Caregiver Concerns for Children and Adolescents With Down Syndrome: A Cross-Sectional Study in Brazil.

Convenience sample recruited via social media and a handful of healthcare institutions in one Brazilian state; not representative of all families with Down syndrome in Brazil or elsewhere. Small subgroups: only 9 caregivers in the 3-5 year band and 16 in the 0-2 year band, so the test had little power to detect real differences in the youngest children. Cross-sectional design with no longitudinal follow-up, so it cannot show how concerns change as a child grows. Single country and single cultural context; findings may not generalise to other healthcare systems. All data are caregiver-reported; no input from the child or adolescent and no triangulation with other sources.

Funded by the São Paulo Research Foundation (FAPESP) and CAPES. The authors declare no conflicts of interest.

The null age comparison does not mean every age group worries about the same things. The descriptive data show different items leading in different bands: mobility in the 0-2 group, communication and participation in the 3-5 and 6-11 groups, and behaviour and participation in the 12+ group. With only 9 caregivers in the 3-5 band and 16 in the 0-2 band, the statistical test had very little power to detect a real difference in the youngest children, so the absence of significance should not be read as evidence that concerns are identical across ages.