shake hands. We have to explain, 'You can't hug everyone. Not everyone is nice.'" Angelica looked sober. "She doesn't get phone calls. She doesn't get a lot of party invitations. We've had her in programs with other children who have disabilities, ballet and music classes. I feel these other children with special needs are her peers. I want her to have that close friend who is going through the same things she is. I started a Girl Scout troop for exceptional girls. We have girls who are autistic, girls with Down syndrome, girls who are wheelchair-bound."

This work occupies a great deal of Angelica's time. "I also have a younger daughter, Leah, who is in those preteen years, and sometimes she's concerned about how she's seen by others. 'Will they accept me if I have a sister with special needs?' We tell Leah, 'There's nothing to be embarrassed about. This is how God gave her to us.'" Erica shows no sign of knowing that she could ever be perceived as an embarrassment. "She realizes that she can't run as fast as other kids. Or she can't jump rope the way other people do. But she's never asked me why. Erica is, 'If you're good to me, I'll be good to you.' Part of me wants her to be aware, and the other part is, well, if she's aware, she won't be happy." she's concerned about how she's seen by others. 'Will they accept me if I have a sister with special needs?' We tell Leah, 'There's nothing to be embarrassed about. This is how God gave her to us.'" Erica shows no sign of knowing that she could ever be perceived as an embarrassment. "She realizes that she can't run as fast as other kids. Or she can't jump rope the way other people do. But she's never asked me why. Erica is, 'If you're good to me, I'll be good to you.' Part of me wants her to be aware, and the other part is, well, if she's aware, she won't be happy."

Angelica had been deeply committed from the first to finding meaning in her experience, and she came to see Erica's disability as an occasion for her own moral growth. When Erica was nine, Angelica developed breast cancer. "Having Erica made me stronger to deal with that," Angelica said. "I became this stronger person because of her." Trinity Church is only a few blocks from Ground Zero, and Angelica was there on 9/11. She kept her cool in the midst of the chaos, and for that, too, she thanks Erica. "God makes these things happen to us sooner rather than later, because maybe our role will be to help others and to grow from this experience," she said. "That's what I feel my ministry is now, to let folks know and invite them to my home, to have conversations. I couldn't stop the planes from coming. I couldn't stop my illness or her condition. You can't stop the future."

In her memoir, Expecting Adam, Expecting Adam, Martha Beck writes, "If you'll cast your mind back to high school biology, you may remember that a species is defined, in part, by the number of chromosomes in every individual. Adam's extra chromosome makes him as dissimilar from me as a mule is from a donkey. Adam doesn't just do less than a 'normal' child his age might; he does different things. He has different priorities, different tastes, different insights." Beck writes of the transformations her son has wrought in her own life. "The immediacy and joy with which he lives his life make rapacious achievement, Harvard-style, look a lot like quiet desperation. Adam has slowed me down to the point where I notice what is in front of me, its mystery and beauty, instead of thrashing my way through a maze of difficult requirements toward labels and achievements that contain no joy in themselves." Martha Beck writes, "If you'll cast your mind back to high school biology, you may remember that a species is defined, in part, by the number of chromosomes in every individual. Adam's extra chromosome makes him as dissimilar from me as a mule is from a donkey. Adam doesn't just do less than a 'normal' child his age might; he does different things. He has different priorities, different tastes, different insights." Beck writes of the transformations her son has wrought in her own life. "The immediacy and joy with which he lives his life make rapacious achievement, Harvard-style, look a lot like quiet desperation. Adam has slowed me down to the point where I notice what is in front of me, its mystery and beauty, instead of thrashing my way through a maze of difficult requirements toward labels and achievements that contain no joy in themselves."

Children with Down syndrome tend to retain what the experts call babyfaceness babyfaceness. These children have "a small, concave nose with a sunken bridge, smaller features, larger forehead and shorter chin, and fuller cheeks and rounder chin, resulting in a rounder face." A recent study found that both the register in which parents speak to their DS child and the variances in pitch resembled the voice patterns parents use to speak to infants and young children. So the infantilizing comes from parents who don't think they're doing it, in response to a biological facial structure that they may not consciously register as meaningful. Intellectual inequality places certain limits on intimacy for parents, yet studies show that fathers of DS children spend much more time with their affected children than most fathers spend with their typical children. parents who don't think they're doing it, in response to a biological facial structure that they may not consciously register as meaningful. Intellectual inequality places certain limits on intimacy for parents, yet studies show that fathers of DS children spend much more time with their affected children than most fathers spend with their typical children.

Other studies show that, on average, children act more kindly, more generously, and with less hostility toward siblings with Down syndrome than toward typically developing siblings. They are also more compassionate and mature. This is true even though siblings of mentally retarded children can suffer social ostracism and are at elevated risk of emotional and psychological problems. DS and non-DS sibling relationships are both warm and courteous, stripped of the volatility of relations between equals. Play between non-Down's siblings and their DS counterparts is more hierarchical and may contain less laughter. Yet writing in Newsweek Newsweek about her brother with DS, Colgan Leaming said, "My brother is not his disability. He is a teenager who loves sports and PlayStation, who cares a little bit too much about his hair and is a little bit too confident, who is kind to every person he meets, who makes you laugh so hard your stomach hurts. He's a boy just like anyone else. Kevin does not have 'special needs.' All he needs is a chance." about her brother with DS, Colgan Leaming said, "My brother is not his disability. He is a teenager who loves sports and PlayStation, who cares a little bit too much about his hair and is a little bit too confident, who is kind to every person he meets, who makes you laugh so hard your stomach hurts. He's a boy just like anyone else. Kevin does not have 'special needs.' All he needs is a chance."