Children with Down syndrome have been described to have language, social-communicative and intentional skills that lag behind age-matched peers, with frequent gesture use that is not accompanied by vocalisations or words. Early intentional communication, particularly requests, has been shown to be an important step in future language development. This is a preliminary study that explores the use of verbal and non-verbal requests in 4 Spanish-speaking children with Down syndrome from very low income families. Children were observed in an elicited request task and language level was evaluated using a parental report. Results showed that all participants were very delayed in their language production. Children used mostly combinations of non-verbal requests. Data support previous studies in that Spanish-speaking children also use non-verbal requests for a prolonged period of time as a strategy to compensate for their linguistic deficits. Findings differ from previous studies in that most combinations of gestures were complementary and not equivalent. Their language development was much more depressed than most data published to date. This lag could be explained because children were from very low income environments and they may lack stimulation because of family situations. It is suggested that data from a larger sample be collected and compared to typically developing children in order to make a stronger proposal about the use of non-verbal forms as a bridge to verbal productions.
This descriptive study investigated the home literacy environment of New Zealand children with Down syndrome. Participants were 85 children with Down syndrome enrolled in predominantly mainstream school programmes in years 1-8, who were aged between 5;4 (y; m) and 14;11 (M = 8;11, SD = 2;6), comprising an estimated 15% of children with Down syndrome in New Zealand primary education[1]. Survey data via questionnaire (modelled on Boudreau[2]), was gathered from participant's parents and targeted three broad themes including parents’ priorities regarding literacy for their child with Down syndrome, ways in which the HLE of children with Down syndrome supports literacy development and the ways children with Down syndrome participate in literacy interactions. Results were analysed for all participants and by age group which are presented when group differences were apparent. Results indicated the majority of parents are involved in regular literacy interactions with their child, although more with reading than with writing. Many children played an active role in joint reading activities, interacting with both pictures and text, although more with pictures than with text. Children were reported to use a wide range of writing materials. Parents also reported other ways in which they facilitated literacy development including active teaching, language games and library visits. Clinical implications for parents and professionals working with children with Down syndrome are discussed with reference to relationships between HLE variables and positive literacy outcomes and provide support for the development of targeted interventions specifically aimed at facilitating literacy with this population.
This article describes the Reading Recovery approach to supporting children's literacy development and evaluates the significant benefits of the approach for a pupil with Down syndrome.
Infants with Down syndrome display characteristic deficits in early communicative behaviours, including requesting. This deficit significantly and negatively impacts later communication and cognitive development. In this study, we explored intervention to address requesting in young infants with Down syndrome. Two infants with Down syndrome were taught increasingly sophisticated forms of early requesting skills (i.e., gaze shifting and gaze shifting paired with vocalisation). One of the infants was also taught a verbal approximation of the word "more". The application of interventions to address and prevent impairments characteristic of the behavioural phenotype demonstrated by infants and children with Down syndrome is discussed.
A review of the Down Syndrome Issues and Information - Adult Living series, series editor Professor Roy I Brown, published by Down Syndrome Education International.
The incidence of immune mediated diseases and hormonal disturbances is increased in people with Down syndrome. However, there are only three published reports of the coexistence of thyroid disorder, insulin dependent diabetes mellitus and coeliac disease in children with Down syndrome. Here we describe a young male with Down syndrome who was diagnosed with congenital hypothyroidism, diabetes mellitus, and coeliac disease. The role of serological screening for coeliac disease in children with Down syndrome is discussed.
This article describes how photographs have been used in literacy activities for young adults with Down syndrome participating in a post-school literacy programme. We describe how the principled use of photographs in literacy teaching can: scaffold literacy learning, specifically in the writing of stories and recounts; support writing about abstract concepts, and support extended autobiographical writing with learners who have diverse literacy strengths and needs. Photographs are intrinsically interesting resources for developing literacy because they are actual representations of important known events in young adults’ lives. Thus in talking and writing about photographs, these young adults are motivated to construct extended texts that have relevance to their own lives. The learners’ developed written texts can be used as more accessible reading material.
