Language,
Communication,
& Down Syndrome
In terms of speech-language abilities, most children with DS are able to learn to communicate effectively, but major communication milestones may be delayed compared to a typically developing child. Early speech-language intervention is crucial to providing this population with the strategies to help them succeed and communicate effectively (ASHA 2015). According to the American Speech-Language and Hearing Association, infants with Down Syndrome should be screened/assessed in the following areas: swallowing, hearing, oral-motor and speech abilities, expressive and receptive language abilities (including the use of gestures), and social communication abilities, as deficits can occur in any or all of these areas (ASHA 2015).
Speech Therapy Interventions //
Video //
"Speech in Down syndrome"
This video is an example of the speech of a 9-year-old girl with Down Syndrome. Ciarra talks about her life and friends at school.
Video //
"down syndrome speech therapy"
This video depicts an example of a speech therapy session with a boy with Down Syndrome.
What ways can Speech Therapy Help? //
Swallowing:
The American Speech-Language and Hearing Association (ASHA) recommends that swallowing intervention be implemented when structural symptoms of Down Syndrome impact the individual’s feeding. Chronic sinus or respiratory conditions may lead to the need for pharmaceutical intervention to improve swallowing ability. Behavioral or oral-motor intervention can be beneficial as well. Alternatively, palatal plate therapy can be used to improve oral-motor movements in individuals with DS.
Articulation:
One treatment approach for articulation difficulties in individuals with Down syndrome that is strongly supported by research is the Naturalistic approach (Betancourt 2015). This treatment method focuses on intelligibility as opposed to accuracy. As individuals in this population often have structural differences of their articulators (tongue, lips, and jaw), 100% accuracy of production of speech sounds is an unrealistic goal for many individuals. This approach aims for consistency and intelligibility of speech, rather than perfect production (Betancourt 2015). Increasing intelligibility can involve aiming for consistency of phonemic errors (for example, using /w/ to substitute for /r/ on a consistent basis), or accurate syllable structure, grammatical roles, and suprasegmentals during speech
production. The main goal of this treatment approach is functional communication. It is executed through child-centered play and frequent recasting of correct production by the clinician (Betancourt 2015).
Language:
Individuals with Down syndrome often have stronger understanding of language than expressive communication skills. This is known as the receptive-expressive gap. (Chapman 2006). For optimal communicative effectiveness, language intervention for individuals with Down syndrome should be inclusive of total communication methods, including alternative and augmentative communication, sign language, oral communication, and/or visual cues and gestures (ASHA 2015). Language therapy should focus on syntax, auditory-verbal working memory, and vocabulary comprehension, as these skills are common deficits in individuals with Down syndrome, particularly during
adolescence.
Social Relationships:
Not all individuals with Down syndrome experience deficits in pragmatic language. In fact, most children with Down syndrome excel in the area of social-interpersonal relationships (NDSS 2015). When intervention is necessary, treatment should focus on improving communication with same-age peers, reinforcing appropriate responses, increasing social initiation, and generalization of these skills in different communication environments (ASHA 2015).
Video //
"Using Humor to Help a Client with Down Syndrome Improve Speech"
This video depicts an example of speech therapy intervention using humor and visual phonetics strategies.