Phrases

Two and three words together

Some children with Down syndrome will be talking in short sentences when they start at primary school but many will be using two and three keywords together. Examples of the range of two and three word phrases that children use is set out in the Sentences and grammar checklists and record sheets. Most children will have comprehension at the three keyword level and will probably be ready to move to using three word combinations to communicate.

For both two and three word phrases one way of encouraging children to move on and to string three words together is to engage in imaginative play.

Two words

! Russian dolls

Figure 10. 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”.

In this section we shall look briefly at encouraging the use of two words together. It is difficult to state an exact moment at which two words or sounds should be expected. When a child has about 50 words is the time to start encouraging them to join words together. The Sentences Checklist provides a guide to the range of two word combinations that children use. Your child needs to be able to use different types of words, not just the names (nouns) that are the first words learned, in order to join words together. The Vocabulary Checklist provides examples of verbs, adjectives and prepositions as well as nouns, to ensure that you encourage this range of words. As with developing single words, models of the combinations required need to be given. Also the child’s understanding must be increasing to the point at which she/he can respond to simple instructions, e.g. “find daddy’s coat” (where they have a choice of other people’s coats or boots) rather than just “find the coat”.

Imitation with expansion

One of the best ways to help your child make the transition from the one word to the two-word stage is to use imitation with expansion. To do this you first repeat a word your child has said and then expand what they have said, stressing the keywords.

! Games to teach textures

Figure 11. Games to teach textures.

Collect objects with different textures and put in a bag. Ask the child to feel one whilst saying “What is it?… Is it hard/soft/shiny/rough/smooth…” Take turns to select an item from the bag.

For example, your child may say “car” while pointing to a car and you may respond with “that’s Grandpa’s car” or “it’s a blue car” or “the car’s going” as appropriate. Or your child may point and say “dog” and you say “the dog’s barking”, “the dog’s sleeping” or “it’s a black dog”. One more example might be, your child says “more” and you expand to “do you want more juice” or “do you want more toast”.

Children’s early two word combinations often consist of one constant word which they join with many different words, e.g. gone, more, please, by, again, where, in and these are sometimes referred to as pivot words. They are then used with nouns to produce two word combinations such as “more biscuits”, “more juice”, “more car”, “more jump” - “big train”, “big shoe”, “big coat”, “big banana” - “biscuit please”, “drink please”, “train please”, “cup please” - “bye daddy”, “bye mummy”. Children may wish to indicate possession, e.g. daddy car, mummy bag, dolly foot, or combine the name of a person with an action, e.g. “Billy jump”, “mummy go”, “baby wash”. There may be combinations of an action with an item name, e.g. “kiss doll”, “eat please” and so on.

Many of the activities as described in the single word section can be adapted to two words together, e.g. posting pictures or objects into a box. You would ask the child first to put the cup, shoe, brick in the box and then perhaps pick up an object, give it to the child who names it, and then puts it in the box and as he is putting it in the box encourage them to say “box” as well so the child begins to say, for example, “cup box”, “shoe box” or “in box” or “cup in”. You would give the child a great deal of help to start with, gradually reducing the help until they can say the utterance by themself. You can also play a disappearing objects game. Take an object that is in front of the child away and model “cup gone”.

! Cars for size or colour

Figure 12. Cars for size or colour.

Toy cars collected to teach size and colour: “Can you give me a blue car?”, “Can you give me a big blue car?” The man can be used to teach prepositions: “Can you put the man on/behind/in front of the yellow car?”

