Supporting the learning of syntax and grammar and the formation of sentences

Grammar needs to be taught

All the evidence indicates that few children with Down syndrome will learn grammar easily from simply listening to everyday conversations, even though this is how other children learn grammar. The main reason for this may be the slow development of the verbal short-term memory span. Learning grammar involves the processing of sentences rather than single words and this will be very difficult for most children with Down syndrome. There are many ways in which various aspects of grammar can be taught using games but we would argue that reading is the most powerful way to teach sentences and grammar once children have reached a two-word stage in comprehension.

Your child is learning grammar all the time you are talking to them in natural sentences. One simple rule will be effective once your child begins to put two and three words together and that is:

Listen to your child’s key words and expand them into the shortest complete sentence. For example “Daddy gone” to “Daddy has gone”, “Cat sleeping” to “The cat is sleeping”, “Play sand” to “Can I play in the sand, please?”, “Mummy go car” to “Mummy has gone out in the car”, “Daddy go work” to “Daddy is going to work”. You will already be using these expansions naturally (without thinking) as you talk to your child during the day at home or at school. This simple approach will also ensure that you teach using examples that are relevant to your child and will be able to be used by them often when they want to communicate for real.

You can use the same strategy when thinking about making simple books. Words that you wish to teach from the vocabulary lists, such as prepositions and joining words will also give you ideas for sentences to practice in games or with reading activities. For example “Put the book on the table”, “The shoe is here not over there”, “There is a dog and a cat”, “If you get your coat, we can go out”, “We need our coats because it is raining”.

You can make use of an observation diary to help you observe and encourage your child’s grammatical development and ability to use longer sentences. Keep a notepad handy and note down the phrases and sentences that your child is using, both in imitation and spontaneously. This will help you to be aware of exactly how they are putting words together and it will help you to follow the guidance on expansion above.

Games can be devised to teach grammatical words and structure

Conversation diaries

! Example pages from a conversation diary

Figure 10. Example pages from a conversation diary

The first author developed the use of conversation diaries [TODO: references 9] during a research project set up to evaluate the effectiveness of language intervention for teenagers with Down syndrome some years ago and they were popular with the teenagers, their parents and teachers. They can be used to support children of any age to develop their use of sentences and grammar.

A conversation diary is a personal book, which your child can take between home and school. In the book, write a sentence about something that your child has done or is going to do, that they would like to tell his/her friends/teacher about - using the words that they would use to tell someone about this event. For example, ‘’Last night, I watched TV’‘,’‘I am going on holiday tomorrow to Spain’‘,’‘We made a cake at Grandma’s’‘,’‘I helped Mrs Smith to tidy the table today’‘,’‘Mum and I will go to the park tomorrow/on Saturday/after school’‘,’‘Mrs Andrews helped me on the computer today. We made a book about electricity’‘,’‘I played the drum in music today’‘,’‘Ben and I played football in the playground’’.

The conversation diary will help your child to say complete sentences and to be able to share their experiences with family and friends. If they can read, they will be able to write (perhaps with help) their own sentences and read them. If they are not yet able to read and write, then you should read the sentence and help your child to imitate it (at home and at school). The conversation diary will serve two useful purposes. It will support your child’s development of spoken language, sentences and grammar, and it will enable them to tell everyone what they do at home and at school. When a child has limited communication skills, they are not able to tell Mum and Dad what they did at school today and they are not able to tell their teacher or friends about the important experiences that they have out of school. The conversation diary can bridge that gap and enable everyone to talk with them about their daily lives. It is important that the child is actively engaged in choosing what they want to tell using the conversation diary. It is one of the times when you will use expansion to decide on what to write. Ask the child what they/wants to tell and make the shortest correct sentence from their keywords. For example, if the child says ‘’Played drum’’ you write ‘’I played the drum today’’.

While we know that most children and teenagers with Down syndrome have difficulty mastering all the grammar and using it in their speech, there have been almost no intervention studies to provide guidance on the best ways to help them. We know that both speech production difficulties and auditory short-term memory difficulties play a part, so speech work will help and so will reading activities. We encourage the use of an observation diary in which you simply note down how your child does try to express themselves in order to see how to help them to progress, using expansions as described above, in speaking to them and in writing activities.

Grammar will be being taught also in all the reading and project activities that you are engaged in across the curriculum.

Grammar can be discussed under two headings - syntax and grammar.

