Speech and language is a particular area of difficulty for children with Down syndrome. High incidences of hearing loss combined with auditory processing and memory difficulties and oral-motor issues mean that language development interventions should begin at an early age for children with Down syndrome, and continue through to adulthood.

Strategies for language development in children with Down syndrome

    • A lot of children with Down syndrome can have hearing difficulties, including ‘glue ear’. Hearing should be checked and monitored frequently. If they meet the criteria, they should be enrolled on the Visiting Teacher for the Hearing Impaired scheme
    • To reduce the effects of any hearing loss, children with Down syndrome should be placed near the front of the class and background noise kept to a minimum.
    • If the child with Down syndrome is not responding to verbal directions, try to work out (a) can they hear you clearly, (b) can they understand you properly, or (c) are they simply not attending to you.
    • Speak clearly and directly to the child, maintaining eye contact and use visual cues such as pictures, signs or gestures to support speech
    • To gain their attention, use the child’s name before giving them an instruction or asking them a question, or move to stand in close proximity to them.
    • New vocabulary should be written on the board as it is being explained and used.
    • Any verbal input should be supported with visuals (key words, symbols or drawings)
    • To improve articulation and phonology, consult a speech and language therapist about activities that can be incorporated into the child’s learning programme.
    • Keep records of the child’s expressive and comprehension abilities. Observe them and write down the gestures, signs and words that they already use. Ask the parents to do the same at home and compare the two lists. Checklists for oral vocabulary are available on the Down Syndrome Education International website (
    • Listen and respond to all of the child’s communications. Create daily opportunities for them to make choices, relate their news and express their opinion.
    • Children with Down syndrome can take longer to process language and formulate their responses. Give them time to organise their thoughts and find the words they want to use. Count to 10 before jumping in.
    • Use styles of conversation that will encourage them to expand on and develop their verbal contribution. Try to avoid closed questions that require only a one word answer.
    • While it is important to speak clearly and avoid long, over-complicated sentences, don’t be tempted to over-simplify your language, or speak in a broken-English style, using keywords only. Use short and clear, but complete, sentences.
    • Back up words with gestures e.g. finger to lips and “Shhh” instead of “Stop talking and get on with your work”. Use signs and reading activities to support all speech work.
    • Repeat individually any instructions given to the class as a whole. Check the child has understood by asking them to repeat back what you have said.
    • Give the child with Down syndrome opportunities to practice their language in situations that are meaningful for them. Wherever possible, encourage them to take the lead e.g. giving instructions to their peers as teacher’s helper.
    • Using signs and gestures (Lámh, Makaton, etc.) can help children to communicate while they are still learning how to speak. Talking when using signs will ensure that speech continues to develop.
    • Similarly, visual aids such as PECS cards can help communication and ease frustration in young children with speech and language difficulties. Use the visual aids as a bridge to speech instead of an alternative, by always speaking when using them, and encouraging the child to do so also.
    • Print can be used to support oral language development from an early age, as many children with Down syndrome find remembering written words easier than spoken words. Teaching reading can improve oral language skills.

(Adapted from Down’s Syndrome Association UK and Down Syndrome Educational Trust)

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