Communication and Down syndrome (young children ages 0-5)

The following is taken from the handouts and notes from a session called Developing Communicatoin and Play Skills in Young Children with Down syndrome by Kristin Greene, M.S., CCC-SLP and Stephanie Metz, M.S., CCC-SLP at the Trisomy 21 Symposium at the Children's Hospital of Philadelphia.

Kids with Down syndrome do well with:

1. gestural advantage
2. visual learners
3. strong communicative intent
4. intersted in social interaction and play
5. imitative
6. early access to support and therapy
7. receptive skills usually more advanced than expressive
8. certain areas of language dvelop more easily, such as vocabulary

Factors that lead to success:

1. experiences and exposure to language
2. opportunities to use language
3. adult response to attemtps at gestring, speaking, and initiating communication and play
4. support, encouragement, and praise
5. individulaized treatment plan
6. family involvement

Importance of Gestures:

• gives them an early way to express themselves and communicate
• helps them to understand language
• gestures often lead to words
• continue signs and gestures even after they start speaking
• gestures are easier to use
• promote signs and gestures at home
• parents using them affects whether the child will use them
• first signs and gestures are often first words to speak
• begin teaching with hand-over-hand
• Signing will not prevent speaking
• Make sure you say the word with the sign.

Activities to encourage speech

0-12 months:

• peek-a-boo, gonna get you, tickle, sleep/wake up, other social games
• sing songs with signs and gestures
• read books and point to pictures
• makes sounds in play-- car goes "vroom", cow says "moo".....
• play "in and out" games with toys
• repeat sounds and noises they make: sneezes, coughing, raspberries, kisses...
• use animal and enviromental sounds
• model gestures like waving bye-bye, pointing, head shaking for no, lifting arms for "up", blow kisses, knocking, drinking, eating

1-2 years:

• practice pointing in books and things around the community and house
• read books and label pictures and actions
• body parts and clothing items: Mr. Potato Head, dressing bear or baby, boo-boo Baby
• sings songs and stop and let them fill in, even if its just jibberish
• look at family photos and label and point to places, objects, and people
• give short commands for the child to follow
• figure out their approximations and gestures and respond to them
• encourage fill in the blank during songs and phrases
• speak to your child one level above where he/she is speaking.  If they are using one word, parents use 1-2 word phrases.

2-3 years

• talk about colors and use the signs
• count and quantity concepts (big/little, more)
• lable and point to body parts and clothing items
• point to things in books and practice saying what it is.  There's the dog.  Dog says "woof"
• find ways to get the child to ask for help
• practice answering yes and no
• demonstrate and model different ways to play with toys

3-5 years

This is when kids usually have a vocabulary and speech explosion!

• Use gestures and signs to continue to support language, even when they begin talking.  It helps fill in the blanks.
• model and practice pronouns: I, me, mine, you, your, he, she
• model prepositional phrases: in, on, under, below.....
• expand vocabulary with action words

More ways to encourage communication and requesting:

• Do not anticipate needs.  Get them to ask for things in whatever way they can.  Give paper with no crayons and get them to ask.
• use pauses and wait time to get them to request with a word or gesture
• give choices and have them point or say which they want
• use self-talk to describe what you are doing, seeing, hearing, feeling
• expand on what your child says by adding one or two words.  daddy-- daddy home, shoe--Mommy's shoe...
• use real objects rather than pictures-- use an animal puppet or stuffed animal while singing Old McDonald had a Farm.
• lots of praise when your child attempts to request or communicate
• accept any gesture, sign, or vocalization.  The more they try, the better they will get
• repeat words or activities that you are teaching
• use physical cues like hand-over-hand for gestures and signs
• use sound cues for speaking.  Close your lips together and run your finger over your mouth for "mmmmmmm" "mommy" or "buh buh" bubbles

Core Vocabulary Book: they help your child learn to say important words that are needed for daily use as clearly as possible

• what to include: child name, age, family members, other important people, foods, drinks, toys, activities they do, favorite places, pets
• get a small photo album from the Dollar Store
• Place pictures in album with the word written on or below the picture
• start with 10-20 words (or phrases for older kids) and build from there
• once the 10-20 are mastered, remove and replace
• read at least once a day to practice
• promotes clearer speech and expressive language

Areas to build vocabulary

1. Bath time
2. meal time
3. dressing concepts
4. play

Toys to consider:

1. board books- repetitive books are best: Brown Bear
2. pop up toys with dorrs to open and close
3. toy foods and kitchen
4. baby dolls with accessories: bottle, diaper, potty, blanket, etc
5. doll house, farm, car garage, fire station, etc
6. wooden puzzles with big pieces, increase degree of difficulty as the master
7. ball toys- balls in a canister, that roll down tubes or slides...
8. water in a plastic bin with fish or animals
9. bubbles- you can pop, point, say "buh buh bubbles"....