Session 5, Individual Papers

A pilot study of the Babbleplay App with babies with Down syndrome

Authors: Tamar Keren-Portnoy1, Sab Arshad1, Laura Boundy2, Sue Buckley3, Kelly Burgoyne2, Helena Daffern1, Mona Kanaan1

  1. University of York
  2. University of Manchester
  3. Down Syndrome Education International

Contact: tamar.keren-portnoy@york.ac.uk

Babbling, the production of language-like syllables (e.g., 'ba'), scaffolds word learning: earlier babbling correlates with earlier word production in typically developing babies (McGillion et al., 2016). Babies with Down Syndrome tend to vocalize less than typically developing babies (Parikh & Mastergeorge, 2018), are spoken to less by their parents (Thiemann-Bourque et al., 2014) and are at risk for language delay (Zampini & D'Odorico, 2013). However, babies with Down Syndrome who participated in an intensive (5-days a week) intervention that led to an increase in their babble had a larger vocabulary at a later age (Yoder et al. 2014). Here we pilot a different way of encouraging more vocalizing in babies with Down Syndrome: We have developed an app, BabblePlay (Daffern et al., 2020), that encourages vocalizing by responding to baby vocalizations with colorful moving shapes on the iPad screen. If babies learn that the shapes are contingent on their vocalizing, they may vocalize more, to see more shapes. We use BabblePlay as a parent-led intervention, to encourage babies with Down Syndrome to vocalize (and babble) more. We expect more vocalizing to also lead to more parental responses, and thus to more speech input to those children, which is also expected to benefit the children's language. This project will serve as a proof of concept, to find out if babies with Down Syndrome aged 7-16 months engage with BabblePlay and increase their vocalization when using it and whether parents find it easy to use.

Method: Families with babies with Down Syndrome receive an iPad with BabblePlay installed on it for two weeks. During the first week the baby looks at a mirror for 5 sessions, each 5 minutes long. BabblePlay records the baby’s vocalizations in the background. In the second week the babies interact with BabblePlay for 5 sessions, each 5 minutes long. BabblePlay again records the baby’s vocalizations. Parents video the fifth session of each week. To-date, 4 families have taken part, and 23 have already enrolled (out of 34 who have expressed an interest in taking part).

Data analysis: Engagement with BabblePlay will be assessed based on parental questionnaires as well as on footage from the final BabblePlay trial, by coding number and duration of looks to the screen and signs of positive affect (e.g., smiles). Increase in vocalizations will be measured based on the app's vocalization counts: While we expect no change in the number of vocalizations in Week 1, if BabblePlay is effective, we expect the number of vocalizations during Week 2 to rise. The talk will report on initial results.

Babble Boot Camp: A new proactive strategy for infants at predictable risk for speech and language challenges

Beate Peter1, Jennifer Davis1, Laurel Bruce1, Linda Eng1, Nancy Potter2, Mark VanDam2, Lauren Thompson2, Lizbeth Finestack3, Susan Loveall4, & Sue Buckley5

  1. Arizona State University
  2. Washington State University
  3. University of Minnesota
  4. University of Nebraska
  5. Down Syndrome Education International

Email: Beate.Peter@asu.edu

Babble Boot Camp is a bundle of activities and routines designed to boost young children’s speech and language skills proactively when challenges are predictable at birth. A pediatric speech-language pathologists (SLP) implements the intervention via parent training, using a telehealth platform. In weekly meetings, the SLP coaches parents in techniques designed to boost children’s communicative skills beginning in earliest infancy. The intervention typically spans ages <6 months to 24 months, with annual assessments of speech and language at follow-up. One condition that places children at predictable risk since birth is classic galactosemia (GG), a metabolic disease that causes diverse health impairments but especially severe speech and language disorders. A 4-year clinical trial, funded by the National Institutes of Health, is nearing its conclusion. Children with CG who completed the Babble Boot Camp intervention show significantly more advanced babble skills during the intervention and higher speech and language skills at follow-up, compared to children with CG who received standard care. Similar to children with CG, children with Down syndrome are at predictable risk for speech and language challenges. A new pilot trial of the Babble Boot Camp is now underway. Nine children with Down syndrome have entered the intervention, three starting younger than 5 months and six at approximately 12 months. All nine children started canonical babble including two children who entered the intervention at age 5 months who started babbling before age 10 months, earlier than expected. Parents with more than four months of participation in the study were asked to provide feedback. All reported high levels of satisfaction with the intervention and one parent whose child was in the later start group indicated a preference for the earliest possible start age. A larger clinical trial of Babble Boot Camp in children with Down syndrome is planned.