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Curriculum

Differentiation not discrimination:


Delivering the curriculum for
children with Down’s syndrome
in mainstream schools
SANDY ALTON

Many more children with Down’s syndrome (DS) are now than for typically developing children, arriving at each
entering mainstream schools. This is the result of several stage slightly later and staying there longer. This simply
factors. The 1981 and 1993 Education Acts encouraged means the gap in development between children with DS
local education authorities to integrate pupils with special and typically developing peers widens with time.
needs into mainstream schools if the parents so wished. In
addition, increasing amounts of research have been published It is also not true that all people with DS are alike in their
enhancing knowledge about the capabilities and potential development. There seems, in fact to be an even wider
of children with DS. Parental awareness of the value and range of development in children with DS than found in
the benefits of inclusion has grown and more parents now their typically developing peers.
wish their child to attend their local mainstream school
with their siblings and friends.
Inclusion
However, this change has implications for schools in
understanding the learning profile typical of children with Every child with DS in mainstream school should be able to
DS, thus paving the way to successful inclusion. As advisory participate in some activities unsupported or with minimal
teacher for children with DS in Oxfordshire, my job is to support. However, much of the curriculum will need to be
support the child, the teacher, the learning support assistant adapted or modified to ensure that the child understands and
(LSA) and the parents to help all placements for children achieves. This means that the child will need some support –
with DS succeed and to ensure that they can access the usually from an LSA. However, it is important to guard
curriculum, learn, progress and develop. against overdependence by encouraging independence skills.

Having two LSAs instead of one usually works better for


Down’s syndrome: Some facts both the child and the LSAs themselves. It is also important
that withdrawal is kept to a minimum; that, in addition to
DS is the most common form of learning disability, affecting working on a one-to-one basis, the child is encouraged to
about one baby in every 600–800 live births. It is a chromosome work co-operatively (with partners, small groups and in
disorder, caused when there is an extra or extra part of whole-class activities); and to aim for the child to access as
chromosome number 21. much of the curriculum as possible. Social skills, too, need
to be included: the child may need help in developing
It is associated with a number of characteristics, both friendships and in learning to establish appropriate patterns
physical and cognitive. It is also associated with a number of behaviour.
of unhelpful myths. There is no evidence that children’s
progress declines as they get older nor that they reach a
plateau in their development. As with any child, progress The early years
for children with DS is an unsteady but continual process,
continuing into adulthood when progress in learning new The prime aim for any 5-year-old is social integration into
living skills continues. The rate of development is slower the school. Situations where other children act as models

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© NASEN 1998.
and set normal expectations for behaviour and achievement Hearing
are extremely important for children with DS, who find
their world more confusing and are less emotionally and Many children experience some hearing loss, especially in their
socially mature than their typically developing peers. Until early years. For some, this will be of a permanent nature. For
they are able to behave and interact with others in a socially many others, this will be fluctuating, caused by susceptibility
acceptable way and to understand their environment, they to infections, colds and glue ear. In addition, many children
find it much harder to make progress in cognitive areas. As with DS have problems with their auditory perception. This
they become more socially integrated, their learning can be means that they have more difficulty in distinguishing
targeted by the provision of appropriate access to the between similar-sounding words such as ‘cheese’ and ‘trees’.
curriculum, in the light of their learning profile.

Differentiation strategies
Specific learning profile
• Ensure that the child is not ignoring you, rather than
It is important that teachers recognise that children with DS unable to hear well on any particular day. Their hearing
are not just generally delayed but have a specific learning can fluctuate daily.
profile with characteristic strengths and weaknesses. These • Place the child at the front of the class.
have, of course, major educational implications, and need • Speak directly to the child.
to be catered for in order for them to learn and progress. • Reinforce speech with facial expressions, sign and gesture.

