An eight-month-old infant with Down syndrome is being seen in the clinic. His mother tells the nurse that he is difficult to hold, that "He's like a rag doll. He does not cuddle up to me like my other babies did." The nurse's best interpretation of this lack of clinging or molding is which of the following?

A. Detachment and rejection are psychosocial interpretations that require deeper behavioral assessment and are not appropriate assumptions based on physical presentation alone. B. Maternal deprivation refers to a lack of emotional bonding or nurturing, which is not evidenced here and is not the cause of the floppiness described. C. While autism can co-occur with Down syndrome, the description given is more characteristic of hypotonia, not autism-specific behavior. D. Infants with Down syndrome commonly have generalized hypotonia (low muscle tone), which causes them to feel “floppy” or like a rag doll when held. This is a well-known physical trait of the condition and not a sign of emotional or developmental issues at this stage.