moderate and severe intellectual disability; trisomy of chromosome 21; the eyes appear almond shaped, and the skin of the eyelids tends to be abnormally thick. the face and nose are often flat and broad, as is the back of the head. the tongue, which seems too large for the mouth, may show deep fissures. the iris of the eye is frequently speckled. the neck is often short and broad, as are the hands. the fingers are stubby, and the little finger is often more noticeably curved than the other fingers; often cheerful