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Down Syndrome Intervention

Emma H. Hinzman

Department of Natural Sciences, Southeastern University

CSDS 3033: Language Disorders and Intervention

Professor Stefanie Renavoles

December 8, 2022
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Down Syndrome Intervention

For Down Syndrome children, what is the effect of the Broad Target Speech Recast

treatment on speech and language improvement? This PICO question will be addressed

throughout this paper. First, we will begin talking about the client to which this research

originates. Everett is a 6-year-old boy in first grade with Down Syndrome. He receives speech

therapy three times a week for 30 minutes, which began one year ago. At this point in therapy,

Everett is working with the Speech-Language Pathologist to formulate and put together phrases

with his Augmentative Communication device (Paul et al., 2018). His genetic disorder causes

speech and language impairments, resulting in overall ineffective communication. He uses a

combination of sign language, verbal speech, gestures, and his speech-generating device.

According to the textbook, sign language encourages oral communication in children (Paul et al.,

2018). Everette uses the NovaChat 8 speech-generating device, which is the Augmentative and

Alternative Communication that helps him to learn and use vocabulary while improving his

overall communication skills. Language goals in treatment for Everett include being able to

retain 2-3 new vocabulary words with 95% accuracy in application, and ultimately being able to

produce 4-5 word utterances at a 90% accuracy. Speech goals include producing the final

consonant position sounds /d/ and /n/ with 90% accuracy given the opportunity. Everett is in the

developing language Brown Stage. Because his genetic disorder causes speech intelligibility it is

severe enough, so “intervention is warranted” (Paul et al., 2018).

Assessment For Down Syndrome

Assessment for Down Syndrome children would include Preschool Language

Assessment Instrument Second Edition PLAI-2 and Clinical Evaluation of Language

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Fundamentals Preschool Second Edition (CELF -2). The Preschool Language Assessment

Instrument Second Edition would assess Everett’s ability to use and understand language. It

would be able to measure if he can apply and integrate pragmatics into everyday communication,

while the Clinical Evaluation of Language Fundamentals Preschool Second Edition would assess

all five areas of language including phonology, morphology, syntax, semantics, and pragmatics.

Broad Target Speech Recast

This intervention plan has 2 main parts and focuses on recasting. The textbook talks

about targets that are selected based on research of that language group, with recasting being one

of the targets (Paul et al., 2018). The two types of recasting are speech recast and grammatical

recast. These types of recast are never used in the same session as only one should be targeted at

a time (Camarata et al., 2006). Conversational recasting can shape a child’s expressive language

into a more complex version (Martin et al., 2009). The first part of this Broad Target Speech

Recast includes familiar games and activities where the Speech-Language Pathologist will ask

the child questions related to their actions, which encourages the child to talk (Vanderbilt

Kennedy Center, 2015). Whenever the child uses a mispronounced word that the therapist can

understand, recast will then play its role (Vanderbilt Kennedy Center, 2015). For example, if

Everett says, “Jump toe,” the therapist would say “Yes, the toad jumps.” When the speech

therapist uses a developmentally appropriate recast that is immediately followed by the child’s

mispronounced utterance, the child can note “the difference between her production and the

adult’s, which leads to support language acquisition” (Cleave et al., 2015). Down Syndrome

children with high imitation skills before treatment benefited from the Broad Target Speech

Recast (Vanderbilt Kennedy Center, 2015).

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Because Everett uses an Augmentative and Alternative Communication device, this

treatment plan would be incorporated with the use of his NovaChat 8 speech-generating device.

For example, it would be modified to relate verbal speech, sign, and his device and recasting

from there. If Everette said, “like cats,” on his device, the Speech-Language Pathologist would

then recast back with “Yes. You like cats.” Everett is able to use his device, gestures, sign, or

verbal speech, and the Broad Target Speech recast is able to continue its position. This

intervention is able to integrate his device while also encouraging verbal speech at the same time.

By adding to the phrase they used, recast plays a role in increasing expressive language in time.

The program is not exclusive to only verbal speech, stimulating all methods of Everett’s

communication. The inclusion quality of the program is beneficial to the Down Syndrome child

with good imitation skills like Everett. According to an article by Assistive Ware, the “use of

speech is often more successful when it’s supported with an AAC system” (AssistiveWare,

2022).

