2/4/2016
Best Practices for Helping Students With
Down Syndrome Be More Independent
Presented By,
Amy Allison
Executive Director
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Top Five Take Aways
• Set the bar high
• Presume competence
• Expect compliance
• Avoid learned helplessness
• Think like an employer
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Down Syndrome 101
• Most commonly occurring genetic
condition resulting in 1:691 births
• Down Syndrome is prevalent in all races,
socioeconomic classes and shows no
gender bias
• 250,000 individuals are living with Down
syndrome in the United States
• No known cause or cure; result of an error
in cell division when a baby is forming in
the womb
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
1
2/4/2016
Down Syndrome 101
• 80 percent of babies with Down
syndrome are born to women under the
age of 35
• Average life span if born with Down
syndrome today: 55-60 years of age
• Varied mental abilities, physical
development, behavior, and
accomplishments
• Prenatal testing recommended for
EVERY pregnancy
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Down Syndrome 101
• Three types of Down syndrome
– Trisomy 21: extra copy of chromosome 21 in all of the cells
The cause of 95 percent of Down syndrome is Trisomy 21. It occurs when a pair of 21st
chromosomes separate improperly. Individuals with Trisomy 21 have an extra copy of
chromosome 21 – for a total of 47 versus 46 chromosomes – in all of their cells
– Mosaic: improper division of chromosome 21
Mosaicism occurs when the improper division of chromosome 21 happens after
fertilization, so people with mosaicism have 46 chromosomes in some cells and 47 in
others. It is the least common form of Down syndrome, accounting for 1 to 2 percent of all
cases.
– Translocation: additional chromosome 21 is attached to another
chromosome. ONLY form that can be inherited
Three to four percent of people with Down syndrome have Translocation in which an
additional chromosome 21 is attached to another chromosome. This is the only form that
can be inherited.
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Possible Medical Issues
• Heart Defects
• Muscle Hypotonia
• Hearing Loss
• Leukemia
• Vision
• Thyroid dysfunction
• Celiac Disease
• Atlanto-Axial Instability
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
2
2/4/2016
Possible Medical Issues
• Tactile Sensitivity
• High pain tolerance
• Potty Training Issues
• Stamina
• Sleep apnea
• Dual diagnosis of Autism
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Possible Medical Issues
• Precocious Puberty
• Atlanto Axial Instability
• Celiac Disease
• Gastrointestinal issues
• Respiratory issues
• Alzheimer’s Disease
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Down Syndrome
Healthcare Guidelines
• Created by medical professionals who are passionate about
people with Down syndrome
• Identifies various screening tests and standardized tests which
physicians should utilize when working with patients who have
Down syndrome
• Categorized by age range
• Currently being reviewed and updated
• With appropriate health care and preventive medicine, people with
Down syndrome have doubled their lifespan in the past few
decades!
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
3
2/4/2016
What can Educators/Therapists
Do About Medical Issues?
• Communication with parents
• Time in lunchroom/restroom
• Administer meds
• Least challenging subjects end of day
• Rule out medical issues as cause of behavior
• Recovery time from illness
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
What can Educators/Therapists
Do About Medical Issues?
• How is work compromised when you are
not feeling well and can’t explain why?
• Accommodate hearing and vision
• Extra support for potty training/puberty
• Recognize avoidance behavior
in lieu of medical issues
• Educate staff on medical issues
• Involve school nurse as needed
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Group Exercise
• Discuss medical issues causing
behaviors in therapy/classroom
• Discuss strategies for supporting
your student moving forward
• How can you communicate with
parents regarding medical issues?
• How can you teach students to
communicate when they are not
feeling well?
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
4
2/4/2016
Communication Issues
• Receptive language vs. Expressive language
• Hearing
• Attention span
• Short term memory
• Speech articulation
• Processing time
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Communication Issues
• Reliving a moment
• Recalling information
• Echolalia
• Behavior is a form of communication
• Generalization
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Communication Strategies
• Demands and Interruptions
o
o
o
o
Necessary vs. Unnecessary Demands
Talking too fast and too much information
10 seconds can change a life
Visual interruptions
• Fallouts of Needless Demands and Interruptions
o Shut Down-Down syndrome drop
o Aggressive or Uncooperative Behavior
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
5
2/4/2016
Communication Strategies
• Ask the student to repeat
instructions back to you
• Emphasize key words and
reinforce with visual aids as
needed
• Ensure you are face to face and
have good eye contact when giving • Avoid closed questions and
instructions
encourage the student to speak in
more than one word utterances
• Use simple and familiar language
and short and concise sentences • Develop language through drama
and role-play
• Reinforce directions with facial
expressions, gestures and signs
• Use a home-school log to help
relay information
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Group Exercise:
Communication foul ups!
What strategies does your student use to
communicate needs?
o
o
o
o
o
verbalization
communication device
picture exchange
sign language
behavior
•Are there any sensory or social issues
causing communication difficulties?
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Communication Resources
http://www.upatdowncountry.com/educational
Positive Strategies for Enhancing Communication
Development –Part 1 and 2
Stephen Camarata, PhD and Mark Wolery, PhD, John F. Kennedy Center on
Development and Disabilities, Vanderbilt University School of Medicine, Nashville, TN
People with DS often develop speech and language skills according to their own unique
set of strengths and weaknesses. This requires
individualized strategies and a positive partnership between the self advocate,
parents, clinicians and teachers to facilitate communication development. The purpose
of this workshop will be to present, in family friendly terms, methods for enhancing
communication development in people with DS. Strategies for team building among
professionals and families will also be discussed.
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
6
2/4/2016
Group Exercise: What’s Working?
• Discuss what strategies you
are using now to help your
students (individual therapy,
group therapy, pull-out, push
in)
• Share suggestions on how
you can promote peers as
being communication
partners.
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Memory Issues
• Students with DS have poor working
memory (visual and auditory)
o Working memory capacity of 3
o Short term = storage
o Working = storage and manipulation
• Used for
o
o
o
o
organization
concentration/attention
problem solving
remembering tasks
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Memory Issues
• How it affects the learner
o Processing and retaining
spoken words
o Understanding/responding to
spoken language
o Following verbal instructions
o Learning abstract or unfamiliar
vocabulary
o Remembering rules or routines
o Reading comprehension
o Generalizing skills across
settings
o Describing events accurately
o Developing organizational skills
o Remember sequences or lists
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
7
2/4/2016
Memory Issues
• Pre-School Age
o
o
o
o
o
Learning the alphabet
Learning to talk
Focusing on short instructions like “come brush your teeth”
Remaining seated to complete independent activities (puzzle)
Listening to and following directions
• Elementary Age
o
o
o
o
Reading and understanding the content (comprehension)
Mental arithmetic
Writing while formulating next part of sentence
Interacting and responding appropriately in peer activities (group
projects/recess)
• Middle School
o
o
o
o
Doing homework independently
Planning and packing for an activity
Solving multi-step math problems
Playing team sports
© 2011 Down Syndrome Foundation of Orange County
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Memory Issues
• Working memory capacity increases
with age to about 15 years old
• Large variations between individuals
• Ability to pay attention and shut out
distractions is important to WM
• Also important is ability to shift
attention between activities
© 2011 Down Syndrome Foundation of Orange County
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Memory Strategies
• General Literacy Instruction
o Practice sentences
o Read aloud
o Increase vocabulary
o Language rich demanding setting
• Targeted Tasks
o Sound discrimination
o Activities to increase attention
o Activities to increase recall –
rehearsal training
o Memory Games
o Digit span tasks (you show, child
says/signs/shows)
© 2011 Down Syndrome Foundation of Orange County
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
8
2/4/2016
How WM Needs May Look
In the School Setting
Is inconsistent in
remembering math facts
Is easily distracted when working on or doing something that is not highly interesting.
Struggles with reading comprehension and has to read through texts repeatedly to understand.
Struggles with problem solving that require holding information in mind, for example
mental math calculations.
Struggles with
completing tasks,
especially multiple step tasks.
