Downs Syndrome

Question 1

What type of heart issues are commonly seen in children with Down’s Syndrome?

Answer 1

Congenital heart defects are common, often requiring monitoring or surgery.

Question 2

Why are children with Down’s Syndrome more prone to infections?

Answer 2

They have a weaker immune system, increasing their risk of frequent infections, especially respiratory.

Question 3

What thyroid condition are children with Down’s Syndrome at higher risk for?

Answer 3

Hypothyroidism (underactive thyroid), which can affect growth and development.

Question 4

What types of vision problems are common in children with Down’s Syndrome?

Answer 4

Strabismus (crossed eyes), cataracts, and short-sightedness are common.

Question 5

What sleep disorder is more common in children with Down’s Syndrome?

Answer 5

Obstructive sleep apnoea — where breathing stops and starts during sleep.

Question 6

What is meant by ‘low muscle tone’ in children with Down’s Syndrome?

Answer 6

It means their muscles are less firm and more floppy, which can affect movement and speech.

Question 7

What are sensory integration difficulties in simple terms?

Answer 7

It means the brain has trouble processing and responding to sensory information (like sound, touch, or movement), which can affect behaviour and learning.

Question 8

What hearing problems might children with Down’s Syndrome experience?

Answer 8

They are at risk of hearing loss due to fluid in the middle ear or structural differences in the ear.

Question 9

What type of hearing loss do bone conduction and bone-anchored hearing aids support?

Answer 9

Sensorineural hearing loss (affecting the inner ear or cochlea).

Question 10

What can a speech and language therapist ask a Teacher of the Deaf?

Answer 10

How they are supporting the child and what their access needs are.

Question 11

What are “access needs” in the context of a child with hearing loss?

Answer 11

The support and adjustments needed for the child to fully participate in learning and communication (e.g. seating, visual aids, use of hearing equipment).

Access needs are the specific adjustments or supports a child requires to fully engage and participate in their environment — especially learning. For a child with hearing loss, this could include:

• Preferential seating (e.g., near the teacher)
• Use of radio aids or sound-field systems
• Visual supports (e.g., signs, symbols, lip-reading support)
• Ensuring background noise is reduced
• Regular check-ins to ensure understanding.

Question 12

Do children with Down’s Syndrome make progress in development?

Answer 12

Yes, they make progress in all areas, but development is usually delayed compared to peers.

Question 13

What are some social strengths in children with Down’s Syndrome?

Answer 13

They often have strong social skills, including smiling, making eye contact, and being sensitive to facial expressions and tone of voice.

Question 14

What type of learners are children with Down’s Syndrome?

Answer 14

They are often visual and kinaesthetic learners.

Question 15

How can small group work support learning for children with Down’s Syndrome?

Answer 15

It lets them watch and learn from peers, supporting both visual and social learning.

Question 16

Why is it important to pitch activities at ‘just the right level’?

Answer 16

If tasks are too hard, children may disengage. If pitched just right, they stay motivated and feel successful.

Question 17

What motivates children with Down’s Syndrome during learning?

Answer 17

They are often highly motivated by social interaction, praise, and encouragement.

Question 18

What are working memory difficulties?

Answer 18

It means they may struggle to hold and use information in their mind for short periods – e.g. following multi-step instructions.

Question 19

How do working memory difficulties affect learning?

Answer 19

They may forget what they were just told or lose track of tasks, so it helps to break things down into small steps.

Question 20

What language skill should we focus on at school age for children with Down’s Syndrome?

Answer 20

Phonological awareness – such as identifying and playing with sounds in words. Also reading

Question 21

Why is phonological awareness important for children with Down’s Syndrome?

Answer 21

It supports the development of reading and spelling skills.

Question 22

What kind of memory training games can help children with Down’s Syndrome?

Answer 22

Simple games like taking one item away from a group and guessing what’s missing – this helps strengthen working memory.

Question 23

Are behaviour problems a direct part of Down’s Syndrome?

Answer 23

No, behaviour problems are not part of the syndrome itself, but some factors make them more likely.

Question 24

Why might children with Down’s Syndrome be more sensitive to negative emotions from others?

Answer 24

They are socially aware and can quickly pick up on facial expressions, tone of voice, and body language.

Question 25

How might negative emotions from others affect a child with Down’s Syndrome?

Answer 25

They may feel rejected or disliked, and express those feelings through behaviour such as hitting or biting.

Question 26

Why is it important to look at the reason behind a challenging behaviour (like hitting or biting)?

Answer 26

Because behaviour is often a form of communication – it may be due to pain, sensory needs, frustration, or trying to get attention or maintain social interaction.

Question 27

Why might behaviour difficulties increase around age 4 in children with Down’s Syndrome?

Answer 27

They may start noticing they are different from peers, such as being taken out of class by a teaching assistant, and may not yet have the language to express how they feel.

Question 28

What are the ways to navigate problem behaviours

Answer 28

-give specific praise -pay attention to the child and not the problem behaviour -keeping consistency in behaviours strategies across setting -using visual cards to promote positive behaviour (e.g. more, help)

Question 29

Why is consistency in behaviour strategies important across settings?

Answer 29

Children with Down’s Syndrome benefit from clear, predictable routines and boundaries. Inconsistency can lead to confusion and frustration.

Question 30

How can video modelling support older children with Down’s Syndrome?

