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It seems unlikely that a child with Down syndrome will have age-appropriate reading skills yet show significant delay on measures of verbal and non-verbal mental age yet this is the pattern reported by Margriet Groen and colleagues in a detailed case study of KS aged 8 years. The paper reports three studies exploring different facets of the reading skills shown by KS.

In the first study, the abilities of KS are compared with a group of 13 other children with Down syndrome who are more able than average and this comparison establishes that KS is reading exceptionally well for a child with Down syndrome. She was the best reader and scored significantly ahead of the rest of the children with Down syndrome on the reading measures even though she did not score ahead of them on verbal or non-verbal mental ability measures.

In the second study, the researchers explore her phonological skills – that is her ability to use letter-sound correspondences and rhyme in a variety of ways – and here her performance is compared with that of typically developing readers. KS demonstrates age-appropriate skills on the majority of the measures showing that she is able to decode words for reading and spelling and does not rely on visual memory and good 'sight-word' skills at this point (though other studies do indicate that children with Down syndrome rely on 'sight-word' skills for longer i.e. at higher reading ages, than other children^[1]).

In the third study, the reading comprehension abilities of KS are compared with those of a group of children who have age-appropriate word reading and decoding skills but some reading comprehension difficulties. KS shows a similar pattern of difficulties in that she has age-appropriate reading comprehension skills when the tasks require literal comprehension – that is, the answers are all transparent in the text, but has delayed comprehension when the comprehension tasks require the ability to make inferences not fully apparent in the text but requiring the reader to draw on world knowledge and past learning to understand fully. On the more difficult comprehension task, KS shows a delay of 13 months in comparison with her word reading ability putting her score just below the average range for readers of her age. She also showed a delay in her performance on a listening comprehension task similar to that shown by the delayed comprehenders she was being compared with.

This is a detailed and fascinating paper as the authors have made full use of the availability of other data sets to address the questions and provide the most detailed published account of the skills of a reader with Down syndrome. Reading ability is not the only strength that KS displays. She has exceptional speech skills (articulation and speech fluency), visual and verbal short-term memory skills and uses longer sentences (better expressive grammar) than most other children with Down syndrome, even though she does not score significantly higher than them on vocabulary or grammar comprehension tasks.

Four questions come to mind when reading this paper. Firstly, are the gains in speech clarity, short-term memory and expressive grammar linked to her reading progress? I have argued in a number of places that such a link is theoretically plausible, that is, that teaching reading will lead to such gains^[2-4] . Longitudinal studies are needed to investigate this possibility.

Secondly, what does a developmental profile as uneven as this (some abilities that are typical for age and some very delayed) tell us about the development of speech, language, literacy, memory and general verbal and non-verbal abilities in the brain – and the possible inter-relationships between them?

Thirdly, what role have specific interventions played in the abilities achieved by KS? The article notes that her parents had been teaching her to read from the age of 3 years and following a programme which specifically works on speech sound discrimination and production from that age and earlier. Here again, longitudinal research is needed to explore these issues.

Fourthly, how exceptional is KS? This is an important question for parents and teachers as they need to know how many other children with Down syndrome might be as successful with reading if given the opportunity to learn. Case study reports of other children with Down syndrome who read at age-appropriate levels exist and also suggest gains for speech (e.g. see REF 3). A number of studies report a range of reading ages for children with Down syndrome including some readers achieving reading ages of 14-15 years (see REF 3 for a review). A recent UK study of 49 children with Down syndrome reported four children reading at age-appropriate levels and identify that reading is a strength for the children, that is, they are often reading better than would be expected for their mental-age scores^[5] . Further research to find and study more of these 'exceptional' readers might go some way to also answering question 3.

 

Sue Buckley is at Down Syndrome Education International, Portsmouth, Hampshire, UK.

 

Original research paper

Groen MA, Laws G, Nation K, Bishop DVM. A case of exceptional reading accuracy in a child with Down syndrome: Underlying skills and the relation to reading comprehension. Cognitive Neuropsychology. 2006;23(8):1190-1214. doi:10.1080/02643290600787721

References

1. Kay-Raining Bird E, Cleave PL, McConnell LM. Reading and phonological awareness in children with Down syndrome: a longitudinal study. American Journal of Speech-Language Pathology. 2000;9:319-330.
2. Buckley SJ, Bird G, Byrne A. The practical and theoretical significance of teaching literacy skills to children with Down syndrome. In: Rondal JA, Perera J, editors, Down Syndrome: Psychological, psychobiological and socio educational perspectives. London, England: Whurr. 1996; p.119-128.
3. Buckley SJ. Literacy and language. In: Rondal JA, Buckley S, editors, Speech and language intervention in Down Syndrome. London, UK: Whurr. 2003; p.132-153.
4. Buckley S, Johnson-Glenberg MC. Increasing literacy learning for individuals with Down syndrome and fragile X syndrome. In: Warren S, Fey ME, series editors and Roberts JE, Chapman RS, Warren SF, volume editors, Communication and language intervention series: Speech and language development and intervention in Down syndrome and fragile X syndrome. Baltimore: Paul H. Brookes Publishing Co. (In press) 2008; p.233-254.
5. Hulme C, Goetz K, Snowling M, Brigstocke S, Nash H. Reading development in children with Down syndrome: relationships with oral language and phonological skills. Paper presented at: The 4th International Conference on Developmental Issues in Down Syndrome, Portsmouth, UK. September, 2005.

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