Has difficulty
remembering long
instruction given in
several steps (i.e., directions for school/work
assignments.
Has difficulties when Struggles to understand
the context in a story or a planning and organizing something that needs to conversation.
be done in separate steps.
Has difficulty staying focused during cognitively demanding tasks but attends well
when cognitive demands
are minimal.
Has difficulty integrating new information with
prior knowledge.
When called on, forgets what he/she was planning to say.
Has difficulty taking
notes and listening at the same time.
© 2011 Down Syndrome Foundation of Orange County
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Classroom Interventions
• Reduce amount of information to process (simpler
sentences, simpler work product)
• Use visual notes (words and/or pictures) and
actions (pointing and/or using hands) to help student
understand lesson and lecture
• Break tasks into sequence of independent steps
(child can track progress and mark off completed steps)
• Repeat information where necessary or have a
classmate serve as “memory guide”
• Use memory aids (proximity to student and
practice at use important)
© 2011 Down Syndrome Foundation of Orange County
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Working Memory Resources
http://www.upatdowncountry.com/educational
Why All the Fuss About Working Memory?: Activities and Classroom
Support to Enhance Learning
Dana Halle, JD, Co-founder and Executive Director, Down Syndrome
Foundation of Orange County/Downs Ed USA, mother of
a son with DS, Newport Beach, CA
Why do researchers talk about visual learning strengths for children with DS?
Why is learning from listening alone difficult? Join us as we explore working
memory and what we know about how weaknesses in memory can impact
learning. We will have fun testing our own memories and provide interesting
and simple activities for home or school to improve your student’s memory.
© 2011 Down Syndrome Foundation of Orange County
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
9
2/4/2016
GROUP EXERCISE: Working Memory
Discuss ways in which your student’s working memory may be inhibiting
their communication with others and what you can do to help
© 2011 Down Syndrome Foundation of Orange County
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Social Issues
• The Dreaded “R” Word
• At-risk population for
bullying/abuse
• 70-80% of people with ID will
be abused
• Issues with self-reporting
• People First Language
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Social Issues
• Self awareness
• Extra curricular activities
• Age appropriate interests
• Puberty/sexuality
• Stereotypes
• Being perceived as a “visitor”
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
10
2/4/2016
Why Inclusive Education?
Inclusive education benefits not
only the student with Down
syndrome, but also leads to
greater understanding and less
prejudice in the community at
large.
Students in inclusive schools
learn to become more tolerant
and patient and to support each
other, rather than competing of
being afraid of the unknown.
They also learn to value diversity
and to appreciate that everyone
has special gifts and talents.
Aims of Inclusion
The acquisition
of new skills
Development of
age appropriate
behavior
STUDENT
The development
of independence
in learning
and behavior
The development
of friendships
with “typical”
peers
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Successful Inclusion Requires
• A belief that all children can learn
• A positive attitude throughout the whole school
• A flexible approach to the use of support staff
• Classroom teacher owns student’s learning
• Good communication between home and school
• Disability awareness for students and educators
• Teaching independence not learned helplessness
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Avoiding Learned Helplessness
• Students with Down syndrome are presumed to need help
in areas where they can actually be quite self sufficient.
• PRESUME COMPETENCE! Provide supports only when the
student requests assistance or proves it is needed.
• Are the supports you have in place transferrable to other
settings?
o Community outings
o Employment situations
o Post secondary education
• Are you training your student to be a productive member of
society?
• Are you setting the student up to fail later in life by
rescuing him/her now?
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
11
2/4/2016
Avoiding Learned Helplessness
Promotes Learned Helplessness
•
•
•
•
•
•
•
•
•
•
Protecting student from taking risks
Rescuing student from anticipated
outcomes
Overlooking errors
Constant prompts
Speaking for your student
Giving inflated grades
Permitting bad behavior
Making excuses
Interceding before they ask for help
Inconsistency in discipline/expectations
Promotes Independence
•
•
•
•
•
•
•
•
•
•
•
Setting clear limits on what is safe
Discussing issues and creating solutions
Giving clear directions/expect follow
through
Student encouraged to speak for self
Teaching at a challenging level using
learning strengths
Using rubric scoring honestly
Coaching student on errors
Consistency in discipline/expectations
Holding student accountable for actions
Allowing student to fail in safe environment
Teaching student to ask for help as needed
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Group Exercise: Learned Helplessness
• Visit each behavior station
• Identify strategies that
promote independence
• Identify strategies that
would cause learned
helplessness
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
How Down Syndrome Affects
Learning
Down’s Syndrome Association
Education Support Packet
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
12
2/4/2016
Preferred Teaching Methods
• Hands on activities
• Structured, sequenced activities
• Routine oriented
• 15-20 repetitions to acquire skill
• Visual learning
• The fewer the cues, the better!
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Preferred Teaching Methods
• Avoid learned helplessness
• Allow student to try and fail
• Use consistent language
between home and school
• Avoid multi-tiered rewards
programs
• Think like an employer
• Peer role modeling
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
A new way of looking at behavior
“If a child doesn’t know how to read, we teach.”
“If a child doesn’t know how to swim, we
teach.”
“If a child doesn’t know how to multiply, we
teach.”
“If a child doesn’t know how to behave, we…”
Are you teaching or Punishing?
John Herner Counterpoint 1998
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
13
2/4/2016
What’s the Function?
• Avoidance
• Attention Seeking
• Sensory (over/understimulated)
• Communication
• Lack of rapport
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Teaching vs. Punishing
• Teaching corrects misbehavior and instills
self-discipline in children.
• Punishment stops misbehavior by inflicting
pain or penalty.
• Focuses on future correct behavior,
whereas punishment focuses on past
incorrect behavior.
• Attitude of love/concern for the child—they
remain calm and relaxed.
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Teaching vs. Punishing
• Punishing demonstrates an attitude of
hostility, frustration and stress.
• Teaching helps children develop a
positive self-image, self-worth, and
self-confidence.
• Punishment leads to feelings of guilt,
anger, hostility, and inferiority in
children.
• Punishing sends a message to the
other kids in school that this child can’t
behave or won’t make a good friend.
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
14
2/4/2016
You’re OVER thinking it
• Common behavior for age
• Typical kids do this
• Too much supervision
• Too many prompts/transitions
• Over verbalizing
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
You’re UNDER thinking it
• You have to teach behavior
• Accommodations/modifications
• Scheduling
• Low expectations
• Judging a book by the cover
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Successful supervising adults
Confident in their actions
Feel no guilt over the disability
Look into the future
Allow student to try and fail
Allow student to feel natural
consequences
• Avoid power struggles
• Are process oriented vs goal
oriented
•
•
•
•
•
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
15
2/4/2016
Successful supervising adults
• Are consistent in interactions
--expectations
--tone of voice
--routines
• Are not guided by a clock
• Measure success by level of
independence achieved by
student
• BELIEVE IN THE STUDENT!!
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Working for rewards
• Student should work for the sake or working
• Cannot be duplicated with frequency in a
work setting
• Student becomes obsessed with rewards
• Expectation that I work, I get a reward
• Multi-tiered systems are too confusing
• If I blow it first hour/day, why behave the rest of the
time?
• Age appropriate (smiley faces, food, candy, stickers)
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
How do I motivate my student without rewards?
• Channel his/her passion
• Contextual learning
• Manipulative or hands on activities
• Visual cues
• Processing time
• Positive note home to parents about the day’s events
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
16
2/4/2016
How do I motivate student without rewards?
• As soon as we do X then we do Y
• Partner student with peers to do task
• Intermittent praise
• Show confidence in your student’s abilities
• Offer help as needed
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
The Role of the Support Professional
• Encourage cooperative learning and
involvement of peers as good role models
• Act as a bridge between student and the
curriculum
• Provide feedback to the classroom teacher
on the student’s response to the curriculum
• Encourage development of age appropriate
behavior
• Set high expectations and refuse to accept
inappropriate behavior
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Behavior is a Form
of Communication
• Annoyed people don’t take the time to
understand
• Appear to misbehave when they are, in
reality, just confused or uncertain
about what to do
• Failed to understand instructions
• Student forgot what they have been
told (short term memory issues).