Two areas where speech fluency problems arise, the motor system and the speech-language interface, are described and their implications for characterising the dysfluencies made by children with Down syndrome are discussed. Research topics are identified and implications for the treatment of speech problems in children with Down syndrome are drawn.
Many children with Down syndrome experience significant speech difficulties which in turn affects their speech intelligibility. This paper describes how electropalatography, a computer-based technique which uses visual feedback to alter speech production, is being used at Queen Margaret University, to assess and treat speech difficulties in a group of children and young people with Down syndrome. Encouraging results from a single case are reported.
A report on the UK Down Syndrome Research Forum, hosted by Down Syndrome Education International 16-17 October 2008.
The use of ICT as an aid to learning has been an integral part of special education for over 20 years in the UK. During this time software resources have developed that are particularly relevant to the learning profile of this group of learners. As access to computers and the Internet becomes cheaper and more available, the 'Digital Divide' gets smaller as more homes have access to resources that enhance the lives and learning of traditionally more isolated groups. While more able users have access to a whole host of free to use activities both on the computer and increasingly 'On Line', young people with cognitive and motor difficulties can struggle to find 'user friendly' resources that meet their needs. This simple investigation brings together information on free resources that tackle this problem and make available a range of educational and leisure opportunities that are more likely meet the individual needs of a range of young people with Down syndrome.
One of the most common genetic abnormalities, Down syndrome is associated with intellectual disabilities as well as increased incidence of autoimmune diseases. Endocrine disorders, such as diabetes and thyroid dysfunction are amongst the most common. We describe the case of a 27 year old woman diagnosed with diabetes at the age of 9, who had associated crises of loss of consciousness from the age of 23 and developed primary autoimmune hypothyroidism from the age of 25 years with chronic pericardial effusion. Neurological examination considered the diagnosis of absence crises; therefore she started taking Carbamazepine 400 mg daily since the age of 23. At admission, the patient was obese (BMI =32 kg/m2), with neck localised acanthosis nigricans. The clinical examination revealed signs of hypothyroidism without goitre. Diagnosis was confirmed by TSH = 350 mUI/L, anti TPOAb = 329.9 U/ml as well as pericardial effusion on echocardiography. She started thyroxine replacement therapy, while being on basal/bolus insulin regimen (short and intermediate acting insulin). Full control of diabetes was not achieved until she also received metformin and basal insulin analog. TSH level reached normal values of 2.4 mU/L only after a LT4 substitution dose of 150 µg daily. Evolution of thyroid status and diabetes under progressive thyroxine substitutive treatment is discussed. Compliance to diet, diabetes and myxoedema treatment is severely influenced by her intellectual disabilities. Screening for thyroid status and autoimmunity in order to detect subclinical hypothyroidism, should be performed in patients with Down syndrome.
This update explores the importance of early auditory stimulation by considering the development of speech processing skills in profoundly deaf children who have received a cochlear implant. This literature is relevant to issues affecting children with Down syndrome, because like them, children with cochlear implants have hearing difficulties, but unlike the former, they do not have oral-motor issues.
This editorial discusses the ways in which evidence-based practice should be developed and evaluated, from first hypotheses to gold standard ‘blind’ randomised control trials but also acknowledges that parents, educators and therapists usually have to make decisions on how to best help children with Down syndrome in the absence of this evidence. Guidance is offered on the ways in which new therapies can be evaluated, arguing strongly for objective evaluations and the avoidance of unproven and scientifically implausible approaches.
Around age 10, if not hopefully way before, parents with a child with Down syndrome make the transition from therapy to sports and recreation; from aquatic therapy to swimming; from hippotherapy to horseback riding. It was readily apparent from Emmanuel’s first golf range practice that he had an innate ability to swing a golf club. It is in his genes. He is at a disadvantage with his typically developing peers that his father has never wielded a golf club in his life.