Syntax refers to understanding the way word order changes meaning, for example, “Pat hits Mary” does not mean the same as “Mary hit Pat”. Similarly “Daddy has gone to work” changes from a statement to a question if we change the word order to “Has Daddy gone to work”

Grammar refers to the ‘bound morphemes’, the word endings that change meaning (for example, ‘ed’, ‘ing’ or ‘s’) and the ‘function’ or joining words such as ‘a’, ‘the’, ‘is’, ‘are’, ‘if’. The function words seem to be the most difficult for children with Down syndrome, though this is also true for other children with speech and language impairments.

Syntax

Children begin to understand and use word order rules in their 3 and 4 keyword sentences and they then move on to question forms and more complex sentences.

Question forms

Your child will display understanding of question such as “What’s that?”, “Who is coming?” from quite early, and they will ‘ask’ questions at the one and two word stage by pointing - but use of question forms in spoken language will come later. Remember to use them as you talk to your child - and to use ‘can’ and ‘will’ - “Can you come here please?”, “Could you go and look for your shoes, please?”, “Will you take this to dad please?”, “Will you drink up your juice please?”

! ‘Is it chocolate?’ - A negatives game

Figure 13. ‘Is it chocolate?’ A negatives game:

put the cards in a bag, or face down on a table, ask the child to select one, saying (for example) “Is it chocolate?… No! It’s not chocolate it’s a key?”

It is possible to model questions and answers to encourage your child, for example, “Why are we putting our coats on?… Because it is raining.” or “When are we going out?… When Granny comes.” In your observation diary, keep a note of the way in which your child ‘asks’ questions and her/his use of question words. You will also be marking them on the vocabulary lists.

Negatives

As all parents soon find out, from quite early on children understand and use ‘no’ when they do not want something or they do not want to do something! Children can be helped to understand negatives in a wider range of uses with simple games such as placing objects in a bag, with one odd one out - for example 4 cars and an animal - and saying “Is it a car?” as you take each one out - then “yes, it is a car” or “no, it is not a car, it is a dog”.

Picture materials can also be used to teach negatives, for example “He has a hat on”, “He has no hat on”, or “He hasn’t got a hat on”. Games to encourage your child to use negatives can be played - “Have you got a hat on?” - and the answer modelled “No, Billy hasn’t got a hat on?” This game can be played in front of a mirror, with a hat! In you observation diary, keep a note of the way in which your child indicates negatives and his/her use of ‘negative’ words. You will also be marking them on the vocabulary lists.

Grammar

When your child or teenager has some 250 to 300 words in her/his vocabulary, they will begin to use some of the grammatical markers (for example’ for plurals or tenses) and more of the function words in their sentences, until they talk in grammatically complete sentences. When you begin to work with Vocabulary Checklist 3, you will use these markers on the words used in sentences.

Plurals

! A plurals game

Figure 14. A plurals game.

Place the cards face down, ask the child to turn a card. Say “It’s two stars/It’s one dinosaur. Now watch for another one the same”. The child keeps their card while the next participant takes their turn. (This is also a simple memory game).

The use of /s/ on the end of a word to indicate a plural is a grammatical rule that is learned early in typical development and simple games can be played to show one or more than one item and use the plural /s/ form. Children with Down syndrome may understand the plural /s/ but not be able to put the /s/ on the words they say because of speech sound production difficulties. There are a number of plural words that are irregular such as feet, and teeth. These just have to be learned and some of the most common ones are in the vocabulary checklists. In your observation diary, keep a note of the way in which your child indicates ‘more than one’ and the words that they are using. You may be marking some of them on the vocabulary lists. When they use the /s/ on words, record this on the Sentences and Grammar checklist. [TODO: tracker]

The use of plurals in sentences also requires the use of the correct auxiliary with the verb, for example, ‘the boy is running’, ‘the boys are running’.

Possession

The use of /s/ on the end of a word to indicate possession is also learned early. Here again, children with Down syndrome may clearly demonstrate comprehension of the possessive form but not be able to actually sound the /s/ on a word when speaking. They may use possessive pronouns such as ‘mine’ before using /s/ on words. In your observation diary, keep a note of the way in which your child indicates ‘possession’ and the words that they are using. You will also be marking some of them on the vocabulary lists. When they use the /s/ on words, record this on the Sentences checklist.

! Examples of prepositions games

Figure 15. Examples of prepositions games.

Ask the child to “Put an animal in/on/under the bag” or ask a child to “Put the man in/on/under the tractor”.

Function words

Prepositions

Some of the first grammatical words children master are prepositions, such as ‘on’, ‘in’, ‘under’. Games to teach the meanings of these are not difficult to plan. More difficult pronouns, such as ‘beside’, ‘above’, ‘below’, may not be understood by children of school age. These can be used in sentences and acted out by children in games. In your observation diary, keep a note of the way in which your child indicates ‘place’ and the prepositions that they are using. You will also be marking them on the vocabulary lists.

