Communication and Down syndrome (school-aged children)

The following is taken from the handouts and notes from a session called Increasing Communication to Decrease Frustration in School-Age Children with Trisomy 21 by Susan Beidermann, M.A., CCC-SLP and Marianne DeCicco, M.S., CCC-SLP at the Trisomy 21 Symposium at the Children's Hospital of Philadelphia.


Speech is the most difficult aspect of communication to learn and use.  Speech will develop later than communication and language.

Communication strengths for people with Down syndrome:

• vocabulary- experiences build vocabulary.  encouraging a variety of experiences encourages vocabulary.  while vocabulary continues to improve, grammar often does not continue to develop.  problems with using grammar in speech are common.
• visual learning of communication skills- learning from watching and experiencing

Communication weaknesses for people with Down syndrome:

• receptive/expressive communication gap- they can understand more than they can express.  life experiences improve this gap.  home is usually better than school, because home is more familiar and consistent.
• difficulties in auditory memory- easily forgetting things they hear (hence visual learners), difficulty remembering words long enough to be able to process and respond to them.
• difficulties in grammar and complex conversation skills.  difficulty with the order that words should go in and with plural and possessive.
• topicalization- how to choose, stay on, end, and change conversation
• speech intelligibility problems- intelligibility = ability to be understood, due to a variety of reasons(stutter, low muscle tone, tongue thrust, apraxia), people with Down syndrome can be difficult to understand when they speak.

Working to improve communication:

• Decide what to work on:

                       1.  choose according to interests
                       2.  address school and home needs first

• Work to understand vocabulary words, learn to use new words, and practice those vocabulary words.

                        1.  choose words related to important events: preparing a Holiday meal with        
a list of guests, recipes, food, ingredients, cookware needed, dishes, and afterwards review the holiday with lists and photos. 
                        2.  choose vocabulary based on what they are learning at school
                        3.  use board games (Scattergories)
                        4.  Role play:  salesperson and customer
                        5.  Go shopping:  talk about clothing, how it feels, what you do with it, talk about types of stores, items in the stores.
                        6.  Create a photo/vocabulary book with events, activities, people.......

• Teaching through reading

                        1.  "Research has shown progression in reading skills is linked to progress in language and short term memory skills."
                        2.  "Researcher Sue Buckley suggests introducing reading when a child can match pictures, select pictures to demonstrate comprehension, and has a comprehension of 50-100 words.

• Helping conversation skills:

                       1.  small conversation groups
                       2.  social stories
                       3.  comic strip conversations
                       4.  video modeling (recording conversation to watch)
                       5.  talk about conversation skills:  turn taking, looking people in the eye, listening to the other person, stay on topic, ask questions, speak clearly, speak up for yourself

iPad apps:
1.  iConverse