A systematic review of speech, language and communication interventions for children with Down syndrome from 0 to 6 years.
Down syndrome
children
intervention
language
review
speech
Journal
International journal of language & communication disorders
ISSN: 1460-6984
Titre abrégé: Int J Lang Commun Disord
Pays: United States
ID NLM: 9803709
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
received:
02
04
2021
accepted:
20
12
2021
pubmed:
23
2
2022
medline:
3
5
2022
entrez:
22
2
2022
Statut:
ppublish
Résumé
Speech and language acquisition can be a challenge for young children with Down syndrome (DS), and while early intervention is important, we do not know what early interventions exist and how effective they may be. To systematically review existing early speech, language and communication interventions for young children with DS from birth up to 6 years, and to investigate their effectiveness in improving speech, language and communication outcomes in children with DS. Other outcomes are changes in parental behaviour and their responsiveness METHODS & PROCEDURES: We conducted a systematic search of relevant electronic databases to identify early intervention studies targeting speech, language and communication outcomes in children with DS published up to May 2020. A total of 11 studies that met the inclusion criteria were synthesized and appraised for quality using the PEDro-P scale. There were a total of 242 children. We identified three types of intervention: communication training and responsive teaching, early stimulation programme, and dialectic-didactic approach. The findings from nine out of the 11 studies reported positive outcomes for children's language and communication up to 18 months following the intervention. All nine studies reported interventions that were co-delivered by parents and clinicians. However, there was also a de-accelerated growth in requesting behaviours in the intervention group reported by one study as well as a case of no improvement for the intervention group. Three studies provided some evidence of improvements to parent outcomes, such as increased parental language input and increased responsiveness. However, there was a moderate to high risk of bias for all studies included. The findings from this review suggest that interventions that have high dosage, focus on language and communication training within a naturalistic setting, and are co-delivered by parents and clinicians/researchers may have the potential to provide positive outcomes for children with DS between 0 and 6 years of age. Due to the limited number of studies, limited heterogeneous data and the moderate to high risk of bias across studies, there is an urgent need for higher quality intervention studies in the field to build the evidence base. What is already known on the subject Speech and language acquisition is usually delayed in children with DS, yet there are currently no standard interventions for children under 6. A number of research-based interventions exist in the literature, yet it is unknown how effective these are. What this study adds to existing knowledge This is the first systematic review that specifically and exclusively focuses on parent- and non-parent-mediated speech, language and communication interventions for children with DS between 0 and 6 years of age. It complements three existing recent reviews, each of which has a slightly different focus. The previously published reviews have covered only parent-mediated interventions, excluding interventions not mediated by parents, have reviewed interventions including children and adults, without any mention of what early interventions may be like or how effective these may be for young children with DS, have not always assessed risk of bias or have focused specifically on language interventions excluding those focusing on speech articulation or pre-linguistic skills. The findings from the current review suggest that interventions that have high dosage focus on language and communication training within a naturalistic setting and are co-delivered by parents and clinicians/researchers may have the potential to provide positive outcomes for children with Diwn syndrome from 0 to 6. We acknowledge that the current evidence base comes from studies with moderate to high risk of bias, hence our conclusions are not definitive. What are the potential or actual clinical implications of this work? Speech and language therapists will have synthesized information and a quick reference point on what type of interventions exist for children with DS under the age of 6, and evidence of which intervention approaches may be promising in terms of providing positive outcomes. However, it is acknowledged that, due to the limited number of studies and the moderate to high risk of bias inherent in the evidence, there is an urgent need for higher quality intervention studies in the field to build the evidence base.
Sections du résumé
BACKGROUND
Speech and language acquisition can be a challenge for young children with Down syndrome (DS), and while early intervention is important, we do not know what early interventions exist and how effective they may be.
AIMS
To systematically review existing early speech, language and communication interventions for young children with DS from birth up to 6 years, and to investigate their effectiveness in improving speech, language and communication outcomes in children with DS. Other outcomes are changes in parental behaviour and their responsiveness METHODS & PROCEDURES: We conducted a systematic search of relevant electronic databases to identify early intervention studies targeting speech, language and communication outcomes in children with DS published up to May 2020. A total of 11 studies that met the inclusion criteria were synthesized and appraised for quality using the PEDro-P scale. There were a total of 242 children. We identified three types of intervention: communication training and responsive teaching, early stimulation programme, and dialectic-didactic approach.