Pronouns

Pronouns are a little tricky to demonstrate, especially ‘I’, ‘you’, and ‘me’. Games played in front of a mirror can help, pointing to yourself while modelling ‘I’ and helping your child to do the same. Children usually refer to themselves using their own name or ‘me’ before using ‘I’. The use of ‘carrier’ phrases, such as ‘I like……’. or ‘I see …..’ , and their use in home-made books with photos of your child can help.

In your observation diary, keep a note of the way in which your child indicates ‘person’ and the pronouns that they are using. You will also be marking them on the vocabulary lists.

Articles

The use of the articles ‘the’ and ‘a’, and others such as ‘some’, takes a while to develop. These words, and the auxiliary verbs such as ‘is’ and ‘are’, may be difficult because they add very little to the meaning of the sentence. They are also not stressed in normal talk and therefore may be difficult to hear and to process in the flow of words. In our experience, children with Down syndrome do not easily learn to use them in their language and they will be helped by reading them in sentences.

! Small toys collected to play to ‘big/bigger/biggest’ and ‘small/smaller/smallest’ games

Figure 16. Small toys collected to play ‘big/bigger/biggest’ and ‘small/smaller/smallest’ games.

The use of the articles ‘the’ and ‘a’, and others such as ‘some’, takes a while to develop. These words, and the auxiliary verbs such as ‘is’ and ‘are’, may be difficult because they add very little to the meaning of the sentence. They are also not stressed in normal talk and therefore may be difficult to hear and to process in the flow of words. In our experience, children with Down syndrome do not easily learn to use them in their language and they will be helped by reading them in sentences.

In your observation diary, keep a note of the way in which your child is talking and note down any use of articles. You will also be marking them on the vocabulary lists. When you have heard the use of ‘a’ and ‘the’ consistently, tick and date the checklist.

Tenses

There are many tenses in the language, but we have simplified them to present, future and past tenses. To use many tenses properly, an auxiliary or ‘helping’ verb is used, for example, ‘He is going’, ‘They will be going’, ‘He has been’, ‘They are running’. It takes most children with Down syndrome a number of years to master the use of auxiliaries and some individuals never learn to use them. However, most children do learn to use present, present progressive and simple past and future tenses to convey these meanings appropriately.

! Boy and girl dolls can be used to teach the pronouns ‘he’, ‘she’, ‘him’, ‘her’, ‘his’ and ‘hers’

Figure 17. Boy and girl dolls can be used to teach the pronouns ‘he’, ‘she’, ‘him’, ‘her’, ‘his’ and ‘hers’.

For example, ask the child to act out “he is eating” or “she is sleeping”. Doll games also give the opportunity to use future and past tenses - for example, “the boy is going to run”/“the girl went to sleep”.

Children use the present tense of verbs first for example push, jump, sleep, run, and this is the way most of the verbs appear in the vocabulary checklists

Present progressive tense

The next tense children learn is the present progressive ‘ing’ form, for example, pushing, jumping, sleeping, running. To use this form correctly in sentences they need to use auxiliary verbs - for example, ‘I am pushing’, ‘he is jumping’, ‘they are sleeping’, ‘we are running’. You will note that the auxiliaries change with the pronouns (I am, he is, she is, Mummy is) and with singular or plural agents (He is, they are). However children will use the ‘ing’ form of the verb on its own before they begin to use the auxiliaries. When you hear your child using ‘ing’ on verbs, tick and date the checklist.

Past tenses

The past tense of verbs comes in two forms, regular and irregular. The regular form is the ‘ed’ form, for example, jumped and pushed. The irregular forms are all different and have to be learned individually, for example, slept and ran.

A number of irregular past tense forms are learned by children before they use the ‘ed’ form. Early ones may include broke, came, cut, drank, fell, gave, had, made, ran, sat, saw, took, were, went. A further list of irregular past tense verbs is included in the Sentences checklist.

Use of the ‘ed’ ending

In typically developing children, there is a stage when they seem to realise that ‘ed’ on the end of a word creates a past tense and they ‘over use’ it - saying buyed, or goed, for example. In our experience, children with Down syndrome rarely do this but we would be interested to know if you hear your child doing this.

In your observation diary, keep a note of the way in which your child indicates past events and her/his use of the ‘ed’ ending. In order to use the past tense and to help your child understand, a wall chart for the week or the month can be a great help. Mark significant events on the chart, then you can look at it with you child and say “Yesterday, we went to the park”, or “Last week, we rowed a boat on the pond at the park”.

