
11-year-olds Laken and Cason Hale are identical twins with Down syndrome.
For most, ‘twinning’ is a fun way to sport the same outfit or hairstyle as someone else, but on Aug. 3, National Twins Day, twinning celebrates similarities in a way few others will ever know – the special bond of being an actual twin, fraternal or identical.
For identical twins, Laken and Cason Hale, ‘twinning’ goes well beyond similar tastes in clothes, food and activities, their health also mimics one another in a way that only genetics can.
In the U.S., twin births account for just 3% of births, the majority being fraternal twins, and identical twins are far more rare, occurring in just 3 to 5 in 1,000 births. The Hale brothers, though, are even more unique. They are identical twins born with Down syndrome, making them 1, or 2, in a million.
“I found out I was carrying twins at my 7-week ultrasound…I was shocked. There were twins in my family, but way down the line,” said the twins’ mom, Chris Smith. “It wasn’t until after delivery, during the newborn screening, that I found out my boys had Down syndrome. It turned my world upside down…I was a new mom, of twins, with a health condition I knew nothing about except that it was a disability. I had no idea, at the time, how not being typical would open up so many wonderful opportunities for us.”
Identical twins occur when 1 egg is fertilized but divides into 2 embryos so the babies share the same DNA and always the same gender. For Laken and Cason, they also both carried the extra copy of chromosome 21 that’s apparent in babies born with Down syndrome.
“We jumped right into life as you do when you become a parent,” said Chris. “I knew as a new mom, getting my boys on a schedule would be the only way I could get through the day so we dug in – sleeping, feedings, diaper changes, you name it; the boys did it together, at the same time.”
The boys met infant milestones in their own time, and at the same time, too.
Although Down syndrome can present in different ways, the boys seemed to have the same challenges with their health. They had their tonsils and adenoids removed at the same time to help with breathing and they both had good interactive skills, but speech was a challenge.
“Language has always been a struggle for the boys…they worked hard to learn letter sounds but it didn’t come easy,” said Chris. “They even developed their own language that no one understood but the two of them. It was cute, but I knew it wasn’t helping them develop the skills they needed to communicate with others.”
When the boys were 3, Chris moved from Arkansas back to her hometown of East Sparta, Ohio, and made an appointment at the Akron Children’s Hospital Down Syndrome Program. They’ve been going regularly ever since.
“It (the Down Syndrome Clinic) has been such a great resource for us,” said Chris. “We go together and they get to see all the specialists at one time rather than having to make trips back and forth to see therapists, audiologists and the whole team. They know the boys and track their progress, which is comforting.”
Through the therapies and the natural highs and lows of growing up, the boys have handled it all – together.

Developmental and Behavioral Pediatrician Dr. Diane Langkamp cares for the boys and is the director of the Down Syndrome Program.
“Hands down the best part of the boys being twins is that they have one another,” said Chris. “I’m not sure they would have found as much success in school and activities if it weren’t for the fact that they knew they’d have each other for support.”
The boys have excelled at playing baseball on their school team, just finished up their first year of dance lessons and are excited to start middle school together in the fall. Although they look alike and are identical in most of their likes and dislikes, they do have a couple differences that help friends tell them apart.
“For years I dressed Laken in blue and Cason in green so others could tell them apart…I swore I would only do it when they were little, but ironically they both still tend to choose those colors so we just go with it,” said Chris. “Laken is left-handed and Cason uses his right, one is more sensitive than the other, but other than that, they’re so similar it’s crazy…they even lost baby teeth at the same time!”
For Chris, Twins Day is a time to celebrate similarities and differences.
“I’m so happy to see how inclusive schools and organizations have become over the years,” said Chris. “I don’t think people look at my boys and see the things they can’t do, I think they see all that they can do and I’m proud of that.”
We agree – twice over.
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