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Most children and adults with Down syndrome experience significant difficulty with speech and language skills. Few achieve clear and fluent speech and few can express what they wish to communicate effectively because of delays in learning all the vocabulary and the grammar that they need. In recent years, there has been a large research effort exploring all aspects of speech and language development, from birth to adolescent years in particular.

In a recent paper, Joanne Roberts and colleagues present a comprehensive review of this research, covering phonology (speech), semantics (vocabulary), syntax (grammar) and pragmatics (communication or use of language). Importantly, the authors also consider hearing and oral motor skills which they rightly identify as factors which may influence progress in learning to talk.

This is a very useful review paper, as the authors both review current knowledge and identify the research needed next in each area. The authors provide detailed advice on interventions that may help, stressing the need to manage otitis media and hearing loss, to initiate language intervention early in development, to intervene to increase speech intelligibility, to assess language in different contexts, to specifically target vocabulary, syntax and pragmatic skills, to plan to promote the generalisation of skills learned in therapy so that they are used in many contexts and to make full use of signing or other augmentative communication aids as needed.

Throughout the paper the authors remind readers of the wide range of abilities and disabilities that can occur for children with Down syndrome and the need to plan for individuals while taking account of the syndrome-related expectations.

Sue Buckley

Original research paper

Roberts JE, Price J, Malkin C. Language and communication development in Down syndrome. Mental Retardation and Developmental Disabilities Research Reviews. 2007;13(1):26-35.