Children with Down Syndrome have different characteristics in communication, motor skills, social interaction, and interpersonal relationships, requiring an appropriate approach. This study aimed to observe interpersonal approaches in building initial interactions with children with Down Syndrome at SLB N Autis Sumatera Utara. The method used direct observation with a descriptive approach through introductions, simple communication, games, and adaptive sports activities. The results showed that interaction should be conducted gradually, patiently, and according to the child's responses. Communication occurred both verbally and nonverbally. Games and adaptive sports can support natural, comfortable interactions and encourage children's participation.
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