Assistive Technology for Young Children With Down Syndrome
General Information On Down syndrome
"Down syndrome is one of the most common genetic syndromes, occurring in one of 800 to 1,000 live births...Because Down syndrome is so common, nearly every family physician provides medical care to at least one family with an affected child. The care of the infant or young child with Down syndrome can be complicated and may involve a myriad of immediate and long-term medical problems and pyschosocial issues." -American Family Physician
"Students with Down syndrome have delays with cognitive ability. Their brains have a delayed reaction when their neurological system sends a message to complete a task. This causes them to take longer to complete a task than their non-disabled classmates. But since federal legislation requires students with learning disabilities to be educated in the same manner (and often the same classrooms) as other children, there has been a need for modifications and tools to assist special needs students in meeting their educational goals...Assistive technology for Down syndrome is a new method that has been developed specifically to help special needs children in the classroom. It includes any type of equipment or materials that will enhance the child's learning and make the tasks easier to complete, from scissors with a spring to a shortened pencil or enlarged graphics."- Concordia University
Infants with Down syndrome
Breast feeding can pose many problems for both mother and baby. "Sucking problems related to hypotonia or cardiac defects may make breast feeding initially difficult, particularly in the premature infant. In this situation, the mother can be encouraged to feed the infant expressed milk by other means, such as a nursing supplementer or a bottle, or, occasionally, by gavage (forced feeding, especially through a tube passed into the stomach). After several weeks, the infant's sucking ability often improves, and the infant becomes capable of nursing effectively. A nursing supplementer may be used to encourage the infant who has a week suck." -American Family Physician
Breast feeding is a very complex task for the body to accomplish. There are 26 muscles involved in feeding. Often times because individuals diagnosed with Down syndrome have weaker muscle development, breast feeding can pose particular challenges. Below are some examples and an informative article on breast feeding aids.
Gavage Feeding
Assistive Technology for Young Babies With Down Syndrome
In transition a baby with Down syndrome from breast/bottle to solids, there are many tools that can aid in this sometimes challenging process.
It is very important for the baby to sit up, and be positioned correctly when feeding/eating solids. This not only allows for proper muscle development/strengthening, but also encourages the baby to reach for food themselves. The chair below is an excellent option to encourage the child to sit up and the tray allows for him/her to practice reaching and grasping food.
When utensils are introduced to older babies, a wide variety of tools exist that aid in a child with Down syndrome gripping the utensil.
This website provides a tremendous amount assistive technology tools for children with different disabilities.
https://www.rehabmart.com/index-pediatrics.asp
It is very important for the baby to sit up, and be positioned correctly when feeding/eating solids. This not only allows for proper muscle development/strengthening, but also encourages the baby to reach for food themselves. The chair below is an excellent option to encourage the child to sit up and the tray allows for him/her to practice reaching and grasping food.
When utensils are introduced to older babies, a wide variety of tools exist that aid in a child with Down syndrome gripping the utensil.
This website provides a tremendous amount assistive technology tools for children with different disabilities.
https://www.rehabmart.com/index-pediatrics.asp
Communication in Young Children With Down Syndrome
Communication in any child is the ultimate gateway to understanding, connecting and aiding your child. Communication begins immediately for all children. Children with Down syndrome are encouraged early on to use signing (ASL) to aid in their communication.
Below is a video detailing the different stages of communication and specifically the stages seen within children with Down syndrome.
Below is a video detailing the different stages of communication and specifically the stages seen within children with Down syndrome.
Down Syndrome International further explains the importance of communication and the development of it in children with Down syndrome.
"What is Communication?
1.1. The importance of learning to talk Learning to talk is central to all other aspects of early childhood development. It is very important for social and emotional development and for the development of intellectual abilities. Being able to talk allows children to gain control over their social and emotional world.
1.2. Social interaction and the role played by speech and language
Because we are human beings, we have to communicate with each other in a social sense. The reason for communication is to exchange information between two or more human beings. Talking means children can ask for what they want, share experiences, understand what is about to happen and express themselves when they are hurt or upset. In order for communication to take place the participants must both speak the same language. In other words, talking helps children to relate to others.
Why do we need to communicate?
When a child cannot communicate a parent can feel isolated and even rejected by the child. This can lead to problems in the relationship between parent and child. We need to form relationships with other people. In order to do this we need to talk about our feelings, our thoughts and to talk about things, events and actions as well as understand other people. When we communicate, we can get people to do things, we can make them react to us. Being able to communicate in the preschool enables children to play together, to share and to learn together. Throughout life communication underpins the development of friendships, supporting one another and negotiating our way through the world – shopping, travelling and working.
