A portrayal of Heaven on Earth: The Adoration of the Christ Child

adoration of the christ child

The previous post discussed how one of the earliest representations of Down syndrome in Western Art had been identified. But what is significant about the painting?

In an article by Drs. Levitas and Reid, they examined a painting from 1515 depicting a Nativity scene, titled The Adoration of the Christ Child. In it, they noticed the angel next to Mary and the shepherd in the painting’s center both displayed facial features associated with Down syndrome. They went on to to discuss the significance of this early portrayal of Down syndrome.

First, they note that this early portrayal of Down syndrome is evidence that counters the view by some that Down syndrome was a relatively modern condition. Instead, the painting is yet one more indication that individuals with Down syndrome have been a part of human history for as long as there have been humans.

Levitas and Reid further suggest that the angel and the shepherd’s inclusion in the painting may mean that medieval society did not consider individuals with Down syndrome as clearly disabled, but just a bit “slow.” They speculate that perhaps physical characteristics were not associated with intellectual disability as they commonly are now.

In the end, they conclude:

After all the speculations, we are left with a haunting late-medieval image of a person with apparent Down syndrome with all the accouterments of divinity. It is impossible to know whether any disability had been recognized or whether it simply was not relevant in that time and place.

Levitas and Reid’s article was published ten years ago. When I first read it, I included both the image of the painting and that final paragraph in my presentations to suggest a different way of looking at Down syndrome. Now, upon my own examination of the painting and reflection on the scholarly article, I have come to a different conclusion on the significance of The Adoration of the Christ Child.

I doubt that medieval Europe was that much different than contemporary society in noticing Down syndrome’s tell-tale physical features and considering those individuals as something different. It is a common human response when encountering those with more obvious disabilities: you notice it and you perceive those individuals as being disabled, “not right,” odd. I mention this because that is why I think the painting is all the more remarkable.

For most of human history, particularly in Western civilization, individuals with Down syndrome have been hidden, ostracized, excluded from society. Langdon Down wrote his description of the condition which now bears his name based on individuals confined in an asylum. The significance of the painting, in my estimation, is that it seeks to challenge this segregation and treatment of Down syndrome as “the other.”

From John M. Starbuck's On the Antiquity of Trisomy 21: Moving Towards a Quantitative Diagnosis of Down Syndrome in Historic Material Culture

From John M. Starbuck’s On the Antiquity of Trisomy 21: Moving Towards a Quantitative Diagnosis of Down Syndrome in Historic Material Culture

The painting is part of the Metropolitan Museum of Art’s collection. The Met’s description says that the painting’s “most compelling” feature is the “great and ineffable” light emanating from the Christ Child. What I find the most compelling feature of the painting is that the artist purposefully chose to include individuals with Down syndrome in such a holy scene. And, the artist did so in a telling fashion.

On first viewing, it appears as though the shepherd is hovering in mid-air above the angel in the middle. But, upon enlarging the on-line photo from the Met’s collection, I noticed that the shepherd is standing behind a wall, peering into the scene through two columns of a window. The shepherd is shut out of the scene–he is not included, or invited into the stable to join in the adoration of the Christ Child, but he inserts himself into the scene, adoring nevertheless.

But, there is an individual with Down syndrome at the adoration. This individual is shown like the other angels, and is seated immediately next to Mary. This individual with Down syndrome is included with the herald of angels adoring the Christ Child.

A fair reading of this depiction is that on earth, individuals with Down syndrome are excluded by human society, but in heaven they are equal and they are as justified as the “normal” angels to be present to adore the Christ Child, Emmanuel, God with us.

And, so, a possible message conveyed in the painting is the continued struggle of parents, advocates, and those who care about human rights to break down the wall of exclusion so that all are included in our society. This is a struggle depicted 500 years ago, but can be seen at every IEP meeting, in the efforts to improve community living options, and in the resistance of expectant mothers to pressure following a prenatal test result to view their child as something other than a child based on the diagnosis.

The Adoration of the Christ Child purposefully portrays an angel with Down syndrome, a member of the Heavenly Hosts, sitting alongside angels without Down syndrome, sharing the same position of respect, adoring their Creator’s begotten Son. The painting is a message from 500 years ago from the artist, or the patron who commissioned the painting, of what they see as heaven here on earth: where individuals with Down syndrome are included and respected, like everyone else. A fitting message for this time of year when all are welcomed to celebrate.

Merry Christmas, everyone.

Your author seeing the painting in person at the Met in 2017

Your author seeing the painting in person at the Met in 2017

I invite you to share: what message do you see in the painting, The Adoration of the Christ Child?


  1. I am wondering whether both characters are modelled on the same young man with DS? They both have remarkably similar frizzy hair and features, though the scale is different, and most people with DS look very different from one another. What do you think?

    • As a second thought, the concept of exclusion (esp through institutions) was alien to people of this century: that really came much later in the 19th and 20th C. Most individuals of that era were illiterate, most tasks manual and repetitive, and the difference of intellect would have been less marked. My guess is that these are two representations of the artists son or a close relative, and that the artist isn’t making a point at all. It is all too easy to have the benefit of artistic hindsight!

