Reading's research outputs online How do maternal interaction style and joint attention relate to language development in infants with Down syndrome and typically developing infants?

Purpose The study explored longitudinally the course of vocabulary and general language development in a group of infants with Down syndrome (DS) compared to a group of typically developing (TD) infants matched on nonverbal mental ability (NVMA). Method We compared the vocabulary and general language trajectories of the two groups in two ways: (a) at three time points during a 12-month period and (b) at two time points when the groups had made equal progress in NVMA (a period of 6 months for the TD infants vs. 12 months for the infants with DS). Results The TD group had overtaken the DS group on all general language and vocabulary measures by the end of the 12-month period. However, expressive communication and expressive vocabulary were developing at the same rate and level in the two groups when examined over a period in which the two groups were matched in gains in NVMA. Furthermore, the infants with DS showed a receptive language advantage over the TD group; this group's auditory comprehension and receptive vocabulary scores were superior to those of the TD group at both time points when NVMA was accounted for. Conclusion The results shed light on the widely reported discrepancy between expressive and receptive language in individuals with DS. Although infants with DS appear to be developing language skills more slowly than chronological age TD peers, when NVMA is taken into account, infants with DS do not have expressive language delays, and they seem to show a receptive language advantage.

Background: Speech and language acquisition can be a challenge for young children with Down syndrome (DS), and while early intervention is important, we do not know what early interventions exist and how effective they may be. Aims: To systematically review existing early speech, language and communication interventions for young children with DS from birth up to 6 years, and to investigate their effectiveness in improving speech, language and communication outcomes in children with DS. Other outcomes are changes in parental behaviour and their responsiveness Methods & Procedures: We conducted a systematic search of relevant electronic databases to identify early intervention studies targeting speech, language and communication outcomes in children with DS published up to May 2020. A total of 11 studies that met the inclusion criteria were synthesized and appraised for quality using the PEDro-P scale. There were a total of 242 children. We identified three types of intervention: communication training and responsive teaching, early stimulation programme, and dialectic-didactic approach. Main contribution:The findings from nine out of the 11 studies reported positive outcomes for children's language and communication up to 18 months following the intervention. All nine studies reported interventions that were codelivered by parents and clinicians. However, there was also a de-accelerated growth in requesting behaviours in the intervention group reported by one study as well as a case of no improvement for the intervention group. Three studies provided some evidence of improvements to parent outcomes, such as increased parental language input and increased responsiveness. However, there was a moderate to high risk of bias for all studies included. Conclusions:The findings from this review suggest that interventions that have high dosage, focus on language and communication training within a naturalistic setting, and are co-delivered by parents and clinicians/researchers may have the potential to provide positive outcomes for children with DS between 0 and 6 years of age. Due to the limited number of studies, limited heterogeneous data

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Background Down syndrome is the most common cause of learning disability, affecting approximately 1 in every 700 babies. Children with Down syndrome have particular difficulties with speech and language. This makes it challenging for them to participate fully in life, access healthcare services and educational opportunities. Improving the language skills of young children with Down syndrome is vital for their future social and emotional well-being and behaviour, and consequently contribution to society. As Down syndrome is detected before or at birth, we can provide support from early on. There are currently no standard interventions for improving the language skills of children with Down syndrome under the age of 36 months. Evidence suggests that early parent-based interventions may be effective in improving language outcomes. In partnership with parents and speech and language therapists, we have co-developed an intervention focusing on early social communication skills and our preliminary work shows that it can lead to better language in children with Down syndrome. Our aim is to carry out a feasibility study which will inform a future pilot/full trial to test whether the intervention is effective in improving language skills before children with Down syndrome start school. Methods This is a two-arm feasibility randomised controlled trial (RCT), with 1:1 randomisation stratified by trial site comparing the intervention (plus standard NHS speech and language therapy) with no intervention (standard NHS speech and language therapy only). We aim to recruit between 25 and 30 children with Down syndrome aged between 11 and 36 months. Sites are defined by the geographical boundaries of three National Health Service (NHS) Trusts. Recruitment is from NHS Speech and Language Therapist caseloads within the 3 Trusts, and self-referral. In the intervention arm, parents/guardians will receive brief training on the parent-based intervention and a manual to follow with their child for 10 weeks. The children’s language and early communication skills and family health outcomes will be assessed by a blinded assessor at baseline, post-intervention and 6 month follow-up. Questionnaire and semi-structured interviews will explore the acceptability of the intervention to parents and SLTs. Discussion The feasibility study’s outcomes will determine whether it would be viable to progress to a full-trial and whether adjustments need to made to the procedures, data collection methods, intervention delivery and the intensity of support needed. We want to assess whether our early intervention can be delivered and rolled out through NHS Speech and Language Therapy (SLT) Services. We anticipate that NHS SLT Services will need to make ongoing changes due to the COVID-19 pandemic, so it is likely that we will need to make adjustments for the definitive trial. We will also calculate descriptive statistics of the language outcome measure which we will use for any future sample size calculation. Trial registration ISRCTN13902755. Registered on 25 August 2020. http://www.isrctn.com/ISRCTN13902755

Background: Down syndrome is the most common cause of learning disability, affecting approximately 1 in every 700 babies. Children with Down Syndrome have particular difficulties with speech and language. This makes it challenging for them to participate fully in life, access health care services and educational opportunities. Improving the language skills of young children with Down Syndrome is vital for their future social and emotional well-being and behaviour, and consequently contribution to society. As Down Syndrome is detected before or at birth, we can provide support from early on. There are currently no standard interventions for improving the language skills of children with Down Syndrome under the age of 36 months. Evidence suggests that early parent-based interventions may be effective in improving language outcomes. In partnership with parents and speech and language therapists, we have co-developed an intervention focusing on early social communication skills and our preliminary work shows that it can lead to better language in children with Down Syndrome. Our aim is to carry out a feasibility study which will inform a future pilot/full trial to test whether the intervention is effective in improving language skills before children with Down Syndrome start school. Methods: This is a two-arm feasibility randomised controlled trial (RCT), with 1:1 randomisation stratified by trial site comparing the intervention (plus standard NHS speech and language therapy) with no intervention (standard NHS speech and language therapy only). We aim to recruit between 25 and 30 children with Down Syndrome aged between 12 and 30 months. Sites are defined by the geographical boundaries of three National Health Service (NHS) Trusts. Recruitment is from NHS Speech and Language Therapist caseloads within the 3 Trusts and self-referral. In the intervention arm parents/guardians will receive brief training on the parent-based intervention and a manual to follow with their child for 10 weeks. The children’s language and early communication skills and family health outcomes will be assessed by a blinded assessor at baseline, post-intervention and 6 month follow up. Questionnaire and semi-structured interviews will explore the acceptability of the intervention to parents and SLTs.Discussion: The feasibility study’s outcomes will determine whether it would be viable to progress to a full-trial and whether adjustments need to made to the procedures, data collection methods, intervention delivery, and the intensity of support needed. We want to assess whether our early intervention can be delivered and rolled out through NHS Speech and Language Therapy Services. We anticipate that NHS services will need to make ongoing changes due to the COVID19 pandemic, so it is likely we will need to make adjustments for the definitive trial. We will also calculate descriptive statistics of the language outcome measure which will we use for any future sample size calculation. Trial registration: ISRCTN13902755. Registered on 25th August 2020. http://www.isrctn.com/ISRCTN13902755