CNN-Based Facial Image Analysis for Pediatric Down Syndrome Classification

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Yunidar Yunidar, Inda Mariana Harahap, Melinda Melinda, Rosmawinda, Nurlida Basir, Aufa Rafiki, Imam Fathur Rahman

2026 Journal of Electronics, Electromedical Engineering, and Medical Informatics Vol. 8 Issue 2 Article Cited by 0 SDG 17SDG 3 Quartile

Abstract

Down syndrome (trisomy 21) is a genetic disorder caused by an extra copy of chromosome 21, resulting in distinctive developmental facial characteristics and intellectual delays. Early detection is crucial to enable timely medical intervention. However, conventional diagnostic procedures still rely on clinical observation and genetic testing, which can be invasive and expensive. This study proposes a facial image–based classification system for detecting Down syndrome using a Convolutional Neural Network (CNN) approach. Seven CNN architectures were evaluated, namely EfficientNetB0, MobileNetV2, ResNet34, ShuffleNetV2, AlexNet, VGG19, and InceptionV3, under two training scenarios: with and without early stopping. The dataset consisted of 1,000 facial images of children with and without Down syndrome, split into training, validation, and test sets at 60:20:20. Face detection was performed using the Haar Cascade Classifier, followed by data augmentation techniques including rotation, zoom, translation, horizontal flipping, and Gaussian noise to improve model generalization and reduce overfitting. Experimental results show that the VGG19 architecture achieved the best performance, with an accuracy of 94.5%, precision of 91.59%, recall of 98%, and an F1-score of 94.69%. A one-way ANOVA test yielded an F-value of 0.003 and a p-value of 0.955 (> 0.05), indicating no statistically significant difference between models trained with and without early stopping. Grad-CAM visualization highlighted key facial regions, namely the eyes, nose, and mouth, as the primary contributors to classification, while analysis using 68 facial landmark points revealed distinctive morphological patterns associated with Down syndrome. The integration of CNN models, Grad-CAM visualization, and facial landmark analysis demonstrates a promising, interpretable, and non-invasive approach to supporting early Down syndrome screening using facial images. © 2026 by the authors.

Affiliations

Department of Electrical and Computer Engineering, Universitas Syiah Kuala, Banda Aceh, Indonesia; Department of Pediatry, Faculty of Nursing, Universitas Syiah Kuala, Darussalam, Banda Aceh, Indonesia; Faculty of Science and Technology, Universiti Sains Islam Malaysia, USIM, Negeri Sembilan, Nilai, Malaysia

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