MAIN CONTRIBUTION
The findings from nine out of the 11 studies reported positive outcomes for children's language and communication up to 18 months following the intervention. All nine studies reported interventions that were co-delivered by parents and clinicians. However, there was also a de-accelerated growth in requesting behaviours in the intervention group reported by one study as well as a case of no improvement for the intervention group. Three studies provided some evidence of improvements to parent outcomes, such as increased parental language input and increased responsiveness. However, there was a moderate to high risk of bias for all studies included.
CONCLUSIONS
The findings from this review suggest that interventions that have high dosage, focus on language and communication training within a naturalistic setting, and are co-delivered by parents and clinicians/researchers may have the potential to provide positive outcomes for children with DS between 0 and 6 years of age. Due to the limited number of studies, limited heterogeneous data and the moderate to high risk of bias across studies, there is an urgent need for higher quality intervention studies in the field to build the evidence base.
WHAT THIS PAPER ADDS
What is already known on the subject Speech and language acquisition is usually delayed in children with DS, yet there are currently no standard interventions for children under 6. A number of research-based interventions exist in the literature, yet it is unknown how effective these are. What this study adds to existing knowledge This is the first systematic review that specifically and exclusively focuses on parent- and non-parent-mediated speech, language and communication interventions for children with DS between 0 and 6 years of age. It complements three existing recent reviews, each of which has a slightly different focus. The previously published reviews have covered only parent-mediated interventions, excluding interventions not mediated by parents, have reviewed interventions including children and adults, without any mention of what early interventions may be like or how effective these may be for young children with DS, have not always assessed risk of bias or have focused specifically on language interventions excluding those focusing on speech articulation or pre-linguistic skills. The findings from the current review suggest that interventions that have high dosage focus on language and communication training within a naturalistic setting and are co-delivered by parents and clinicians/researchers may have the potential to provide positive outcomes for children with Diwn syndrome from 0 to 6. We acknowledge that the current evidence base comes from studies with moderate to high risk of bias, hence our conclusions are not definitive. What are the potential or actual clinical implications of this work? Speech and language therapists will have synthesized information and a quick reference point on what type of interventions exist for children with DS under the age of 6, and evidence of which intervention approaches may be promising in terms of providing positive outcomes. However, it is acknowledged that, due to the limited number of studies and the moderate to high risk of bias inherent in the evidence, there is an urgent need for higher quality intervention studies in the field to build the evidence base.
Identifiants
pubmed: 35191587
doi: 10.1111/1460-6984.12699
doi:
Types de publication
Case Reports
Journal Article
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
441-463Informations de copyright
© 2022 Royal College of Speech and Language Therapists.
Références
Andrade, R.V. & Limongi, S. (2007) The emergence of expressive communication in the child with Down syndrome. Pro-fono: revista de atualizacao cientifica, 19, 387-392.
Anlar, B. & Yalaz, K. (1996) Denver II developmental screening test manual: Adaptation and standardization for Turkish children. Ankara: Meteksan.
Barton, E.E. & Fetting, A. (2013) Parent-implemented interventions for young children with disabilities: A review of fidelity features. Journal of Early Intervention, 35(2), 194-210
Bayley, N. (1969) New York: The Psychological Corporation.
Bidder, R.T., Bryant, G. & Gray, O.P. (1975) Benefits to Down's syndrome children through training their mothers. Archives of Disease in Childhood, 50, 383-386
Booth, A. & Fry-Smith, A. (2004) Developing the research question. Etext on Health technology Assessment (HTA) Information Resources.
Brunet, O. & Lezine, I. (1971) Escala para medir el desarrolla psicomotor de la primera infancia. Madrid: MEPSA.
Buckley, S. & Bird, G. (2001) Speech and language development for infants with Down syndrome (0-5 years), Down Syndrome Educational Trust.
Buschmann, A., Jooss, B., Rupp, A., Feldhusen, F., Pietz, J. & Philippi, H. (2009) Parent based language intervention for 2-year-old children with specific expressive language delay: A randomised controlled trial. Archives of Disease in Childhood, 94, 110-116.
Chapman, R.S. & Hesketh, L.J. (2000) Behavioural phenotype of individuals with Down syndrome. Developmental Disabilities Research Review, 6, 84-95.