Children with DS commonly have specific characteristics


in the following areas, each with implications for their Cognitive aspects
education:
Poor auditory short-term memory
• Hypotonia
• Sensory deficits: hearing and vision The auditory short-term memory is the memory store,
• Short-term auditory memory difficulties holding and retaining spoken information for long enough
• Speech and language problems to process and understand it. This involves hearing,
• Shorter concentration span understanding and assimilating meaning, relating this to
• Cognitive delay other information on the subject, storing it and then
• Difficulties with consolidation and retention of learning. responding to it. In order to do all this, good short-term
• Generalisation, thinking and reasoning difficulties memory is required, as the words only exist for a short
• Strong visual awareness and visual learning skills time. Two strategies often used to remember information
• Ability to use and learn sign, gesture, visual support and are rehearsal – silently repeating information – and
the written word organisation – categorising, chunking and grouping similar
items together. It is thought that children with DS have a
short-term auditory memory deficit, and fail to develop
Physical aspects these strategies to increase memory capacity.

Hypotonia It is clear, then, that any deficit in short-term memory can


be a great handicap when trying to understand speech. It
Many children with DS have poor muscle tone and loose also affects the rate at which children learn new words, and
joints, often causing co-ordination difficulties. Fine motor their ability to learn grammar and syntax which require the
control difficulties are especially noticeable in the classroom. holding of sentences while they are being processed for
Gross motor skills can be affected, too, with some children meaning. Children will have much more difficulty in
reluctant to participate in PE. However, all motor skills do following stories, complex verbal instructions or ‘teacher
improve with daily practice. talk’, and general discussions. However, research has
shown that memory can be improved and children with DS
can be successfully taught to use the appropriate strategies.
Differentiation strategies

• Provide wrist- and finger-strengthening activities such Differentiation strategies


as sorting, cutting, drawing, squeezing and rolling materials,
building. Occupational therapists can offer invaluable • Teach rehearsal techniques.
help here. • Practise classifying objects, pictures and words. Start by
• Encourage independence in small steps in self-help skills. sorting two categories only (such as animals and food)
• In PE offer small-group activities with set objectives and build up slowly. Where possible, make use of games
rather than team events. such as Track and Dice games, since they are multifaceted
• Provide additional visual cues – gesture, markings on activities which develop wider cognitive skills while
hands, feet, floor – to indicate correct positions. retaining an element of fun.