2. How do we communicate?
We can do all of the above verbally i.e. talking, laughing, groaning, listening, or by using non-verbal communication i.e. making gestures, using body language, eye contact, or facial expressions, or written communication. Learning to talk is an everyday activity. Children will communicate because they want to. The human being is a social being above all else. All parents want their child to talk because most people around us talk. When we communicate this way, we have to learn to listen when someone else is talking and take turns to talk. Some children find this difficult. These children can be helped either by using a sign language e.g. The Makaton System, or use a communication board. Communicating through gestures leads to talking for many children.
3. How does the child develop language?
3.1 Key words What do the following words mean? Language: The ability to express oneself in an appropriate arrangement of words and sentences. Speech: the sounds we use when we express words or sentences Voice: the use of a voice that is pleasant to listen to and easy to understand. Fluency: the ability to speak without many repetitions or hesitations (pauses). People who can speak fluently need
• enough intelligence
• to be able to hear
• to be able to use the tongue, the lips, the mouth properly
3.2. Foundations of language
The child also needs to be able to imitate in order to use language and to be able to recognise objects. Before he can understand language, the child needs to be able to:
• be aware of speech these stages are what we call
• recognise speech auditory development. This has to
• tell the difference between sounds happen before a child can develop
• understand speech Receptive Language. Receptive language describes all the words, sounds, signs and body movements that a person understands.
N.B. The child’s understanding of language is always better than his expression or use of language i.e. his expressive language. Feeding is important for the development of expressive language because the same muscles that are used for feeding are used for speaking. The developmentally delayed child may have difficulty coordinating the movements of the lips, tongue and jaw that are needed for feeding. This means he will have difficulty in making speech sounds. The development of expressive speech follows these stages: maintenance of eye contact cooing and gurgling babbling imitating pointing first word telegraphic speech and sentences Communication is anything the child does to make his needs known. So if the child can understand language (has certain receptive language skills) but cannot express himself with speech, he may try communicating by doing the following:
• Asking/demanding by reaching
• Refusing/protesting by shaking his head
• Greeting by smiling and waving • Commenting by pointing/making gestures
• Questioning by pointing as well as making a sound This is communicating and we must respond to it.
4. How can we help the child to communicate?
It is very important to talk to the child all the time, even if the child does not talk back to you. Here is a list of things you can do to encourage the child to communicate. (Remember, communication should be fun and play time is the best time to teach language).
• Copy the sounds and gestures the child is making
• Expand on what the child says e.g. if the child says “Boy sit” you say, “The boy is sitting”.
• Respond to the child immediately. This encourages the conversation. It shows that you are listening.
• Talk about what the child is doing
• Follow the child’s lead in communicating – this keeps his interest and encourages more communication from him.
• Repetition is very important. Repeat words and movements to your child.
• Praise with a pat, a smile, a hug or with words
• Take turns to speak. Ask open-ended questions to keep the conversation going. Avoid giving orders. The use of questions, giving choices and explanations will lead to children who do the same.
• Try not to be so worried about his level of development that you do not respond to his attempts to reach you. Have fun interacting with him and then he will want to do it more often...
Is there a critical period for learning language?
Apparently the brain is most ready for speech and language learning between birth and 6 to 8 years and the ability to learn language lessens after this. What should be understood is that there is no reason for speech and language skills to steadily progress into adult life. However, if some control over both grammar and speech production is not in place by six years of age, then the child may never attain the fully sophisticated control over these aspects that most of us take for granted. Some researchers suggest that the parts of the brain that would be used especially to control grammar and speech production would be used for something else if grammar does not develop. This fact emphasises the importance of early language intervention. Parents, therapists and teachers should therefore realise the importance of ensuring that children are exposed to both listening to and saying grammatically correct sentences by 5 years of age if possible. This can be done by reading to a child who is not yet able to use sentences. There is also evidence that a child needs to have a 300 word vocabulary before the learning of grammar can begin. If the above statement is true, then it is important to try and teach a language delayed child a 300 word vocabulary before the age of 5 or 6 years and probably earlier.
6. Some ideas for attempting to improve the development of speech and language in children with Down syndrome
Children with Down syndrome want to communicate. They do so effectively from the early years and use gestures to compensate for their difficulties with spoken language.
• Children with Down syndrome find speech production difficult. They will benefit from therapy directed toward motor control of the tongue, mouth and vocal tract as well as exercises emphasising rhythm and pacing, awareness and control of starting and stopping gestures and sounds and of gradually or abruptly increasing and decreasing their speed and volume.
• Children with down syndrome may find learning word meanings from sentences difficult and will be helped by extra opportunities to learn from language teaching games in which words can be learned one at a time. This will be particularly helpful for early vocabulary when it is mainly nouns and verbs that are being learned. Later specific teaching of early grammar and sentence meanings may also help to accelerate learning.
• The anatomical differences associated with Down syndrome, (differences in skull shape, jaw, palate, dentition, tongue size relative to mouth and difficulties with motor skills development and fine motor control,) will all contribute to the greater difficulties that children with Down syndrome have in developing clear speech. Therapy aimed at increasing oral-motor control from infancy will help articulation but there is no evidence that surgery for tongue reduction improves speech.
