Implications for teaching strategies and interventions

Teaching approaches

In addressing the question of teaching methods, the main issue is whether there are any differences in the way one should teach a child with Down syndrome to read compared with the teaching methods used for typically developing children. There is no published research which evaluates teaching methods for children with Down syndrome, though one study is underway at the University of York, UK.^[1] However, the experience of the Portsmouth psychologists, who have been supporting the education of children with Down syndrome in mainstream classes for some 13 years, suggests that the same methods should be used for all children, but teachers will need to take account of the relative delay in language knowledge and memory skills of the children with Down syndrome when teaching them to read. The children will have smaller vocabularies and limited grammar, and with hearing difficulties and speech production difficulties they do not start school well prepared to master phonics. However, reading instruction and phonic instruction will help to improve their sound discrimination skills and speech clarity.

In the Portsmouth area and across the country, the Portsmouth research team provides training for teachers and support children in mainstream schools. In their experience, the approaches recommended in the UK National Literacy Strategy are appropriate for children with Down syndrome. They may be working at an earlier or differentiated level in each area of activity, supported by a Teaching Assistant, but they need the same range of activities. Therefore, with appropriate planning, they can and should be included in the Literacy hour.

The principles set out below apply to students of all ages, including those who are beginning reading instruction in their teenage or young adult years. For this reason, students are referred to rather than children.

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Quality and quantity of reading instruction

Reading instruction needs to be fun - to build on the students’ enjoyment of stories and their experience of text in their environments. Reading instruction should also demonstrate the benefits of being able to record ideas and information right from the start. One of the benefits of learning a sight vocabulary on cards is that students can be helped to build sentences and create messages, before they can write, spell or decode. Computer software can also help them to do this. The aim is to show students why they want to learn to read.

It is important that the first message that students receive about reading from these activities is that we read for meaning i.e. that there is a message in the text. Reading is a language activity, it is a written form of spoken language and language ability will influence students’ ability to obtain meaning from text. Activities which help all students to look for meaning in text - to find the key words that convey meaning and to use the picture to help themselves - should be a priority. Work on creating texts together and then reading them is fun and will support reading comprehension skills, i.e. reading for meaning. Teaching and learning should be an interactive process with teacher or assistant working together to create and read text. Books on favourite activities or interests and individual diaries can be fun, and can be shared with friends and families. For both young and older students, photographs can make a good starting point for making text together.

Establish a sight vocabulary

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While engaged in making books together, beginning readers of all ages will begin to establish a sight vocabulary of useful words for making sentences and words that are important to them like their own name and family names. The author and colleagues recommend teaching all students by establishing a small sight vocabulary first, choosing words and sentences that the children use everyday in their speech and encouraging them to build their own phrases and sentences with this sight vocabulary. This builds their confidence and enables them to learn that we read for meaning. The larger a student’s sight vocabulary, the larger the database that they can draw on to begin to understand how letters or groups of letters in these words represent sound.

Learning to understand and to use phonics is difficult for many students and typically takes children several years to master to a stage where they can attempt to spell and decode words independently (7 to 8 years). Although learning phonics is important, it should not distract from the engaging in the fun of being able to enjoy text and create messages using a ‘sight’ vocabulary with adult support. In addition, the more a student reads, the greater their opportunity to learn to understand the reading process and to establish a well-learned sight vocabulary. (Unfortunately, students who are slow to learn to read often have very limited experience of reading as a consequence, whereas students who are quick to learn do a lot of reading and so have increased opportunities to learn compared to the slower learner).

Learning phonics

Learning about sounds in words can also be developed in fun ways, starting with singing rhymes for younger students and drawing their attention to the rhyming words, including showing them how they are written. Giving students the texts for songs that they know ‘by heart’ from singing them, can be an effective way for them to succeed in linking words to text as well as seeing the sound to letter correspondences. Games which ask students to find something in the room which starts with a particular sound can be another fun way to learn about sounds. This game is often called ‘I Spy’ and each player says ‘’I spy with my little eye something beginning with p’’ - (use sound for letter rather than name) - and the student who is first to find the answer takes the next turn. Read books that make use of rhyme, and write out a list of the rhyming words. Rhyme books may be more difficult to find for older students but a fun activity could be to write rhyming ‘poems’ together. These are just some ideas to make learning about sounds in words fun.

