The language development of children with Down syndrome: First words to two-word phrases
Bonamy Oliver and Sue Buckley
A longitudinal study was conducted to investigate the early language development of children with Down syndrome. Using parental records of their children's speech, the study investigated very early language development, from first words to the consolidation of two-word phrases. Seventeen children were studied, all with Down syndrome and the age range of these subjects when the study began was one year to four years. The mean age for reaching the ten word stage was 27.3 months, a delay of around 12 months. The results showed that the children with Down syndrome studied here learned very similar words to those of typically developing children. The results also indicated that, as with typically developing children, some children with Down syndrome experienced a vocabulary explosion. The mean age for this language explosion was 30 months, with a mean vocabulary of 24.4 words. However, it was clear that there was a wide range of individual differences with some children showing no explosion. The mean age for two-word phrase consolidation was 36.9 months, suggesting a delay of around 18 months. The results indicated that, having reached the ten word stage, children with Down syndrome proceed in their language development at a slower rate to a two-word stage than typically developing children. Detailed individual profiles are included to illustrate the wide range of individual differences observed in the rate of language acquisition in this group.
Oliver B, Buckley SJ. The language development of children with Down syndrome: First words to two-word phrases. Down Syndrome Research and Practice. 1994;2(2);71-75.
doi:10.3104/reports.33
Introduction
It is well known that, in the early stages of language learning, children
will imitate adult speech. As single word speech develops into sentences,
the question of how much imitation is involved becomes more difficult to
answer because the child will often produce utterances which he or she has
never heard in adult speech, such as "me no want milk".
Research into the difference between the imitations of typically developing
children and those of children with Down syndrome seems to imply that, while
"normal" children selectively imitate (Bloom
et al 1974), children with Down syndrome appear to imitate different
words from those used in later spontaneous speech (Coggins
and Morrison 1981). However, Gunn (1985) warns that caution should be
taken when forming definite conclusions from these findings. In general,
according to Gunn, studies show little or no significant differences between
the imitation of children with Down syndrome and that of typically developing
children, and thus there is a great necessity for longitudinal studies to
show whether, like typically developing children, a significant proportion
of the imitations of children with Down syndrome occur in their later spontaneous
speech.
Typically developing children begin to produce imitated speech words at
around 10 to 13 months of age (Gillham
1979) and spontaneous speech tends to occur between 12 to 18 months
(Gleitman 1984
: Nelson 1981).
Research by
Cardoso-Martins et al (1985) has shown that, at the onset of
object word comprehension and production, children with Down syndrome are
at a very similar level of cognitive development to typically developing
children, although, of course this does not necessarily mean that they are
of similar chronological age. Gillham (1979) suggests that children usually
begin to produce spoken language when their mental age reaches around 15
months.
Most researchers agree that spoken language, at least in the early stages,
"maps on to" the concepts and categories which the child had developed before
language production begins to develop, and that this factor is reflected
in what the child talks about (e.g.
Nelson 1973). This
appears to be true of both typically developing children and those with
Down syndrome alike. Detailed investigation by Gillham (e.g.
1979,
1990) has indicated
that the words included in the early vocabularies of Down syndrome children
are strikingly similar to those of typically developing children. However,
Gillham also points out that the rate of acquisition in children with Down
syndrome tends to be slower than in typically developing children.
Cardoso-Martins
et al (1985) argue that this slower paced language acquisition is due to
specific cognitive deficits in children with Down syndrome.
By the time the typically developing child reaches around 18 months of age,
the pattern of language development changes. Within the next few months,
with somewhere in the region of twenty words in his or her vocabulary (Nelson
1981: Miller
1989) the child may experience a period of very rapid vocabulary acquisition.
Although not all children experience this (Nelson
1981), but rather increase their vocabulary in a gradual and steady
manner, this vocabulary explosion is common. The change is a dramatic one.
The child will increase his or her rate of language acquisition from three
to four new words per month to thirty to fifty new words per month (Nelson
1981).
As yet, it remains unclear whether children with Down syndrome experience
a similar language acquisition explosion. Miller (1988
and 1989) believes
that some children with Down syndrome do indeed show evidence of a period
of rapid language acquisition at a mental age of around 30 months, with
a vocabulary of about 45 words. These findings indicate that children with
Down syndrome are not only delayed in reaching this stage, but, interestingly,
that they also have more words in their vocabulary.
Rondal (1978) believes
that this may be due to their advanced chronological age reflecting more
linguistic (and non-linguistic) experience.
