Two US companies are designing clothes to better fit the body shapes of people with Down's syndrome. But are different clothes really needed?
"Ashley has a typical Down's syndrome body," says Connie DeRamus. Talking about her 32-year-old daughter, she says: "At 5ft tall, Ashley is shorter than most women. She has a stocky, wide build, is short in the torso and is small in the top half."
Indicators of Down's syndrome includes smaller femurs and humerus bones, meaning arms and legs aren't quite as long as average. Typically people with the syndrome are shorter and it's reported that some can have stomachs which are a little larger, thought by many to be a medical consequence of the condition.
Ashley DeRamus began designing dresses for women of a similar shape to herself when she couldn't find anything in High Street shops that fitted well. The company she founded with her mother, Ashley by Design, based in Alabama, sells dresses based on Ashley's own measurements. Providing clothes for women, the outfits include features like ruffles and overlays "to cover up big stomachs" as Connie puts it.
In Ohio, Karen Bowersox runs Down's Designs, a company which makes jeans and fashionable trousers for kids and adults with the syndrome. When she struggled to find clothes on line with arms and legs short enough to fit her granddaughter Maggie, she suspected that others might be having similar problems and investigated further.
Agreeing with DeRamus, she says that in most cases, her customers are larger round the middle - something she attributes to low muscle tone: "Holding in the tummy is challenging." She says 60% of them have told her they don't like trousers that sit on their stomach. Her solution is what she calls "dip-downs" which are of regular fit at the back but sit below the "tummy" at the front.
The knees of people with Down's are much higher up, she says, so her company uses lots of stretchy fabrics to create "a more appropriate bend".
But as well as look and feel, Bowersox says there are many practical matters when putting on clothes. Many with Down's syndrome have fine motor skill problems which make buttons and zips hard to use. Some, she says, are "relegated to wearing sweat pants".
Bowersox strongly believes that dressing independently instils confidence. She says: "Imagine school having to help you pull your pants down."
Though the idea for accessible fashions which flatter the body might be new to people with Down's syndrome, wheelchair-users are already able to purchase clothing designed for them to look good and feel comfortable while sitting - including trousers which are higher at the back so that they don't slip down, with long legs that don't ride up.
Tops for wheelchair-users are available with bigger-than-usual arm holes for more freedom when self-propelling, and for women, there's a lot of detail high up on the garments to draw attention away from the legs and towards the bust line. Dresses and coats are cut to fit over the chair and drape elegantly.
So are specially adapted clothes welcomed by the Down's syndrome community?
Writing on the Future of Down's forum on Facebook, mum Linsey Tree Sim says: "[My daughter] has short, chubby arms and legs. It's a struggle finding clothes to fit unless it's t-shirt and leggings. She also has small feet so onesies that fit her torso flap around her legs and feet.
"I would definitely shop from a place that had specific designs as long as it wasn't extortionately expensive."
Another mum, Jane Gordy, whose daughter is Sarah Gordy, an actress with Down's syndrome who has appeared in BBC TV's Call the Midwife, dismisses the idea that people with Down's have shapes which aren't catered for. She says there's no need to use special shops and, addressing the stomach size in particular, says: "I bet there's no reason for the majority of people not to have good muscle tone." She believes this could be more about parents' expectations of their children and a "lack of ambition" for them. She says: "Sarah works out every day using three exercise tapes and she is a dancer so is pretty fit."
Not everyone has the energy to put in lots of time towards staying in good shape and it is recognised by many that it is more of a challenge for people with learning difficulties.
The two specialist companies Ashley by Design and Down's Designs are growing, however, and believe they've hit on something that people really want.
DeRamus says her clothes are sold before they even get listed online, and not just to people with Down's. They are bought by non-disabled women of a similar shape, and by siblings of people with Down's so that they can have matching outfits - helpful for occasions when people need to coordinate, such as bridesmaids at a wedding.
More than 72,000 people follow Bowersox's Facebook page and she has shipped her jeans to eight countries. She raised more than $20,000 in a crowdfunding campaign this summer and won a $50,000 marketing bursary.
But neither of the companies is a money-making venture and Bowersox says that's why more people aren't designing for people with Down's: "There are only 400,000 people with the syndrome in the US." She deals with each order personally, which is time-consuming.
Ashley DeRamus says: "I feel good in my clothes and I feel great seeing other people wearing my clothes." She and her mum feel so strongly that looking great means feeling great, they regularly give their dresses away to women with Down's syndrome who can't afford their designs.