Davis-Mcfarland, E. (2008) Family and cultural issues in a school swallowing and feeding program. Language, Speech, and Hearing Services in Schools, 39, 199-213.
Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., et al. (2010) Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model. Pediatrics, 125, 17-23.
Feldman, H.M., Dale, P.S., Campbell, T.F., Colborn, D.K., Kurs-Lasky, M., Rockette, H.E., et al. (2005) Concurrent and predictive validity of parent reports of child language eat 2 and 3 years. Child Development, 76(4), 856-868
Fenson, L., Dale, P., Reznick, J., Thal, D., Bates, E., Hartung, J., et al. (2003) MacArthur communicative developmental inventories: User's guide and technical manual. Baltimore, MD: Paul H. Brookes.
Fenson, L., Dale, P., Reznick, J., Thal, D., Bates, E., Hartung, J., et al. (1993) MacArthur communicative development inventories (CDI). San Diego, CA: Singular Publishing Group.
Fey, M.E., Yoder, P.J., Warren, S.F. & Bredin-Oja, S.L. (2013) Is more better? Milieu Communication Teaching in toddlers with intellectual disabilities. Journal of Speech, Language, and Hearing Research, 56, 679-693.
Fidler, D.J. (2005) The emerging Down syndrome behavioural phenotype in early childhood: Implications for practice. Infants & Young Children, 18, 86-103.
Fidler, D.J. & Nadel, L. (2007) Education and children with Down syndrome: Neuroscience, development, and intervention. Mental retardation and Developmental Disabilities Research Reviews, 13, 262-271.
Fong, N.W.Y., Ho, S.K.Y., So, B.J.W. & Lian, W.B. (2012) Evaluation of the Hanen it takes two to talk intervention programme. Proceedings of Singapore Healthcare, 21, 251-256.
Girolametto, L., Weitzman, E. & Clements-Baartman, J. (1998) Vocabulary intervention for children with Down syndrome: Parent training using focused stimulation. Infant-Toddler Intervention, 8, 109-125.
Griffiths, R. (1954) The abilities of babies. A study in menta measurement. London: University of London Press.
Griffiths, R. (1970) The abilities of young children. A comprehensive system of mental measurement for the first eight years of life. London: Child Development Research Centre.
Hampton, L.H. & Kaiser, A.P. (2016) Intervention effects on spoken-language outcomes for children with autism: A systematic review and meta-analysis. Journal of Intellectual Disability Research, 60, 444-463.
Hans, P., England, R., Prowse, S., Young, E. & Sheehan, P. (2010) UK and Ireland experience of cochlear implants in children with Down syndrome. International Journal of Pediatric Otorhinolaryngology, 74, 260-264.
Hanson, M.J. (1979) A longitudinal, descriptive study of the behaviours of Downs's syndrome infants in an early intervention program
Hedrick, D.L., Prather, E.M. & Tobin, A.R. (1984) Sequenced inventory of communication development. Seattle: University of Washington Press.
Higgins, J., Thomas, J., Chandler, J., Cumpston, M., Li, T. & Page, M. et al. (2019) Cochrane Handbook for systematic reviews of interventions version 2nd Edition. Chichester (UK): John Wiley & Sons
Hughes-Mccormack, L.A., Mcgowan, R., Pell, J., Mackay, D., Henderson, A., O'leary, L., et al. (2020) Birth incidence, deaths and hospitalisations of children and young people with Down syndrome, 1990-2015: Birth cohort study. BMJ open, 10, e033770.
Karaaslan, O. & Mahoney, G. (2013). Effectiveness of responsive teaching with children with Down syndrome. Mental Retardation, 51(6), 458-469.
Karaaslan, O., Diken, I.H. & Mahoney, G. (2013). A randomized control study of responsive teaching with young Turkish children and their mothers. Topics in Early Childhood Special Education, 33(1), 18-27.
Landry, S.H., Smith, K.E., Swank, P.R., Assel, M.A. & Vellet, S. (2001) Does early responsive parenting have a special importance for children's development or is consistency across early childhood necessary? Developmental Psychology, 37, 387-403
Laws, G. & Hall, A. (2014) Early hearing loss and language abilities in children with Down syndrome. International Journal of Language & Communication Disorders, 49, 333-342.
Laws, G., Byrne, A. & Buckley, S. (2000) Language and memory development in children with Down syndrome at mainstream schools and special schools: A comparison. Educational Psychology, 20, 447-457.