• The growth in verbal memory span during childhood is specifically delayed in children with Down syndrome. This affects the learning of words and grammar. There is some evidence that memory training can increase the short-term memory spans for these children. This increases the rate at which grammar is learned.
7. Alternative approaches to support learning from listening
The difficulties in hearing, auditory discrimination and working memory indicate that learning language from listening, the way most babies do, will be difficult for children with Down syndrome.
7.1. Signing
Evidence suggests that parents should be encouraged to learn to use signs (e.g. with systems such as Makatonor Signalong) to support the development of spoken language with their baby from 7/8 months of age. Research shows that children with Down syndrome do not learn words from speech input alone and that those children who have been on sign supported therapy programmes have bigger spoken vocabularies at 5 years. Some parents have difficulty accepting this as they believe that the use of signs will delay speech development. Others fear that signing makes their child appear more ‘handicapped’.
7.1.2. The benefits of using signs as a bridge to talking
• Being able to sign allows them to communicate effectively and reduces frustration
• Parents who sign can engage in more effective language teaching and communication with their children
• Signs helped children to learn and understand words.
• Signs help children to be understood whils their speech is still difficult to understand
• Children with Down syndrome have larger vocabularies when they have been in sign supported programmes
• Signs are a bridge to speaking and should be needed less as children learn to talk.
• Speech sound work should be focused on from infancy alongside the use of signs
• The focus should always be on learning to say words with signs used as an aid.
7.2. The benefits of teaching reading to teach talking
• Children with Down syndrome find learning visually easier than learning from listening
• Printed words seem to be easier for them to remember than spoken words
• Print can be used from as early as 2 years of age to support language learning
• All language targets can be taught with the aid of written material, even to children who are not able to remember the words and read independently.
• Reading enables the child with Down syndrome to practice complete sentences – teaching grammar and supporting correct production
• Reading can help speech at the level of sounds, whole word production and sentence production
• Reading to children with Down syndrome and teaching them to read may be the most effective therapy for developing their speech and language skills from infancy right through the school years
• Research shows that reading also has a significant effect on working memory development for children with Down syndrome."- Down Syndrome South Africa
Assistive Technology for Communication for Children with Down Syndrome
One of the greatest assistive technology tools that can be given to children with Down syndrome to aid in communication is speech/communication therapy.
The National Down syndrome Society elaborates on the importance of speech/communication therapy as an assistive technology tool for children with Down syndrome.
"Speech and language therapy is a critical component of early intervention. Even though babies with Down syndrome may not say their first words until 2 or 3 years of age, there are many pre-speech and pre-language skills that they must aquire before they can learn to form words. These include the ability to imitate and echo sounds; turn taking skills (learned through games like “peek-a-boo”); visual skills (looking at the speaker and objects); auditory skills (listening to music, speech, or speech sounds for lengthening periods of time); tactile skills (learning about touch, exploring objects in the mouth); oral motor skills (using the tongue, moving the lips); and cognitive skills (understanding object permanence and cause and effect relationships).
A speech and language therapist can help with these and other skills, including breastfeeding. Because breastfeeding employs the same anatomical structures used for speech, it can help strengthen a baby’s jaw and facial muscles and lay the foundation for future communication skills."- National Down syndrome Society
Early Intervention is key in aiding children with Down syndrome.
Below is a helpful article on the importance of Early Intervention and its benefits on communication.
The National Down syndrome Society elaborates on the importance of speech/communication therapy as an assistive technology tool for children with Down syndrome.
"Speech and language therapy is a critical component of early intervention. Even though babies with Down syndrome may not say their first words until 2 or 3 years of age, there are many pre-speech and pre-language skills that they must aquire before they can learn to form words. These include the ability to imitate and echo sounds; turn taking skills (learned through games like “peek-a-boo”); visual skills (looking at the speaker and objects); auditory skills (listening to music, speech, or speech sounds for lengthening periods of time); tactile skills (learning about touch, exploring objects in the mouth); oral motor skills (using the tongue, moving the lips); and cognitive skills (understanding object permanence and cause and effect relationships).
A speech and language therapist can help with these and other skills, including breastfeeding. Because breastfeeding employs the same anatomical structures used for speech, it can help strengthen a baby’s jaw and facial muscles and lay the foundation for future communication skills."- National Down syndrome Society
Early Intervention is key in aiding children with Down syndrome.
Below is a helpful article on the importance of Early Intervention and its benefits on communication.
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Assistive Technology For Overall Development of Young Children With Down Syndrome
The overall development of children with Down syndrome can be greatly impacted by the aid of assistive technology. Not only can it aid in basic functions, such as eating, it can also help develop fine and gross motor skills. It can also aid in developing a child's social
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