• Student may find it hard to learn new
rules and routines and still do things in
the old way.
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
17
2/4/2016
Behavior is a Form
of Communication
• Rule out medical reasons for
behavior
• Compromised concentration or
memory skills compared to peers
• Immature play and social skills
• Immature behavior=center of
attention
• Is student treated like his/her
peers?
• First response to a request is NO!
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Behavior is a Form
of Communication
• What part do adults play in behavior
• Environmental changes
• Resents having an adult by their side all the
time
• Resents adult helping other students
• Used to getting special treatment and object if it
is withdrawn.
• Attention seeking behavior has worked in the
past
so why not use it again?
• Misbehave because they are angry, frustrated or
hurt
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
What is Your Student Telling You?
•
Subjected to a high level of structure and
supervision. As a result they may feel the need
to exert some control over their lives.
•
Refusal to cooperate with teacher or assistant
to gain control.
•
Give opportunities to choose activities.
•
Students may feel under pressure and need a
break.
•
Students may resent being regularly withdrawn
from class and separated from their friends.
•
The student’s immaturity may lead to behaviors
more appropriate to a younger child.
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
18
2/4/2016
What is Your Student Telling You?
• Wants to do the same work as
everyone else but an adult insists
they do something different.
• Tries to do the same as others, but
find they can’t cope without help.
• Presumes the work they are being
given is too difficult or sees it as
uninteresting.
• Are you over supporting?
• Confused by different adults giving
conflicting messages.
• Self stimming and sensory issues.
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Strategies for Disruptive Behaviors
•
Give choices in activities.
•
Give the child the opportunity to resolve a conflict with
another child before intervening.
•
When intervening - problem solve with the child, do not
just stop the behavior.
•
Give an alternate suggestion on what to do with the
impulse. Redirect to another more appropriate activity.
•
When possible allow the child to experience the natural
consequence of his/her behavior.
•
Repeat rules and limits frequently; keep to a few basic
rules.
•
Reinforce behavior you want to continue.
•
Be persistent; the child probably has had a lot of
practice in testing the limits.
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Strategies for Disruptive Behaviors
•
Warn children before transitions are made.
•
Arrange the learning environment for positive
interaction.
•
Intervene before “robust” play becomes rough
play.
•
Encourage and assist children to verbally come
up with their own solutions.
•
Schedule the student’s day for success.
•
Try not to let the student become overly tired.
•
Some students respond to role-playing, using
puppets or social stories to work out solutions
to conflict situations.
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
19
2/4/2016
Strategies for Disruptive Behaviors
• If/Then scenarios to give clarity to tasks
required.
• Visual task boards/schedules/lists .
• Timers to help with awareness of time (this
non-preferred activity WILL end at some
point!)
• Break tasks into smaller manageable steps
• Consistency is the key!
• Decrease opportunities for distractions.
• Verbal redirection first. Physical redirection
only when necessary.
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Are you teaching the core behavior?
Core behavior
• The behavior that makes the
MOST sense
• Can be used in multiple
settings
• Bottom line behavior
Examples of core behaviors
• Crossing the street
• Rebecca and the steps
• Running off
• Masturbation
**Finding core behavior
worksheet
Group exercise**
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Strategy
Behavior
Elopement
•
•
•
•
Threepeat Method
•
•
•
•
•
Flop and Drop
•
•
•
•
What’s happening when elopement occurs
Threepeat
Emergency response plan in place
Examine number of transitions
Problem behavior
Preferred behavior
Mantra
Scene of Crime
Action steps
Let child/student stay on floor
No direct eye contact
Use cell phone for pretend text/call
When child/student gets up, move on
without comment
• MOVE CHILD in dangerous situations
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG
60
20
2/4/2016
Strategy
Behavior
Rule out medical issues
Helps child/student focus
Increase sensory diet
Evaluate placement
MOVE CHILD in dangerous situations
Provide coping strategies to replace
stimming
• Data collection on number of prompts
you are giving and amount of processing
time
• Reduce prompts and increase
processing time
•
•
•
•
•
•
Self stimming
Says NO to every command
**teach proper way to use
and say no**
*** Still saying NO to commands?***
• Act as if you didn’t hear the no
• Redirect to task
• Turn your back or walk away
• After processing time then give as soon
as scenario or offer help to complete
task
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG
Strategy
Behavior
Playground strike
Refuses to work
•
•
•
•
•
•
•
•
Transfer of authority
Say come down from slide/bars/swings
Adult goes to bring child/student down
Next recess slide/bars/swings not available
Have child raise flag or sign to come in
Give them a job/reason to come in
Get a peer buddy to line up with them
15-20 attempts
•
•
•
•
•
•
•
Transfer of authority
Accommodate/modify work as needed
Look at placement
Work makes no sense!
Contextual learning
More time to process and do work
Peer mentoring
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG
62
Strategy
Behavior
Under chair/table or on top
of chair/table
61
•
•
•
•
•
•
•
•
Attention seeking or avoidance behavior
Increase sensory diet
No emotion
Accommodate/modify work so it’s
meaningful and student/child wants to
engage
Build breaks into the task or schedule
“Don’t stand on chair, sit on your chair”
“Come out from under the table and sit on
your chair.”
Keep track of lost time and have
child/student
“pay it back”
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG
63
21
2/4/2016
Group Exercise: Self Reflection
• Identify a daily challenge you are facing with
your student.
• What are the contributing factors?
o
o
o
o
o
o
too many prompts/too much supervision
medical issues
communication issues
social issues
cognitive issues
working memory issues
• What are the functions of the behavior?
• What can you do differently?
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
What Works for Students with DS?
• Rely heavily on visual aides rather than verbal
• Teach in context
• Modify worksheets
•Fewer items and/or more visuals
•More border around edge of page
•Highlighted text that is important
•Large print
•Meaningful context to learner
• Use of manipulatives
• Multiple choice tests vs. spontaneous answers
• Writing utensils
• Books on tape
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
What Works for Students with DS?
• Use meaningful material within or close to
the pupil’s experience.
• Introduce new concepts in a familiar
context.
• Show samples of completed work.
• Provide plenty of visual cues- pictures,
diagrams and print.
• Ensure illustrations tie in closely with text
and task.
• Give plenty of opportunities for success.
• Use technology! Ipads, computers, cell
phones, Nintendo DS
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
22
2/4/2016
What Works for Students with DS?
•
Student feedback to know if you met
educational aims and objectives.
•
Tape instructions so student can play back
•
Several versions of same worksheet
•
Differentiate clearly between text and
illustrations.
•
Wide border around edge of the page.
•
Provide opportunities for collateral success.
--fractions
--writing
--spelling
•
Sample of finished product/steps to get there
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Group Exercise:
Visit each station as a group
• List some ways you would motivate
the student to do this task or
assignment
• List some accommodations or
modifications you could provide in
each situation to enhance the
likelihood of compliance
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
“The Groove”
• Patterns/routines which must be followed
• Script running in the mind that is on a loop
• Making order out of chaos
• Calming and allows a sense of control over
environment
• Becomes default setting
• Perseveration and obsession
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
23
2/4/2016
What’s Good About “The Groove”
• Sense of order/structure
• Moving slower in a fast paced world
becomes easier to manage
• Provides predictability
• Refuge from stress or strain because of
familiarity with routine/script
• Powerful means of communication and
self-expression
--Dennis McGuire, Co-founder Adult DS Clinic
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
What’s Bad About “The Groove”
• Perseveration on one topic/event/preferred
item or person
• Slows down a schedule
• Lack of flexibility (has to finish the groove
before doing anything else)
• Poor decisions/bad habits (eating too much,
unsafe behavior)
• Unable to accept changes in environment or
schedule
--Dennis McGuire, Co-founder Adult DS Clinic
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Should We Stop the Groove?
