Research shows that the cause of Down syndrome is the presence of an extra copy of chromosome 21. That is why, in clinical circles, Down syndrome is often referred to as Trisomy 21. Unfortunately, children with Down syndrome often have severe delays in physical growth, cognitive abilities, and invariably exhibit distinct physical and facial characteristics.
Another consequence of Down syndrome is the impairment of language. Children with Down syndrome generally have a speech-language delay which includes having difficulty expressing and understanding speech and language.
It has been shown repeatedly that early intervention in the form of an individualized speech teletherapy program helps to correct speech sound errors. It can also enhance intelligibility and encourage the development of literacy skills.
Symptoms and Characteristics of Down Syndrome
The characteristics of Down syndrome exist in both mental and physical categories.
Mentally, children with Down syndrome often have intellectual disabilities, namely a lower IQ, delay in fine motor skills as a result of compromised muscle tone, and, as previously mentioned, speech-language delays.
Physically, these children grow slower than average, they have lower muscle tone, a smaller than normal chin, a broad head, and a flattened nose.
These children are significantly delayed in acquiring language and verbalization. Some children with Down syndrome may not begin speaking until they are 2-3 years old. It has been found that the cause of the speech delay is poor muscle tone (hypotonia) in the region surrounding the mouth, making clear pronunciation difficult.
Hypotonia has been found to cause other problems as well, such as feeding and swallowing difficulty. Also, these children are often found to have narrow Eustachian tubes in the middle ear, which can lead to a build-up of fluid. This, in turn, will usually negatively impact the child’s ability to hear clearly, consequently becoming another cause of language processing problems.
Speech Profile for Down Syndrome Children
Children with Down syndrome present a wide range of abilities regarding speech. Intelligible speech (speech that is easy to understand) is generally one of the most challenging areas for those with Down syndrome at any age. Children with Down syndrome often find coordinating and timing the muscles required for speech difficult.
Factors that compromise speech intelligibility include articulation problems, low oral-facial muscle tone, difficulty with oral tactile feedback and sensory processing, and the usage of phonological processes (e.g., leaving off the final sound of a word).
Language Profile for Down Syndrome Children
Research and clinical experience have shown that the difficulties these children experience with speech and language are not uniform. In other words, some areas are easier, and others are more difficult. Children with Down syndrome are stronger in the areas of social interactive language and vocabulary. Most of these children develop a wide-ranging vocabulary as they mature.
Children with Down syndrome, for the most part, have well-developed social interactive skills. What’s more, they understand how to use facial expressions and gestures to enhance their communication. Socially, they are quite adept and have both the desire to communicate and enjoy the satisfaction of interacting with other people.
However, morphology (word roots, suffixes and prefixes, verb tenses) and syntax (sentence structure) are far more challenging, probably due to their more abstract and complex nature. Because children with Down syndrome find the various aspects of grammar challenging, they tend to communicate with shorter sentences.
These children generally score higher on receptive language tests than on tests of expressive language. This is because children with Down syndrome can understand language much better than they can express themselves. This is what those in the field refer to as the “receptive-expressive gap.”
Language is Vital for Mental and Social Development
When it comes to intervention for children with Down syndrome, it would be safe to say that speech and language therapy is the most crucial of the services provided for these children. This is because cognitive and social development are so significantly impacted by speech and language development.
The first reason that speech and language development is so critical to cognitive development is that, the quicker the child develops vocabulary, the faster he/she can acquire knowledge about the world.
The second reason is that language is at the core of thinking and reasoning. The human mind has an amazing ability to learn and comprehend spoken language and then leverage that understanding to empower cognitive activities. Such cognitive functions as thinking, reasoning, and remembering are carried out in the mind as “silent speech.”
So it would follow that a child with Down syndrome, beset by speech and language delays, will consequently suffer in the development of cognitive faculties as well.
Language development is crucial for children’s social development, as well. Such development enables them to control their behavior and navigate their social world. As children master language, they can better ask for what they want, explain their feelings, and share what is going on in their lives. Although social skills are a relative strength, children with Down syndrome will invariably struggle with their language deficits in this realm, as well.
The Profile is Unbalanced
The profile comprised of language, cognitive, and social development is generally uneven for children with Down syndrome. Their developmental delays are not equal in all areas. As was mentioned, whereas social understanding and social development are typically strengths, these children are usually weaker in spoken language development.
Speech and Language Therapy for Down Syndrome
A speech-language pathologist (SLP) delivering teletherapy services can both evaluate and treat speech and language disorders of children with Down syndrome. She would craft a comprehensive treatment plan, addressing all of the areas in which the child is experiencing difficulty.
Regarding language development, children with Down syndrome reach early milestones practically on a par with other children; after 12 months, the gap begins to widen. This being the case, it is essential not to limit students with Down syndrome to one communication modality.
These children are unique and, consequently, need a variety of speech teletherapy interaction modalities to optimize their performance. It has been shown that children with Down syndrome greatly benefit from Total Communication.
Total Communication means providing speech therapy through verbal and other modalities such as auditory, tactile awareness, visual, and kinesthetic. Included in these options are visual manipulatives, signing, and voice output devices. The objective is to integrate several to yield more successful outcomes.
Parents are Key
Perhaps the most critical variable in the entire equation is parental involvement. Since language can develop and grow daily, children need that reinforcement from their families. Therefore, the most effective therapy begins at home with dedicated parents who undoubtedly will become the child’s best therapist, carrying over the skills taught by the SLP.