Working with Children with Down Syndrome
I recently received an email from a speech pathology graduate student inquiring about strategies I could recommend regarding how to stimulate speech and language with a child with Down syndrome. Reading her email reminded me that I have not yet written a post about children diagnosed with Down syndrome, despite the fact that this population of children is often a significant portion of my EI caseload.
One of the first thoughts I had regarding my experience in working with children with Down syndrome is that although they share the same primary diagnosis, their personalities, characteristics, strengths and weaknesses are all different and vary between individuals and families.
For example, I currently have three little ones on my caseload with Down syndrome and each of them of course requires their own individualized therapeutic plan. Two of the children are turning 3 within the next two months. One of them has incredible verbal skills, yet just started walking within the past 6 months, while the other walked by around 18 months and yet continues to struggle significantly to communicate. This little one also has several older siblings and has wonderful role models to help her along. The third child is similar to the latter. She will be three in December and only has about 10 words/signs that she uses independently; however their home is much quieter and there is less reinforcement for speech and language.
Below is the email I received from our graduate student reader, which I would like to share with the public with the intent of prompting a variety of helpful responses:
"I currently am a grad student in Buffalo, NY for Speech Path and am working with a 2 1/2 year old with Down syndrome. So far, I've done a lot of play therapy with her, but those skills are pretty well developed. I am having trouble thinking of more structured activities that will meet her goals that are also age appropriate. I want to include books in every session also. We are working on artic sounds (b,m,h,s,d, and wh), as well as following directions involving actions, labeling pictures/objects/actions, and using two combined signs to request, label, or comment. If you have any great ideas, or books that you've found kids her age just LOVE, I'll take any advice!"
My response: Some initial suggestions I have are to use a complete oral motor plan (if that is not happening already), as well as a picture communication system to help her become more independent in her daily routine. Also, I use a speech book with the one very verbal child I work with and it has proven to be very successful. We use the book to work on both speech (artic sounds) and language ("I want _____"). This also gives the family something concrete to practice throughout the week. Next, make sure to include the family in your plan. Ask them where she is struggling right now and figure out how you can address these areas to help make your work more functional.
Please write in and share your suggestions as well as any other helpful information regarding working with young children diagnosed with Down syndrome.