The next major change in language development for both typically developing
children and those with Down syndrome is the onset of multi-word speech,
often beginning with phrases consisting of just two words such as "hello
dolly" and "mummy drink." For most children this usually occurs at around
19 months to two years of age, with around fifty words in their vocabulary
(Nelson 1973). The
onset of multi-word phrases is delayed in children with Down syndrome, although
the extent of the delay is very variable due to the high influence of individual
differences in the development of the children (Miller
1989). However, as a guide line, Rondal
(1988) suggests that the first
multi-word utterances do not usually appear in children with Down syndrome
before a chronological age of around four to five years.
Miller (1989) believes that children with Down syndrome may be: "demonstrating
well developed referential vocabulary acquisition skills but deficiencies
in the grammatical marking of their lexicon."
In addition, Miller indicates that at 20 months (mental age) his children
with Down syndrome were delayed by six months in productive language development,
but show a progressive deficit and are delayed by ten months at a mental
age of 30 months.
For many years it was believed that the language development of children
with any type of learning disability was simply a delayed reflection of
typical development. However, as shown above, recent research has shown
that, despite similarities with the development of typically developing
children, language learning, certainly in children with Down syndrome is
not just a slow motion version of typical language development. Although
the differences may be subtle ones, they must not be ignored.
In this study, we report the progress of 17 children with Down syndrome
through the first word to two-word stage, noting the range of first words,
evidence for a vocabulary explosion and the age at which two word phrases
appear.
Methodology
The data, results and conclusions discussed here are based on parent kept
diary records on seventeen children, all with Down syndrome, ten females
and seven males. Families volunteered to take part in this study, by post
from around the U.K.
Firstly, all families were given an explanatory letter stating the initial
aims of the study. Parents were told that the experimenters wished to study
the same group of children over a number of years to learn as much as possible
about language development in children with Down syndrome.
Parents were then informed what information they would need to record, depending
on the developmental stage their particular child had reached. Base-line
information was then acquired from the parents by way of an initial record
sheet which included basic information about the child, such as name and
sex as well as the child's present stage of speech and language development.
In the following months, parents were given new record sheets once a month,
and encouraged to continue keeping records as long as possible. The first
of these record sheets for each of signing, single word speech, spoken phrases
(two or more words together) and reading, was accompanied by a guide to
record keeping for the parents.
Records indicated the date the word, sign or phrase was first used, whether
it was an imitation or spontaneous production, who it was directed at and
any relevant comments on the context in which it occurred.
Parents received advice from a psychologist at the Sarah Duffen Centre while
in the study, so joined the study as they wished, hence the age variation
at the outset. Some families maintained records over longer periods than
others. If we had data on a child's early lexical acquisition to ten words
and later, and/or we had data on the onset of two-word phrases, they are
included in this analysis.
Results
There were a total of 17 children, seven male, 10 female with a mean age
of 25.6 months and an age range of one year to four years at the beginning
of the study.
Table 1 shows the age range of the children at each stage of the study and
the mean ages at each stage. In addition, Table 1 shows separate age ranges
and mean ages at each stage for male and female children. Mean ages are
calculated in months.
Table 1. Age at which children reach 10 word and two word phrase
stages.
|
|
Start of
records |
10 word
stage |
2 word phrases
consolidate |
| All subjects= |
Number of subjects |
17 |
9 |
14 |
| Age range (months) |
12 to 48 |
19 to 38 |
25 to 52 |
| Mean age (months) |
25.6 |
27.3 |
36.8 |
| Males |
Number of subjects |
7 |
4 |
4 |
| Age range (years:months) |
12 to 41 |
19 to 38 |
36 to 52 |
| Mean age (months) |
25.1 |
27.8 |
42.5 |
| Females |
Number of subjects |
10 |
5 |
10 |
| Age range (years:months) |
12 to 48 |
22 to 36 |
25 to 49 |
| Mean age (months) |
25.9 |
27 |
34.6 |
First ten words
Data on the first 10 words learnt by children with Down syndrome was acquired
from nine of the 17 children, four males and five females. The age range
for reaching this stage was 19 to 38 months and the mean age was 27.3 months.
Of the 90 words recorded as the first ten words of the nine children, there
were a total of 42 different words. The most frequently used word was "Daddy"
closely followed by "Mummy" and a person's name and "bye-bye".
Table 2 illustrates the full range of words used in the first ten words
of this group of children.
