How Speech and Language Therapy Can Help Children With Down Syndrome

Mother hugging child with Down syndrome

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Down syndrome can make it challenging for a child to articulate their words and it can affect their ability to hear and understand.

Early language intervention via speech and language therapy can make a life-changing difference.

What Is Down Syndrome?

Down syndrome, also called trisomy 21, occurs when a baby is born with an extra copy of chromosome 21.

There are three types of Down syndrome:

  • Complete trisomy 21
  • Mosaic trisomy 21
  • Translocation trisomy 21

Similar developmental differences exist at varying degrees between the three types.

Neurotypical people are born with two copies of each of the 23 chromosomes, having received one copy from each parent. Therefore, every cell in the neurotypical human body contains 46 chromosomes in it, with the exception of the sperm and egg cells.

With Down syndrome, there is an extra chromosome or part of a chromosome present.

Chromosomes are like a code that controls the way a person grows and develops. Having an extra chromosome alters the way a child grows and learns.

How Down Syndrome Affects Speech and Language

Because people with Down syndrome are born with a slightly different DNA code, they develop in a unique way. Some of these differences can impact speech and language.For example:

  • Low facial muscle tone can make articulation challenging.
  • A comparatively large tongue for their mouth size can make it harder to form sounds.
  • Frequent ear infections can impede hearing due to the presence of fluid in the ears.
  • Slower learning capabilities can push back developmental milestones, including speech milestones.

These differences lead to receptive language (what the child understands) being stronger than expressive language (what the child says). There are several preventative and proactive treatments that can be done early on to help bridge this gap.

With proper support, children with Down syndrome can better communicate their needs and experience less anxiety and greater confidence.

Feeding Therapy

Children with Down syndrome often have anatomical and physiological differences in the mouth and throat region that affect feeding, swallowing, and oral motor skills.These differences include low facial muscle tone, a small oral cavity with a relatively large tongue, and a narrow, high-arched palate. 

If your child struggles with mealtime or seems to have difficulty swallowing, feeding therapy can help solve these issues while also supporting proper language development.

Feeding therapy given by a speech language pathologist or an occupational therapist can help strengthen the facial muscles necessary for articulation.

Down Syndrome and Hearing Loss

Approximate two-thirds of children with Down syndrome experience hearing loss.Hearing problems in childhood affect language development, and they can often go unnoticed.

Children with Down syndrome are prone to frequent ear infections. Ear infections are caused by the accumulation of fluid behind the eardrum, which makes it difficult to hear. The shorter, narrower ear canals characteristic of Down syndrome are more susceptible to fluid build up.

Regular hearing tests are essential to prevent this issue. Ear infections can be treated with antibiotics. If ear infections are a recurring issue, however, your child's doctor may suggest surgically-inserted ear tubes that will properly drain fluid and prevent future infections.

Benefits of Sign Language

Sign language can support speech and language development in children with Down syndrome when it is used a transitional tool. While sign language can be used as a primary communication system for children who are deaf or hard of hearing, it helps children with Down syndrome communicate their needs while also supporting them on the path to developing oral language.

By 10 to 12 months of age, children with Down syndrome understand that spoken language is a form of communication. Barring any hearing issues, they can comprehend what is said to them. This being said, they are often not physically or neurologically ready to speak until closer to age two or three.

Sign language gives preverbal children a way to express their needs, thereby reducing anxiety and discomfort. When used together with gestures and spoken language, sign language helps children with developmental delays learn to talk.

Parents and other caregivers should speak and sign simultaneously. Whenever you sign, say the word aloud as well. Your child will most likely respond with signs until they are ready to speak.

Other Speech and Language Supports

Along with signs and gestures, communication boards and synthesized speech systems can be used to help bridge the language gap.

Communication boards are made of pictures that children can point to in order to express their needs.

For example, one image might mean "hungry" while another indicates the need to use the toilet. While the child will point initially, the adult should speak and point together, such as pointing to the "hungry" picture while saying, "Are you hungry? I'll get you a snack."

Synthesized speech systems can be helpful for children whose speech is more severely impacted. A speech language pathologist or an augmentative communication specialist can help your family set one up and teach your child to use it.

Environmental Factors and Language Development

Parents and caregivers can best support babies' language development by surrounding them with language from birth. Children with Down syndrome benefit from this just as much as any other child.

To immerse children in language you can:

  • Talk to them about anything and everything, such as narrating your day and pointing out types of fruits and vegetables in the grocery store.
  • Read aloud 15 minutes each day or more. Adding a story before naps and bedtime is a good way to ensure you read to your child regularly.
  • Sing to your baby throughout the day. Nursery rhymes or lullabies are good options.

Children with Down syndrome often have some level of cognitive delay, so it's even more important to expose them to as much language as possible and to provide multi-sensory experiences, such as letting them hold and taste an apple while repeating the word aloud.

A Word From Verywell

Down syndrome affects a child's ability to communicate in a variety of ways. If you have a child with Down syndrome, know that early speech and language interventions can improve their quality of life tremendously.

Instead of thinking of Down syndrome as a disability, think of it as a developmental difference that requires a unique type of support. Your child will certainly lead a life that is different than most of their peers, but it can be a happy and fulfilling life if their needs are understood and met.

3 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Martin GE, Klusek J, Estigarribia B, Roberts JE. Language characteristics of individuals with down syndrome. Top Lang Disord. 2009;29(2):112-132.

  2. Anil MA, Shabnam S, Narayanan S. Feeding and swallowing difficulties in children with Down syndrome. J Intellect Disabil Res. 2019;63(8):992-1014. doi: 10.1111/jir.12617

  3. LoRe D, Ladner P, Suskind D. Talk, read, sing: early language exposure as an overlooked social determinant of health. Pediatrics. 2018;142(3). doi: 10.1542/peds.2018-2007

By Elisa Cinelli
Elisa is a well-known parenting writer who is passionate about providing research-based content to help parents make the best decisions for their families. She has written for well-known sites including POPSUGAR and Scary Mommy, among others.