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• Play memory games such as Kim’s Game or Pairs. If a child has a smaller vocabulary and less general
• Allow the child time to process and understand what is knowledge, s/he will have more difficulty in understanding
said, and to prepare a response. the language of the curriculum. For example, it was
• Accept that many children with DS will not be able to explained to a year 7 child learning about Passover that it
absorb lengthy class instructions or discussions. Offer was a festival, celebrated by the Jews, yet these were three
visual translation and/or an alternative activity after words which were not in his vocabulary. If the child
reasonable participation has been shown. appears to have a problem with number, it could quite
easily be a problem with the language used rather than the
concepts themselves.
Speech and language problems
Any child with a delay in language acquisition is likely to
The development of language for children with DS is very be cognitively delayed as a result. Any impact on their
specific to their syndrome and is an area where most will thinking and reasoning skills makes it more difficult for
have some difficulties. This will inevitably affect their them to transfer knowledge, make generalisations and
ability to access the curriculum: it is therefore particularly make choices – abilities often taken for granted, especially
important that the child receives appropriate help. First in older children. But for children with DS, they are major
impressions of a child with DS are often wrong, as challenges and need careful consideration.
assessment is generally based upon the level of speech the
child has. However, their expressive skills are often below
their comprehension skills – a mismatch which can mask Differentiation strategies
other abilities.
• Do not base assumptions about general ability purely on
competence in spoken language.
Speech and language characteristics • Use simple, direct language with clear, concise explanations
and instructions.
• More difficulty in forming words physically, due to a • Provide alternative opportunities (body language, gesture
combination of smaller mouth cavity and poor muscle tone and facial expression) to communicate and convey
• Slow language development: they learn to talk later than understanding.
their peers and make slower progress • Signing can aid language and comprehension, especially
• Smaller vocabulary, thus less general knowledge in the early years. Always speak and sign simultaneously.
• Problems with learning grammar: connecting words are • Phrase questions in a way that requires more than a
often left out, resulting in a telegraphic style yes/no answer.
• More difficulty in producing extended sentences • Encourage the child to speak in more than one-word
• The longer the sentence, the more difficulty the child utterances.
has with articulation • Teach reading and use the printed word to help with
• Receptive skills are greater than expressive skills speech and language. The children as visual learners
will learn language – vocabulary and sentence structure
Some of these difficulties are linked to hypotonia, which – from reading, and reading aloud will improve articulation.
affects speech production, and to auditory perception and • Reinforce speech visually whenever possible with the
memory difficulties. However, another interesting printed word, drawings, diagrams, pictures, signs.
explanation could be that these language difficulties are to • Reinforce key words visually. List them with a concise
do with the actual formation of the brain. For most people, definition, linked to words and concepts within their
the main speech functions are in the left hemisphere – that experience. Illustrate if possible. Keep in their book, or
is, they are left-dominant for language. However, several separately in a subject explanation book. This can
studies have suggested that the reverse may be true for also help parents when they help their child with
children with DS: they may be using the right hemisphere homework.
for language (see Buckley1985). • Encourage sentence structure and awareness of
connecting words such as and, to and the. Ask the
children to read sentence strips for familiar phrases
Implications of language deficit which they are saying incorrectly, such as ‘Can I go to
the toilet, please?’
Speech and language problems for these children often • Teach prepositions by setting up scenarios using objects
mean that they receive fewer opportunities to use language. or card games with pictures.
It is more difficult to ask for help and explanations. Adults • Reinforce the preposition with the printed word (flash card).
also tend to ask questions requiring only a yes/no answer or • Give the children time to assimilate their thoughts,
finish the sentence for the child, without allowing time or search for the words and produce them.
help for them to do it themselves. Overall, they are getting • Ensure consistency from all staff involved: terms such as
less language experience than their peers to enable them to minus, subtract or take away all mean the same thing
learn new words and sentence structures, and less practice and can cause confusion.
to improve their clarity of speech. • Encourage the child to lead.

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Social use of language The important aspect of teaching a child with DS to read is
to use a whole-word approach. Start by building up a sight
Children with DS need more help in learning and managing vocabulary using words that are within their understanding.
social language – this is particularly important for
teenagers in secondary school – so that they can better • Introduce a small number of words at a time and match
manage the range of social situations they will encounter as flash cards to flash cards.
a growing adult. • Add pictures/photographs/objects to ensure meaning
initially.
• When the child can match cards successfully, ask
Differentiation strategies him/her to select a card.
• When the child can select, ask him/her to name a card.
• Encourage the children to speak aloud in class by giving • Make books with the words learnt.
visual prompts: reading information is easier for children • Provide reading books that have only one or two words
with DS than speaking spontaneously. With younger per page, progressing on to short phrases, reinforced
children, a short sentence strip will be a good start. with a clear picture. The vocabulary in the books must
• The use of a home–school diary can facilitate children in be within the child’s experience.
telling their news. • Play reading games with other children – make it fun
• Provide lots of opportunities to interact with other children and successful.
without adult intervention. • Begin putting two words together to form phrases the
• Develop language through drama and role-play and children use themselves. This does not have to be
practise in real situations. grammatically correct, as the child will not yet be using
• The Social Use of Language Programme (Rinaldi 1993) the connecting words: for example, ‘Mummy gone’ or
and the Asdan Youth Award Scheme are programmes ‘Mummy home’. However, once the child is reading two
specially designed to develop social language within life word phrases successfully, connecting words can slowly
skills. be introduced.
• Make books with short sentences and matching sentence
strips.
Reading • Make daily conversation diaries with a sentence about
something the child has done.
Given their strong visual ability, many children with DS • Use the computer for reading activities and games.
can learn to read words before they can say them or speak
in sentences and many can be successfully taught from nursery
age. Reading is a very powerful tool to aid understanding Phonics
and general knowledge, improve language and access the
curriculum. It also: Learning to use phonics to decode words is complex and
can be very difficult for children with DS. It involves
• increases vocabulary: seeing the word in print, if necessary accurate hearing and discrimination of sounds and
reinforced with a picture to ensure meaning, will often problem-solving skills – areas in which children with DS
enable children with DS to remember it; have difficulties. However, although children with DS
• helps with articulation – many children are able to begin to read by reading the whole word and not using
pronounce the word better when reading it aloud; letter-to-sound knowledge, some basic knowledge of
• helps with learning sentence structure – reading will phonics will be valuable, and they should be given every
help the child become more aware of the connecting opportunity to learn the concepts they are capable of learning,
words. one step at a time. Many children are able to learn initial
sounds successfully.
However, it is important to realise that, for the child with
DS, learning to read is a very different process from that of
the typically developing 5-year-old, who is simply learning Differentiation strategies
an alternative code for the spoken language already mastered.
Children with DS will not have this mastery: their vocabulary • Use the match–select–name method and teach lower-
will be smaller, they may not be speaking in full sentences and upper-case letters together.
and their knowledge of grammar will be limited. They will
thus be learning to read as if reading were a first language
and they will be learning to read and speak simultaneously. Reading to writing

