By the time children with Down’s Syndrome reach school, they are likely to have been receiving input from a range of professionals for some time. Most will have been referred to a local Child Development Centre or equivalent hospital service, where they will be screened for medical problems and offered the opportunity to receive physiotherapy. Parents will generally have been shown how to work with their child at home, exercising weak muscles and encouraging early learning skills. They may also have received input from a speech therapist and introduced to a signing system such as Makaton. In many areas of the country, children with Down’s Syndrome and their families will have been offered weekly support from a Portage Service or other form of early intervention.