Speech therapy Made Easy

Talking the Language of People with Down Syndrome

By: Kathy B. Reyes, MS, CCC-SLP, CSP-PASP

Objectives
 To know what SLPs do in the team managing people with down syndrome
 To identify communication models
 To understand how home logistics affects communication
 To understand communication, speech, language and feeding challenges of infants and
individuals with down syndrome
 To understand how to better facilitate communication at home
 To identify hindrances that would maximize the child’s communication skills

Who are the SLPs? What do they do?

Content Form Use

Issues of Individuals with Down Syndrome

According to NYSDOH Quick Reference Guide: Down Syndrome

Medical Motor Cognition/Communication

Typical Children learn communication:

 play
 social interaction with peers
 observation of environment

When Children with Down Syndrome are younger

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 Physical Characteristics Developmental Characteristics

Implication in life….

 A child who is an atypical learner would:

 Understand communication process differently
 Learning would depend on the opportunities we give at home
 Experiential in nature
 Meaningful for the child

As the child is growing up, communication becomes more integrated to social settings…
Stages What happens
Toddler stage
Pre-school stage
School age stage
Adulthood

What is the importance of communication models?

 Teaches the child how
 To say or communicate what he needs
 He would approach others
 Listen to the people around him
 Memorize interaction
 Recall how to respond to a situation
 Regulate actions of adults, often misunderstood and labeled as MANIPULATION

Issues of Adults with Down Syndrome [Jackson et al (2014)]

 Learning disability
 Stuttering
 Self esteem issues (social comparison)

Why do communication breakdown?

 Wrong interpretation of events
 Conditioned response
 If I hit mommy, she will hug me…
 Therefore, if I want to be hugged, what will I do?
 Response of people watching the interaction
 Sensation I get from the interaction
 Lessons I have learned from previous experiences

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Communication/speech issues persists because
 Because of the following reason
 Communication models
 Situations
 Schedule
 Cognitive issues
 Language use issues
 Response issues
 Sensory issues

Knowing all these, what should I do?

1. Address all medical issues associated with Down Syndrome

2. Have them tested (genetically) and assessed for services
3. Some suggested tips by NYDOH Quick guide:Down Syndrome
a. Planning the assessment

 Ensure that professionals are experienced with this age group

 Be available and be present for the assessment
 Express your needs and expectations
 Inform professionals about medical conditions that might influence the infant’s
tolerance for the assessment process
 Be considerate of the child’s sleep/wake/alert routines

4. Know primary areas of affectation: cognitive, motor, visual, fine motor

5. Ask: Would he be able to speak? (speech comprehensibility)
6. Ask clinicians to give you home work
7. Do home work diligently

Some additional things to do:

Younger kids
Physical Environment
 Things are arranged (or for that matter un arranged)
 How toys are being circulated
 How we interact with our children
 Ease of reach
 Synchrony of activities
 Flow of traffic inside the house
Language
 Model actual sentences and words
 Speech recasting
 Play

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  Toys should be within in visual field but not always within reach
 Make a rule on toy at a time for a specific time
 Child has a designated areas to play, work etc
 Parents should be “monitoring” people
 Specific activity- not repetitive or aimless
 A child needs to hear a specific word or concept at least 250 times before he could
memorize it?
 Most children are ATYPICAL learners because they have a different way or learning?
 Children learn better if there is a theme

Tasks
 Would need to allot a specific number of hours vs. number of trials
 Discrete trial training- concepts/vocabulary
 For long term learning, consider THEMATIC APPROACH
 Daily activities
 Table and chair

For older person with Down Syndrome

 Equip with scripts
 Train in context
 Anticipation of difficult situation
 Support system
 Integration
 Being heard
 Other modes of communication
 Independent living

How would you know that your child needs?

List down top 5 issues you or your child is facing right now

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Things to think about
 Issue One: time
 Time spent vs. quality of time
 Trade in something for something better
 Choices
 Activities
 Communication model
 Continuity
 Consistency
 Issue two: Siblings
 Determine age
 Mental age
 Empathy
 Time given/allotted
 Discipline
 Define fairness
 Loving an individual
 Issue three: skill
 Competency vs. urgency
 Ignorance vs. denial
 Motivation vs. hopelessness
 Passion vs. responsibility
 Therapist vs. parent

Thank you!

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