A systematic review of speech, language and communication interventions for children with Down syndrome from 0 to 6 years

Abstract

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

The association between expressive language skills and adaptive behavior in individuals with Down syndrome

“…The present study has demonstrated that expressive language skills are linked to socialization and daily living skills in individuals with DS, which raises the possibility that interventions focused on improvements in expressive language may lead to, or at least provide a foundation for, improved adaptive behavior for those with DS. Unfortunately, there are few such evidence-based language interventions for this population focused on the targeted expressive language domains 58 , 59 . Therefore, there is a pressing need to develop such interventions.…”

Transcranial Direct Current Stimulation in neurogenetic syndromes: new treatment perspectives for Down syndrome?

“…Limited vocabulary and speech intelligibility represent major issues in DS, and supporting communication is crucial for promoting socialization, improving adaptive abilities, and enhancing overall quality of life (Rodenbusch et al, 2013 ; Wilkinson and Finestack, 2020 ). Some evidence suggests the efficacy of interventions for speech and language impairment in younger children with DS (Seager et al, 2022 ). However, challenges persist, especially for older children and adolescents (Rvachew and Folden, 2018 ).…”

Achondroplasia.

“…With hearing loss or co-occurring Down syndrome, however, some children may have communication issues. Seager et al (2022) provided a systematic review of interventions to address communication issues in early years. The studies reviewed by Seager et al were predominantly codelivered by parents and teachers, with increases in communication function.…”