There are other past tense constructions such as ‘we have been’, ‘he has jumped’, ‘he might have jumped before’. We suggest that you leave these to develop with literacy. If at the stage your child is learning to read, you help her/him to keep a simple diary, you will find that you begin to use these constructions.

Children with Down syndrome will understand the language more quickly if the examples used refer to their own activities and actions, rather than to characters in a book - hence the value of keeping a diary.

In your observation diary, keep a note of the way in which your child talks about past events and think of ways to expand her/his own combinations to fully grammatical sentences for practice.

Future tenses

The future tense comes next, but again needs the use of auxiliaries and the verb ‘go’, for example, “We are going to Grandma’s house”, “Daddy is going to work on Monday”, “You are going to school tomorrow”, “He will be going to school tomorrow”.

The wall planner for the week or the month will help you to use future tenses and to encourage your child to do so. Mark the future events in the next week and talk to your child about them. As your child gets older, you can extend the planner to cover the year - and teach days of the week, seasons, months, weather - time words, ‘tomorrow’, ‘today’ - and time concepts - ‘next week’, ‘last month’ - all with reference to events on the wall planner that your child takes part in.

In your observation diary, keep a note of the way in which your child talks about future events and think of ways to expand her/his own sentences to fully grammatical ones for practice.

More advanced structures

There is a lack of research into the emergence of more complex structures in children’s language and even less research on effective ways to teach children to use them. However, the evidence does suggest that both modelling by expanding your child’s utterance to the correct sentence and getting your child to imitate by copying you or by reading, are both important strategies. Most children with Down syndrome will be using 2 and 3 keyword sentences by 5 and 3-4 11 years of age, some will be further ahead than this and some more delayed. Therefore, most children will not use complex sentences until they are in primary school or even later. Young adults with Down syndrome often continue to improve their spoken language through their twenties.

The examples included here are those that will be needed in primary and secondary school, such as comparatives for understanding quantity, and those that occur in assessments of children’s grammar. More research is needed on the development of grammar in the spoken language of children with Down syndrome and we suggest that you continue to use your observation diary to note down the sentences your child is using as a basis for deciding how to extend them.

Comparatives

!

Figure 13. Russian dolls

These can be used to teach adjectives such as ‘’big/little’’ and ‘’tall/short’‘, and later to teach comparatives such as’‘bigger/biggest’’ and ‘’shorter/shortest’’.

Once children have some understanding of words such as big and small, they move on to understanding that size can be relative.

• Big, bigger, biggest
• Small, smaller, smallest
• Daddy is taller than Mummy
• Jenny is taller than Bob but Mummy is taller than Jenny

In this example - Daddy is the tallest and Bob is the smallest. Many children with Down syndrome will be in junior school or older before they really understand comparatives. We have used the example of height because it is easy to choose real life examples from family or school friends to teach it.

More complex sentences

There are many more complex sentence constructions such as embedded clauses, passives and the use of ‘but not’ for example. You may not feel that your child needs to be able to use these but they are included to provide further development for children who are making good progress and are reading and writing at junior school level or above (8 years and older). Many complex sentence forms will be used in children’s reading books at this level and children’s ability to understand what they read will be undermined if their grammatical knowledge is very limited.

Embedded clauses

‘The dog chasing the cat is black’ and ‘The boy who is hungry is getting his dinner’ are examples of sentences containing embedded clauses.

A child who can understand, ‘The dog is chasing the cat’ and ‘The dog is black’ as two separate sentences, may not understand the compound sentence. Picture material can be used to help children to understand these expressions. For children with Down syndrome, reading them in order to support learning to understand them will help, as their limited verbal short term memory skills may make these sentences very difficult to listen to and process.

Passive sentences

‘Sally is being teased by her brother’, ‘The cat is being chased by the dog’ are examples of passive sentences.

‘The cat is being chased by the dog’ is the passive form of ‘the dog is chasing the cat’. Many typically developing children do not master passives until they are in school and reading from books. If you wish to teach this construction to older children, again use their everyday experiences to make teaching materials. They can act out - for example, ‘Jenny is brushing Annie’s hair’ to ‘Annie’s hair is being brushed by Jenny’ - and then write the two examples down under a picture of the action. -Billy is cleaning the car’ or ‘the car is being cleaned by Billy’.

X but not Y sentences

‘It is windy but not raining’. ‘Billy has fallen over but he is not crying’. This type of sentence can be taught with actions and simple picture materials.

These are just some examples of complex sentences that we all use. However, we would remind you that if you listen to what your child wants to talk about and then expand their utterances into correct sentences, you will teach them all the useful grammar that they need and that they will be able to use in real situations. Always try to teach using examples that are relevant to you child and will be able to be used by them often when they want to communicate for real.

