Sign Language with Toddlers with down Syndrome

Early intervention is an essential part of working with children with disabilities. Intervention delivered by a Speech-language pathologist (SLP) is meant to alleviate the effects of a specific disability in order to change or give strategies to aid in communication. The use of Sign language with toddlers who have Down syndrome is an example of those who can benefit from SLPs. Expressive language is a crucial part of communication and children with Down syndrome struggle to use spoken language, so they benefit from other ways to communicate such as Augmentative and Alternative Communication (AAC). One form of AAC that both research articles explore is the use of sign language with toddlers. Topics of debate are the effects that sign language has on the vocabulary and expressive language for children with Down syndrome. The purpose of the first study (Wright, Kaiser, Reikowsky & Roberts, 2012) was to determine the effects of naturalistic intervention on expressive signs, spoken words, generalization to different settings, and joint engagement and symbol infused joint engagement. The purpose the second research article (Ozcaliskan, Adamson, Dimitrova, Bailey & Schmuch, 2015) was to demonstrate how children with Down syndrome compare to typically developing children and what effect baby sign or spontaneous gestures have on their vocabulary acquisition later in life. There are few research articles addressing this subject and the articles serve to show the correlation between signing at an early age and the effect it will have on their vocabulary and expressive language later in life.

Description of the Studies

Wright (2012) studied the effects of naturalistic sign intervention on the expressive language of toddlers with Down syndrome. The focus of the article was on four toddlers with Down syndrome between the age of 23 and 29 months. There were multiple criteria for toddlers that were chosen such as diagnosis of Down Syndrome, 18-36 months old, vision or hearing within normal limits, expressive vocabulary of less than 15 words, minimum of one sign, imitate hand placement, English as primary language, and parental consent. Researchers used an intervention strategy known as EMT/JASPER teaching strategies with the toddlers on both spoken language and manual sign. The study was conducted over a short period of time, approximately 10 weeks. After they established a baseline on expressive language skills for the participants the study lasted for a total of 20 sessions: 2 times a week for 20-30 minutes. This study examined the effects of naturalistic teaching on the acquisition of spoken words and signs in young children. According to the study (Wright et. al, 2012), EMT was used throughout the article as a teaching strategy which includes following the child's lead in a play based setting, responding to a child's attempt at communication, mirroring the child, which includes, imitating and describing what the child is doing, expanding on communication attempts, modeling signs, and wait in order to promote communication. Another method used was JASPER, according to (Wright et. al, 2012)Included teaching new play actions and play sequences by modeling and expanding play based on child interests (p.998). This study is a quantitative design due to their analysis of the use and rate of signs and spoken words in relation to their language acquisition. This is an experimental study because of the variables and the researcher is manipulating them by using a naturalistic intervention approach.

Ozcaliskan, Adamson, Dimitrova, Bailey & Schmuck (2015) studied if baby sign (ASL) or gestures predict vocabulary later in life for children with Down syndrome and for typically developing children. The subjects in the article by Ozcaliskan et. al. (2015) were twenty-three children with Down syndrome and twenty-three typically developing children. These children were put into a playroom with their parents and used the Communication Play Protocol. The protocol is supposed to be a semi-naturalistic observation of parent and child communication that encourages commenting as well as requesting from the children. After the observation they used coding to determine the number of baby signs as well as gestures such as conventional, deictic, and iconic during the video. At the beginning of the study they assessed the children vocabulary and then one year later gave the children the Expressive Vocabulary Test to determine their spoken vocabulary. All of these measures were compared one year apart to see if the signs and gestures had an effect on their spoken vocabulary. Since the study was over a year period, it is considered a longitudinal study. Some definitions that are the terms used to describe various gestures in Ozcaliskan et. al. ( 2012) including deictic (i.e. indexical gestures that indicate objects/locations, such as pointing at a ball, holding up a bottle), conventional (i.e. gestures that convey culturally prescribed meaning with prescribed gesture forms, such as nodding the head to convey affirmation), or iconic (i.e. spontaneous gestures that convey actions or features associated with objects, such as holding cupped hands in air to indicate roundness of a ball). This is a quantitative design because it is studying their rate of signs and gestures compared to the number of vocabulary words acquired later. This study is descriptive in nature because the researchers are not manipulating variables, but rather observing the toddlers over a year to find the relationship between their use of signs and vocabulary acquisition.

Synthesis

The articles are both evaluating the effects of signs/gestures and the result they will have on children with Down syndrome and their expressive language/vocabulary later in life. The first study (Wright et. al, 2012) had strengths, the most obvious being the number of questions they addressed in the research. They addressed the effect EMT/JASPER has had on expressive sign, spoken words, generalization of skills, and the time spent in joint engagement. Since their study was researching multiple questions it expands beyond the effects on just spoken and expressive signs and onto the effects on joint engagement and being able to generalize the skills. Another advantage to this study is the amount of criteria required of the subjects. Researchers were able to make the research specific to a certain group of people by reducing the number of outliers. A weakness of this study is the low number of participants. There were only 4 children in the study, which make it difficult to get a good view of the true effect of the naturalistic intervention. Another weakness of this study was the inability to measure the effects it had on joint attention due to the inability to use coding to decipher the change in total joint attention. Wright (2012), recommends that future research focus on researching the number of signs and words that are used within each intervention and figuring out which number is the most effective in order for the children to learn these words and generalize them. An additional topic for further research would be to come up with a method to evaluate the development of joint attention based on the intervention that was used. This study was not systematically evaluated based on both EMT, JASPER, and words and signs mode for teaching, which means that they are unable to determine if the increase in expressive language was due to a combination of all three or just one of the methods.

The second study (Ozcaliskan et. al, 2015) had some weaknesses. The main weakness was the length of time; if they were studied over a longer period of time they would be able to see the differences in the long-term effects of their sign/gestures. The main strength of this study was the large number of participants. The large numbers of participants gave the study the ability to reach more people and show the effects it had on both typically developing children and children with Down syndrome. A recommendation for further research for Ozcaliskan (2015) is to research children with Down syndrome, who do and who do not use baby sign, and whether or not the use of gestures would show a correlation with their vocabulary later in life.

Early intervention plays an important role by showing the effects of sign language on expressive language and their vocabulary later in life. Wright (2012) showed that the use of different teaching methods including EMT and JASPER in correlation with words and sign language can increase their use of signs and spontaneous words in more generalized setting. The second study by Ozcaliskan (2015) showed us that although children with Down syndrome did not use many gestures, their use of baby signs(ASL) showed a positive correlation with their spoken vocabulary a year later. They both reveal the importance of using sign and how it will impact spoken language for children with Down syndrome. Both studies looked at similar aspects within early intervention, but the naturalistic intervention study would be more practical for clinical settings. The naturalistic intervention could be applied to clients and used in order to gain expressive sign, spoken words and to generalize the skills. The other study using signs and gestures would not be practical because it is a descriptive study rather than an experimental study. Both of the studies would be fairly easy to duplicate as long as you had the time and the resources. Neither of the articles had controversial findings since there are not many studies addressing this issue.

Discussion and future implication

Research for the use of sign language for children with Down syndrome has not been studied much in recent years. These two studies realized the need for research to show how the use of sign language is essential for expressive language and teaching children with Down syndrome to communicate in an effective way. Since children with Down syndrome have difficulty with spoken language, the use of signs aid in the process of communication as well as a stepping-stone to spoken language. Using sign intervention with spoken language will improve how children with Down syndrome communicate with peers in a meaningful way.

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