Colleen Ribb had no idea her fourth child, the baby she had just given birth to and cradled in her arms, had Down's syndrome.
Colleen,33, and her husband Bruce, a 34-year-old Johns Hopkins Hospital engineer, were more immediately concerned that Brandon had to be rushed to intensive care because of respiratory problems. Doctors feared the critically ill baby with the large blue eyes and streaks of blond hair had a hole in his heart.
That diagnosis turned out to be wrong. But something definitely wasn't right.
Within hours of the birth, the couple found themselves inside a conference room at Hopkins. Four solemn doctors informed them that their son had Down's syndrome and began bombarding them withinformation and offers of assistance.
Down's syndrome is a congenital condition caused by abnormal chromosomes and can result in mild to severe retardation. Youngsters suffering with the disease bear easily identifiable features, including a broad face and slanting eyes.
"You hear about it on TV and you see other people, but you never think it will happen to you," Bruce Ribb says. "We both cried for a while, but we were encouraged by the amount of support we received and the fact that they allowed us to hold him and visit any time."
Thebond between mother and son was established early by frequent visitsto the ward where Brandon spent the first 13 weeks of his life. Bringing with her prepumped mother's milk, Colleen Ribb's visits were an attempt to maintain the routine she had planned.
Today, sitting intheir cozy Riviera Beach home, one sees no suggestion of unhappinessin the gurgling, smiling 6-month-old baby -- or in the couple and their three children who squeeze and hug him.
"People call it Down's, but I call him my 'up's baby,' " Colleen Ribb says, kissing his cushiony pink cheeks.
"We concentrate on what he can do, not what he can't," Bruce Ribb says. "Every child is different, and we will just have to wait and see."
Addressing the needs of their young son includes biweekly visits from Amy Anderson, a county special education teacher in the Parent Infant Program.
Since 1980, PIP has offered home-based training for children and education for parents. The sessions improve the chances of success for the future student. More than 300 infants will be served this year.
Three-year-old Ryan and 5-year-old Justin know when it is time for the lady with the bag of toys to visit their new brother. They position themselves in the living room, ready to welcome her.
"Did you bring us anything?" a wide-eyed Ryan asks as she enters.
Anderson reaches into a large orange canvas bag for the toys she brings to entertain them while she works withBrandon.
Ryan and Justin scatter to the backyard. Brandon looks perfectly content in a seat on the floor next to his mother and his teacher, who engage him in simple games. But the intent is not merely to keep Brandon busy: They hope these activities will stimulate his senses and measure his auditory skills.
"The two major areas we are working on include environmental awareness and sensory stimulation,"Colleen says. "We want him to respond to sound, turning toward voices, vocalizing sounds. We're laying the groundwork for communication."
Dressed in a light-blue sleeper with a white-and-yellow bunny patch on its front, Brandon begins wiggling in his seat. Anderson waves a chain of colorful plastic links up and down and side to side, encouraging him to grab the toys.
"He's doing a nice job of reaching," Anderson says. "I'd like to see how he's exploring toys now."
Brandon grabs the link and puts it in his mouth.
"Good," both mother and teacher coo.
In this early classroom, everything is a lesson. Hopefully, this small accomplishment will lead to further progress before he enters school.
Large and small bubbles are blown near him, another exercise to stimulate the infant. At first, he pays no attention. Finally, Brandon splatters a large bubble floating near his facewith both hands. But before he has a chance to go after more, brother Ryan, who is now watching the lessons, can't resist popping them for him.
The mischievous interruption offers a welcome break for laughter. Colleen Ribb works to keep Justin and Ryan occupied, while Brandon is turned on his stomach and placed on a yellow-and-white blanket. Anderson places a mirror in front of him, then taps on it to encourage him to notice his reflection and work on lifting his head -- preparation for crawling.
But his weak upper-body development, commonwith Down's syndrome, makes it difficult to lift himself, sit on hisown or lie comfortably on his right side for more than a few minutesat a time.
Anderson places his hand on a bright yellow pad connected to a small fan. When he touches the pad, a cool breeze slips lightly over the top of his head. The exercise is designed to measure hisunderstanding of stimulus-response.
Then there's peek-a-boo with a small orange blanket. Brandon quickly peeps from underneath, smiling, and Anderson is impressed.