Mouse models are a standard tool in the study of many human diseases, providing insights into the normal functions of a gene, how these are altered in disease and how they contribute to a disease process, as well as information on drug action, efficacy and side effects. Our knowledge of human genes, their genetics, functions, interactions and biochemistry, has dramatically improved over the last few years. Recently, several different drugs have been shown to rescue learning and memory deficits in a major mouse model of Down syndrome. Here, we first review the challenges inherent in using mouse models in Down syndrome research and then describe the successful molecular/genetic interventions that are cause for cautious optimism. We then predict critical molecular abnormalities that can be tested for relevance to learning and memory and that are potential targets of existing pharmacotherapeutics.
Individuals with Down syndrome are predisposed to show a specific behavioural phenotype, or a pattern of strengths and challenges in functioning across different domains of development. It is argued that a developmental approach to researching the Down syndrome behavioural phenotype, including an examination of the dynamic process of the unfolding of the phenotype, will advance science and service for this population. Related issues including the distinction between primary and secondary phenotypic features, heterotypic continuity, and methodological implications are discussed.
This paper outlines the strengths and weaknesses in both short-term and long-term memory in Down syndrome, and the implications of these patterns for both other aspects of cognitive development and underlying neural pathology. There is clear evidence that Down syndrome is associated with particularly poor verbal short-term memory performance, and a deficit in verbal short-term memory would be expected to negatively affect aspects of language acquisition, particularly vocabulary development. Individuals with Down syndrome also show impaired explicit long-term memory for verbal information, and may also have particular problems in explicit long-term memory for visual-object associations. However, implicit memory appears to be less affected in Down syndrome, and may therefore provide an important basis for intervention approaches. These findings are consistent with the suggestion of dysfunction within the hippocampal system in Down syndrome, and problems in verbal memory may be linked to impaired functioning of pre-frontal brain regions.
Background: This study evaluates the effects of a language and literacy intervention for children with Down syndrome. Methods: Teaching assistants (TAs) were trained to deliver a reading and language intervention to children in individual daily 40-min sessions. We used a waiting list control design, in which half the sample received the intervention immediately, whereas the remaining children received the treatment after a 20-week delay. Fifty-seven children with Down syndrome in mainstream primary schools in two UK locations (Yorkshire and Hampshire) were randomly allocated to intervention (40 weeks of intervention) and waiting control (20 weeks of intervention) groups. Assessments were conducted at three time points: pre-intervention, after 20 weeks of intervention, and after 40 weeks of intervention. Results: After 20 weeks of intervention, the intervention group showed significantly greater progress than the waiting control group on measures of single word reading, letter-sound knowledge, phoneme blending and taught expressive vocabulary. Effects did not transfer to other skills (nonword reading, spelling, standardised expressive and receptive vocabulary, expressive information and grammar). After 40 weeks of intervention, the intervention group remained numerically ahead of the control group on most key outcome measures; but these differences were not significant. Children who were younger, attended more intervention sessions, and had better initial receptive language skills made greater progress during the course of the intervention. Conclusions: A TA-delivered intervention produced improvements in the reading and language skills of children with Down syndrome. Gains were largest in skills directly taught with little evidence of generalization to skills not directly taught in the intervention.
This paper provides a brief overview of what is currently known about families of children with Down syndrome. In addition, it highlights a number of issues that require further research if we are to have a thorough understanding of the impact of a child with Down syndrome on families as a system and on the individuals who make up that system. Some of these issues include the need for: 1) a more balanced perspective – one that acknowledges both positive and negative aspects of the experience, 2) greater attention to the experiences of fathers, 3) more cross-cultural research and studies focused on cultural perspectives, 4) increased attention to the change in demands for families as the individual with Down syndrome ages, 5) more longitudinal studies, 6) greater variety in methodological approaches, for example greater use of qualitative approaches and observational methods, and 7) an increase in the use of statistical approaches that model change and test hypotheses about predictors of change in both parents and children.