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Words in students’ sight vocabularies that begin with the same sound can be put together to illustrate initial letter-sounds. As the student can already say these words when they see them, they can form the link for themselves between print and pronunciation begin to see how the letter-sound knowledge can help them to read an unfamiliar word.

In the classroom, use small sets of rhyming words and draw the students’ attention to onset and rime e.g m/at, h/at, p/at, c/at, f/at, and later s/ee, b/ee, tr/ee, kn/ee.

In phonological awareness training and assessments, students are asked to demonstrate:

• Rhyming awareness - which words rhyme or which is the odd one out
• Awareness of onset and rime - splitting word into initial sound and remainder
• Alliteration awareness - which words start with the same sound or which does not
• Phoneme blending - putting sounds together to make a word
• Phoneme segmentation - splitting a word into its sounds
• Phoneme deletion - what is the word left if a sound is taken away

There is very little research into the development of phonological awareness in children with Down syndrome though there is evidence that their abilities in this area are linked to reading progress, as they are for all children.^[2],[TODO: 89] Most primary age children with Down syndrome find the tasks listed above quite difficult to understand and carry out but practice at them is likely to help them to improve. In the author’s experience, children with Down syndrome in primary classes enjoy learning the letter-sound links with the other children, using the class phonics scheme and class activities. In fact, the children learn better than might be expected given the high incidence of mild to moderate hearing losses that they experience and the fact that almost all the children have difficulty in articulating the sounds at this age. Other children with speech difficulties (in articulation and phonology) show delays in phonological awareness and it has been suggested that these children may have a specific difficulty in classifying and analyzing speech sounds, underlying their speech difficulties and their reading difficulties.[TODO: 57] Their speech errors may result from poor and incomplete phonological representation of spoken words, rather than motor difficulties and therefore they do not have adequate sound representations of words to be able to link them to phonemes.

One could speculate that this is also the case for most children with Down syndrome when they start school, as a result of poor phonological loop functioning in working memory.^[3] [TODO: 43] However, the experience of learning about sounds and seeing them represented visually may well help the children to improve their stored information of the sounds and then to speak more clearly. Just practice of saying sounds and words may also have positive benefits for speech clarity.

Writing, creating texts and reading with understanding

Many students with Down syndrome find reading with comprehension difficult and it is very important to help them to make meaningful text to read back from the start of reading instruction. Learning to put thoughts onto paper and to read back with comprehension can be usefully linked.

The individually created books already mentioned make a good starting point built around photographs of activities or cuttings of the favourite football team or pop group. However, many aspects of the daily school curriculum provide opportunities to record information with support and to support comprehension of texts. The examples in [Figure 8], [Figure 9] and [Figure 10] show work that has been supported in a variety of ways for primary and secondary school pupils.

These pupils have Teaching Assistants to provide one-to-one support for at least part of the school day. The Teaching Assistants are encouraged to keep the student fully involved in thinking about what they want to write and creating the text for themselves, though they may need help to form sentences.

! Using a storyboard to support writing - age 12 years

Figure 8. Using a storyboard to support writing - age 12 years

! Support for reading comprehension work - age 7 years

Figure 9. Support for reading comprehension work - age 7 years

! Supported writing - age 13 years

Figure 10. Supported writing - age 13 years

Handwriting

The examples included in this module show a range of handwriting skills and illustrate that many children and teenagers are developing legible handwriting.

The Portsmouth psychologists encourage children to write from the start of reading instruction, tracing over words and sentences with fingers and pens, then moving on to copying and free writing. They have two reasons for doing this, firstly to develop the children’s motor skills and fine-motor control and, secondly, because research indicates that it is through early writing rather than early reading that children learn about letters in words.^[4] However, students who do not begin to read and write until they are older can still make very good progress with handwriting, as the examples in [Figure 12] and [Figure 13] show. Philip was not introduced to writing until he was 7 years old and [Figure 11] shows that he had difficulty copying at that time but within 2 years he had legible hand writing. He was helped by activities to develop his spatial awareness and gross motor skills as well as his fine motor skills with the support of a specialist teacher and occupational therapist.

