360 degrees of Speech and Language - Alison Mann The Voice 360 degrees of Speech and Language - Alison Mann

I was doing some preparation for an activity the other day and looking at news articles for research. I came across an article about a young girl with Down Syndrome (DS) who was in the news because she had recently starred in an advertising campaign for Matalan children’s clothes. Have a look at the beautiful Lily Beddall and check her out here

It got me thinking about Down syndrome.  I have a close friend with a child with DS and she posted a photo of him on facebook recently along with the caption “celebrating differences”.  Then I realised that it is Down syndrome awareness week from 20th – 26th March 2017. All around the world people will be trying to raise awareness of the condition and indeed celebrating differences. The theme for this year is My Voice, My Community.

So, in the spirit of that, let me share with you some things you may or may not know about Down syndrome from a communication perspective.  Did you know that people with DS have a particular communication profile?  

All people with Down syndrome experience some delay in their development, however, they are not equally delayed in all areas, but have a specific pattern of cognitive and learning difficulties” (Prof. Sue Buckley, Down Syndrome Education International).  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, and 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.


Research and clinical experience demonstrate that some areas of language are generally more difficult for children with Down syndrome while other areas are relatively easier.

  • Their receptive language is usually superior to their expressive language skills. Most children with Down syndrome are able to understand much, much more than they can express. As a result, their test scores for receptive language are higher than for expressive language. This is known as the receptive-expressive gap.

  • In language, 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’. 

  • Children with Down syndrome have strengths in the area of vocabulary and pragmatics (social interactive language). They often develop a rich and varied vocabulary as they mature.

  • When we are learning language we generally see an object and hear a sound string and then we match the two together and store it (and its meaning) in our brains.  For example, we hold up an object, let’s say a big red ball and then say to the child in a squeaky, friendly voice “ball”.  The child then matches the two things together, red, shiny object and sounds b, a, l, l and attributes meaning to it.  We’ve all done this many times with little kids and we kind of take it for granted. This process is dependent on the ability to hear sounds, remember them temporarily and then link together to form meaning.  We refer to this as the phonological loop.  For all children, the phonological loop is thought to play a critical role in learning a spoken language, but we know that children with Down syndrome often have poor auditory short-term memory and auditory processing can be an area of weakness too. So, the ability to remember the sound they’ve heard and process it is not an area of strength and it can therefore be difficult for them to acquire expressive language.

  • However, while auditory short- term memory and auditory processing can be areas of weakness, children with Down syndrome often have excellent visual memory. Seeing words and images associated with sounds can help speech and language develop.  So, when they are learning language it is vitally important that there is a strong visual element to it. Offering pictures, signs and symbols at the same time as you say a word can help them learn. Reading and the use of computer programs focusing on language skills can be very beneficial to helping them learn. Tracing their fingers around written letters/words when you introduce them to a new word can be really beneficial.

  • This is why children with Down syndrome are often excellent readers.

  • Because of this visual strength, abstract concepts such as grammar, verb tenses, word roots, suffixes and prefixes are more difficult areas. Children with Down syndrome frequently have difficulty with grammar, tenses and word endings and use shorter sentences to communicate.

  • They have good social interactive skills and use gestures and facial expressions effectively to help themselves communicate. They generally have the desire to communicate and interact with people.

  • One of the areas of communication difficulty that most people are familiar with in people with DS is speech intelligibility. This is often one of the most difficult areas for people with Down syndrome at all ages. Speech is highly complex. It involves coordinating breathing (respiration), voice (phonation), and the production of speech sounds (articulation). 

  • Factors that can contribute to speech intelligibility problems include: a small oral cavity, articulation problems with specific sounds, low oral-facial muscle tone, difficulty with sensory processing and oral tactile feedback and difficulties in motor planning for speech.

Despite these challenges many children with DS go on to develop effective communication skills.  This is often as a result of a lot of work from the person themselves and the support of their families and others.  My question is this, having developed these skills……..do we listen?  

The DS awareness campaign for this year is themed around #ListenToMe and states that   “All of these people have something to say.  They want to be heard.  Their opinions count”. 

So, if you get a moment over the next week, listen to what they have to say. It’s taken a lot for them to be able to have a voice, the least we can do is hear them.

There are some lovely videos on the website, which are really inspirational: https://www.downs-syndrome.org.uk/about/campaigns/awareness-week-2017/


Written by Alison Mann on behalf of Integrated Treatment Services