Due to fine motor difficulties, many children find it difficult


Teaching reading to learn to write. Slow progress in this area can be very
frustrating for children and for teachers who are having
There is not space in this article to dwell far in this area; difficulty recording work which represents their abilities in
however, I will give a brief outline of the main principles. other areas. Because of their difficulty and their awareness

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that they are not as able as their peers, many children are • Explain specific maths vocabulary, use it consistently
inevitably reluctant to practise. But daily practice is and teach rules.
necessary. • Encourage generalising skills to new situations.
• Teach maths for life skills.
Emergent writing often comes much later. Children have
more difficulty in sorting their thoughts into sentences,
remembering these and how to spell each constituent word. Concentration span
Initially, children will need help in ordering their thoughts
into sentences, which will then need to be written down for Many children with DS have a short concentration span and
them to copy. are not able to stay on task as long as their peers. In
addition, the intensity of one-to-one learning one is much
Later, more independent emergent writing can be encouraged higher and the child tires more quickly.
through the use of an ‘Emergent Writing Folder’. Basically,
the words in their sight vocabulary are attached to strips of
Velcro across the folder. The children can now see all the Differentiation strategies
words within their sight vocabulary and can then be
prompted to build a sentence by choosing what they want • Break down tasks and activities into short, clear and
to say, picking the words off and ordering them correctly concise steps.
themselves. This can then be copied into their books, and • Tackle one task at a time.
overall gives them far more independence than having a • Change to a different, less demanding activity when
scribe. concentration has lapsed.
• For younger children, provide a box containing activities
that can be done independently or with a partner. This
Differentiation strategies provides structured choice, preventing wandering
around the classroom looking for things to do.
• Provide plenty of hand–eye co-ordination practise, such • Many children at secondary level have trouble with
as threading and tracing. double lessons, especially if the lesson has not been
• Have daily handwriting sessions, keeping tasks short, suitably differentiated. Sometimes it may be advisable
varied and achievable. for the child to attend one lesson and then leave for
• Have available a wide range of media, and multisensory reinforcement or work on basic skills.
activities and materials – writing boards, sand trays,
pencil grips, chalks – felt tips are useful for children
having difficulty pressing hard enough with a pencil. Structure
• Practise sequencing.
• Only expect the child to write about events and concepts Children with DS are generally able to work better under
which are meaningful and familiar – for example, while focused, closely structured conditions, finding less structured
most of the children in one year 4 class were making up sessions (involving making choices, decisions and
their own fairy stories, a child with DS wrote about the generalisations, and transferring knowledge) more difficult.
Spice Girls. This can result in lack of confidence, insecurity and
• Make use of their visual skills by providing access to misbehaviour. Many are great sticklers for routine, feeling
their sight vocabulary. much more confident if they know what is expected from
• Keep sessions short and achievable. them and what is to happen next. They are easily thrown by
• Explore whole-word computer programs. changes in routine and take longer to adjust to change.

