DSE recommends RLI for use with children with Down syndrome aged from 5 to 11 years where sufficient commitment and resources are available to plan, prepare and deliver the teaching programme consistently for an initial period of at least 20 weeks.

Given the findings from the evaluation study, DSE believes that this reading and language intervention is likely to improve reading and language development for many children with Down syndrome. We therefore recommend its use where sufficient commitment and resources are available to plan, prepare and deliver the teaching programme consistently.

How should the intervention can be delivered?

Our study shows that the programme can be successfully delivered by teaching assistants. Many primary age pupils with Down syndrome in the United Kingdom will be supported by teaching assistants and we recommend that the intervention is adopted in schools. Other delivery models are also possible. Although, we evaluated the intervention in mainstream schools, it is designed for one-to-one instruction and should be equally suitable for use in special education settings.

Who may benefit?

Children with Down syndrome aged from 5 years can benefit from the intervention, despite their language and cognitive delays. Many children with Down syndrome will be participating fully in a rich range of literacy activities during their first (reception) year at school. Where this is the case, we recommend starting the intervention in their second year (Year 1) when they will be on average aged around 5½ years. Most students with Down syndrome should continue to benefit from the intervention throughout their primary/elementary school years. However, children who achieve a word reading age of 8 years should discontinue the reading strand and move on to more appropriate activities targeting reading comprehension.

Will some children not benefit?

Some children did not make as much progress as others when receiving the intervention. In general, those who had better language skills, were younger and attended more intervention sessions made more progress. However, some older children, some children with poorer language skills at the start and some children who attended fewer sessions did make good progress.

Of 8 children (16%) who made very little or no progress on word reading throughout the study, we can identify 3 who had particularly poor language skills and who were aged 68 or 70 months at the start, two of whom also had relatively poor behaviour ratings. This may suggest that children sharing a similar profile may make little progress on the intervention. However, one child of a similar age with similar language and non-verbal abilities did make progress with word reading on the intervention and it is not clear what initial measures could have predicted the lack of progress for the other 5 children on word reading over 60 weeks.

Some children may not benefit from the intervention. However, it is not possible to predict if an individual child will make little or no progress on any single or multiple measures if taught using the intervention, based on the data we collected. The only way to find out if the intervention will help an individual child is to try it for a sustained period of time.

How often should the children receive the intervention?

The intervention is designed to be delivered through daily 40-minute teaching sessions (or two 20-minute sessions). Many children with Down syndrome need sustained additional support for learning.

The evaluation study found that the children who received the most intervention sessions generally made the greatest progress with word reading. We found that 71% of the children who received 80% more of the recommended intervention sessions achieved gains on word reading scores higher than the average gains for 'teaching as usual', compared with 39% of children who received less than 80% of the recommended sessions. We therefore recommend that is delivered daily throughout term time.

How quickly should we see progress?

Many children made noticeable gains quite quickly, while others progressed more slowly. The evaluation study identified gains on many measures for the initial intervention group when compared to the control group, four of which were statistically significant, after 20 weeks.

Of 28 children in the intervention group during the first phase of the study, 25 (89%) gained one or more word on the word reading measure, whereas only 13 out of 25 children (52%) in the control group gained one or more word, during 20 weeks of intervention or 'teaching as usual', respectively. During this period, 13 children (46%) receiving the intervention gained 5 or more words on the word reading measure, while 3 children (12%) receiving 'teaching as usual' gained 5 or more words. When the original control group (2) moved onto the intervention, 19 (76%) of 25 children gained one or more word on the word reading measure and 10 children (40%) gained 5 or more words.

Progress should therefore be noticeable for many children with Down syndrome within 20 weeks of starting the intervention. However, some will progress more slowly: after 40 weeks of supported intervention, 27 (96%) of the 28 children in the initial intervention group gained two or more words on the word reading measure (compared with 89% gaining one or more words after the first 20 weeks).

In general, children with Down syndrome require consistent, high quality teaching over a sustained period to make good progress. Another study of literacy instruction with children with intellectual disabilities including children with Down syndrome reported that it took 1 to 2 years of teaching before some children made gains. We recommend that teachers monitor the children's progress carefully, using the tools provided with the programme, to ensure that individuals are making progress with the skills and knowledge being taught. The programme provides guidance about how to adapt teaching to meet the needs of children who are progressing more slowly.

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