Pre school

Lots of communication happens before your child learns to talk, and children who have Down syndrome are very individual in how they develop. Don’t despair if your child is taking a while to start talking or signing to you, just keep giving plenty of opportunities to interact, remembering to observe, wait and listen to your child’s attempts to communicate.

Start by focusing on turn taking, eye gaze, making sounds and joint attention.

These sound complex, but just like any other child, your child who has Down syndrome needs you to smile and wait for a smile back; to copy any sounds they make, and wait for the next sound.

Stop and make time for ‘face to face’ interaction, as this is important. Your child needs to learn to look and pay special attention to faces. You need to allow a bit of extra time, and extra repetition, so see if you can build it into your daily routines. Use songs and nursery rhymes, like ’round and round the garden’ or ‘this little piggy went to market’. Pause at a critical time and see if your child will make a noise or movement to ask you to carry on. (Remember to give plenty of time for this to happen.)

Practice taking turns using games that don’t involve talking, like rolling a ball or a car, clapping hands, etc.

The singing in this video is a bit fast, but shows a child having fun, and understanding much more than he can say!

It may take your child a bit longer to respond, so don’t give up if you don’t get a response straight away. Remember that babies who have Down syndrome will need more opportunities to learn and practice new skills.

Sometimes babies who have Down syndrome are long-sighted and therefore have difficulty focusing and making sense of things that are very close to them. Try holding toys a little further away and see if it helps.

Be alert to hearing issues. All newborn babies in Ireland should have a hearing test, but if your child is not responding to sounds, he or she may be having difficulty hearing, and need to be checked again.

Receptive language

Receptive language is the term that speech and language therapists use for the words, signs and gestures your child understands.

Babies who have Down syndrome can find it difficult to learn from sounds alone, so signs, gestures and facial expression can be a big help.

Early vocabulary is based around everyday things, people and events. Your child needs to learn to anticipate events, so make consistent signs and words before and during regular daily events (meals, nappy changes, trips in the car) so your child starts to associate the word and sign with the meaning. Children who have Down syndrome may find it difficult to pick up new words from general conversation and will need more repetition and direct teaching of new vocabulary.

At this stage, children will usually understand many more words and signs than they can produce, and it might be helpful to keep a record. (The Downsed vocabulary checklists are useful for this.)

Make sure that your child is learning action words as well as names of people and things. This video is a bit fast, but shows that he can understand much more than you would guess from his sounds.

Be alert to hearing and vision issues, and seek advice if you are concerned with your baby’s ability to notice sounds or faces.

Literacy

Children who have Down syndrome often benefit from early exposure to written words as it can be hard to learn just by listening.

The best way to start is by making little picture books of your child’s favourite people, places, toys, etc. These should just have one word and one picture to a page (for example, ball, cup, dog) and should be only 4 to 5 pages long initially. It’s better to have lots of small, topic-based books than one big book. The print should be large and the picture clear and colourful.

When you are reading these books, point out the word and read it (e.g. ball), but then talk to your child about the ball (That’s your ball. You like playing ball. Shall we find the ball?) leaving them space to take their turn in the conversation.

Try to build up a small collection of these (my toys, my family, my places, my friends, my food, etc). It’s important that these are objects and people that are relevant for your child.

Take a couple of minutes to sit down with your child most days to look at a book. Start with a simple book you have made, then move on to favourite picture books or nursery rhymes.

The see and learn programme called First Written Words is useful for children at the preschool stage.

Here you can see a child linking written words and their meaning using signs:

Expressive language

Expressive language is a term that speech and language therapists use to describe the words, signs and gestures that your child uses to communicate with you.

Babies communicate from birth. You’re communicating with, and learning from your baby from the very beginning. Initially the communication is reflexive, like crying when uncomfortable. This gradually develops into intentional communication, where your baby is making sounds and movements to try to tell you something.

You can help your baby to develop intentional communication by responding consistently to the sounds and movements they make and by adding language. We do this naturally with babies. When they cry, we talk to them as if they are deliberately trying to tell us they are hungry or need a nappy change. This kind of response helps all babies to learn. For your toddler who has Down syndrome, allowing extra time, and adding in facial expression, gesture or sign (as well as talking) will help. In time, your child will start to make consistent sounds or signs to try to tell you something, and these gradually develop into words and signs. Giving your child choices will encourage communication, so start by holding out a ball and a book, and ask which one they would like to play with. Initially, they may communicate by just reaching for the desired toy, but in time this will develop into pointing, signing and attempting the word.