Table 2. Words used in the first 10 word vocabularies of the
children.
| Word |
N |
Word |
N |
Word |
N |
| Daddy |
7 |
Up |
3 |
Duck |
1 |
| Person's name |
5 |
Ball |
2 |
Gone |
1 |
| Mummy |
5 |
Shoe |
2 |
Hat |
1 |
| Bye-Bye |
5 |
More |
1 |
Lady |
1 |
| Dog |
4 |
Arrow |
1 |
Me |
1 |
| Car |
4 |
Bag |
1 |
Out |
1 |
| Yes |
4 |
Bear |
1 |
Roll |
1 |
| Baby |
4 |
Bed |
1 |
Teeth |
1 |
| Hello |
4 |
Bib |
1 |
Tried |
1 |
| No |
3 |
Biscuit |
1 |
Toilet word |
1 |
| Ta |
3 |
Bowl |
1 |
Window |
1 |
| Teddy |
3 |
Brick |
1 |
Dance |
1 |
| Wassat? |
3 |
Chair |
1 |
Doll |
1 |
| There |
3 |
Cat |
1 |
Dog |
1 |
| N = number of children with this word in their
first 10 words. |
Vocabulary explosion
It appears that the children studied here show that there may be an explosion
of language acquisition (as recorded in typically developing children e.g.
Nelson 1981) in some children with Down
syndrome but not all. In the group of twelve children for whom continuous
records are available from ten words to two-word phrases, five show a clear
"explosion" in acquisition and their language profiles are described below.
The mean age for this explosion for the five children was 30 months. The
age range was 28 to 32 months and the mean number of words in the vocabulary
at this explosion was 24.4 words ( the range was 16 to 36 words ).
Records of "A. L." show that she has no words in her vocabulary at the beginning
of the records and she does not start producing any words until she is in
her 34th month. Within this month she reaches, and passes, the 10 word stage
and rapidly, by the age of 24 months she has a vocabulary of 20 words. Over
the next three months, she learns no new words, but then, at 28 months with
her vocabulary still at 20 words, her language development seems to take
off and her vocabulary climbs dramatically over the following months. She
learns 14 new words at 28 months and more than 20 new words per month at
both 29 and 30 months. In the final month she learns 30 new words (plus
six 2-word phrases) bringing her vocabulary to 109 words as two-word phrases
are consolidated at 31 months. Thus, from learning a mean of four words
per month in the first five months of language acquisition, she seems to
experience a "spurt" in development to learning an average of 22.3 words
per month in the last four months before reaching the two-word phrase stage.
The records of "F. M." begin at 12 months with no words in her vocabulary
and her language acquisition does not start until 17 months. It takes her
seven months to bring the total number of words in her vocabulary to just
over the ten word stage (giving a mean of 1.4 words per month from 18 to
24 months) and a further four months to reach over the 25 word mark (a small
increase in mean words learnt per month to 3.8 words). At this point, with
26 words in her vocabulary, her language acquisition picks up considerably,
learning twelve new words (plus two two-word phrases) at 29 months and ten
words (plus seven two-word phrases) in the final month as two-word phrases
are consolidated at 30 months. This gives a mean of 11 words learnt per
month after reaching a vocabulary of 26 words. She has 48 words in her vocabulary
when two-word phrases are consolidated.
The records of "A. T." begin at the age of 16 months when he has just one
word in his vocabulary, and he learns no new words in the first month. Over
the following twelve months, he learns only seven new words, bringing him
to just under the ten word mark, with a mean of 0.6 words learnt per month
at this stage (up to 29 months). He then learns seven new words in the next
month bringing the size of his vocabulary to 15 words, but in the following
month he learns no new words. The next ten words are again learnt in just
one month, but no new words are learnt in the next two months. Then, however,
with a vocabulary of 25 words, his rate of language acquisition increases
dramatically and he learns 26 words in one month bringing his total vocabulary
to 51 words at 33 months. In the final month when two-word phrases are consolidated
(36 months) he learns just four words bringing his vocabulary to 55 words.
"H. A." has ten words in her vocabulary already when her records begin at
the age of 29 months. In the next three months she learns a mean of 1.7
words per month, increasing her vocabulary by just five words. At this point,
at the age of 32 months and with a vocabulary of 15 words, the rate of her
language acquisition increases and she learns 13 words in the next month
(plus two two-word phrases) followed by ten words in the next (plus three
two-word phrases). Thus she brings the mean number of words learnt per month
to 11.5 words in the final two months, with a vocabulary of 38 words when
two-word phrases are consolidated at 34 months.