Treatment Findings

Research and multiple studies found that the Broad Target Speech Recast treatment was

most effective for children who already had good imitation skills when they entered treatment,

however, it also found that Down Syndrome children who entered treatment with low imitation

skills developed stronger imitation skills that where they were at previously, (Yoder et al., 2015)

and these speech recasts were credited to those results (Yoder et al., 2016). In comparison to

another treatment called Easy Does It for Articulation, Yoder said, “For kids with Down

syndrome who begin therapy at just above the mean for imitation ability, our results indicate that

speech recasting works better than EDI” (Marketing, 1970). Expressive language skills are
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increased due to recasts. These recasts have been found to encourage communication, regardless

of the form. Through the treatment intervention, it has been found that Down Syndrome

children’s speech and language can be improved. In conclusion, speech recasts would help a

Down Syndrome child similar to Everett because they are learning from comparison to the recast

and their incorrect pronunciation. Also, the child is not required to try working to comprehend

the adult’s speech recast because it isn’t a different meaning (Schuele & Young, 2017).
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References

AssistiveWare. (2022). Will AAC stop a person from learning to speak? AssistiveWare. Retrieved

December 6, 2022, from

https://www.assistiveware.com/learn-aac/roadblock-aac-will-stop-a-person-from-learning

-to-speak

Camarata, S., Yoder, P., & Camarata, M. (2006). Simultaneous treatment of grammatical and

speech-comprehensibility deficits in children with down syndrome. Down Syndrome

Research and Practice, 11(1), 9–17. https://doi.org/10.3104/reports.314

Cleave, P. L., Becker, S. D., Curran, M. K., Van Horne, A. J., & Fey, M. E. (2015). The efficacy

of recasts in Language intervention: A systematic review and meta-analysis. American

Journal of Speech-Language Pathology, 24(2), 237–255.

https://doi.org/10.1044/2015_ajslp-14-0105

Marketing, C. and. (1970, April 17). Peabody Faculty Pioneer Down Syndrome speech and

learning interventions. Vanderbilt University. Retrieved December 6, 2022, from

https://news.vanderbilt.edu/2015/04/17/peabody-faculty-pioneer-down-syndrome-speech-

and-learning-interventions/

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.

https://doi.org/10.1097/tld.0b013e3181a71fe1
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Paul, R., Norbury, C., & Gosse, C. (2018). Chapter 4 . In Language disorders from infancy

through adolescence: Listening, speaking, reading, writing, and Communicating (5th ed.,

p. 109). essay, Elsevier Health Sciences.

Paul, R., Norbury, C., & Gosse, C. (2018). Chapter 9 . In Language disorders from infancy

through adolescence: Listening, speaking, reading, writing, and Communicating (5th ed.,

p. 353). essay, Elsevier Health Sciences.

Paul, R., Norbury, C., & Gosse, C. (2018). Chapter 9 . In Language disorders from infancy

through adolescence: Listening, speaking, reading, writing, and Communicating (5th ed.,

p. 371). essay, Elsevier Health Sciences.

Paul, R., Norbury, C., & Gosse, C. (2018). Chapter 9 . In Language disorders from infancy

through adolescence: Listening, speaking, reading, writing, and Communicating (5th ed.,

p. 390). essay, Elsevier Health Sciences.

Quinn, E. D., Kaiser, A. P., & Ledford, J. R. (2020). Teaching preschoolers with down syndrome

using augmentative and alternative communication modeling during small group

Dialogic reading. American Journal of Speech-Language Pathology, 29(1), 80–100.

https://doi.org/10.1044/2019_ajslp-19-0017

Yoder, P., Woynaroski, T., Camarata, S., & Bush, C. (2015, August). An effective speech therapy

method for school-aged children with ... - VUMC. School-Aged Children with Down

Syndrome. Retrieved December 6, 2022, from

https://vkc.vumc.org/assets/files/resources/yoderdsreport15.pdf
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Yoder, P. J., Camarata, S., & Woynaroski, T. (2016). Treating Speech Comprehensibility in

Students With Down Syndrome. Journal of speech, language, and hearing research :

JSLHR, 59(3), 446–459. https://doi.org/10.1044/2015_JSLHR-S-15-0148