Public Awareness, Misconceptions, and Social Attitudes Toward Individuals With Down Syndrome in Attock, Pakistan: A Mixed-Methods Study

Background: Down syndrome (DS) is the most common genetic cause of intellectual disability worldwide, resulting from trisomy 21. In Attock,Pakistan, limited community-level research exists on public perception of DS. Objective: To evaluate public awareness, identify misconceptions, and analyze social attitudes toward individuals with Down syndrome in Attock, Pakistan, using survey data complemented by real-world observations. Methods: A mixed-methods approach was employed, combining a structured questionnaire administered to 70 participants (30 elderly adults aged 60+ years, 20 students aged 18–25 years, and 20 young adults aged 26–40 years) with informal observational data collected in public spaces. Convenience sampling was used. Results: Awareness varied significantly across age groups (χ² = 18.45, df = 2, p < 0.001): students demonstrated the highest awareness (80%), followed by young adults (70%), while elderly adults showed markedly low awareness (27%). Accurate understanding of the genetic basis of DS was limited: 70% of young adults correctly identified the cause, compared to 45% of students and 0% of elderly adults. Misconceptions regarding curability were widespread, with 90% of elderly adults, 50% of students, and 55% of young adults believing DS is curable or may become curable through future medical advances. Negative social attitudes were prevalent among elderly adults (80%) and students (80%), whereas young adults exhibited predominantly positive attitudes (70%). Observational data revealed verbal ridicule, stigmatizing language, and exclusionary behaviors in public spaces. Conclusion: Awareness of Down syndrome in this sample is often superficial and does not guarantee accurate understanding or positive social attitudes. Improving societal acceptance will require targeted educational interventions, public awareness campaigns, and structured exposure to individuals with DS.