Thursday, October 25, 2012

Speech and Language, Part 2: Strategies for Early Intervention (31 for 21, Day 25)

According to all the experts, early intervention with Down syndrome is the key, especially in regards to speech and language development.  This can seem a bit daunting, however with the aid of an early intervention team, you can create the best environment possible in which your child can learn.

The following information is taken from Buckley and Le Prèvost's article Speech and Language therapy for children with Down syndrome (2002).  So far, it is the best one-stop source of information regarding early interventions with speech therapy that I have found. Listed by age group, it outlines the goal centered approach that is often used.

Preschool

Knowledgeable therapists who are up to date with the latest research materials are important to this age group.  As kids with DS tend to have issues with hearing, speech and memory issues it is important to focus on auditory discrimination, oral-motor skills, speech and language work. In the first year, home visits should occur at least monthly. if not more frequently.  When the child is over a year old, other methods can be employed, including groups sessions. Groups are particularly helpful as children tend to mimic each other.

Goals for the first year
  • Create an environment that encourages communication, including understanding how speech and language develops and the specific needs of the child
  • Provide support for feeding, including oral-motor activities
  • Encourage various communication skills:  eye contact, turn taking, pointing, joint-referencing
  • Improve auditory discrimination by targeting speech sounds, including those in the phonological loop and babbling.
  • Encourage signs and gesturing to augment comprehension

Two Years of Age

  • Continue to foster an optimum environment for communication
  • Keep a record of speech sounds as work is continued to support hearing and speech sounds.
  • Teach word comprehension through play:  games, objects, pictures and actions.  Keep a record of words spoken/signed
  • Encourage constructions of two or three words through play and imitation
  • Address any other issues (due to high incidence of ASD)

Three to five years of Age

  • Continue to foster an optimum environment for communication
  • Continue to target hearing/speech production; keep a record of speech sound and progress
  • Teach vocabulary, grammar and syntax using play and visual aids such as books.
  • Keep a record of vocabulary and comprehension.  
  • Continue to address any other issues (such as ASD)

Primary School

It is ideal if children receive speech and language therapy in school.  Although individual children will vary greatly in skills, all will understand much more than they can produce.  As with the younger ages, therapists working with children with Down syndrome between 5 to 11 years of age should be knowledgeable re: current research, development, working memory, etc.  For this age group, they should also understand how reading supports the development of vocabulary, grammar, and clarity of speech, as well as the importance of auditory discrimination for speech sounds, phonics and working memory.

Goals

  • Focus on speech, vocabulary, grammar and communication.  Keep detailed notes of progress
  • Separate comprehension and production goals for vocabulary and grammar
  • Goals for speech, such as articulation, phonology and intelligibility
  • Assist teachers:  with incorporating speech/language goals into lesson plans and encouraging use of visual aids/reading to assist with language
  • Assess oral-motor skills, such as feeding, chewing and drinking.
  • Review goals with parents and teachers
  • Continue to foster an optimum environment for communication, ensure all (including teachers) understand needs of child, goals set and why.
  • Continue to address any other issues (such as ASD)

Methods for Goal Implementation

  • Seen and assessed monthly at school.  All involved (teachers, parents, assistants) should have activities to include daily
  • Activities to be created by speech/language therapist
  • Additional weekly or monthly sessions with speech/language therapist to assess progress and change approach if necessary

Secondary School

Therapy should continue with this age group;  however age-appropriate modifications should be made to activities.  Skill level will vary, however comprehension will still outweigh the ability to express one's self.  Continue reinforcing that reading supports the development of vocabulary, grammar, and clarity of speech, as well as the importance of auditory discrimination for speech sounds, phonics and working memory.  Social skills, such as conversation may need to be addressed further.

Goals

  • Focus on speech, vocabulary, grammar and communication.  Keep detailed notes of progress
  • Separate comprehension and production goals for vocabulary and grammar
  • Goals for speech, such as articulation, phonology and intelligibility
  • Assist teachers:  with incorporating speech/language goals into lesson plans and encouraging use of visual aids/reading to assist with language
  • Assess oral-motor skills, such as feeding, chewing and drinking.
  • Review goals with parents, teachers and teenager
  • Continue to foster an optimum environment for communication, ensure all (including teachers and teenager) understand needs of child, goals set and why.
  • Continue to address any other issues (such as ASD)

 Methods for Goal Implementation

  • Seen and assessed monthly at school.  All involved (teachers, parents, assistants) should have activities to include daily
  • Activities to be created by speech/language therapist
  • Additional weekly or monthly sessions with speech/language therapist to assess progress and change approach if necessary

 Adulthood
Studies have shown that therapy can continue to improve speech and language skills well into adulthood.  However, more resources are needed for this age range as they are generally not readily available



Buckley SJ, Le Prèvost P. Speech and language therapy for children with Down syndrome. Down Syndrome News and Update. 2002;2(2);70-76.

No comments :

Post a Comment

Thank you for your comment.

Although discussion is encouraged, disrespectful or hurtful dialogue will be removed.

Spam will be fried up with a side of tomatoes.

Related Posts Plugin for WordPress, Blogger...