Number skills Differentiation strategies

In mathematics, many children with DS have serious • Provide structure, routine and focus.
difficulty, since it involves abstract concepts, processes and • Allow extra time to learn the structure and routine.
language. In addition, they are less likely to develop concepts • Use other children in the class as role models.
from exploratory play and loosely structured sessions. • Provide clear, visual instructions to understand the
However, development seems to follow the same stages as structure of the day. All ages have been found to benefit
that of their peers. from a clear, visual timetable, using the printed word,
pictures, signs or photographs. For smaller children,
where a choice of activities is offered, limit these to two
Differentiation strategies or three to encourage decision-making. Keep the
timetable simple, clear and not too busy.
• Use concrete and practical materials. • Provide older children with a clear, visual map if they
• Reinforce all number work visually have to transport themselves from place to place. Colour
• Offer repetition, reinforcement and variety in small steps. code rooms, with dots put on particular doors.

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Retention and consolidation concentration and learning differences, they have faced
more failure than many of their peers. As a consequence,
Children with DS generally take longer to learn and consolidate they develop avoidance strategies to reduce the cognitive
new skills and what seems to be learnt one day is unlearnt demands made on them. If a task appears too demanding or
the next! Skills previously learnt begin to fade, if not kept the language used too confusing, they try to opt out.
up to date. This can be very frustrating and demoralising Wishart (1993) concludes that they are less motivated than
for the child as well as the teacher and LSA. However, it is other children at a similar developmental level and tend to
a common phenomenon, and perseverance and patience are adopt behavioural strategies that undermine their learning
the keys. progress. This is especially noticeable when the task is
answer orientated, where quick thinking and quick
Research has shown evidence of low arousal, poor persistence organisation of speech are involved. However, although
and passivity, and deficits in exploratory behaviour and avoiding tasks which seem too difficult may seem to be an
mastery motivation (Wishart 1996). Weaknesses such as understandable response, it seems that it is not the only
these in the learning style of children with DS need to be reason. The poorer retention, consolidation and motivation
taken into account if we are to succeed in helping them levels discussed in the previous section also play their part
learn and achieve. Buckley and Bird (1993) found that it in avoidance behaviours.
seemed to be more difficult for children with DS to correct
wrong responses once they were made, and Wishart’s Behavioural problems are usually amenable to the usual
(1988) research on aspects of early cognitive development methods of behavioural modification used with most children.
highlights these children’s sensitivity to failure and lack of However, the basic idea of rewarding good behaviour and
consolidation strategies. Both Buckley and Bird and discouraging bad, although simple in theory, is not always
Wishart recommend ‘errorless learning’ strategies to build so easy to put into practice in a mainstream classroom, so
success and self-confidence. it is vital, when trying to deal with behaviour problems, that
your expectations are reasonable for the child. The child’s
developmental, not chronological, age must always be
Differentiation strategies taken into account, together with their level of oral
understanding. Similarly, any reward offered has to be
• Aim for ‘errorless learning’ – teaching children to complete suited to the child’s developmental level and not their
a new task by guiding them through each step correctly, chronological age.
not allowing failure. As the child becomes more capable,
the prompt is faded until the child can do the task unaided.
• Children with DS need repetition and reinforcement in Differentiation strategies
order to consolidate new skills.
• Present new concepts and skills in a variety of ways, • Reward younger children immediately for good behaviour.
using concrete, practical and visual materials. • Star/target charts (being visual) can be used effectively
• Offer extra explanation and help, to compensate for any for the older child.
difficulties in their ability to transfer knowledge, generalise • Images (such as photographs and drawings) can be used
and make choices. effectively on star charts as additional, visual reinforcement
• Continually check backwards to ensure that previously of the targeted behaviour. A big tick or a cross drawn
taught skills have not been forgotten: children with DS over an image will reinforce meaning.
need a firm base on which to build and learn new skills. • Put pictures of the reward next to the desired behaviour.
For example, if the reward is time on the computer, have
a picture of a computer.
Behaviour • Target the behaviour that is most important and work on
this one only. Too many targets for the child results in
There are no behaviour problems unique to children with confusion.
DS. When they occur, problems are generally similar to • Establish clear and consistent rules and limits and keep
those seen in typically developing children of a younger to established routines.
age, children with DS reaching each stage in their development
later than average. However, it is important to recognise
that the thresholds needed to trigger difficult behaviours in Conclusion
children with DS may be lower than with their peers. This
is due to the nature of their learning difficulties and the The Green Paper Excellence for All Children (Department
impact of the social world – that is, expectations from others for Education and Employment 1997) proposes that more
or their own confusion at the world around them. They are pupils with special educational needs should be included in
also often aware that they learn more slowly and are more mainstream schools. I have shown how an understanding of
susceptible to messages that they are less good than others. the profile of learning difficulties, together with tasks
differentiated into small achievable steps, are essential for
A very common form of behaviour is avoidance. Due to children with DS to integrate into the class and behave
problems with speech and language, memory, co-ordination, appropriately. In addition, firmness, consistency, informed