When groove is maladaptive
When it inhibits relationships
Person becomes rigid and inflexible
When environment does not allow for it
(job, school, public setting)
• Be careful not to misinterpret a groove
as stubbornness or non-compliance
•
•
•
•
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
24
2/4/2016
Changing the Script….
Football Man Video
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Changing the Script….
Football Man Video
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
We’ve Come A LONG Way
Over the last thirty years, research has increased
our knowledge about the capabilities of people with
Down syndrome. At the same time,
significant advances in health care, early
intervention and family support have
vastly improved the quality of life for people
with Down syndrome and their families.
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
25
2/4/2016
What Does the Future Hold for
Students With Down Syndrome?
• Post secondary opportunities
• Real jobs for real people
• Relationships and marriages
• Actively participating in their
communities
People with Down syndrome have
unlimited potential when given
opportunities and support!
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
What Does the Future Hold for
Students With Down Syndrome?
• Living independently or in
semi-supported environments
• Amazing medical advances
• A potential cure for cancer found
in people with Down syndrome?
• Research which will result in
therapies or medications which
could enhance cognition
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Where Can You Find Help?
•
Case Manager for the student
•
Student’s parents
•
Other professionals
•
IEP Team
•
Peers at school
•
Internet Resources
•
Library (books authored prior to
2005 are likely outdated )
•
Down Syndrome Associations
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
26
2/4/2016
Don’t Limit Me!
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
THANK YOU FOR ALL YOU DO!
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
Resource Materials
• Down’s Syndrome Association Education Support Packet
http://downs-syndrome.org.uk/
• Down Syndrome Guild of Greater Kansas City
http://www.kcdsg.org/for_educators.php?show_child=80
• Down’s Ed International http://www.downsed.org/
• Prep Program http://www.prepprog.org/
• Down Syndrome Association of Central Texas Educator Packet
http://www.dsact.com/images/docs/Educatormanual2008.pdf
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
27
2/4/2016
Questions???
To learn more about supporting
students with Down syndrome:
Down Syndrome Guild
of Greater Kansas City
5960 Dearborn Street Ste. 100
Mission, KS 66202
913.384.4848
[email protected]
www.kcdsg.org
© 2013 Down Syndrome Guild of Kansas City. All rights reserved. This document contains Down Syndrome Guild confidential and/or proprietary information which may not be reproduced or transmitted without the express written
consent of DSG.
28
2/4/2016
Speech and language therapy for children with Down syndrome
Speech and language therapy for children with Down
syndrome
Sue Buckley and Patricia Le Prèvost
Contents
Full Text Article
Other formats
PDF Document
The provision of speech and language therapy services for children with Down syndrome is a
controversial issue. Families receive different services depending on where they live, and the knowledge and interest of local speech and
language therapists in the specific needs of children with Down syndrome. This article is an attempt to provide guidelines for speech and
language therapists, based on the best evidence of the children's speech and language needs currently available. It is a summary of the key
facts about their speech and language profile and needs, followed by recommendations for service provision.
Buckley SJ, Le Prèvost P. Speech and language therapy for children with Down syndrome. Down Syndrome News and Update. 2002;2﴾2﴿;70‐76.
doi:10.3104/practice.171
Language is vital for mental and social development
It can be argued that speech and language therapy is the most important part of intervention services for children with Down syndrome if we
wish to promote their cognitive ﴾mental﴿ and social development.
Cognitive development
In our view, speech and language development are absolutely central to the cognitive development of all children. First, words equal
knowledge and the faster a child learns vocabulary, the faster he or she is acquiring knowledge about the world. Therefore vocabulary
development is very important – the number of words that a child knows when he or she enters school at five years will have a very significant
influence on progress. Secondly, language supports thinking and reasoning. The human brain has evolved a remarkable ability to learn spoken
language with amazing ease and then to use that spoken language for mental activities. Thinking, reasoning and remembering, for example,
are usually carried out in mind as 'silent speech'. It follows, therefore, that any child with significant delay in acquiring language will be delayed
in the ability to use these cognitive processes. Although delayed, almost all children with Down syndrome will use spoken language as their
main means of communication. The use of signs in early years will help them to progress but for most children signs are used as a bridge to
talking, not to teach a sign language.
Social development
Language is equally important for children's social development as it enables them to negotiate their social world and to control their
behaviour. For example, as children acquire language, they can ask for what they want, explain how they feel, describe what they have been
doing and share thoughts and worries with friends. Children are able to begin to control their behaviour by using silent speech to instruct
themselves and to plan their actions.
The more we can do to help children with Down syndrome to learn to talk, the faster they will progress in all areas of cognitive and social
development.
The speech and language profile associated with Down syndrome
Specific speech and language difficulties
http://www.down-syndrome.org/practice/171/
1/9
2/4/2016
Speech and language therapy for children with Down syndrome
Children with Down syndrome usually have an uneven profile of social, cognitive and language development – they do not have a profile of
equal delay in all areas, they have a profile of strengths and weaknesses. For example, social development and social understanding is typically
a strength, while spoken language development is a weakness. There is now consistent evidence that these children have a profile of specific
speech and language delay relative to their non‐verbal mental age. There are considerable individual differences in rates of progress but the
overall specific profile is usually evident for all children with Down syndrome. [1,2]
An uneven profile within the language domains
While the speech and language skills of children with Down syndrome are delayed relative to non‐verbal mental abilities, different aspects of
speech, language and communication skills are not equally delayed.
Communication skills are a relative strength with good understanding and use of non‐verbal communication skills and good use of gesture.
[1,2]
In language, the children show delayed development of vocabulary in infancy, with comprehension ahead of production, but by the teenage
years, vocabulary is a relative strength with vocabulary 'ages' ahead of grammar 'ages'. In grammar, there is evidence of specific difficulties in
both comprehension and production. [1‐3]
In speech, there is considerable difficulty at all levels from planning to articulation and phonology. Most teenagers still have significant
intelligibility problems. [4,5]
Individual differences are seen within the typical profile, with some children having more speech difficulties than others, relative to language
comprehension and some children having larger differences between comprehension and production than others, for example. Therefore,
each child with Down syndrome should receive an individualised therapy programme but the principles for effective practice upon which this
should be based is the same for all children with Down syndrome.
Possible primary causes
Research is beginning to provide some useful information on the underlying causes of the speech and language profile associated with Down
syndrome.
Working memory
Children with Down syndrome have specific impairment in the phonological loop component of working memory relative to their non‐verbal
abilities, and this is now thought to be a major cause of their speech and language difficulties.[6] For all children, the phonological loop is
thought to play a critical role in learning a spoken language as it holds the sound pattern of the word to enable the child to both link this with
meaning and to store it to support production of the spoken word. Phonological loop difficulties will affect both vocabulary learning and
grammar learning. [see 26]
Visual short‐term memory is not impaired relative to non‐verbal mental abilities and is described as a relative strength. In addition, research
has indicated that visual coding of verbal information may be used by children with Down syndrome in short‐term memory tasks. [6,7]
Hearing
Most children with Down syndrome ﴾at least 80‐90%﴿ suffer from conductive hearing loss and auditory discrimination difficulties which will
compound the phonological loop difficulties. However, the phonological loop difficulties are thought to exist independently of any hearing
impairment. [6]
Speech‐motor difficulties
speech sound and word production difficulties also have physical causes. These are linked to the motor skill difficulties associated with Down
syndrome and the oral‐motor difficulties demonstrated from the first year of life, which affect feeding and chewing patterns. For all children,
first words can be predicted from the speech sounds that they can make in babble – in other words early spoken vocabulary is influenced by
existing articulation and phonological skills, not the reverse. [8]
Possible secondary causes
Slow vocabulary acquisition
http://www.down-syndrome.org/practice/171/
2/9
2/4/2016
Speech and language therapy for children with Down syndrome
The development of early grammar has been shown to be linked to total productive vocabulary for typically developing children as well as for
children with Down syndrome. Therefore, the very slow rate of productive vocabulary development that is typical for children with Down
syndrome may mean that the development of grammar is delayed beyond the optimal period for grammatical acquisition ﴾1‐6 years﴿ – for a
full discussion of this issue see [24].
