Communication performance of children with Down Syndrome: An ICF-CY based multiple case study

Abstract

Enhancing communication performance skills may help children with Down Syndrome (DS) to expand their opportunities for participation in daily life. It is a clinical challenge for speech-language pathologists (SLP) to disentangle various mechanisms that contribute to the language and communication problems that children with DS encounter. Without clarity of different levels of functioning, appropriate interventions may be poorly conceived or improperly implemented. In the present study, the International Classification of Functioning, Disability and Health – Children and Youth Version (ICF-CY) framework was used to classify contributing factors to communication performance in a multiple case study of six young children with DS. Within a comprehensive assessment, we identified individual and environmental facilitators and barriers, leading to an integrative profile of communication performance (IPCP) for each child. Whereas these six children shared a developmental, and/or expressive vocabulary age and/or level of communicative intent, the children faced similar but also unique personal and environmental factors that play an important role in their communication performance. Our data reveal that a combination of different factors may lead to the same language outcomes and vice versa, based on a unique pattern of interdependency of ICF-CY domains. Planning SLP interventions for enhancing communication performance in children with DS should therefore be based on a comprehensive view on the competences and limitations of every individual child and its significant communication partners. This evaluation should address facilitators and barriers in body functions, structures, activities, participation and environment, with a specific focus on individual strengths. The ICF-CY provides a useful framework for constructing an IPCP that serves this purpose.

Insights into Shared Decision-Making in Interprofessional Teams for a Boy with Down Syndrome with Communication and Language Issues: Simulation-Based Training for Medical and Allied Health Students

“…Participants first received a lecture about interprofessional collaboration, shared decision-making, ICF-CY and the code set of Deckers et al [ 26 ], language development in Down syndrome, and AAC. Although we are well aware of the debate in using the ICF as a framework (i.e., [ 30 ]), the fact that ICF-CY codes refer to a well-defined parameter provides a good opportunity to at least “talk about the same” and “use the same language”, which is highly important for interprofessional collaborative work.…”

“…[ 25 ] found high correlations between language and communication skills and measurements of a wide range of developmental domains in children with Down syndrome: attention, perception, social–emotional development, memory, cognition, orientation and adaptive behavior, and motor development. In a study by Deckers et al [ 26 ], the ICF-CY framework was used to classify contributing factors to communication skills in a multiple case study of six young children with DS; the case used further on in the present paper was part of that study. Within a comprehensive assessment, individual and environmental facilitators and barriers were identified, leading to an individual integrative profile of communication skills.…”

Influence of gestures on the intelligibility and comprehensibility of utterances with stuttering events in individuals with Down syndrome

“…Treatment of stuttering in individuals with DS may pose challenges because therapy methods that are used in a population with typical development rely on metacognitive skills and the ability to reflect on one's speech, thoughts, and emotions (Bray, 2015). Therefore, it has been proposed that as clients have lower metacognitive skills, clinicians focus more on improving their clients' confidence in speaking and communication skills, by starting from the individuals' strengths (Bray, 2008(Bray, , 2015(Bray, , 2016Deckers et al, 2016;Preus, 1990). By focusing on communication rather than stuttering, these interventions resemble language/communication interventions rather than stuttering therapies in clients with typical development.…”

“…Researchers have proposed that communication could improve by working with skills they already possess (Bray, 2008(Bray, , 2015(Bray, , 2016Deckers et al, 2016;Preus, 1990). Beat gestures call upon several strengths of individuals with DS such as the spontaneous use of gesture and feel for rhythm (Cassiman & Engelen, 2005;Te Kaat-Van Den Os et al, 2015;Vandereet et al, 2011).…”

Predictors of receptive and expressive vocabulary development in children with Down syndrome

“…An important variable that should thus be accounted for is the number of communication partners within the social network (Blackstone & Hunt-Berg, 2003), next to the family's social economic status (SES). Following the model of holistic development (Deckers, Van Zaalen, Stoep, Van Balkom, & Verhoeven, 2016b;Fro ¨hlich & Haupt, 2004), the vocabulary development of children is interrelated with several other developmental domains, such as cognition, memory, attention, adaptive level of functioning and socioemotional skills.…”