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Session 12 - Symposium: Social communication and caregiver-child interactions with individuals with Down syndrome

Organizer: Susan J. Loveall, sloveall-hague2@unl.edu, University of Nebraska-Lincoln

Lead Presenters

Discussant: Marie Moore Channell, channell@illinois.edu, University of Illinois at Urbana-Champaign

Social communication has been described as both a relative strength and relative difficulty for individuals with Down syndrome (Martin et al., 2009). This is, perhaps, because social communication is an umbrella term that encompasses many different components, including social interaction, social cognition, pragmatics, and language processing (ASHA, n.d.). Caregivers, including caregivers of children with Down syndrome, play an important role in helping children develop their social communication skills (Daunhauer et al., 2021). For example, to help facilitate their children’s language development, caregivers can use “serve and return” strategies (Center on the Developing Child, 2017), in which they respond to and expand on their young child’s looks, gestures, babbles, or other communication attempts. Parents can use shared book reading to help their children learn about characters’ emotions, and as children get older, parents can encourage conversational skills by engaging in back-and-forth dialogue.

Documenting how caregivers interact with their children with Down syndrome is important for understanding the development of their social communication skills and for informing intervention efforts. The aim of this symposium is to present the latest research on social communication in individuals with Down syndrome, and specifically social interactions with their caregivers.

Smith and colleagues present data from a large scoping review on the pragmatic abilities of individuals with Down syndrome and then narrow in on data from parent-child interactions specifically. Bosley and Channell examine the features of maternal talk with school-age children with Down syndrome during a wordless storybook interaction, and Jeremic and colleagues present on data from parent-child dyads to examine if and how shared book reading interactions relate to language and cognitive outcomes.

References

American Speech-Language and Hearing Association (ASHA). (n.d.). Components of social communication. https://www.asha.org/practice-portal/clinical-topics/social-communication-disorder/components-of-social-communication/.

Center on the Developing Child. (2017). Five steps for brain-building serve and return. Brief. Retrieved from https://developingchild.harvard.edu/resources/briefs/5-steps-for-brain-building-serve-and-return.

Daunhauer, L. A., Schworer, E., & Howshar, M. (2017). Parenting matters: Parent–child interactions in Down syndrome and recommendations for future research. International Review of Research in Developmental Disabilities, 53, 1-43. https://doi.org/10.1016/bs.irrdd.2017.08.003

Martin, G. E., Klusek, J., Estigarribia, B., & Roberts, J. E. (2009). Language characteristics of individuals with Down syndrome. Topics in Language Disorders, 29(2), 112-132.

Presentation 1: Pragmatic skills in individuals with Down syndrome: A scoping review

Authors: Emma Smith1, Susan J. Loveall1, Kara Hawthorne2

Esmith113@unl.edu

  1. University of Nebraska-Lincoln
  2. Gallaudet University

Background: Pragmatics (the use of language in social context), is an area of social communication that includes many subskills (ASHA, n.d.). Despite some documented strengths and difficulties (Smith et al., 2017), it is unclear the extent to which various pragmatic subskills have been researched in individuals with Down syndrome. Further, although standardized assessments provide useful data, they typically involve unnatural settings, while caregiver or teacher questionnaires can be subjective. It is therefore important to also consider how pragmatics is being measured. Because caregivers play an important role in the development of their children’s social communication skills, we were particularly interested in what research has examined pragmatics during naturalistic caregiver-child interactions.

Research Question: What research has been conducted on the pragmatic skills of individuals with Down syndrome, including during live caregiver-child interactions?

Scoping Review Methods: We searched three databases with terms “Down syndrome” (and synonyms) and “pragmatics,” “social communication,” and specific pragmatics subskills from the American Speech-Language-Hearing Association definition (ASHA, n.d.). Included studies were peer-reviewed, published in English, and included original data from participants with Down syndrome on at least one pragmatic subskill. Articles were screened for eligibility and coded for participant information, comparison groups, pragmatic subskills and if they were measured via naturalistic caregiver-child interactions, and correlates.

Results: The initial search identified 1649 articles. After screening, 196 studies were included in the larger scoping review. Some pragmatics subskills have been well-researched in DS, such as narrative macrostructure. Others have very little or no research, such as prosody and proxemics. Sixty-seven studies measured pragmatics via naturalistic caregiver-child interactions. Additional data will be reported.

Conclusion: This study provides an overview of the available literature on pragmatics in individuals with Down syndrome. These results can provide practitioners with a better understanding of the literature and set the stage for future research.

References

American Speech-Language and Hearing Association (ASHA). (n.d.). Components of social communication. https://www.asha.org/practice-portal/clinical-topics/social-communication-disorder/components-of-social-communication/.

Smith, E., Næss, K. A. B., & Jarrold, C. (2017). Assessing pragmatic communication in children with Down syndrome. Journal of Communication Disorders, 68, 10-23.