Speech‐motor effects
Delayed output of first words and unintelligible utterances may reduce or change the language input to the children. Difficulties with speech
production probably compound the grammar learning and grammar production difficulties. [2]
Principles for effective interventions
There is considerable agreement among international experts on the principles that should guide speech and language therapy for children
with Down syndrome, based on research into their difficulties and into effective interventions. [see 1‐5]
Targets for all four domains
All experts identify the need to have separate targets for the four components of speech and language skill ‐ communication, vocabulary,
grammar and speech work, for each child.
Targets for comprehension and production
In addition, for vocabulary and grammar separate targets will be needed for comprehension and for production. [3]
Use of signing
There is agreement on the use of sign systems to promote spoken language with benefits for both comprehension and production.
Use of reading
There is agreement on the importance of using reading activities to teach spoken language for those of all ages. In particular, the benefits
of using early reading in preschool years as an explicit language teaching activity are recognised.
Parents are the main therapists
All experts identify that language is learned all day, every day, as children are involved in communication with their families and friends and
therefore the focus of effective therapy must be to share skills with parents because they will be their child's best therapist.
Implications for a comprehensive therapy programme
Preschool services
Specialist training for work with children with Down syndrome will be helpful and up‐to‐date knowledge of the research literature is essential.
The needs of children with Down syndrome tend to be different from the needs of other children with learning difficulties. Their hearing,
phonological loop impairment and speech‐motor difficulties make them different and therapists need to be skilled in auditory discrimination,
oral‐motor function and speech work as well as language work.
Knowledge and skills
to have up‐to‐date knowledge of the specific research literature on speech and language development, working memory and effective
therapies for children with Down syndrome
to understand the significance of the specific impairment in the phonological loop component of working memory for the speech and
language profile associated with Down syndrome
to understand the importance of reading work to support the development of vocabulary, grammar and speech clarity, using strengths in
visual memory
to understand the importance of auditory discrimination for speech sounds, phonics activities, phonological awareness training and speech
work in order to improve working memory function as well as speech.
Models of delivery
in the first year of life families should receive a service at home ﴾or in intensive care if baby is sick﴿ for several months from birth on at least
a monthly basis
in the second to fourth years various models can be effective, including group sessions to ensure families know about speech and language
development and at which individual targets can be set for them and their infant.
http://www.down-syndrome.org/practice/171/
3/9
2/4/2016
Speech and language therapy for children with Down syndrome
Group activities can be started with babies from about 18 months and they usually enjoy learning in this way, with the opportunity to copy and
learn from other children. Group activities can also develop attention and the ability to take turns. In the groups, activities can be modelled by
the therapist to increase parent's confidence at carrying them on at home. Parents frequently report that children are often more willing to
show what they can do in groups than when asked to do the same things at home! Groups may reduce the individual pressure on children,
though sometimes children do not enjoy groups and can become resistant to group activities. Groups are a cost effective way to offer services
and also provide general parent support. Parents often have effective tips to share with each other and the progress of older children is
motivating for parents of younger ones.
parents should be able to choose the delivery models that suit them as some parents will prefer individual home visits to groups
any model used should offer continuous support throughout this vital period for speech and language development and no family should
receive less than monthly contact with a therapist
First year of life
1. Encourage a good communication environment at home and ensure that parents understand the speech and language needs of their
child, and how speech and language develops.
2. Provide support for feeding and activities for oral‐motor development.
3. Encourage all communication skills, eye‐contact, turn‐taking, pointing and joint‐referencing by the end of the first year.
4. Target auditory discrimination for speech sounds to improve auditory discrimination in the phonological loop.
5. Target auditory discrimination for speech sounds in order to support the development of babble ﴾typical babies tune their babble to
the language they are hearing by 12 months – in other words they are setting up the speech‐motor skills for talking﴿.
6. Encourage the use of gesture and sign primarily to aid comprehension.
The Swedish therapist Irene Johansson has evaluated and promoted this type of programme for infants with Down syndrome for a number of
years and others have stressed the need for speech as well as language work to begin early. [4,5,9]
Second year
1. Encourage a good communication environment at home and ensure parents understand the speech and language needs of their
child, and how speech and language develops.
2. Continue with targeted work in support of hearing and producing speech sounds – single sounds and reduplicated babble ﴾for
speech and for auditory memory development﴿. [4,5,12,24] Keep a record of speech sound progress.[23]
3. Teach comprehension and production of early vocabulary with games using objects, pictures and actions to supplement the daily
language exposure of the child. This approach is currently recommended by the Hanen programme for children with Down
syndrome. [10,11] They recommend targeted teaching and practice of words, then two and three word constructions, as they do not
believe that the quality language immersion approach is sufficient for children with Down syndrome. They advise that the words
chosen for imitation are chosen with initial consonant sounds that the child can already make, highlighting the need to address
speech sound production skills in advance of vocabulary and language progress. Keep a record of words understood and words
signed or spoken.
4. Teach two and three words constructions through play and encourage imitation by child.
5. Address communication skills if necessary ﴾3‐5% have autistic spectrum difficulties﴿.
Third to fifth years
1. Encourage a good communication environment at home and ensure parents understand the speech and language needs of their
child, and how speech and language develops.
2. Continue with targeted work in support of hearing and producing speech sounds – as single sounds and in whole words ﴾for speech
and for auditory memory development﴿. [13,14] Keep a record of speech sound progress. [see 23]
3. Continue to teach vocabulary and develop early grammar and syntax. This can be done through play and by making books with the
language to be learned in print. [see 25]
These reading activities will be an aid to parents to support the teaching and practice of vocabulary and grammar, but there is also
increasing evidence that seeing words as well as hearing them is a significant aid for many children with Down syndrome. Indeed, the
research evidence indicates that the most effective interventions for speech, language and working memory development for children
with Down syndrome is to place them in mainstream preschools and schools, and to teach them to read. This leads to very significant
gains in expressive language structure, speech intelligibility and verbal and visual short‐term memory spans by the teenage years.
Significant gains are seen by 10 years of age. [15‐21]
The benefits of reading may come initially from the ability to store the whole printed word image more accurately than the spoken
form – and the former then supports the learning of the latter. As letter sounds are learned, auditory discrimination for speech sounds
http://www.down-syndrome.org/practice/171/
4/9
2/4/2016
Speech and language therapy for children with Down syndrome
will improve and then phonological awareness – the ability to hear sounds in words. Longitudinal studies demonstrate this happening
for children with Down syndrome as they learn to read and to spell. [19] All reading activities are planned to ensure the children
understand, or are taught to understand, what they are reading otherwise no language benefits would be seen. If observers complain
that children with Down syndrome read but do not understand what they are reading, this is the fault of the teacher not the child. [see
25]
4. Records of vocabulary comprehension and production should be kept [23] and therapists should be aware of the important link
between productive vocabulary size and the development of grammar in production, which has been demonstrated for typically
developing children and children with Down syndrome. [see 24] This means that at least some of the grammar delay seen in children
with Down syndrome is the result of delay in learning vocabulary. Further there is evidence of a critical period for learning grammar
﴾to about 6 years﴿ when the brain is maximally receptive and there is evidence that mastering grammar significantly effects
phonological development in children. All these findings have significant implications for our understanding of the speech and
language profile usually seen in children with Down syndrome and significant implications for early and continued therapy.
5. Address communication skills if necessary ﴾3‐5% have autistic spectrum difficulties﴿.
Primary school years
Ideally all children with Down syndrome should receive speech and language therapy in school but access to this service will vary considerably
from place to place.
Progress at five years will vary widely between children, with some having quite clear production of 3 or 4 word sentences but with
grammatical markers missing, the majority at a 2 or 3 word stage in production, much of this difficult to understand, and some with very few
words or signs. Most children will have significantly better comprehension than production.
Reading activities will be an important support for speech and language development throughout the school years.
Detailed information on the range of progress of children can be found in the books in the DSii series on Development and Education – see
Resources.
