Speech and language development for school-aged children Understanding the profile and working together to address support needs Leela Baksi Speech and language therapist.
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The workshop will discuss how to understand the profile of school-aged children with Down’s syndrome and how to work together with your child’s school to address their speech and language development needs.
With the right opportunities and support, they can develop communication skills that support them to
There are a range of tried and tested strategies, with research literature that describes and supports, that address the speech, language and communication needs (SLCN) associated with Down syndrome
Sue Buckley and Patricia Le Prevost of the Sarah Duffen Centre at the University of Portsmouth, in their article making recommendations about Speech and Language therapy for children with Down syndrome, state that
“The needs of children with Down syndrome tend to be different from the needs of other children with learning difficulties. Their hearing, phonological loop impairment and speech-motor difficulties make them different and therapist needs to be skills in auditory discrimination, oral-motor function and speech work as well as language work.”
People who have Down Syndrome require direct teaching of specific aspects of speech, language and communication skills, as well as good language models and general language stimulation to support language learning.
Writing in Speech and language development for individuals with Down Syndrome- An overview (Down syndrome Issues and Information Series), Sue Buckley states:
“the evidence from available research does suggest that improving the quality, quantity and sensitivity of the talk to children with Down syndrome does help … this type of language experience approach is not sufficient on its own but needs to be accompanied by teaching specific vocabulary and sentences, using techniques which encourage the child to imitate production.”
There are plenty of widely used speech and language therapy interventions that are effective in addressing the underlying impairments and real-life communication challenges faced by people who have Down Syndrome.
When describing some of these, Sue Buckley comments:
“The proposals for intervention…follow logically from the available evidence from research, the profile of language development of children with Down syndrome and the probable causes”
Are our children more skilled at understanding language or putting ideas into language?
What aspects of language are particularly challenging? Learning words? Learning grammar? Learning sentences?
Patterns of specific language difficulties (e.g. certain morphemes), rather than slower progress through typical patterns of development.
Speech errors are different to those characteristic of typical development. There are issues with learning the sound structure of words, and with learning to say sounds and words.
Differences in patterns linguistic competence- of patterns of cerebral specialisation, poor phonological short term memory (limited capacity in remembering and repeating back things you they have just heard).
Major communication challenges that children with Down’s Syndrome face (Miller, Leddy, Leavitt, Improving the communication of people with Down’s Syndrome, 1999)
Key research findings: the profile of strength and needs associated with Down’s Syndrome (Robin S. Chapman, Adolescents with Down’s Syndrome, 1997)
People who have DS are better at understanding language than expressing themselves through language, from an early age.
So…conversational language should be pitched at the level that the individual understands, rather than tailored to the sort of language s/he produces.Some implications of key research findings
People who have DS are more skilled at understanding vocabulary and have more difficulty in learning names for things.
So.. don’t oversimplify the vocabulary that you use in conversations with people who have DS.
Make sure pupils are stretched with regard to teaching new topic based vocabulary- take baseline as what the child understands, rather than vocabulary s/he says or signs.Some implications of key research findings
‘In syntax production, children with Down’s Syndrome show greatest difficulties’ (Chapman 1997)
Putting ideas into well formed sentences is an area of development that presents great challenges and lags behind.
People who have Down’s Syndrome
So… provide direct teaching using a language-through-reading approach, using written words to rehearse and learn sentences and grammar structures.
‘Pragmatic skills that can be accomplished with limited language use are more advanced than those that depend on the mastery of complex structure’
People who have DS have strong motivation to interact with people and awareness of other people’s feelings; however learning more complex language to use in social interaction is challenging.
So…teach social skills, and social language, to support strengths in this area.
Some implications of key research findings
‘Children with Down’s Syndrome will have persistent problems in producing intelligible speech’ (Miller, Leddy, Leavitt 1999)
Producing clear speech remains a long term challenge
Libby Kumin’s survey of parents of adolescents with DS in 1994 found that 97% reported that their son or daughter had difficulty with intelligibility: 54% reported frequent difficulty, and 43% reported difficulty sometimes.
Pueschel and Hopmann’s survey of parents of adolescents with DS found that 91% report that their children were effective in getting others to understand them. 88% of parents of 11-16 year olds stated that their children were understood by strangers. 91% of parents of 17-21 year olds reported this.
Much of the variation in the communicative abilities of children with Down’s syndrome is better understood when hearing status is taken into account (Chapman 1997).
So.. provide a comprehensive programme of therapy activities that addresses the issues that contribute to speech difficulties. This includes getting mouths ready for talking, showing the sound structure of words using visual representations, and step by step teaching developing skills at using more and more complicated patterns of sounds in words.
Typically, young people with DS make good use of strategies to overcome these challenges, and achieve successful communication with great effort.
Also identify and teach strategies that individuals can use to get their message across when there are difficulties with speech intelligibility, and build confidence as effective communicators
children with Down’s Syndrome have particular difficulty in remembering and repeating back things that they have just heard (the phonological loop) and this is a skill that can be addressed through specific intervention.
Learning to read is associated with a significant advantage in language and memory skills:
Teaching reading supports language development and memory skills.
People who have Down’s Syndrome can continue to develop their skills in communicating and reading throughout childhood and adulthood.
These interventions can be deployed at any age, alongside motivation to become a more effective communicator.
‘Expectations are important determiners of outcome’ (Sue Buckley)
‘Intervention will have only a limited effect in furthering development and functioning if the attitudes and opportunities of the inclusive educational or community setting are less that appropriate’ (Jean Rondal)
Experiences of positive, successful and rewarding communication- facilitative communication environments
Targeted Intervention at each stage of language development
‘Intervention might work better when….professionals try to tailor intervention to specific etiological groups’ i.e. characteristics of the syndrome (Jean Rondal)
Speech is an auditory signal and more difficult to process
Visual signals are morepowerful
Identify sentence frames/carrier phrases that link to the topic and build ‘next step’ expressive language skills.
e.g. Rabbit lives in the hole, fish lives in the water… rabbits like holes, fish like water.
e.g. Ancient egyptians used to build pyramids, Ancient egyptians used to worship gods …. Ancient egyptians used to have pyramids, Ancient egyptians used to have gods… Ancient egyptians had pyramids, Ancient egyptians had gods.
Start with familiar, everyday sequences in the pupil’s life.
Work on to familiar sequences that the pupil sees but may not carry out.
Then work on novel story sequences.
…. This builds skills for describing events.
Then focus on adding information about the story:
What was it like?
Who? Where? When?
Give the story a title.
Teach our children to play, starting out with simple pretend play and working through to imaginative play- acting out situations
Touch on face song
Direct work on auditory memory skills: listening, recalling, repeating back what you have heard