Presentation 2: Storybook moments: maternal interactions with school-age children with Down syndrome

Authors: Rebekah Bosley1, Marie Moore Channell1

rbosley2@illinois.edu

  1. University of Illinois at Urbana-Champaign

Background: Caregiver language facilitates development in children with developmental disabilities (Anderson et al., 2021). Research has examined caregiver-child interactions with preschool-age children with Down syndrome and found them more directive than caregivers of age-matched children with neurotypical development. A notable gap exists concerning caregiver input to school-age children with Down syndrome. Evidence indicates that children with Down syndrome continue to develop language throughout school-age, and caregivers report regularly reading with their school-age children with Down syndrome. However, until this study, no research had examined the nature of these interactions.

Research Question: What are the key features of maternal talk to their school-age children with Down syndrome during a wordless storybook interaction?

Methods: Mothers of 40 school-age children with Down syndrome (6-11 years) completed a wordless storybook task that was recorded and transcribed using Systematic Analysis of Language Transcripts software (Miller & Iglesias, 2012). Maternal talk was coded for communicative function: Prompting Communication (e.g., asking questions; encouraging child talk), Verbal Responding (e.g., answering questions; responding to child talk), and Directing Behavior (e.g., maintaining the interaction). The coding scheme was modified from prior literature (Hilvert et al., 2021; Sterling & Warren, 2014; 2018) to fit a wordless storybook.

Results: The rate of maternal talk (i.e., frequency of type of talk per minute) was highest for Prompting Communication (M = 3.17), then Verbal Responding (M = 0.92), and Directing Behavior (M = 0.32). Maternal talk that was off-task (M = 0.11) or storytelling (M = 4.13) was coded but excluded from analyses.

Conclusion: As the first study examining caregiver talk with school-age children with Down syndrome, caregivers actively provided opportunities for their children to engage in the storybook. Notably, caregivers were not as directive as compared to previous findings. Future research must replicate and extend these findings, including caregiver talk to school-age children in other communication contexts.

References:

  • Anderson, N. J., Graham, S. A., Prime, H., Jenkins, J. M., & Madigan, S. (2021). Linking quality and quantity of parental linguistic input to child language skills: A meta‐analysis. Child Development, 92(2), 484-501.
  • Hilvert, E., Lorang, E., & Sterling, A. (2021). Maternal use of decontextualized and contextualized talk: An in-depth investigation of early parent–child interactions in Down syndrome. American Journal of Speech-Language Pathology, 30(4), 1767-1780.
  • Miller, J., & Iglesias, A. (2012). Systematic Analysis of Language Transcripts (SALT) (Research Version 2012).
  • Sterling, A., & Warren, S. F. (2014). Maternal Responsivity in Mothers of Young Children with Down Syndrome. Developmental Neurorehabilitation, 17(5), 306–317. https://doi.org/10.1038/jid.2014.371
  • Sterling, A., & Warren, S. F. (2018). Parenting of children with Down syndrome compared to fragile X syndrome. Developmental Neurorehabilitation, 21(1), 64–67. https://doi.org/10.1080/17518423.2016.1259274

Presentation 3: Shared book reading with young pre-school children with Down syndrome: exploring parent-child interactions and comparing with typically developing peers

Authors: Mirjana Jeremic1 Emma Pagnamenta1 Vesna Stojanovik1 Kelly Burgoyne2 Sue Buckley3

  1. School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
  2. Manchester Institute of Education, University of Manchester, Manchester, United Kingdom
  3. Director for Science and Research; Down Syndrome Education International; Emeritus Professor of Developmental Disability; Dept Psychology, University of Portsmouth, United Kingdom

Background: The development of social communication skills may be delayed in children with Down syndrome but is also a relative strength. Many people with Down syndrome are sociable and motivated to engage in communication. Shared book reading (SBR) offers a naturalistic context for fostering language development through naturalistic interaction, leveraging the fact that people with Down syndrome enjoy social interactions. However, limited research has examined parent-child SBR in children with Down syndrome. This study investigates parental and child behaviours during SBR, comparing children with Down syndrome to age- and language-matched typically developing peers.

Method: We recruited 32 families: 12 with 2- to 4-year-old children with Down syndrome (DS), 10 age-matched typically developing children (AM), and 10 typically developing children matched on language ability (LM) with the DS group. Language and cognitive measures were collected using standardised assessments and parent reports. The home literacy environment was examined using the Home Literacy Environment Parent Questionnaire (Loveall, S. J., 2013; Dulin, M., 2023). Parent-child SBR interactions were video-recorded and analysed using the Child and Maternal Behaviour Rating Scales (Mahoney, 2008; Mahoney, 1998). Child language use during the SBR interactions was measured by counting vocalisations, words, signs and gestures.

Results: Parents reported frequent SBR and enjoyment of the activity. Preliminary findings showed strong positive correlations between parental responsivity and child attention, initiation, and language use across groups during SBR interactions. In the DS and AM groups, parental responsivity positively correlated with the number of words the child said during the interaction; in the LM group, parental responsivity positively correlated with child vocalisations.

Conclusions: These findings highlight the importance of parental responsivity during parent-child interactions and how it may be associated with the development of child attention, initiation of communication, and language use. SBR, a highly enjoyable activity for parents and children alike, may offer a natural environment that fosters child engagement and increased participation.

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