Computers and communication aids

Computers and communication aids can make a significant contribution to the speech and language progress and communicative effectiveness of teenagers with Down syndrome. In the USA this topic is referred to as assistive technology, and a useful chapter on the use of assistive technology by Jamie Murray-Branch and Julie Gamradt [TODO: references 39] is included in the excellent practical book Improving the Communication of People with Down Syndrome. [TODO: references 14] They identify that assistive technology can help individuals to:

1. Enhance thinking skills related to communication development
2. Learn to use symbols (i.e. words) for communication
3. Use alternate methods to express ideas when speech is difficult
4. Learn to use words in combination to create longer sentences
5. Learn to understand sentences of greater length
6. Establish social relationships with peers.

A range of software suitable for use by most teenagers is available, including programmes produced by Laureate Learning to support vocabulary learning and sentence structures; programmes such as Clicker 4, Book Spinner, Inclusive Writer, which support language and literacy work, and Writing with Symbols 2000, which includes symbols to support. (Suppliers for these software programmes are listed in the [Resources] section.)

There is also a range of communication ‘low-tech’ aids, such as communication boards, which can be developed to support the teenagers with more limited language and with severe speech intelligibility problems. Some may also benefit from aids which ‘speak’ for them - but the advice of a speech and language therapist should be sought before purchasing a communication aid of this sort, as they can make a proper assessment of an individual’s needs, and will be familiar with currently available aids.

A practical chapter on how to make use of assistive technology, i.e. develop simple communication aids, will be found in Libby Kumin’s recently published book Classroom Language Skills for Children with Down Syndrome. [TODO: references 38] This book focuses mainly on how to assist young people to cope with the language of the classroom, particularly the mainstream classroom. It is not a book on speech and language therapy. However, it is full of practical ideas and illustrations for worksheets and activities that could be used to implement many of the activities recommended in this module.

Overview from 5-11

This module has been written to encourage you, as a parent or teacher, to make a carefully planned effort to accelerate your child’s speech, language and communication skills. We hope that you have found the checklists, the advice and activities useful and relatively easy to use. We realise that we have provided a large amount of information and have asked you to spend some weeks learning about communication and assessing your child in order to make use of the programme.

We have included this amount of information and detailed guidance because we think that it is impossible to exaggerate the importance of speech and language development for every aspect of your child’s social and mental development. Please let us know how helpful or difficult you have found this module and please contact us if you need further help.

Remember that you are helping your child to progress all day everyday, at home and at school, as you talk naturally to them - the extra activities will help but are an addition to all the language learning that is occurring naturally. Remember to speak clearly and to encourage eye-contact with your child in these everyday conversations. They need to be looking and listening. They will also be helped by visual cues in sign or picture. Remember also that background noise will make listening much more difficult for them if they have any hearing loss. Small rooms help, turn off the TV and radio at home and sit children near the front of the class in school.

Your primary age child will also benefit from as much social experience at clubs and activities with non-disabled children as possible, to offer a range of experience and communication opportunities.

This module has been written to encourage you, as a parent or teacher, to make a carefully planned effort to accelerate your teenager’s speech, language and communication skills. We hope that you have found the checklists, the advice and activities useful and relatively easy to use. We realise that we have provided a large amount of information and have asked you to spend some weeks learning about communication and assessing your teenager in order to make use of the programme.

We have included this amount of information and detailed guidance because we think that it is impossible to exaggerate the importance of speech and language development for every aspect of your teenager’s social and cognitive development. Please let us know how helpful or difficult you have found this module and please contact us if you need further help. If your teenager is in a mainstream school or a special school, try to integrate targets for vocabulary, grammar and speech work into the regular curriculum. Try to ensure that your teenager has a language book and a conversation diary. Remember to identify new words that will be needed for topic work and add them to vocabulary lists for practice. Learning to say a new word such as centimetre or volcano correctly can be assessed as an achievement in a maths or geography lesson.

Remember that you are helping your teenager to progress all day every day, at home and at school, as you talk naturally to them - the extra activities will help but are an addition to all the language learning that is occurring naturally. Remember to speak clearly and to encourage eye-contact with your teenager in these everyday conversations. They need to be looking and listening. They will also be helped by visual cues in sign or picture. Remember also that background noise will make listening much more difficult for them if they have any hearing loss. Small rooms help, turn off the TV and radio at home and sit teenagers near the front of the class in school.

Teenagers with Down syndrome will also benefit from as much social experience at clubs and activities as possible. This will increase their range of experience and communication opportunities.