Down’s syndrome and speech and language development – what to expect

Every person with Down’s syndrome is an individual, with their own unique personality, strengths and differences.

This page is about some of the characteristics which many people with Down’s syndrome have in common. People with Down’s syndrome can continue to make progress with their speech and language skills throughout their lifetime. All children are individuals and there is a wide range of what to expect in terms of how your child’s language develops. Many people with Down’s syndrome grow up to use spoken language and some people may communicate in alternative ways, such as signing, pictures or body language. Often it is a combination of spoken language and these alternatives.

Below are some speech and language features which many children with Down’s syndrome have in common.

Hearing problems

• More common in babies and children with Down’s syndrome. It may be harder for your child to hear the words and sounds you are saying.
• You can help your child by getting their hearing tested regularly and helping them get used to wearing hearing aids if they need them.
• Using Makaton signs helps make what you are saying visual if your child is finding it hard to hear.

Understanding language

Your child may find it hard to understand words and sentences. There are lots of steps involved in listening and understanding, including:

• Hearing the words
• Paying attention to the words
• Hearing the different sounds in the words
• Understanding the words
• Remembering the words

For children with Down’s syndrome, moving through the steps in this process can take longer so they may need more time to work through them, or ‘process’ the language. There may be a maximum number of words a child can remember in a sentence. This is likely to improve over time.

Using language

Your child may take longer to learn language. Your child is likely to be able to understand more than they can express initially. They will need extra chances to learn new words and may find it harder to learn how to use the grammatical aspects of language. This does not mean they will not have a lot to talk about! They just might need some extra help to get across their thoughts and ideas.

Since children with Down’s syndrome are strong visual learners, visual support systems such as Makaton signing can help children to express themselves. For more information about Makaton signing please see ‘Getting started with Makaton‘ page.

• Keep talking to your child, even when they are not yet talking back.
• Playing and chatting together will help all aspects of their communication.

Your speech and language therapist will talk to you more about the different strategies you can use to develop your child’s language and communication skills – further information and ideas can also be found in the ‘Language strategies for children with Down’s syndrome‘ page.

Speech sounds

It can be harder for people with Down’s syndrome to hear and use speech sounds.

There are a number of things that can make it hard for people with Down’s syndrome to have clear speech. This includes:

• Difficulty hearing the difference between speech sounds
• Difficulty remembering sounds and putting them into words
• Low muscle tone in the muscles of the mouth
• Difficulty co-ordinating the muscles of the mouth

Makaton signing and other visual supports can help children get their message across while their speech sounds are developing.

Eating and drinking

Some children with Down’s syndrome may have difficulties with their eating and drinking, others do not experience any difficulties.

Indications your child may have a feeding difficulty include:

• Breathlessness when eating or drinking
• Coughing, choking or changes in their voice or cry
• Recurrent chest infections
• Weight loss
• Difficulty controlling saliva, food or drink in mouth

There are a number of reasons why a child may have difficulties with their eating or drinking. These include:

• Anatomical differences such as smaller mouths and jaws, high, narrow arched palates, tongue sitting more forward in the mouth
• Other co-existing health issues such as heart problems, reflux, enlarged adenoids and tonsils
• Low muscle tone affecting posture and co-ordination
• Sensory sensitivities such as hypersensitivity to particular textures or tastes

If you have any concerns about your child’s eating or drinking skills please discuss with your speech and language therapist or medical team.