Goals for speech and language therapists working with 5‐11 year olds with Down syndrome
Knowledge and skills
to have up‐to‐date knowledge of the specific research literature on speech and language development, working memory and effective
therapies for children with Down syndrome
to understand the significance of the specific impairment in the phonological loop component of working memory for the speech and
language profile associated with Down syndrome
to understand the importance of reading work to support the development of vocabulary, grammar and speech clarity, using strengths in
visual memory
to understand the importance of auditory discrimination for speech sounds, phonics activities, phonological awareness training and speech
work in order to improve working memory function as well as speech.
Therapy plans
1. to have clear targets for 4 areas of work, speech, vocabulary, grammar and communication skills and to keep detailed records of
progress
2. for vocabulary and grammar, to have separate targets for comprehension and for production, as comprehension in both domains is
typically significantly ahead of production
3. for speech work, separate targets may be needed for articulation, phonology and intelligibility ﴾pacing, voice etc﴿
4. to assist teachers in using reading to teach language and to incorporate speech and language targets into literacy activities
5. to review oral‐motor function, feeding, chewing and drinking patterns and advise accordingly
6. all targets should be shared with parents, teachers and assistants
7. encourage a good communication environment at home and at school, and ensure parents, teachers and learning support assistants
understand the speech and language needs of their child, and how speech and language develops.
8. address communication skills if necessary ﴾3‐5% have autistic spectrum difficulties﴿.
Models of delivery
children with Down syndrome should be seen at least monthly in school, targets reviewed and activities set for parents, teachers and
assistants to include in their daily routines
http://www.down-syndrome.org/practice/171/
5/9
2/4/2016
Speech and language therapy for children with Down syndrome
these activities should be modelled with the child by the speech and language therapist, so that parents and assistants can confidently
enable the child to practice daily. Therapy sessions will not change speech and language development unless they lead to an increase in
daily teaching activities and appropriate styles of communication at home and at school.
some children with Down syndrome of primary school age may need weekly individual or group sessions of speech and language therapy
with a therapist who has the specialist knowledge and the skills to address their profile of difficulties, particularly for speech and
intelligibility work.
Secondary school years
Speech and language therapy should continue for all teenagers with the same list of key objectives and targets as for the primary age group,
but adapted to focus on age appropriate language needs and activities.
Some teenagers with Down syndrome will be making good progress and talking in reasonable sentences, others will still have fairly limited
spoken language. The range of individual differences is very wide. Many secondary school pupils with Down syndrome will have small
productive vocabularies ﴾800 words or even less﴿ and limited productive grammar.
Reading activities will still be an important way to help all teenagers. Most will still have phonological and intelligibility difficulties that should
be targeted, and the social use of language, particularly the ability to initiate and maintain conversations, may need addressing.
Goals for speech and language therapists working with 11‐16 year olds with Down syndrome
Knowledge and skills
to have up‐to‐date knowledge of the specific research literature on speech and language development, working memory and effective
therapies for children and teenagers with Down syndrome
to understand the significance of the specific impairment in the phonological loop component of working memory for the speech and
language profile associated with Down syndrome
to understand the importance of reading work to support the development of vocabulary, grammar and speech clarity, using strengths in
visual memory
to understand the importance of auditory discrimination for speech sounds, phonics activities, phonological awareness training and speech
work in order to improve working memory function as well as speech.
Therapy plans
1. to have clear targets for 4 areas of work, speech, vocabulary, grammar and communication skills and to keep detailed records of
progress
2. for vocabulary and grammar, to have separate targets for comprehension and for production, as comprehension in both domains is
typically significantly ahead of production
3. for speech work, separate targets may be needed for articulation, phonology and intelligibility ﴾pacing, voice etc﴿
4. to assist teachers in using reading to teach language and to incorporate speech and language targets into literacy activities
5. to review oral‐motor function, feeding, chewing and drinking patterns and advise accordingly
6. all targets should be shared with parents, teachers and assistants
7. encourage a good communication environment at home and at school, and ensure parents, teachers and learning support assistants
understand the speech and language needs of their teenager, and how speech and language develops
8. address communication skills if necessary ﴾3‐5% have autistic spectrum difficulties﴿.
Models of delivery
teenagers with Down syndrome should be seen at least monthly in school, targets reviewed and activities set for parents, teachers and
assistants to include in their daily routines
these activities should be modelled with the teenager by the speech and language therapist, so that parents and assistants can confidently
enable the young person to practice daily. Therapy sessions will not change speech and language development unless they lead to an
increase in daily teaching activities and appropriate styles of communication at home and at school.
some teenagers with Down syndrome of secondary school age may need weekly individual or group sessions of speech and language
therapy with a therapist who has the specialist knowledge and the skills to address their profile of difficulties, particularly for speech and
intelligibility work.
Adult life
http://www.down-syndrome.org/practice/171/
6/9
2/4/2016
Speech and language therapy for children with Down syndrome
A recent study in the UK and work in the USA has indicated that speech and language skills can be improved with therapy during the adult
years.[2,22] However, speech and language therapy services for adults are even scarcer than those for children. This is an area for further work
and an article on work with adults will be published in next year's issue of this journal written by a practitioner in this field.
Speech and language therapy resources
Record keeping
Six checklists to enable parents and therapists to plan activities and to keep a record of children's progress in vocabulary, grammar, speech
and communication are available from Down Syndrome Education International:
Vocabulary checklists and record sheets: Checklist 1 ‐ First 120 words. Portsmouth, UK: Down Syndrome Education International. ISBN: 1‐
903806‐32‐1
Vocabulary checklists and record sheets: Checklist 2 ‐ Second 330 words. Portsmouth, UK: Down Syndrome Education International. ISBN: 1‐
903806‐33‐X
Vocabulary checklists and record sheets: Checklist 3 ‐ Third 280 words. Portsmouth, UK: Down Syndrome Education International. ISBN: 1‐
903806‐34‐8
Speech sounds checklists and record sheets. Portsmouth, UK: The Down Syndrome Educational Trust. ISBN: 1‐903806‐35‐6
Interactive communication and play checklists and record sheets. Portsmouth, UK: Down Syndrome Education International. ISBN: 1‐903806‐
36‐4
Sentences and grammar checklists and record sheets. Portsmouth, UK: The Down Syndrome Educational Trust. ISBN: 1‐903806‐37‐2
Practical Activities
Three age specific guides to practical activities to encourage speech and language development are available from Down Syndrome Education
International. They should be helpful to parents and classroom assistants:
Speech and language development for infants with Down syndrome (0‐5). By Sue Buckley and Gillian Bird ﴾2000﴿. Portsmouth, UK: The Down
Syndrome Educational Trust. ISBN: 1‐903806‐05‐4. [Open Access Full Text ]
Speech and language development for children with Down syndrome (5‐11). By Sue Buckley and Gillian Bird ﴾2001﴿. Portsmouth, UK: The
Down Syndrome Educational Trust. ISBN: 1‐903806‐06‐2. [Open Access Full Text ]
Speech and language development for teenagers with Down syndrome (11‐16). By Sue Buckley and Gillian Bird ﴾2000﴿. Portsmouth, UK: The
Down Syndrome Educational Trust. ISBN: 1‐903806‐07‐0. [Open Access Full Text ]
Books
Communication skills in children with Down syndrome – A guide for parents. By Libby Kumin ﴾1994﴿. Bethesda: Woodbine House, MD, USA.
ISBN: 0‐933149‐53‐0.
Classroom language skills for children with Down syndrome – A guide for parents and teachers. By Libby Kumin ﴾2001﴿. Bethesda: Woodbine
House, MD, USA. ISBN: 0‐890627‐11‐9.