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© NASEN 1998.
expectations and praise for every effort made are vital, so BUCKLEY, S. and BIRD, G. (1994) Meeting the Educational Needs of
that the child is clear about his/her actions and their Children with Down’s Syndrome: A handbook for teachers.
Portsmouth: University of Portsmouth.
consequences. Support, advice, training and adequate resources DEPARTMENT FOR EDUCATION AND EMPLOYMENT (1997)
are also needed to ensure a secure and successful placement. Excellence for All Children: Meeting special educational needs.
London: HMSO.
However, it is not only through the provision of an appropriately PETLEY, K. (1994) An investigation into the experiences of parents and
headteachers involved in the integration of primary aged children with
differentiated curriculum, sufficient resources and training, Down’s syndrome into mainstream schools. Down’s Syndrome:
that we can ensure success. The attitude of the whole Research and Practice, 2 (3), 91–7.
school is a significant factor: a negative attitude questions RINALDI, W. (1993) Social Use of Language Programme. Windsor:
the placement and the child while a positive attitude solves NFER-Nelson.
WISHART, J. (1988) Early learning in infants and young children with
problems of itself (Buckley and Bird 1994, Petley 1994). Down’s syndrome. In L. Nadel (ed.), The Psychobiology of Down’s
Moreover, in his foreword to the Green Paper, David Syndrome. New York: NDSS.
Blunkett writes, ‘[where] all children are included as equal WISHART, J. (1993) Learning the hard way: Avoidance strategies in
partners in the school community, the benefits are felt by young children with Down’s syndrome. Down Syndrome: Research
and Practice, 1(2), 47–55.
all’. And successful inclusion is a key step towards preparing WISHART, J. (1996) Avoidant learning styles and cognitive
these children for true integration as full and contributing development in young children with Down’s syndrome. In B. Stratford
members of the community. and P. Gunn (eds), New Approaches to Down Syndrome. London:
Cassell.

References
Correspondence
BUCKLEY, S. (1985) Attaining basic educational skills: Reading, writing Sandy Alton
and number. In D. Lane and D. Stratford (eds), Current Approaches to
Down’s Syndrome. London: Cassell.
Centre for the Study of Special Education
BUCKLEY, S. and BIRD, G. (1993) Teaching children with Down’s Westminster College
syndrome to read. Down Syndrome Research and Practice, 1.1, 34–9. Oxford OX2 9AT

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© NASEN 1998.