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Background: Previous studies have explored the size and word type composition (nouns, predicates, etc.) of expressive vocabularies of preschool children with Down syndrome, both spoken and signed. Separately, overall preferences for modality of expression have also been explored., Aims: To extend previous findings by describing the relationships between expressive vocabulary size and both word type and modality of expression in the preschool period including changes to modality preference over time., Methods & Procedures: Mothers of 35 children with Down syndrome, aged 36-66 months and attending the same early intervention programme, completed a version - with both spoken word and sign options - of the New Zealand MacArthur-Bates Communicative Development Inventory (CDI): Words and Sentences. Most mothers completed the CDI on multiple occasions across the duration of the study. Completions (n = 114) were analysed cross-sectionally and longitudinally in terms of (1) word type relative to vocabulary size, (2) modality of expression relative to word type and vocabulary size, and (3) individual trajectories in vocabulary size and modality of expression., Outcomes & Results: (1) Word type relative to vocabulary size was similar to previous studies with a greater proportion of the SOCIAL words being present in the children's vocabularies throughout, followed by NOUNS, PREDICATES and CLOSED class words, with proportions converging as vocabulary sizes increase. (2) An initial spoken word preference for SOCIAL and CLOSED class words and sign preference for NOUNS and PREDICATES was found, with more spoken words in larger vocabularies overall. (3) Individual trajectories were highly variable and also revealed temporary points of regression in overall expressive vocabulary size in some children. Children who shifted from reliance on sign to predominantly spoken word expression did so at different ages and at different vocabulary sizes. At school entry, while most of the children used both modalities, some children continued to rely on sign for most vocabulary items whereas others used only spoken words., Conclusions & Implications: An appreciation of both the general trends and potential for individual variation in vocabulary structure, modality of expression and change over time will better position clinicians and education specialists to provide individually tailored support to both preschool and school-aged children with Down syndrome., What This Study Adds: What is already known on this subject Preschool children with Down syndrome have been shown to demonstrate developmental patterns in overall conceptual vocabulary size and word type development broadly similar to typical development. The use of signed vocabulary has also been explored, but independently from word type development and with less attention to individual trajectories in either vocabulary size development or modality preferences throughout the preschool period than is necessary for clinical use. What this paper adds to existing knowledge This study found interactions between word type and modality of expression in relation to vocabulary size as well as a few temporary vocabulary size regressions similar to those found in much younger typically developing children. An initial spoken word preference for social and closed class words, and sign preference for nouns and predicates, was followed by a general trend towards spoken words for all word types as vocabulary (with some fluctuations) increased over time. Children demonstrated considerable individual variation in size of vocabulary and age at which they pivoted from a signed to a spoken word preference. Moreover, while most children used both modalities at school entry, a few retained a sign-only vocabulary and others had moved fully onto spoken word-only expression. What are the potential or actual clinical implications of this work? An understanding of both the general trends and individual variation in vocabulary structure and modality of expression development will better position clinicians and educational specialists to provide individually tailored support to children with Down syndrome., (© 2022 The Authors. International Journal of Language & Communication Disorders published by John Wiley & Sons Ltd on behalf of Royal College of Speech and Language Therapists.)

Background: Personal narratives are descriptions of past events experienced by the speaker and are one of the most commonly found forms of narration in children. The ability to tell personal narratives is considered critical for socio-emotional wellbeing and academic performance., Aims: This study investigated the personal narrative skills of 25 children with Down syndrome (age 5;11-13;1 years) who attended predominantly mainstream primary schools in New Zealand and were classified as beginning readers., Methods & Procedures: Personal narrative samples were elicited by the children's speech-language therapists using a standard protocol commonly used with New Zealand children. Children were shown a series of 11 photographs with scripted introductory prompts and were asked if anything like that ever happened to them. Transcribed samples were analysed on measures of mean length of utterance in morphemes (MLU-M), semantics (number of different words; NDW), and personal narrative quality (PNQ)., Outcomes & Results: Consistent with previous research, results showed wide variability in performance. Although 92% of the children produced at least 50 utterances in response to the prompts, in general MLU-M was very low (mean = 2.67, SD = 1.04). NDW ranged from 19 to 126 (mean = 61.52, SD = 25.39). Regression analyses showed no significant effect for age on MLU-M (p= 0.094), nor on PNQ. There was a significant effect for age on NDW (p= 0.03), with performance improving with age. Analysis of PNQ revealed that only four children (ages 9;11-12;7) were able to relate a personal narrative containing a high point. Correlational analyses indicated significant correlations between PNQ, MLU-M, NDW and performance on a standardized reading test., Conclusions & Implications: The findings highlight the difficulties children with Down syndrome have in producing personal narratives, despite exposure to a national English curriculum that encourages children to develop and convey 'personal voice'. Clinical implications of these findings will be presented., (© 2011 Royal College of Speech & Language Therapists.)

Background: Children with Down syndrome experience difficulty with both spoken and written language acquisition, however controlled intervention studies to improve these difficulties are rare and have typically focused on improving one language domain., Aims: To investigate the effectiveness of an integrated intervention approach on the speech, letter knowledge, and phonological awareness development of ten pre-school children with Down syndrome aged between 4;4 and 5;5., Methods & Procedures: A multiple single-subject design was used to evaluate treatment effectiveness. Baseline and intervention measures for speech and pre- and post-intervention measures for letter knowledge and phonological awareness were compared. The intervention comprised three components: a parent-implemented home programme; centre-based speech-language therapy sessions, and 'Learning through Computer' sessions with a total intervention time of 20 hours over 18 weeks. Letter knowledge and phonological awareness activities were linked to each child's speech targets., Outcomes & Results: Results indicated significant treatment effects on speech measures for all ten participants. Six of the ten participants showed increases on letter knowledge and nine showed increased awareness of initial phonemes in words but responses were not above binomial chance level (that is, 70% correct) for phonological awareness tasks. Individual results are presented and implications for parents and therapists are discussed., Conclusions and Implications: The findings of this study suggest an intervention approach that integrates speech, letter knowledge, and phonological awareness targets is effective in remediating speech error patterns at the single-word level in young children with Down syndrome. Phonological awareness and letter knowledge appeared to be stimulated through the intervention, but significant improvement above chance levels on untrained phonological awareness tasks was not evident. Follow-up investigation is necessary to determine longer-term outcomes.