Action words (aiming for name of person and the action)

You could play ‘Simon Says’. You say “Simon says ‘Billy jump’ (or ‘daddy hop’ or ‘mummy sit’)”. The child is gently encouraged to join in and direct the action using two words. Two word combinations can also be encouraged in doll play. Instead of just asking the child which body part you are going to wash, you could encourage him to use the action word “wash” as well, so that he is telling you to “wash feet” or “wash face” etc. Likewise with the dressing activity you could encourage your child to use combinations such as “coat on”, “shoes off”, dolly’s skirt”, dolly’s socks” etc. when describing what they want you to do or what you are doing to the dolly. In the tea party situation you could also encourage the use of two words, e.g. when giving out crockery and cutlery encourage the child to say “plate to teddy”, “cup dolly”, “dolly drink”, “teddy eat” and so on.

As with single word activities, there are many opportunities throughout the day for encouraging language development and the situations discussed in the single word section can be adapted so that you use two word combinations, e.g. at bedtime you could, as you are talking about the clothes they take off, say “shoes off”, “pants off” and encourage them to use these combinations.

In this section, activities have been suggested which can give you an opportunity to concentrate on and work on developing your child’s language, both her/his understanding and her/his ability to express her/himself. Many more ideas are listed in some of the books listed in the reference list. [9-12]

Using visual and motor cues

Libby Kumin suggests the use of a pacing board to provide a visual and tactile reminder of the number of words your child is trying to use. [TODO: references 9] For example, she suggests that a pacing board may consist of two coloured dots on a piece of cardboard, or two teddy bear blocks put next to each other, or anything else that your child likes. As you use two words point to each spot on the board as you do so. She suggests that helping your child to put their hands on the spots as they say the word will prompt them to recall the number of words that they need and to help them increase their combinations to two, three and four word sentences.

Encouraging your child to continue to sign as they speak may also act as a prompt as they begin to join words. It seems that if they sign each word they may well be able to recall the signs in sequence, and this will act as a prompt for the words that they need. However, remember that at this stage we do not want signs to be used without an explicit reason for them, so you might use signs to model a two word utterance but not use the same signs in other contexts where the child can understand and use the words without help. It will also be apparent that the use of printed words can also help the child to produce multiword sentences.

Reading

The teaching of reading and the use of print to support practice should begin once your child understands some 50 words, and can say or sign some of them. They are now ready to understand and use two words together. At this stage we would expect your child to be able to match and select pictures, for example, when playing a picture lotto game, and to name some of the pictures. Your child can then be introduced to learning printed words by playing matching, selecting and naming games.

Researchers worldwide all agree that children with Down syndrome are visual learners. Their visual discrimination and visual memory skills are strengths, while their auditory discrimination and auditory memory skill are a weakness. We have been teaching children with Down syndrome to read from the age of two years for the past twenty years. Progress will vary but many children make surprisingly fast progress and the words that they see in print soon emerge in their spontaneous spoken language. Furthermore, children who start early - at two to three years of age - make the greatest gains in both spoken language and reading skills. They are often reading at an age appropriate level at 8 or 9 years and have very good comprehension and use of spoken language. We would speculate that we may be taking advantage of a period when the brain is maximally open to language learning and that we really are using print as a way into spoken language for these children. Please look at the programme described in the reading module and make maximum use of reading to help your child.

Researchers worldwide agree that children and teenagers with Down syndrome are visual learners and benefit from reading instruction. [23-25], [TODO: references 14], [TODO: references 40] Their visual discrimination and visual memory skills are strengths, while their auditory discrimination and auditory memory skill are a weakness. The approaches used in the Australian Latch-on programme [TODO: references 23] and in the use of computers by Meyers [TODO: references 26], [TODO: references 44] - both outlined earlier in the section on ’ Literacy activities and using computers’ - will be appropriate for a wide range of teenagers.

We have been teaching children and teenagers with Down syndrome to read for the past twenty years. Progress will vary but many young people make surprisingly fast progress and the words that they see and read in print soon emerge in their spontaneous spoken language. We would speculate that we are using print as a way into spoken language for these children. Please look at the programme described in the reading module and make maximum use of reading to help your teenager.