"K. G." has 24 words in her vocabulary at the age of 27 months when the
records begin. Over the next three months, she learns new words at a steady
rate, bringing her vocabulary well over the 30 word mark with a mean of
5.7 words learnt per month. At this point, with a vocabulary of 36 words
at the age of 30 months, her rate of language acquisition seems to take
off, as she learns 28 words (plus four two-word phrases), 13 words (plus
one two-word phrase) and 25 words (plus two two-word phrases) respectively
in the following three months. This gives a mean of 22 words per month in
these final three months when two-word phrases are consolidated at 33 months.
She has 102 words in her vocabulary at this stage.
These five children show a clear language acquisition explosion at the point
of having 20 words, 26 words, 25 words, 15 words and 36 words in their vocabulary,
with ages of 28, 28, 32, 32 and 30 months respectively. The individual results
give a mean number of words in the vocabulary at the beginning of the rapid
language acquisition stage for the five children of 24.4 words and a mean
age of 30 months.
Both the size of the vocabularies, and most surprisingly, given the possible
variety of individual differences and the variation of ages for these children
at the ten word stage, the ages at the onset of the rapid language acquisition
period are incredibly similar. That is, at the point where the five children
seem to experience the period of language acquisition spurt, the age range
is just 28 to 32 months and the range in the vocabulary size is 15 to 36
words.
There are a further seven children for whom it is possible to detail their
rate of vocabulary acquisition month by month. However, for these seven
children, evidence of a rapid spurt in language acquisition is less obvious.
Nelson (1981) states that, in typically developing children, although a
period of vocabulary explosion is common, there are individual differences,
as well as large variations in the age of the vocabulary spurt:
"... some children never spurt at all, plugging away, adding a few words
each week, and gradually increasing their rate of acceleration ..."
This may account for the lack of obvious language acquisition explosion
in the remainder of the children recorded here, especially "H. H.", "D.
V." and "E. C."
In addition, it is noticeable that in four of the seven cases, that is,
"V. W.", "T. M.", "M. T." and "M. M.," the children have consolidated two-word
phrases by the time their vocabularies are around the 20 to 30 word stage.
In the case of "V. W." for example, she has a steady climb to a vocabulary
of just 21 words when two-word phrases are consolidated at 41 months. Similarly
"T. M." gradually increases her vocabulary to 22 words at which point two-word
phrases are consolidated when she is aged 25 months.
"M. T." does not seem to have a smooth climb in his language acquisition,
learning a few words at a time, with long breaks of several months where
no new words are learnt at all. However, when he has 16 words in his vocabulary,
there is a definite change in the pattern and he steadily learns a few words
each month. The change, which it would be dubious to call a language explosion,
may have been the beginning to such a spurt. Unfortunately, this can only
be speculation since records of his later language acquisition (past a vocabulary
of 27 words) are not available.
The same is true of "M. M." for whom, past a vocabulary of 21 words there
are no records.
For the children for whom a language acquisition explosion is evident, it
should be noted that it is much less dramatic than for typically developing
children. The explosion in typically developing children is signified by
learning 30-50 new words per month during the appropriate period. For the
children recorded here, the explosion was very variable, but tended to be
up to only around 10-30 new words per month.
Two-word phrases
The mean age for the consolidation of two-word phrases was taken from fourteen
children, four male, ten female, nine of whom there are records for concerning
their first ten words. These are shown in Table 3.
Table 3. Individual profiles for early language production.
|
Sex |
Age record
begin |
Age 10
word stage |
Age 2
word stage |
Age 2-word phrases
adjusted to account
for estimated 12 mth.
delay at 10-word stage |
| "A.L" |
F |
21 |
23 |
31 |
19 Months |
| "M.M" |
M |
16 |
24 |
|
|
| "F.M" |
F |
12 |
23 |
30 |
18 Months |
| "T.M" |
F |
17 |
22 |
25 |
13 Months |
| "E.C" |
F |
27 |
31 |
39 |
27 Months |
| "E.O" |
M |
12 |
19 |
|
|
| "M.T" |
M |
24 |
38 |
|
|
| "A.T" |
M |
16 |
30 |
36 |
24 Months |
| "V.W" |
F |
24 |
36 |
41 |
29 Months |
| "H.A" |
F |
29 |
|
34 |
22 Months |
| "K.G" |
F |
27 |
|
33 |
21 Months |
| "H.H" |
F |
25 |
|
33 |
21 Months |
| "N.H" |
F |
48 |
|
49 |
37 Months |
| "F.K" |
M |
32 |
|
40 |
28 Months |
| "M.N" |
M |
41 |
|
42 |
30 Months |
| "L.O" |
F |
29 |
|
31 |
19 Months |
| "D.V" |
M |
35 |
|
52 |
40 Months |
The mean age for reaching this stage was 36.9 months. For males, the mean
age was 42.5 months and for females was 34.6 month. Although it appears
that there is a large diversity between the means for males and females,
it is probable that, due to the considerable individual differences involved,
there is too big a difference between the number of children of each sex
recorded for the results to be reliable when separated by sex. The age range
for reaching the two-word phrase stage was 25 to 52 months.
