A Multi-Method Investigation of Pragmatic Development in Individuals With Down Syndrome

Abstract

This longitudinal study examined pragmatic language in boys and girls with Down syndrome (DS) at up to three time points, using parent report, standardized and direct assessments. We also explored relationships among theory of mind, executive function, nonverbal mental age, receptive and expressive vocabulary, grammatical complexity, and pragmatic competence. Controlling for cognitive and language abilities, children with DS demonstrated greater difficulty than younger typically developing controls on parent report and standardized assessments, but only girls with DS differed on direct assessments. Further, pragmatic skills of individuals with DS developed at a delayed rate relative to controls. Some sex-specific patterns of pragmatic impairments emerged. Theory of mind and executive function both correlated with pragmatic competence. Clinical and theoretical implications are discussed.

Specificity: A Phenotypic Comparison of Communication-Relevant Domains Between Youth With Down Syndrome and Fragile X Syndrome

“…The existing literature has been mixed with regard to these latter domains. Although several studies have pointed to sex-differences in pragmatics, behavior, and communication skills (Lund, 1988 ; Berglund et al, 2001 ; Määttä et al, 2006 ; Van Gameren-Oosterom et al, 2011 ; de Sola et al, 2015 ; Lee et al, 2017 ), studies focused on the adolescent period specifically have generally shown no sex differences with regard to pragmatics (Martin et al, 2017 ) or behavior (Jacola et al, 2014 ). Taken together, these results suggest that sex differences in DS may vary as a function of chronological age and developmental level and, perhaps, the context of assessment.…”

“…Regarding language skills, there is considerable research documenting that structural language skills (i.e., syntax, vocabulary, phonology) constitute one of the most impaired aspects of the cognitive profile of individuals with DS. Indeed, expressive syntax is especially impaired, with performance lagging relative to both NV cognitive and vocabulary level-expectations (Finestack and Abbeduto, 2010 ; Channell et al, 2015 ; Lee et al, 2017 ). At the same time, there is evidence of sex-related variability in structural language skills in the DS population, with females displaying a longer mean length of utterance (MLU) in words, and using richer vocabulary and syntax than males from a very young age (Berglund et al, 2001 ).…”

“…At the same time, however, other aspects of pragmatics are observed to be quite impaired in those with DS, including requesting (Coggins et al, 1983 ; Beeghly et al, 1990 ), topic initiation and elaboration (Tannock, 1988 ; Roberts et al, 2007c ), appropriately maintaining a topic of conversation (Tannock, 1988 ; Beeghly et al, 1990 ), providing clear referential descriptions (Abbeduto et al, 2006 ), recognizing and requesting clarification of unclear messages (Abbeduto et al, 2008 ), use of stereotyped language (Laws and Bishop, 2004 ), and understanding the contexts of conversation (Smith et al, 2017 ), with performance below MA-expectations in several of these areas. In addition, sex-related differences in pragmatic abilities in favor of females have been found in DS, although the extent of these differences varies as a function of CA, overall cognition, and methods of assessment (e.g., semi-naturalistic conversational context vs. standardized methods) (Lee et al, 2017 ).…”

Inferential language use by youth with Down syndrome during narration

“…Furthermore, there is some evidence linking structural language to broader pragmatic language skill development in children and adolescents with DS (Lee et al, 2017; Tager-Flusberg & Anderson, 1991), emphasizing the need to account for language in the current study. Given that expressive morphosyntax, in particular, is a phenotypic weakness in DS, we accounted for the potential role of MLU in our models examining group differences.…”

“…Far less is known about the pragmatic language abilities, or social use of language, of individuals with DS, particularly for individuals who have progressed beyond pre-linguistic babbling or single-word use. The limited literature points to a complex pragmatic language profile of relative strengths and difficulties, varying by sub-domain assessed and comparison group (e.g., autism spectrum disorder and fragile X syndrome; typical development) used (Abbeduto et al, 2008; Lee et al, 2017; Martin, Losh, Estigarribia, Sideris, & Roberts, 2013; Roberts et al, 2007; Smith, Naess, & Jarrold, 2017). …”