Common patterns in development
Common patterns in development among children and young people with Down syndrome…
A specific developmental profile
The specific developmental profile associated with Down syndrome
Children with Down syndrome are all individuals and vary in their rates of progress - however, they tend to have a specific profile of strengths and weaknesses:
- Social development and social learning are strengths, right from infancy - the children enjoy and learn from social interaction with adults and peers
- Motor development is usually delayed and may hold back progress in self-help skills, handling toys in play and in writing, though the use of gesture to communicate is a strength
- Speech and language development is usually the children’s area of most significant delay - it is more delayed than non-verbal abilities. Most children understand more than they can say and signing is an important bridge to speaking. Speech intelligibility is usually a difficulty. A high incidence of hearing difficulties is contributing to speech and language delay.
- Working memory development is specifically delayed relative to non-verbal abilities, particularly the verbal short-term memory component - so that learning from listening is difficult for the children. Working memory also supports thinking, problem solving and reasoning. Visual and spatial processing and memory are relative strengths - so that the children learn effectively from visual information - they can be thought of as visual learners.
- Social behaviour- the children have strengths in social skills and in developing age-appropriate social behaviour, if this is encouraged and expected. However, their good social understanding and empathy leads them to pick up on non-verbal emotional cues, such as those for anxiety or disapproval, very quickly. They are therefore sensitive to failure and may use behavioural strategies to avoid difficult situations.
Over the last 15 to 20 years, researchers have made progress in understanding the effects of having Down syndrome on development, though there is still much more to learn in order to fully understand how to help the children. Research has identified a specific profile of developmental strengths and weaknesses. However, while this profile is typically associated with Down syndrome, the degree to which any individual with Down syndrome shows this pattern will vary. It is helpful as a guide to understanding any child’s developmental needs and learning profile, but it should be treated as a checklist for any individual child, as they may have all or none of these characteristics and if they do have some, the degree to which they show any strength or weakness will need to be assessed in order to develop an appropriate therapy, early intervention or teaching programme.
While children with Down syndrome experience some delays in all areas of development, the extent of the delay is not the same across all areas of development.
Social understanding and social interactive skills are a relative strength and less delayed than speech and language skills. Most children with Down syndrome make eye-contact, smile and interact by cooing and babbling from the first months of life, and show little delay in social interactive skills. They are socially sensitive and understand the non-verbal cues to emotions, such as facial expression, tones of voice and body postures, from the first year of life.
Motor skills, including reaching, sitting and walking, are delayed but the main milestones are steadily achieved and most children become mobile and independent in self-help skills, such as feeding and dressing, which require motor skills.
Speech and language skills are more delayed than the children’s non-verbal understanding and reasoning abilities. This is a pattern of specific language impairment. Most children with Down syndrome understand more language than they can use as a result of specific speech production difficulties. For this reason, learning to sign will help the majority of children to communicate, to show their understanding and reduce their frustration. Hearing difficulties, usually due to ‘glue ear’ are common (see the ’ Hearing disorders’ section) and contribute to speech and language difficulties.
For most children with Down syndrome, the most serious delay that they experience is in learning to talk. This is not only frustrating but it has serious consequences for all other aspects of their social and cognitive development.
As children learn to talk, each new word that they learn is a new concept or piece of information about their world. Once they can string words together, speech becomes a powerful tool for learning and for communicating with everyone in their world, and it also becomes a tool for thinking, remembering and reasoning. We carry out these mental activities using silent speech in our minds. While we can also use visual imagery to imagine and recall events, reasoning with the use of language is considerably more powerful. It follows that a serious delay in learning to understand and to use language will lead to delay in all aspects of mental or cognitive development. Conversely, if we can improve the rate at which children learn language, this should benefit all areas of their social and cognitive development.
Working memory development, particularly verbal short-term memory, seems to be specifically impaired - again not progressing as fast as would be expected for non-verbal abilities - and this has consequences for the children’s ability to process information.
Visual memory and visual processing are relative strengths, while auditory processing and auditory memory are more impaired. This means that children with Down syndrome should be thought of as visual learners and all teaching supported with visual materials.
Reading ability is often a strength from as early as two years of age, perhaps because it builds on visual memory skills, and reading activities can be used to teach spoken language from this time.
Number seems to be relatively more difficult for children with Down syndrome and their number skills delayed relative to reading skills.
Social behaviour is a strength as children with Down syndrome are less likely to develop difficult behaviours than other children with similar levels of cognitive delay. However, children with Down syndrome are, as a group, more likely to develop difficult behaviours than non-disabled children of their age.
