Below is a short tutorial directed at my son’s teachers; a love letter of sorts, if you will. He is 3, and in a preschool for exceptional children within our local elementary school. I think these ideas apply broadly though, to all professionals and all parents whose children have Down syndrome or other cognitive disorders. I hope there are takeaways in here that apply to children of any age. Let me know what you think!
To My Son’s Teachers: Research-Based Strategies for Learning
Some notes from a conference presented in Charlotte, N.C., last fall by Down Syndrome Education International, a UK-based research and training organization that has been using clinical trials to study how people with Down syndrome learn for 30 years. Professor Sue Buckley is the lead scientist at DownsEd and was the featured speaker at the conference along with some of her colleagues. For more information: www.downsed.org.
You may have heard that children with Down syndrome are “visual learners,” meaning that they learn better when information is presented visually rather than just spoken to them. The reason for this is that they have specific impairments in their auditory short-term memory and relatively strong visual memories.
What this means is they may need visual prompts like pictures or signs in order to learn language, follow directions, or answer questions. For a one-step direction or word, no visual prompt may be needed, but if you are asking the child to complete a two-step direction or say two or more words, a visual aid may be necessary until the child has mastered this skill.
(Visual aides like pictures are also great for a child who has difficulty with transitions so he knows what to expect next.)
For instance, when trying to increase the length of your child’s spoken phrases, holding up a card with two dots (or three dots, etc., depending on the child’s level) and pointing to each dot as you say each word can help serve as a visual reminder to compensate for the child’s weaker auditory memory. This is known as a pacing board. If your child looks at his toy and says “ball,” try to get him to add the color also by using a pacing board with two dots and saying “Ball. Red ball,” and pointing to each dot as you say “Red…ball.” For more information about this, please see the fascinating book by Libby Kumin, PhD., CCC-SLP, “Early Communication Skills for Children With Down Syndrome: A Guide for Parents and Professionals.”
About a half dozen studies have shown that reading progress is often above the mental age for language and verbal skills, and in many cases children with Down syndrome can read at age level! The researchers at DownsEd, as the organization is called, learned that many 3-year-olds could remember a visual word easier than a spoken word.
(Mathematical skills are more difficult, and often lag 2 years behind reading skills. More on that another time.)
Reading can be fostered in the classroom and at home with the use of letter cards or letter books — pages with a letter written in big type and accompanied by a picture of something that starts with that letter. Show the card, then say the letter sound to the child, then say the word and see if the child repeats it. Over time, you can ask the child to categorize by putting all the “b” words in one pile, the “d” words in another, etc.
Studies of children naming picture cards showed that speech production was clearer when imitating (watching closely as the adult spoke the word slowly). This showed that another problem was storage and retrieval from memory, not a motor skill or vocabulary issue, although some children with Down syndrome also have oral-motor weakness that impedes their speech.
Children with Down syndrome are good at matching games, so you could have a group of pictures with the word written underneath, and have the child match the corresponding picture with the word underneath. Over time, you can gradually progress to having the child match only a word to the correct picture, and then match word to word, with no pictures at all.
Once children with Down syndrome acquire a basic vocabulary through signs and spoken words, introducing the printed word will help them increase their vocabularies and also begin to learn grammar. In fact, once a child is putting 3 or 4 words together, reading will be the best way to learn grammar (for instance “Mommy is driving the car,” rather than “Mommy drive car.”)
Reading, Word Recognition
Preschool children can start whole word/sight reading when they have a vocabulary of 50-100 words and are able to match pictures (find the one the same) and select pictures (Where is the dog?).
Phonics instruction should not begin until the child has a sight vocabulary of 30-40 words, or with the rest of the class in school. Many of the early phonics skills will overlap with speech and language activities that teach letter sounds and initial consonants.
The computer plays to the visual strengths of children with Down syndrome, said Professor Buckley. She said the iPad is going to revolutionize education of our children. So please keep encouraging them to use the computer and don’t hesitate to play letter and number recognition games.
One fascinating tip presented at the conference is that children with Down syndrome are very sensitive to failure. If they sense they will not be able to do something correctly, they may simply refuse to do it. You may present a task to them, and they may start smiling at you or otherwise getting distracted. This may be just a behavior, but it may also be their way of trying to “get out of” doing the task.
A way around this is to use errorless learning. In other words, do not let the child get something “wrong.” Assist him in getting the answers right until he learns to do it himself. For instance, if you are asking the child to point to the dog and he points to the duck, keep prompting for the right answer. Avoid saying the word “no” or “that’s not right,” or similar language.
Instead, say something like, “That’s the duck, do you see the dog?” Prompt a few times and if the child doesn’t get it, take his finger and point to the dog, saying “There’s the dog!” Similarly, if you are asking the child to choose from among a group of cards and he is not finding the right one, gently push the correct one forward to encourage him to choose it. Praise him for making the correct choice and try another activity. Over time, you will slowly decrease the amount of support and prompts you are giving to the child.
Ending on a High Note
Perhaps the most striking yet simple idea presented at the conference by Professor Buckley is that we all should treat our children according to their chronological age as much as possible, not their developmental age.
As an example, she told us about her own daughter, who is now an adult and has never had a strong spoken vocabulary. They always treated her very protectively, and she took a special bus to either school or day service until the age of 22. Around that age, she joined the “real world,” moving to a supported living situation and beginning a relationship with a young man.
Finally, she came into herself, Professor Buckley said. Her daughter learned more between the ages of 20 and 30 than in the previous 20 years, she said.
I love this story! Let’s all work for full inclusion for our children and have the ultimate goal of letting our adult children be adults when the time comes. I anticipate this will be harder than it sounds. Thank you for helping us get there!