Speech sounds

Babies make sounds. Early sounds are reflexive, like crying when uncomfortable. As your baby gets bigger, copying their sounds and facial expressions is the beginning of two way communication. Encourage all sounds, but particularly encourage and respond to speech-like sounds. Vary your voice to make it interesting to listen. Play with sounds. Moo like a cow, meow like a cat, woof like a dog. Early babbling and sound play is an important stage in learning to make sounds on purpose.

It may be harder for your child who has Down syndrome to copy sounds or make sounds. It can be difficult to coordinate movement and breath. It’s easy to forget to keep talking when your child doesn’t seem to be responding. The rate at which children develop speech sounds is extremely variable. Don’t be discouraged if your child spends a long time watching and listening.

Repeating the same sounds and stories, using nursery rhymes or songs and adding in the written word will all help your child to start using sounds consistently and with meaning.

Some toddlers may benefit from focused work on speech from an early age. See and Learn speech is a programme specifically developed for children with Down syndrome which targets early speech sound development.

Reading and talking often go hand in hand for children who have Down syndrome, so See and Learn First Written Words may also be useful.

Talk to your therapist about which might be helpful for your child.

Memory

As babies become toddlers, they gradually learn that things continue to exist even when you can’t see them (this is a concept that psychologists call ‘object permanence’). This is a big step in understanding the world!

Verbal memory is an area of difficulty for many children who have Down syndrome, which is why it can be difficult for them to learn speech and language. Lots and lots of repetition provides opportunities to learn, saying similar things each time, and making sure that your child is looking at the things you are talking about, so that they begin to make the link between the word and the meaning.

Visual memory is often a relative strength, and children who have Down syndrome may enjoy visual memory games. This is also why signing can be so useful in helping to develop language. Speech sounds are present for a very short time (fractions of a second), while signs can be held for as long as the child needs. Their relatively good visual memory is the reason we introduce written words early to children with Down syndrome.

Encourage the development of visual memory by keeping favourite things in the same place each time, and letting your child help to find them. As your child becomes interested in print, label things around the house and draw attention to the words.

Memory does improve with practice and familiarity. It’s easier to remember words that we use every day. It’s also easier to remember things we have seen and experienced rather than things we have just heard about. This means that repetition and learning through seeing and doing will be very important for your child.

Your child won’t remember things they didn’t see or hear properly in the first place, so be alert to hearing and vision issues, and seek advice if you are concerned.

Pragmatics

Pragmatics is about how we use our language every day to communicate. We use language to connect with other people, to get something we need, to express like or dislike, to let people know we want something (or don’t!). We use language to get information, to draw attention to something, or to think out loud.

Your child may use sounds or gestures accidentally at first, but these will form the basis of intentional communication. Noticing and responding to these early sounds and gestures will help your child’s communication skills to develop.

As children begin to interact with the wider world, maybe going to toddler groups or preschool, it’s important to support communication in settings outside the family.

If your child primarily uses signs to communicate, it’s important that the preschool staff and other children understand at least a few key signs. The best way for your child’s teachers to learn signs is face to face in a Lámh signing course, but there are also resources such as Lámh a Song DVD and the Lámh Time App which will be fun for other children, as well as your child.

Total communication

Total communication is about using and accepting all methods of communicating, not just speech.

We can communicate using body language, facial expression, sign, gesture, sounds, words, pictures and objects.

A total-communication approach encourages you to value all the ways your child can get a message across. Sometimes parents think that signing may reduce the child’s need to speak. Actually, the reverse is true. People who can successfully get their message understood are more likely to keep communicating.

In this video, a four-year signs while singing Twinkle Twinkle Little Star:

Don’t forget to watch, wait and listen for your child to communicate. It’s also important to offer choices. These encourage meaningful communication about things that matter to your child.

We recommend that parents start introducing one or two Lámh signs from the time the child is around six months old and continue using signs to support new words and concepts throughout the preschool stage (and longer if needed). Ask if there’s a Family Lámh course running near you.