Down syndrome is a chromosomal disorder. People with this syndrome have an extra copy of Chromosome 21. The additional genetic material on the third chromosome causes several developmental and physical changes that characterize Down syndrome.

Down syndrome is NOT a disease. Therefore it has no cure. Currently, there is no surgery, medicine, or treatment that can manage or cure the condition.

Down syndrome presents a wide range of health issues, developmental and intellectual challenges, and medical conditions that require long-term therapy and management. People who have Down syndrome typically face multiple health problems throughout life, which demand regular monitoring, testing, and treatment.

Nonetheless, children with Down syndrome require some extra attention and care. They begin talking much later than typically developing children and exhibit a limited vocabulary of spoken language. Speech and language delay is a common trait of children with Down syndrome.

Early interventions with speech therapy and feeding therapy can help children with DS expand their vocabulary and widen their repertoire of language. Most importantly, SLPs (speech language pathologists) can chalk up therapy plans that address your child’s unique speech and language issues.

Speech therapists can work with children with down syndrome to build on their existing communication skills.

What Are The Focus Areas of Effective Speech Therapy For Children with Down Syndrome?

Speech therapy interventions for children with Down syndrome are typically based on research on their unique process of speech and language development.

Speech-language pathologists (SLP) focus on several areas of speech and language including –

• The improvement of oral motor skills
• The development of emerging language skills
• The improvement and development of speech sounds
• The use of alternative and augmentative communication (AAC) methods
• Expanding their vocabulary
• Addressing the more complex speech disorders

The choice of intervention methods depends upon the needs and abilities of the individual. During speech therapy, the therapist will utilize the individual's strengths, such as using non-verbal communications, to power their therapy.

There is no hard-set protocol for the speech therapy of a child with Down syndrome. Speech therapists need to alter these programs and accommodate the needs and skills of each child.  Since communication is vital for the mental and social development of children, the speech therapy program must meet all the communication needs of a child with DS.

Speech therapists should work with a team of pediatricians, ENTs, speech-language pathologists, and special educators. Most importantly, parents of the child should be an integral part of this team.

How Can Speech Therapy Help 1-Year Old Children with Down syndrome?

When a child is between 0 to 12-months old, the diagnosis and treatment of Down syndrome can be challenging. If you have received confirmed reports from your pediatrician or geneticist that your child has Down syndrome, then you may begin therapy at home with assistance from a licensed speech-language pathologist.

Here’s how parents of a child with Down syndrome can help with speech therapy during the first year of their life –

Foster a good and safe communication environment at home. Use both spoken and sign language to encourage communication.

• Take training to support their oral-motor development through feeding activities. Children with Down syndrome may require additional support during feeding activities due to the atypical structure of their articulators.
• Encourage all forms of communication such as eye contact, pointing, and other forms of gesturing.
• Encourage auditory discrimination of speech/word sounds to aid and improve the auditory discrimination process in the developing child.
• Target the use of signs and gestures as the primary mode of communication

How Can Speech Therapy Aid 2-Year Olds with Down syndrome?

Children between the ages of 12-months and 24-months need close attention since they acquire language rapidly. Maintaining a healthy and supportive communication environment at home is imperative. However, there are a few additional areas that require the attention of parents and SLPs.

• Support and encourage the hearing and production of speech sounds in children with Down syndrome. You should keep a record of the speech sound babble.
• You can teach comprehension to kids with Down syndrome using interactive games, objects, photos, and actions. You can rely on smartphone apps to aid the comprehension of your developing child.
• The SLP can help you teach your child two and three-word sentence constructions through gameplay. Children with Down syndrome typically have a penchant for imitation, which can aid spoken communication through the emulation of your actions.

At this age, an SLP may be able to assess if a child with Down syndrome has tendencies of autism spectrum disorder (ASD). Around 3-5% of all children with Down syndrome also have signs of ASD. They may require special therapy sessions that address communication skills for ASD.

How Can Speech Therapy Help 3 To 5-Year Old Children with Down syndrome?

Apart from maintaining a supportive and encouraging communication environment at home, parents should ensure that they are following their child’s speech and language development closely. Working with an SLP is mandatory for the proper development of communication of a child with Down syndrome.

• Children between the ages of 3 and 5-years require special attention on developing grammar, syntax, and vocabulary.
• Practice reading to your child at least 15-minutes per day. It may help in the development of cognition as well as the language skills of the child. Speak to your SLP so that you can help your child understand what you are reading.
• Your SLP will help you with exercises if your child is also on the autism spectrum.
• You should keep an updated record of your child’s vocabulary use and comprehension.

Research shows that children with Down syndrome require the help of special educators and speech therapists. However, enrolling them in mainstream schools is one of the most effective interventions for enhancing language and working memory.

Additional studies show that part of the grammar delay seen in school-aged children with Down syndrome happens due to a delay in developing vocabulary. Mastering grammar has a profound effect on the phonological development of children. Therefore, focusing on their education and working on expanding their vocabulary may augment their language and phonological skills significantly by the time they are at least 6-years old.

How Does Speech Therapy Help 5 To 11-Year Old Children with Down syndrome?

Children between the ages of 5 and 11-years require the active intervention of an SLP along with support from their families. Therapy for children with Down syndrome in this case should consist of a plan that targets all four areas– speech, grammar, vocabulary, and communication skills.

• Encourage a healthy communication environment at home and in school.
• Parents, teachers, special educators, and therapists should have common targets.
• The SLP may separate the various target areas of speech, such as articulation, phonology, and intelligibility.
• Parents and SLPs should talk to their teachers to include language targets in their daily lessons.
• Separate targets may be set for comprehension and production of language at home and in school.
• Persistent encouragement of the discrimination of speech sounds to improve comprehension of spoken language.

Several children with Down syndrome require weekly therapy sessions that focus on speech and language acquisition. All children with Down syndrome, between the ages of 5 and 11 years, require evaluation at least once a month. It should help address their unique challenges in the fields of speech, vocabulary, and intelligibility. The SLP should evaluate the target jointly with the parents and teachers.

Why Is Speech Therapy Necessary for Individuals with Down syndrome Irrespective Of Their Age?

Speech therapy can contribute significantly to the speech and language skills of children, adolescents and adults with Down syndrome. However, the improvement is more noticeable when the speech therapy interventions are introduced early in the lives of the individuals.

Therapy protocol should consider the individual's vocabulary, grammar, speech, and communication skills at each stage of development. The protocol should evolve as the child acquires new sets of skills.

Most importantly, parents should be an integral part of every speech therapy plan for children with Down syndrome. Parents will learn new skills such as asking open-ended questions, gradually increasing the quality and quantity of communication at home, providing multi-sensory input to the child, and understanding the pace of the child.