! Philip’s work - age 7 years

Figure 11. Philip’s work - age 7 years

! Philip’s work - age 9 year

Figure 12. Philip’s work - age 9 years

! Philip’s work - age 11 years

Figure 13. Philip’s work - age 11 years

Use of computers

Research indicates that children with Down syndrome are ‘visual learners’, that is, they learn more easily from visually presented than spoken information. The computer is therefore an ideal teaching aid to use to build on their strengths. Most young children with Down syndrome enjoy using computers and readily master the necessary skills to use the multi-media PC with mouse and keyboard. The range of software designed to teach all basic skills (including literacy and numeracy) to children with special educational needs is growing all the time. Many programmes designed for use with all children are also suitable. Meyers,^[5] [TODO: 83] reports on the use of computers to teach language and reading to children with Down syndrome with successful outcomes. She points out that ‘’with the help of the computer scaffolding, the children … can immediately function as readers and writers, experiencing the pleasure in achievement that motivates them to learn both spoken and written language structure’’.[TODO: 82: p.258] Many children with Down syndrome enjoy using the computer to write, using software that will help them to construct text and to spell, with picture and symbol support.

In summary

The research-based evidence available on the reading development of individuals with Down syndrome is limited. However there is evidence to indicate that many children with Down syndrome (some 60 to 70%) are able to achieve a useful level of literacy ability if given effective instruction and that all the children should have an opportunity to learn to read, as even a small sight vocabulary will help their speech and language skills and may improve their auditory discrimination and working memory function. Reading instruction should be provided at the same age and in the same way as for all other children. There is also evidence to suggest that reading should be considered as soon as the child has single word comprehension as the earlier the child is able to establish a sight vocabulary, the greater the benefit for their language and cognitive development.

However, there has been no actual research into effective teaching strategies and the above conclusions are based on teachers’ and researchers’ experience of monitoring children’s progress. It is clear from the limited literature available that while sight word reading is often a strength, reading comprehension at sentence and text level is more of a challenge for many children with Down syndrome and more research on how to develop reading comprehension is needed.

The evidence also indicates a wide range of individual differences for this group of children and this presents a problem for the teacher of an individual child with Down syndrome. It is not possible to provide guidance on the expected levels of achievement for individual children at the present time. A large longitudinal study is needed to provide this information.

For children and adults with Down syndrome, the benefits of learning to read may go beyond simply acquiring a functionally useful level of reading and writing skill. Progress in reading can develop speech and language skills, auditory perceptual skills and working memory function; all areas where individuals with Down syndrome usually display difficulties. [TODO: references 84] [TODO: references 85] This is probably also true for many other children with moderate to severe learning difficulties.

Children with Down syndrome seem to often be good ‘visual’ readers, finding it relatively easy to establish a sight vocabulary from as early as two years of age. Children with Down syndrome will usually have considerably less language knowledge than other children at their reading level, so be less able to use context and phonological recoding strategies to access words and meaning. Further, to be good at phonological recoding, a child must be able to hear all the sounds in the words and given the hearing loss and auditory processing problems that the children often have, they are likely to be less able to use this route with ease than their typically developing peers.

Our observations however, suggest that despite these very real additional difficulties experienced by the child with Down syndrome compared to typically developing children, many do progress to being able to use phonological recoding for reading and spelling and they are able to use context. For the teacher, it is essential that they understand the level of skills that the child brings to the task and that they help the child to progress slowly but steadily. It is particularly important that teachers know how much language knowledge a child has in order to avoid exposing the child to material that they can read aloud but cannot decode for meaning. Further, all children learn new language from reading^[6],[TODO: 37],[TODO: 80],[TODO: 81] so it is very important that the teacher appreciates that reading can be a powerful way to help the child expand their language knowledge.

Students with Down syndrome can continue to develop their reading skills into adult life, and should have the opportunity to continue to receive good literacy instruction in secondary and further education.^[7].