      • Thanks, Rob. As Levitas and Reid note in their own article, an artists’ viewpoint is experienced by his own experiences, and no doubt my hindsight view of the painting is similarly informed by my own experiences/perspective. But I do think the artist was clearly making a point by representing one of the angels as having Down syndrome as a testimony that individuals with Down syndrome should be considered as holy and included as everyone else.

        • That would only be true if we had evidence of systematic discrimination in medieval Europe against people with DS/learning disabilities, and I don’t think we do. Do you have and evidence? The references that do exist are few and far between, and somewhat ambiguous. In fact, one of the very first laws passed by the Scottish Parliament back in the C13th was to protect the rights of heirs to estates who had learning disabilities from predation by their relatives, through the appointment of Trustees.
          Post renaissance I might cite the fool in King Lear, but also the very interesting description of a privately run madhouse divided between two parts for “fools and madmen” in Middleton and Rowley’s “The Changeling” – though both date from the early 1600’s. Before then most ‘institutions’ were presumably monastic, and my guess is that many a Monastery provided a home for those who has been excluded or rejected by society. Umberto Eco’s “The Name Of The Rose” is well researched and includes some very interesting characters.

          • I do not have any evidence of systematic discrimination in medieval Europe, aside from the reference in the Levitas/Reid article which seemed one-sided in the presentation of individuals with intellectual disabilities as fools and knaves and not as individuals worthy of the same respect as all others, or, particularly, with the accouterments of divinity as the nighttime Adoration depicts individuals apparently with Down syndrome.

          • Miguelina OConnor says:

            “In fact, one of the very first laws passed by the Scottish Parliament back in the C13th was to protect the rights of heirs to estates who had learning disabilities from predation by their relatives, through the appointment of Trustees.” Perhaps this is evidence in itself of ystematic discrimination in medieval Europe, and why the artist chose to depict these individuals, to bring about awareness as we commonly do today.

  2. I think a more relevant discussion would be about the working realities of artists at the time. They often used family, friends and local characters as models, so the inclusion may have been for personal reasons. Another realistic possibility is that these models were family or friends of the donors or patrons of the artwork, and were customarily included. Another, broader social context has been suggested that those with DS were seen then as angelic themselves, though again, this perspective would likely have been shared by the painter if these models were someone close to him.

  3. I loved reading this article. Thank you. Whether or not the angel has Down syndrome doesn’t matter to me. Isn’t art suppose to have different meanings to each person who sees it? I especially love your last paragraph. My three-year-old son with Ds just loves singing praise and worship songs. He was diagnosed prenatally at 15 weeks. We appreciated the extra time to prepare for his arrival, but my heart aches for all the little ones who will never be born because of this new technology. He is our greatest earthly gift.

    • I’m glad you enjoyed the article and smiled hearing of your son singing–a favorite activity of my daughter, as well (though more pop music than praise and worship!).

  4. Andrew Levitas, M.D. says:

    I was delighted to find these posts (which I stumbled upon accidentally, searching for any update on what might be known about Jan Jest of Kalkar) ten years after the publication of our article. The speculations about what the painting has to tell us about the position of people with DS in late medieval times follow the speculations Dr. Reid and I went through as we prepared the article. We arrived at the same point as these posts: plenty to speculate upon, little evidence. Our feeling that this child was not seen as “different” was based on the lack of description of any currently-recognized congenital syndromes in the medical literature of the time (notably “Monsters and Marvels”, cited in the bibliography, which is full of descriptions of legendary abnormal births, none directly observed)–again, Langdon Down’s description of DS in the 19c was only the second such description, the first being Cretinism (congenital hypothyroidism–portrayed in a painting by Velazquez, of one of Philip IV’s court jesters–which was widely recognized in areas where water was poor in iodine). These posts raise the question of how such individuals were thought of by the non-medical public.

    One speculation we were left with was this: This is the portrait of a family group; the angel/children’s physical resemblance is unmistakable. The other children appear female; it is at least arguable that the child with DS is male. This was a family wealthy enough to commission a painting with themselves as models for the holy family in a nativity scene. The child with DS appeared to our eyes to be the youngest. Did an older mother give birth to a child with DS?Is it possible that after the pregnancies that produced the 4 girls, they were continuing to try for a son and heir? Was it an accidental pregnancy? Is he positioned next to his mother, and near father, perhaps to help him through the difficult experience of holding a pose for the artist? The story is logical, but again, there is no evidence.

    One other possibility that teased us–with even less evidence–was: is this the artist’s own family, or family and friends?

    Either way, that child is included in the painting, a full member of the family, unashamedly portrayed–included.

    • Thank you for your comment, and your additional conjecture is appreciated as well, as I had not considered the possibility of the individual having DS as a result of one last attempt for an heir. Your comment prompted me to update the post with the picture of me seeing it in person in February 2017, where it was back on display at the Met. A wonderful, serendipitous experience to visit the Met for the first time and see the painting back on public display.


  1. […] Part 2 of this post can be read at this link; it discusses the significance of the painting The Adoration of the Christ […]

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