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ACQ
Volume 13, Number 1 2011
ACQ
uiring knowledge in speech, language and hearing
Research updates
Anne van
Bysterveldt
Nearly 90% of children were able to produce 50 utterances;
however mean length of utterance in morphemes (MLU-M)
was generally low with over one-third of children producing
PN samples with MLU-M of < 2. High point analysis revealed
that most children produced early developing PN narrative
structures, with only 4 children producing a PN with a high
point.
Overall, the results of these investigations identified
widespread and persistent spoken and written language
disorder in school-aged children with DS. In addition, while
home and school literacy environments were generally
positive, and children were receiving regular reading
instruction, many children were not equipped with the
necessary prerequisite skills to enable them to become
independent readers. These findings also highlighted
the need for early, focused and integrated intervention
to facilitate language development and to better prepare
children with DS for the language learning environment at
school.
To investigate the impact of an early intervention strategy,
10 pre-school children with DS participated in an integrated
intervention linking spoken and written language and
designed to simultaneously facilitate speech production,
letter name and sound knowledge and phonological
awareness. The intervention contained three components:
a parent-led home-based reading program using print
referencing techniques to draw the child’s attention to
intervention targets, a computer-based program and an
activities-based speech therapy component, all focusing
on the same speech, letter name and letter sound targets.
All 10 children made statistically significant gains on
speech production targets and the majority of children also
showed an increase in letter knowledge and phonological
awareness skills (van Bysterveldt, Gillon, & Foster-Cohen,
2010a). Follow-up assessments after 2 terms of formal
schooling revealed 7 of the 10 children made continued
improvements in speech and phonological awareness skills
and 5 children demonstrated some generalisation of these
skills to real word reading and spelling (van Bysterveldt,
Gillon, & Foster-Cohen, 2008a). These results suggest
an integrated phonological awareness intervention which
simultaneously targets speech, phonological awareness and
letter knowledge can be effective in facilitating development
in these skills for young children with DS.
Findings of these studies have identified the need for
longitudinal research into spoken and written language
development in children with DS to allow for the evaluation of
specific early interventions within a preventative framework.
The persistent nature of language difficulties in individuals
with DS also suggests the need for sustained interventions.
The evaluation of home- and classroom-based activities to
promote spoken and written language development in this
population is also warranted.
I
ndividuals with Down syndrome (DS) have a phenotypic
spoken and written language profile which includes
elements of both delay and disorder, with considerable
variation reported (e.g., Miller & Leddy, 1998). Significant
advances have been made in understanding the spoken
and written language in this population and the directions
interventions might take. However, little is known about
the language profiles of these children in the New Zealand
(NZ) cultural and educational environment. Over the last 5
years, joint research between the Champion Centre and the
University of Canterbury has focused on addressing this gap
by investigating spoken and written language development in
NZ children with DS. The first sizeable national investigation
to be carried out in NZ involved 88 school-aged children,
comprising an estimated 15% of children with DS receiving
instruction in years 1–8 in NZ schools. Children’s parents
and teachers completed comprehensive questionnaires
investigating the home and school literacy environment. The
majority of homes were rich in literacy resources and children
and parents read together on a regular basis. However,
parents reported that many children took a very passive role
during these interactions, that fewer than one third of the
children had complete letter name and sound knowledge,
and that only 25% of the children were regular independent
readers (van Bysterveldt, Gillon, & Foster-Cohen, 2010b).
Teachers reported that nearly all children took part in regular
classroom reading instruction, most frequently in small
groups or in a one-on-one context. Teachers’ reports of
children’s literacy skills were largely in line with those of
parents. Far fewer children were reported to take part in
regular writing compared to reading activities, both in the
classroom and for allocated homework.
To investigate the development of phonological
awareness, letter knowledge and decoding skills, 77 of these
children completed further assessments. Results revealed a
wide range of phonological awareness and decoding skills
with some children demonstrating mastery of phoneme
identity and letter knowledge tasks while others were unable
to achieve correct scores on any assessment measure.
Twenty-four percent of children were unable to read any
words correctly and 6.6% were able to decode at a level
expected for 7–8 year old children. Analysis of data by age
group (5–8 and 9–14) revealed the development of skills with
maturation. As a group, older children achieved significantly
higher scores than younger children on all measures (van
Bysterveldt, Gillon, & Foster-Cohen, 2008b).
The 31 children who could decode 10 or more words
on a standardised reading test were invited to complete
additional assessments of speech, reading accuracy and
comprehension, and personal narrative (PN) production.
Twenty-six children completed these assessments and
produced analysable PN transcripts that were at least 60%
intelligible (van Bysterveldt, Westerveld, Gillon, & Foster-
Cohen, submitted). Results revealed considerable variability.
Spoken and written language
development in children with
Down syndrome
Anne van Bysterveldt