The mean size of vocabulary at the point of two-word phrase consolidation
was 54.4 words; this was calculated from the ten children for whom the relevant
information on total vocabulary was available. However, the range of vocabulary
size, which was 21 words to 109 words, indicates the importance of looking
at the individual results as the means can be very misleading.
From previous research such as that of Nelson (1973) (as cited by
Miller
1988) it seems that, in the language development of typically developing
children, the onset of two-word phrases occurs at around 19 months with
a vocabulary of about 50 words. Thus, from the means of the results recorded
in this study, it appears that, individual differences apart, children with
Down syndrome have, on average, a similar number of words in their vocabulary
at the two-word phrase stage, but that, age wise, they are delayed to the
extent of about 18 months.
As previously discussed, the children with Down syndrome recorded here tended
to be already delayed at the ten word stage by around 12 months.
For this reason, the initial delay (that is, 12 months) was deducted from
the individual ages at two-word phrase consolidation. It can be seen that
the mean age for reaching this stage was then just 24.9 months which is
a six month delay. The range of individual "adjusted" ages was 13 months
to 40 months which clearly indicates, as all the other results have, the
wide range of individual differences seen in the acquisition of language
in children with Down syndrome.
Comment
The records from which this data is taken do not contain information on
variables which might explain the individual differences recorded. These
may include hearing status of the child, language learning opportunities
and styles of intervention. Further research to identify, if possible, the
reasons for this wide variation would be valuable to parents and therapists.
Acknowledgement
The authors wish to thank the parents who collected the data for the study,
which was funded by the Portsmouth Down Syndrome Trust.
References
- Bloom, L.,
Hood, L. & Lightbown, P. (1974). Imitation in language development:
if, when and why. Cognitive Psychology, 6 (3), 380-420.
-
Cardoso-Martins,
C., Mervis, C.B. & Mervis, C.A. (1985). Early vocabulary acquisition
by children with Down syndrome. American Journal of Mental Deficiency,
90 (2), 177-184.
- Coggins, T.E. &
Morrison, J.A. (1981). Spontaneous imitations of Down syndrome children
- a lexical analysis. Journal of Speech and Hearing Research, 24
(2), 303-308.
- Gillham, B. (1979). The First Words
Programme. London : Allen and Urwin.
- Gillham, B. (1990). First words in
normal and Down syndrome children: a comparison of content and word-form
categories. Child language Teaching and Therapy, 6, 25-32.
- Gleitman, L.R. (1984). Biological
predispositions to learn language. In Marler, P. & Terrace, H. S. (Eds.),
The Biology of Learning. New York: Springer-Verlag.
- Gunn, P. (1985). Speech and language.
In Lane, D. & Stratford, B., Current Approaches to Down Syndrome.
Cassell.
- Miller, J. F. (1988). Facilitating
speech and language development. In Tingey, C.(Ed.), Down Syndrome:
A Resource Handbook. Boston, MA: College Hill Press.
- Miller, J.F.(1988). The developmental
asynchrony of language development in children with Down syndrome.
In Nadel, L. (Ed.), The Psychobiology of Down Syndrome. MIT
Press.
- Miller, J. F. (1989). Speech and
language performance in children with Down syndrome. Presented in
the lecture series on Human Development and Mental Retardation, John F. Kennedy Center for Research on Education and Human Development,
October, 12.
- Nelson, K. (1973). Structure and strategy
in learning to talk. Monographs of the Society for Research in Child
Development, 38, 1-2, Serial no. 149.
- Nelson, K. (1981). Acquisition of words
by first language learners. In Franklin, M. B. & Barten, S. S. (Eds.),
Child Language: A Reader. Oxford: Oxford University Press (1988).
- Rondal, J.A. (1978). Patterns of correlations
for various language measures in mother-child interactions for normal and
Down syndrome children. Language and Speech, 21 (3), 242-252.
- Rondal, J.A. (1988). Language development
in Down syndrome: A life-span perspective. International Journal
of Behavioural Development, 11 (1), 21-36.