A fossil of the inner ear of a six-year-old Neanderthal child that showed signs of Down syndrome seems to indicate that the ancient, now-extinct species were compassionate caregivers, according to a new study in the publication Science Advances.

Archeologists in eastern Spain unearthed the fossil in 1989, which showed the complete inner ear anatomy of the Neanderthal child who scientists nick-named Tina. The abnormalities in Tina’s ear are known only in people with Down syndrome, making the fossil the earliest-known evidence of the genetic condition.

Scientists say that, to survive for six years, Tina would have required care from the community around her.

“The pathology which this individual suffered resulted in highly disabling symptoms, including, at the very least, complete deafness, severe vertigo attacks and an inability to maintain balance,” paleoanthropologist Mercedes Conde-Valverde, who was the lead author of the study, told the Reuters news agency. “Given these symptoms, it is highly unlikely that the mother alone could have provided all the necessary care while also attending to her own needs. Therefore, for Tina to have survived for at least six years, the group must have continuously assisted the mother, either by relieving her in the care of the child, helping with her daily tasks, or both.”

Neanderthals, or homo neanderthalensis, were a more robustly built species than homo sapiens, our human ancestors, and had a very pronounced brow. Research has shown that they were intelligent, hunting in groups and creating art, and they may have had language skills. 

They lived between 430,000 and 40,000 years ago, and went extinct soon after homo sapiens spread into their territory.

The precise age of the fossil of Tina’s ear has not been determined.

Scientists still debate what the reasons were for Neanderthals to apparently have cared for sick members of their group like Tina.

“There are authors who believe that caregiving took place in a context of reciprocal selfishness between individuals able to reciprocate the favor, while other authors argue that assistance to sick or injured individuals among Neanderthals went beyond reciprocal selfishness and was produced by a genuine feeling of compassion,” the study said.