Communication skills are important, especially considering their contribution to inclusion and integration in numerous settings. There is no single pattern of speech and language common to all children with DS - but many display various speech and language challenges. All problems demonstrated by children with DS are faced by other children as well - that is to say, that no speech and language problems are unique to DS.
        Though speech is the most difficult form of communication for individuals with DS to develop, more than 95% use speech as their primary communication system. The actual course of speech and language in those with DS is difficult to predict - but simply put, they acquire the same language skills as the "average" child, just at a slower rate. Most fail to acquire language structures beyond an early preschool level, with impairments seen in several areas; though expressive language continues to develop well into their adolescent and young adult years. Since approximately 95% sometimes have difficulty being understood by those outside of their immediate family, speech and language services should be considered throughout life.

What are the language characteristics of children with DS?

Strengths:

• vocabulary and pragmatics
• learn well through visual means and often learn to read - for some, the written word can provide a cue when using expressive language
• receptive skills exceed expressive - "Expressive-Receptive Gap"
• the desire to communicate; appropriate gestures; and facial skills are positive factors which aid children with DS in communicating

Weaknesses:

• syntax and morphology (grammar, verb tenses, word roots, suffixes and prefixes) more difficult - most likely due to their complex and abstract nature
• use shorter sentences to communicate
• children with DS may have difficulty expressing themselves through speech, but may express themselves effectively with gestures or facial expressions
• difficulty with sequencing of sounds - difficulty with intelligibility of speech and articulation
• some have fluency problems

What are the Speech Characteristics?

• difficulty with the strength, timing and coordination of muscle movements for speech
• articulation problems with specific sounds; low oral-facial muscle tone; difficulty with sensory integration and oral tactile feedback; use of phonological processes and difficulties in motor planning for speech
• when children begin producing sentences and conversation, rapid rate and dysfluency often become areas of concern
• may have weak muscles that make it difficult to control movements for sound production, but may learn exercises to help develop better speech production skills

What effect does hearing loss have on speech and language development?

• speech and language are learned through hearing, vision and touch
• the process of speech and language development can be negatively affected by chronic ear infections - often have fluctuating hearing loss due to the frequency of fluid build-up in the middle ear
• when children do not hear consistently well, listening skills and ability to associate certain sounds with certain events is affected
• may have difficulty with hearing information but have a strong ability for understanding information sent to them visually

What skills are related to speech and language development?

• speech uses the same anatomical structures used for feeding and respiration - ie. low muscle tone
• skills include:
  • ability to imitate and echo sounds · turn-taking skills (learned via use of games like peek-a-boo)
  • visual skills (look at speaker, look at objects)
  • auditory skills (listening to music and speech for increasingly longer lengths of time)
  • tactile skills (exploring objects in the mouth)
  • oral motor skills (using tongue and moving lips)
  • cognitive skills (understanding cause and effect relationships)

Milestones

• use single words between 2 and 3 years - age of first word varies
• by 10-12 months, they understand the relationship between a word and a concept - but do not have the neurological skills developed to speak

What can parents do to help their child's speech?

• provide extra practice in various speech and language skills
• varied and inclusive experiences help the child and adolescent with DS continue to acquire and use new communication skills
• increase the opportunity to communicate and you increase the number and level of communicative skills
  • language is more than spoken words - in teaching a word or concept, focus on conveying meaning to the child through play or through multi-sensory experiences
  • provide many models - need many repetitions and experiences to learn a word
  • use real objects and situations - in teaching a concept - aids in generalization
  • repeat what the child says and follow your child's lead - provide them with words for concepts they are interested in (person, event etc.)

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