For detailed reviews of the relevant literature see the following Overview modules from the Down Syndrome Issues and Information
Development and Education Series:
Reading and writing for individuals with Down syndrome – an overview. By Sue Buckley ﴾2001﴿. Portsmouth, UK: Down Syndrome Education
International. ISBN: 1‐903806‐09‐7. [Open Access Full Text ]
Speech and language development for individuals with Down syndrome – an overview. By Sue Buckley ﴾2000﴿. Portsmouth, UK: Down
Syndrome Education International. ISBN: 1‐903806‐00‐3. [Open Access Full Text ]
Memory development for individuals with Down syndrome. By Sue Buckley and Gillian Bird ﴾2001﴿. Portsmouth, UK: Down Syndrome
Education International. ISBN: 1‐903806‐08‐9. [Open Access Full Text ]
Teaching Materials
Four early language games are available from Down Syndrome Education International, sold either separately or as a set, saving 15%.
DSE picture lotto, illustrating first words with full colour photographs.
DSE picture dominoes, for picture matching and teaching vocabulary.
DSE consonant sound cards, with picture prompts for 20 English consonant sounds to encourage toddlers to listen to and to imitate the
sounds.
DSE language cards, with colour photographs illustrating a selected set of first words.
http://www.down-syndrome.org/practice/171/
7/9
2/4/2016
Speech and language therapy for children with Down syndrome
For details of these and specialist courses for speech and language therapists, see Down Syndrome Education International's website at
http://www.dseinternational.org/
Videos/DVDs
Understanding Down syndrome (1) ‐ learning to talk. By Sue Buckley ﴾1995﴿ Portsmouth, UK: Down Syndrome Education International.
Available from http://shop.dseinternational.org/
Understanding Down syndrome (2) ‐ learning to read. By Sue Buckley ﴾1995﴿ Portsmouth, UK: Down Syndrome Education International.
Available from http://shop.dseinternational.org/
Acknowledgements
The authors would like to thank Leela Baksi and Margaret Wright, Speech and Language Therapists, for feedback on an earlier draft of these
guidelines. However, the opinions expressed, and any errors or omissions, are the responsibility of the authors.
References
1. Chapman, R.S. ﴾1997﴿ Language development in children and adolescents with Down syndrome. Mental Retardation and Developmental
Disabilities Research Reviews, 3, 307‐312.
2. Miller, J.F., Leddy, M. & Leavitt, L.A. ﴾Eds.﴿ ﴾1999﴿ Improving the Communication of People with Down Syndrome. Baltimore: Paul H Brookes
Publishing.
3. Chapman, R.S. and Hesketh, L. ﴾2001﴿ Language, cognition and short‐term memory in individuals with Down syndrome. Down Syndrome Research
and Practice, 7 ﴾1﴿, 1‐8. [Open Access Full Text ]
4. Stoel‐Gammon, C. ﴾2001﴿ Down syndrome phonology: Developmental patterns and intervention strategies. Down Syndrome Research and
Practice, 7 ﴾3﴿, 93‐100. [Open Access Full Text]
5. Stoel‐Gammon, C ﴾in press﴿ Speech acquisition and approaches to intervention. In J.A. Rondal & S.J.Buckley ﴾Eds﴿ Speech and Language
Intervention in Down Syndrome. London: Colin Whurr.
6. Jarrold, C. & Baddeley, A. ﴾2001﴿ Short‐term memory in Down syndrome: Applying the working memory model. Down Syndrome Research and
Practice, 7 ﴾1﴿, 17‐24. [Open Access Full Text ]
7. Broadley, I., MacDonald, J. & Buckley, S.J. ﴾1995﴿. Working memory in children with Down syndrome. Down Syndrome Research and Practice, 3﴾1﴿,
3‐8. [Open Access Full Text ]
8. Stoel‐Gammon, C. ﴾1998﴿. Sounds and words in early language acquisition: The relationship between lexical and phonological development. In R.
Paul ﴾Ed.﴿ Exploring the Speech‐language Connection ﴾pp.25‐52﴿. Baltimore: Paul H. Brookes.
9. Johansson, I. ﴾1994﴿. Language Development in Children with Special Needs ‐ Performative Communication ﴾2nd Ed.﴿. London: Jessica Kingsley.
10. Weitzman, E. & Clements‐Baartman, J. ﴾1998﴿ Vocabulary intervention for children with Down syndrome: Parent training using focused
stimulation. Infant Toddler Intervention, 8 ﴾2﴿, 109‐125.
11. Clements‐Baartman, J. & Girolametto, L. ﴾1995﴿ Facilitating the acquisition of two‐word semantic relations by preschoolers with Down syndrome:
Efficacy of interactive versus didactic therapy. Canadian Journal of Speech‐Language Pathology, 19, 103‐111.
12. Hart, B ﴾1996﴿ The initial growth of expressive vocabulary among children with Down syndrome. Journal of Early Intervention, 20, 211‐221.
13. Cholmain, C.N. ﴾1994﴿ Working on phonology with young children with Down syndrome – a pilot study. Journal of Clinical Speech and Language
Studies, 1,14‐35.
14. Dodd, B., McCormack, P. & Woodyatt, G. ﴾1994﴿ Evaluation of an intervention program: relation between children's phonology and parent's
communicative behaviour. American Journal on Mental Retardation. 98 ﴾5﴿ 632‐645.
15. Laws, G., MacDonald, J., Buckley, S.J. & Broadley, I. ﴾1995﴿. Long‐term maintenance of memory skills taught to children with Down syndrome.
Down Syndrome Research and Practice, 3﴾3﴿, 103‐109. [Open Access Full Text ]
16. Laws, G., Byrne, A. & Buckley, S.J. ﴾2000﴿. Language and Memory Development in children with Down syndrome at mainstream and special
schools: A comparison. Educational Psychology, 20﴾4﴿, 447‐457.
17. Buckley, S.J., Bird, G., Sacks, B. & Archer, T. ﴾in press﴿. A comparison of mainstream and special school education for teenagers with Down
syndrome: Effects on social and academic development. Down Syndrome Research and Practice, 8. [Open Access Full Text ]
18. Laws, G., Buckley, S.J., Bird, G., MacDonald, J. & Broadley, I. ﴾1995﴿. The influence of reading instruction on language and memory development in
children with Down syndrome. Down Syndrome Research and Practice, 3, 59‐64. [Open Access Full Text ]
19. Byrne, A. ﴾1997﴿ Teaching reading to children with Down syndrome. Unpublished PhD Thesis. University of Portsmouth.
20. See parents' accounts and research on early reading in Down Syndrome News and Update Volume 2 Issue 1. [Open Access Full Text ]
21. Buckley, S. ﴾in press﴿. Literacy and language. In J.A. Rondal & S.J. Buckley ﴾Eds﴿ Speech and Language Intervention in Down syndrome. London:
Colin Whurr.
22. Jenkins, C. ﴾2001﴿. Adults with Down syndrome: an investigation of the effects of reading on language skills. Unpublished PhD Thesis. University of
Portsmouth.
http://www.down-syndrome.org/practice/171/
8/9
2/4/2016
Speech and language therapy for children with Down syndrome
23. See Record Keeping checklists] in Resources list.
24. Buckley, S. ﴾2000﴿. Speech and language for individuals with Down syndrome – an overview. Portsmouth, UK: The Down Syndrome Educational
Trust. [Open Access Full Text ]
25. Buckley, S. ﴾2000﴿. Reading and writing for individuals with Down syndrome – an overview. Portsmouth, UK: The Down Syndrome Educational
Trust. [Open Access Full Text ]
26. Buckley, S. & Bird, G. ﴾2001﴿. Memory development for individuals with Down syndrome. Portsmouth, UK: The Down Syndrome Educational Trust.
[Open Access Full Text ]
New from DSE: See and Learn Numbers
See and Learn Numbers is designed to help parents and educators teach
children with Down syndrome basic number skills and concepts.
See and Learn Numbers is designed to teach young children to count, to link
numbers to quantity, to understand important concepts about the number
system and to calculate with numbers up to 10.
Now available as teaching kits and apps. Find out more...
Copyright © 1996‐2016 Down Syndrome Education International.