All speech and language targets can be linked to literacy work. Phonics activities will help speech sound awareness and sound production skills. Literacy work at word, sentence and text level will link to vocabulary, grammar, narrative and conversation targets. Supported reading will help sentence planning and fluent production of sentences.

One ten year old known to the authors made the link between her phonics knowledge and her speech intelligibility for herself. After several attempts to get her mother to understand a word that she was saying, she ‘sounded’ the word out, identifying the letters in the word she was trying to say, so that her mother could understand her!

Symbols

Picture symbol systems are often advocated for use with children with learning delays and children with Down syndrome. These are often associated with sign systems, but we do not recommend that they are used unless your child is having particular difficulty with learning to talk or to read. We always use ordinary printed words to teach children to read, from as early as two years of age. If properly taught, almost all children will learn the words as easily as symbols. In school situations, placing the word cards around the environment - with picture clues if necessary - will be far more likely to teach children to read than putting symbols everywhere. Like spoken words, the more often a printed word is seen in a context where you can see what it means the faster a child will learn and remember it.

If symbols are used in an unplanned way, learning symbols and then print is like learning two languages, like learning Chinese and then learning English. A further problem with the use of sign and symbol systems is that they cannot teach English grammar, unless adapted to do so. Written English is essentially the same as spoken English.

Symbols can be used to support reading of print if used in a planned way. Symbols can help to prompt the grammatical words or new words in a sentence and to illustrate topics in an interesting way. Symbols can be used to interest a child in reading, when the child has already experienced failure and is not keen to try reading activities. Then a symbol-supported system, particularly used on the computer, may motivate the youngster because it looks like something new rather than something already disliked. Symbols can also be used to interest teenagers in reading and writing, when they have already experienced failure and are not keen to try reading activities. A symbol-supported system, particularly used on the computer, may motivate teenagers because it looks like something new, especially if they are finding reading difficult. Writing with Symbols 2000 is a programme that will help many pupils.

Three words together

At the next stage your child will be moving to understand and to use three keywords together and examples of the range of three word phrases that children use is set out in the Sentences Checklist.

As with two word phrases one of the best ways to encourage your child to move on and to string three words together is to engage in imaginative play as already described. Playing games with your child gives you many opportunities for encouraging choices that require comprehension or production of three words or more, such as ‘put the cat in the box’, ‘put the red car on the big box’.

Once your child has comprehension at the three word level, you can encourage expression by playing with your child and getting your child to instruct you to carry out the activities, so reversing the roles of teacher and pupil. Libby Kumin draws attention to carrier phrases such as ‘I want’, ‘I like’, ‘I see’ and identifies that these can be readily taught requiring the child only to add a novel third word.

Prepositions such as ‘in’, ‘on’ and ‘under’, are learned at this three word stage and it is easy to devise games asking children to put something in or on a box or a table or a chair.

Making simple books on a theme such as ‘I like’ or ‘I can’ and developing reading activities will help your child to expand the sentences that they understand and use.

Many teenagers with Down syndrome will be talking in short sentences when they start at secondary school but some will be using two and three keywords together. Examples of the range of two and three word phrases that young people may use is set out in the Sentences and grammar checklists and record sheets.

All the evidence indicates that few children with Down syndrome will learn grammar from simply listening to everyday conversations, although 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 teenager is learning grammar all the time you are talking to them in natural sentences.

One simple rule mentioned earlier, imitation with expansion, will be effective to help your teenager progress from two and three words together to proper sentences:-

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

You can use the same strategy when thinking about making [language 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 practise in games or with reading activities. For example ‘’Put the drink on the table’‘,’‘The video is here, not over there’‘,’‘There is a burger and a coke’‘,’‘If you get your coat, we can go to the disco’‘,’‘We need our coats because it is raining’’.

You can make use of an observation diary to help you observe and encourage your teenager’s grammatical development and ability to use longer sentences. Keep your diary near to hand and note down the phrases and sentences that your teenager 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.

Conversation diary