Participation by Individuals with Down Syndrome Who Have Atlantoaxial Instability
There is evidence from medical research that up to 15 percent of individuals with Down syndrome have a misalignment of the cervical vertebrae C-1 and in the neck. This condition exposes Down syndrome individuals to the possibility of injury if they participate in activities that hyperextend or radically flex the neck or upper spine.
Special Olympics requires temporary restriction of individuals with Down syndrome from participation in certain activities that pose potential risk. This restriction may be lifted once an X-ray is produced showing no evidence of instability on the C-1 vertebrae.
Accredited Programs may allow all individuals with Down syndrome to continue in most Special Olympics sport training and competition activities. However, such individuals shall not be permitted to participate in sport training and competition activities which, by their nature, result in hyperextension, radical flexion or direct pressure on the neck or upper spine, until the requirements of 2 and 3 below are satisfied. Such sports training and competition activities include:
butterfly stroke and diving starts in swimming
diving
pentathlon
high jump
equestrian sports
artistic gymnastics
football (soccer)
alpine skiing and
any warm-up exercise, placing undue stress on the head and neck.
Restriction from participation in the above-listed activities shall continue until an individual with Down syndrome has been examined (including x-ray views of full extension and flexion of neck) by a physician who has been briefed on the nature of the Atlantoaxial Instability condition and the results of such an examination demonstrate that the individual does not have Atlantoaxial Instability condition; or
For any individual diagnosed as having the Atlantoaxial Instability condition, the examining physician shall notify the athlete's parents or guardians of the nature and extent of the individual's condition, and such athlete shall be allowed to participate in the activities listed in 1 above only if the athlete submits written certifications from two physicians, on forms prescribed by Special Olympics, combined with an acknowledgment of risks signed by the adult athlete or his/her parent or guardian if the athlete is a minor.