Down Syndrome Education International is a UK registered charity, number 1062823.
http://www.down-syndrome.org/practice/171/
9/9
Memory Activities
May Enhance Learning
By Dana Halle, Newport Beach, CA
Parents and teachers often hear
that children with Down syndrome
(DS) are visual learners who find
learning from listening alone
difficult. Information presented
visually is easier to understand
and remember than information
presented solely in verbal form.
Why? Research suggests working
memory may play a role.1
Working Memory Model
Central
Executive
Visuospatial
short-term
memory
Verbal
short-term
memory
What Is Working Memory?
Working memory describes the
mind’s “mental workspace” or the
system responsible for temporary
storage and manipulation of visual
and verbal information. The
working memory system is based
on a model that identifies three
interlinked components: central
executive, verbal short-term
memory and visuo-spatial shortterm memory. The central executive
directs attention and is involved in
higher-level mental activities that
require coordinating storage and
processing, such as mental math.
The two other components
temporarily store different types
of information. Verbal short-term
memory stores information you hear
or that can be expressed in spoken
language, such as words and
numbers. And visuo-spatial shortterm memory stores information
36 •
d o w n s y nd r o m e n e w s
•
you see, such as shapes, colors or
the location of objects in space.2
Why Should We Care?
Working memory is important for
a wide range of skills, including,
organizing, concentrating and
problem-solving. For young children,
working memory is involved in
speech and language development
and following directions. In
elementary school, working memory
impacts reading comprehension,
the ability to listen to a teacher and
stay on task, mental arithmetic
and writing. In junior high and high
school, working memory directs
attention for finishing projects,
prioritizing activities and handling
conflicts.3
It is well accepted among
researchers that short-term and
V OL U ME 3 5 , # 3
working memory function is
impaired in children with DS. It is
also known that visual short-term
memory skills tend to be less
affected than verbal (or auditory)
short-term memory skills.4 Hence,
the traditional intervention has been
to focus on teaching with visual
support and to minimize strategies
that rely solely on auditory input
(i.e., show it, don’t just say it). But is
there more we can do? Researchers
at Down Syndrome Education
International suggest the following
activities and interventions to
support improved memory function
and enhanced learning.5
What Can We Do?
•Get routine hearing tests.
Make sure your child can hear.
If she has a hearing loss, consult
your doctor about medical
options (such as using ear tubes
or hearing aids) and non-medical
options (reducing background
noise, speaking clearly and
enunciating consonants). If she
has a hearing loss, she will not
be able to establish clear
representations for spoken words
or discriminate consonant sounds.
Hearing loss may impact her
speech, language and memory.
•Engage in literacy activities.
Research shows that children who
engage in reading instruction
have better verbal and visual
short-term memory spans. Create
a language-rich and languagedemanding home with plenty of
opportunities to practice reading,
phonics, spelling and writing.
Read aloud to your child and
have him read aloud to you.
Have him practice reading
grammatically correct sentences
to help memory for longer
sequences of information and
to improve speech production
and clarity.
•Play games to improve
phonemic awareness and
sound discrimination.
So your child knows the
difference between rhyming or
similar sounding words, plan
activities to help her develop
letter sound knowledge and
discrimination skills. Developing
these listening skills helps her
with reading, writing and
memory. For younger children,
you might play the “sound-word”
game, in which you move through
the alphabet saying each letter
sound and a word that starts with
that letter (e.g., “a-acorn, buhbear,” etc.). Your child may also
have fun playing a “show me”
game, in which you display two or
more rhyming objects and ask her
to “show you” one object (e.g.,
dog and frog are showing, say
“show me the frog.”). For older
students, games can be more
challenging. “I Spy” games in
him choose between food items,
clothing, books and games. Start
with a choice between two items
(“Would you like crackers or an
apple?”) and move to choices
between more items (“What game
would you like to play?”).
which you spy objects that start
with a chosen letter sound or
rhyme with chosen word can be
fun (e.g., “I spy something that
rhymes with floor.” The answer
might be “door.”).
•Use games to improve
attention and increase
processing capacity.
Give your child activities that
require him to pay attention
and process information. Playing
board games, coloring or
•Practice remembering
activities. Help your child build
memory with remembering
activities. Younger children can
play games in which objects are
hidden or removed. In a “Where
Halle and her son, Nick,
work on a visual picture sequence.
painting, using Play-Doh and
even reading a book together all
require focused attention. If he
has trouble paying attention, start
with short, high interest activities.
Move to longer activities as his
attention span increases. Also,
give him opportunities to make
choices. Holding information in
mind while making a decision
builds processing capacity, so let
V OL U ME 3 5 , # 3
did it go?” game, you show her
one to three items, then hide the
item(s) under a cloth or cup and
ask her to find it/them. In a
“What’s missing?” game, you
show her a group of objects, she
closes her eyes, and then you
remove one object. She must
identify what is missing. In
addition, children of all ages
continued on page 38
•
d o w n s y nd r o m e n e w s
• 37
Memory Activities
May Enhance Learning
continued from page 37
can play memory pair or
concentration games. Simply
vary the number of pairs to
match a child’s age and ability.
•Conduct rehearsal training.
Rehearsal training refers to a
wide range of activities designed
to teach children to remember
information in the order
presented. For example, if a child
sees pictures of a bird and a hat,
he works on rehearsal training
when he is asked to say the name
of the pictures in the order
shown — first bird and then hat.
Rehearsal training can be
conducted with information
presented visually or verbally.
For younger learners, start with
To read more about
memory development or
for additional ideas for
working with your child
at any age, visit Down
Syndrome Education
International at
www.down-syndrome.
org. DSEI is in the
process of developing
materials for See and
Learn Memory,
expected to launch in
late 2012.
38 •
d o w n s y nd r o m e n e w s
•
visual picture cards. Show two
picture cards and say or have
him say aloud the name of the
item depicted. Then, turn the
cards over and ask him to recall
the pictures in the correct order).
As children become more
comfortable and confident
with tasks, you can move to
information presented verbally.
Since information presented
verbally will be more difficult to
recall, be patient. Start with
recall of only two or three words
or numbers.
Many of these activities can be
created from items and objects you
already have in your home.
However, commercially available
products are also available to
support development of many of
these skills.6 For more information
on memory activities, contact Down
Syndrome Foundation of Orange
County at [email protected].
Wrapping It Up
Educational interventions follow
research. As researchers learn more
about short-term and working
memory function in children with
DS, we can create appropriate
supportive interventions. Hopefully,
these targeted activities will help
improve memory function and result
in improved academic outcomes.
Try some of the ideas and activities
outlined above and let us know if
you see improvements.
V OL U ME 3 5 , # 3
Editor’s note: Dana Halle, J.D., is the
parent of 13-year-old Nick, who has DS;
executive director of Down Syndrome
Foundation of Orange County; and
developer of The Learning Program™,
a nationally-recognized program that delivers
evidence-based educational support to
children, parents and teachers. Halle also is
vice-president of Down Syndrome
Education USA, a U.S. non-profit affiliated
with Down Syndrome Education
International, a recognized world leader in
scientific research into early intervention,
education and cognitive development for
children with DS. At the NDSC Convention
in Washington, D.C., Halle will present a
preconference session and five workshops,
including one on working memory.
ENDNOTes
1 B
uckley, Sue and Bird, Gillian,
Memory Development for Individuals
with Down Syndrome (Down
Syndrome Education Intl. 2001).
Free download at http://www.downsyndrome.org/information/memory/
overview/.
2 G
athercole, S. E., and Tracy Packiam
Alloway, Working Memory &
Learning: A Practical Guide for
Teachers (London: Sage. 2009).
3 www.cogmed.com
4 J arrold, C, Nadel L. and Vicari, S,
Memory and Neuropsychology in
Down syndrome (Down Syndrome
Research and Practice. 2008).
5 B
uckley, Sue and Bird, Gillian,
Memory Development for Individuals
with Down Syndrome.
6 If you use an iPad, iPod Touch,
iPhone or tablet with your child,
there are many applications to help
build memory skills. Additionally,
sound discrimination games, picture
flash cards and other helpful tools
are often available at Target and
local teacher supply stores.