Frequently Asked Questions
Communication, and specifically its verbal aspect which is language, represents today the essential basis of all social integration. Acquisition of language is one of the essential elements in recognizing the individual as a full member of "society" and failure in this area has many consequences. When such a problem exists in connection with a disability, the stakes are even higher.
1. The child’s language development follows three commonly accepted successive stages
1.1 The pre-linguistic step in which verbal language has not yet appeared, but during which many other aspects of communication will develop and which represent basic acquisitions necessary for the later establishment of language.
1.2 The language period during which its various aspects will develop (lexical, syntactic, etc.).
1.3 The language of the child and adolescent : period of linguistic development beyond the age of 5 – 6.In comparison with ordinary development, there will first be noted a lateness in acquisition by the child although the chronology and hierarchy of attainment remain the same.
Communication comes long before language. From the first months of life the first exchanges between the baby and its surroundings will appear. The notion of reciprocity appears. It is first through looking that the infant reacts with its mother. Later the social smile, mimicking, reactions to familiar noises, etc. will be added. Towards the end of the first year, the child enters the first phase of dialogue, through the game of “I speak/I wait for a response/I speak again" with the adult.
A Down syndrome child will, compared to a child of the same chronological age, be quiet, too quiet, not very responsive, to the point of affecting the emotional relationship with those around him. Here again, it is a matter of time. Eye contact will be effective only around the eighth week (a month later than expected).The child will start to initiate the first manifestations of communication with his parents around the age of 5-6 months and it is after the seventh or eighth month that there will be prolonged episodes of eye contact. All of that is essential for recognising and structuring of the world around him. It will be the origin of many cognitive delays, especially for vocabulary. The pre-conversational phase when the child must become aware of taking turns in vocal interaction will appear only towards the second half of the second year.
However, when one analyses the first productions of sound, one notices that the baby babbles and repeats syllables at the normal age. The chronology of the appearance of phenomena will also be the same as for “normal” children, notwithstanding the organic malformations of the oral cavity (anterior lengthening of the jaw, narrowing of the oral cavity, flattening of the angles of the mandible, etc.) and the frequent presence of hypotonia of the joint muscles.
The linguistic potential of the child is more limited. It is therefore necessary to compensate these difficulties, more efficient if done early, to compensate, as they appear, the weaknesses making language development difficult.
The first words come at around two years and a half, i.e. a year later than normal, and vocabulary will develop slowly until the age of 4 years. Then it will involve specific words in relation to the child's daily life. It will be noted that this vocabulary is imprecise, with a single word having several meanings. For example, “wawa” may mean all animals, or “app” all fruits, etc.
Around four years, if vocabulary is sufficient, there will appear combinations of two or three words to begin the first sentences as well as notions of localisation (over there), possession (mine), presence/absence (no more, gone), quality (dirty), descriptions and comments (dog eats), etc. At this stage, the style is called telegraphic. However, it is important to encourage to the fullest these verbal productions to lead the child towards more efficient and relevant communication.
The phonological (or articulatory) aspect will show major defects. First, it must be remembered that sounds will appear later. Constrictive consonants such as f/v, j/ch or s/z will for a long time be incorrect or imprecise and, when in combinations of sounds, the longer the word, the more difficult to pronounce. There are multiple origins for these difficulties: muscular hypotonia of the joint muscles, the delay in neuromotor maturity, not to mention associated problems such as hearing loss.
Above all at this stage, don’t focus on his articulation at the risk of blocking his willingness to express himself, thereby causing a backslide in language development. Bit by bit, through maturity and helpful exercises, the quality of articulation will continue to improve until, around the age of twelve, a very satisfying plateau will be reached, even if it is not what is normal.
We will see verbal statements progressively lengthening, and their relative complexity increasing. However, overall, the language of the adolescent and then the adult, will be made up of medium-length sentences with few subordinates. Tenses and modes are learned with difficulty. The present tense will be spontaneously favoured. Here again, you must not take appearances at face value. The formulation is simple, but the semantic content may be very rich and relevant. You must take the exchange itself into account.
Note that the understanding of language will be a reflection of its production: the content of the message will be well understood in context, especially if the situation has already been experienced or visualized and the shortest (limited number of elements) and less formally complex (few subordinations) sentences will be best understood.
2. Help and intervention
As we have seen, spontaneous development is characterised by slow, late acquisition .It is therefore imperative to intervene in the development process to optimise its perspectives. The process to follow must comply with several essential rules.
2.1 The basic rule is to start as soon as possible and stick with it. The work will be much more efficient if those around participate intensely. The primary role of the speech therapist and the family is to stimulate the child as often as possible, then to help it to reach the characteristic notions of the pre-linguistic stage.
2.2 These aspects must be adapted bit by bit to the linguistic level reached by the child. Language simplified to the extreme has no enriching value and formulations that are too complex will not be understood and thus ignored. Therefore conversation must be modulated depending on the capacities of the child and his development.
2.3 Feedback from the adult to the child’s output is essential in order to constantly give him examples of an adequate linguistic environment.
2.4 Language does not spring out of nowhere – it is the result of experience and reality, its analysis and assimilation. The more the child is helped to discover the reality around him, the more he will develop and enrich his language.
2.5 Care must be taken to go back over prior acquisitions in order to ensure that the child has well assimilated them and that he is capable of using them again and appropriately.
2.6 It is important to define the objectives to be reached and to rank them by degree of difficulty.
2.7 Finally, as a general rule for any educational process, progressive evaluation (as to both quantity and quality) is an essential structuring tool.