Answer 30

They can watch videos of themselves or others doing tasks, which helps them learn through visual demonstration.

Question 31

What should adults be alert to, even in a predictable routine?

Answer 31

Changes in the routine that might cause stress or confusion – these should be prepared for with visual supports or clear explanations.

Question 32

What percentage of children with Down’s Syndrome use spoken language as their main way of communicating?

Answer 32

Around 90%.

Question 33

How does comprehension compare to expressive language in children with Down’s Syndrome?

Answer 33

Comprehension is usually stronger than expressive language.

Question 34

What areas of language can be difficult for children with ds

Answer 34

- learning new words more slowly but can develop a broad vocabulary over time. should focus on building vocab - learning grammar

Question 35

Why is speech clarity often reduced in children with Down’s Syndrome?

Answer 35

Due to factors like low muscle tone, oral motor difficulties, and hearing issues.

Question 36

Why might children who aren’t speaking yet hear less language from adults?

Answer 36

Parents tend to respond more when a child uses words, so non-verbal children may get fewer language-rich interactions.

Question 37

In addition to general language strategies, name some helpful strategies when working with children who have DS.

Answer 37

- hearing words in isolation and repeating - use a photobook (e.g. from a zoo trip) makes language more meaningful to the child - recasting; using correct grammar - saying concept words (describing) last, e.g. the car is blue - teaching words alongside makaton and doing actions - using written words - encouraging repetition - a conversation diary - teaching verbs

Question 38

What is the purpose of using a checklist in language support? give an example.

Answer 38

A checklist helps adults stay consistent with strategies (e.g. “Am I giving enough wait time?” or “Did I model the target word?”). A therapist might use a laminated list of prompts to tick off during play, such as: “Modelled key word,” “Used Makaton,” “Offered choice.”

Question 39

What is a conversation diary, and how does it support language?

Answer 39

A conversation diary is a visual or written record (photos, drawings, words) of what the child did, which can be used to support recall and conversation.

Question 40

Can you give an example of using a conversation diary?

Answer 40

After a zoo trip, print photos and stick them in a book with captions like “Saw a lion.” Use it to talk about the event with adults or peers.

Question 41

How can a mirror be used in speech therapy for children with Down’s Syndrome?

Answer 41

A mirror lets the child see how their mouth moves when making sounds, supporting visual feedback.

Question 42

What facial/oral structural differences may affect speech in children with Down’s Syndrome?

Answer 42

They may have low muscle tone, a high palate, different jaw alignment, and differences in facial musculature.

Question 43

How can a high palate affect speech?

Answer 43

It may lead to increased nasality or difficulty forming certain sounds due to the shape of the oral cavity.

Question 44

Why might a child with Down’s Syndrome have a protruding tongue?

Answer 44

This can help with breathing if their airway is small or they have structural differences.

Question 45

What causes open-mouth posture in some children with Down’s Syndrome?

Answer 45

Low oral tone, tongue position, or nasal congestion may result in an open-mouth posture. It can lead to poor saliva management and symptoms like chapped lips or drooling.

Question 46

Why can speech clarity be reduced in children with Down’s Syndrome?

Answer 46

Because of low muscle tone, structural differences, slower and less precise movements, and auditory/phonological processing challenges.

Question 47

Why are speech movements particularly difficult for children with Down’s Syndrome?

Answer 47

Speech requires fine, coordinated movements, and low muscle tone makes it harder to sustain or control them.

Question 48

What does an example of this difficulty look like with the ‘f’ sound?

Answer 48

The child may struggle to hold the lip-teeth position, resulting in a less precise or “vague” version of the sound.

Question 49

What types of speech errors are common in children with Down’s Syndrome?

Answer 49

They may show typical phonological errors (like fronting or final consonant deletion), but more frequently or for longer than typically developing peers.

Question 50

Is speech development possible in children with Down’s Syndrome throughout life?

Answer 50

Yes – progress is absolutely possible, even into adulthood.

Question 51

Why is it important to check if a child’s airway is clear before speech work?

Answer 51

Blocked noses or poor airflow can affect resonance, nasal quality, and the ability to produce clear speech sounds.

Question 52

Why is it important to be face-to-face and level with the child during speech interaction?

Answer 52

It supports better attention, clearer modelling, and enhances social engagement.

Question 53

Why is appropriate seating important during speech sessions?

Answer 53

Children with low tone need postural support to stabilise their body and allow better oral motor control.

Question 54

What kinds of facial movements can help build oral strength?

Answer 54

Activities like smiling, blowing kisses, licking lips, and using straws can help strengthen facial muscles.

Question 55

Why should we avoid pretending to understand a child’s unclear speech?

Answer 55

Children with Down’s Syndrome are socially sensitive and may notice when adults aren't being genuine, which can affect trust and confidence.

Question 56

How can grouping target words support speech development?

Answer 56

Using words that share a strong sound helps the child succeed and build confidence.

Question 57

Can you give an example of grouping target words based on a strong 'k' sound?

Answer 57

Yes – if the child produces /k/ well, you might target: “cat,” “car,” “cup,” “coat,” “cookie.”

Question 58

What is errorless learning, and why is it helpful in speech therapy?

Answer 58

Errorless learning involves setting the child up for success by modelling the correct response before errors occur. This builds confidence and reinforces the right production.