Maher, C.G., Sherrington, C., Herbert, R.D., Moseley, A.M. & Elkins, M. ( 2003) Reliability of the PEDro scale for rating quality of randomized controlled trials. Physical Therapy, 83, 713-721.
Mahoney, G.D. (1999) Maternal behaviour rating scale. Tallmadge, OH: Family Child Learning Centre.
Mahoney, G. & Wheeden, C. (1998) The effects of teacher style on the interactive engagement of preschool-aged children with disabilities. Journal of Developmental and Learning Disorders, 2, 293-315.
Mahoney, G.J., Finger, I. & Powell, A. (1985) Relationship of maternal behavioural style to the developmental of organically impaired mentally retarded infants. American Journal of Mental Deficiency, 90(3), 296-302.
Manolson, A. (1992) It takes Two to talk. A parent's guide to helping children communicate, (Hanen Centre).
Marshall, J., Goldbart, J., Pickstone, C. & Roulstone, S. (2015) Application of systematic reviews in speech-and-language therapy. International Journal of Language & Communication Disorders, 1-12.
Martin, G.E., Klusek, J., Estigarribia, B. & Roberts, J.E. (2009) Language characteristics of individuals with Down syndrome. Topics in Language Disorders, 29, 112-132.
Mason-Apps, E., Stojanovik, V., Houston-Rpice, C., Seager, E. & Buckley, S. (2020) Do infants with Down syndrome show an early receptive language advantage? Journal of Speech, Language and Hearing Research, 63, 585-598
Miller, J. & Chapman, R. (1993) SALT: Systematic analysis of language transcripts. Madison, WI: University of Wisconsin.
Miller, J.F., Sedey, A.L. & Miolo, G. (1995). Validity of parent report measures of vocabulary development for children with Down syndrome. Journal of Speech, Language, and Hearing Research, 38(5), 1037-1044.
Murray, E., Powel, E., Togher, L., Mccabe, P., Munro, N. & Smith, K. (2013) The reliability of methodological ratings for speechBITE using the PEDro-P scale. International Journal of Language and Communication Disorders, 48, 297-306.
Naess, K.-A.B., Lervag, A., Lyster, S.-A.H. & Hulme, C. (2015) Longitudinal relationships between language and verbal short-term memory skills in children with Down syndrome. Journal of Experimental Child Psychology, 135, 43-55.
Neil, N. & Jones, E.A. (2018) Communication intervention for individuals with Down syndrome: Systematic review and meta-analysis. Developmental Neurorehabilitation, 21, 1-12.
O'toole, C., Lee, A.S-Y., Gibbon, F.E., Van Bysterveldt, A.K. & Hart, N.J. (2018) Parent-mediated interventions for promoting communication and language development in young children with Down syndrome. Cochrane Database of Systematic Reviews, (10).
O'toole, C. & Chiat, S. (2006) Symbolic functioning and language development in children with Down syndrome. International Journal of Language & Communication Disorders, 41, 155-171.
Pepper, J. & Weitzman, E. (2004) It takes two to talk: A practical guide for parents of children with language delays. The Hanen Centre.
Perdices, M., Savage, S., Tate, R., Mcdonald, S. & Togher, L. (2009) Rater's manual for between-group studies (RCTS and NonRCTs): Introduction to the physiotherapy evidence database (PEDro) Scale for rating methodological quality, adapted for PsycBITE (Pedro-P). Sydney, NSW: University of Sydney.
Petticrew, M. & Roberts, H. (2008) Systematic reviews in the social sciences: A practical guide. John Wiley & Sons.
Pring, T. (2004) Ask a silly question: Two decades of troublesome trials. International Journal of Language & Communication Disorders, 39, 285-302.
Sanz Aparicio, M.T. (1989) Effects of observation training of parents in the early stimulation of trisomy-21 babies. Early Child Development and Care, 41, 89-101
Sanz Aparicio, M.T. & Balana, M. (2002) Early language stimulation of Down's syndrome babies: A study on the optimum age to begin. Early Child Development and Care, 172, 651-656
Sanz Aparicio, M.T. & Balana, M. (2003) Social early stimulation of trisomy -21 babies. Early Child Development and Care, 173(5), 557-561
Sanz, T., Menendez, J. & Rosique, T. (2011) Study of different social rewards used in Down's syndrome children's early stimulation. Early Child Development and Care, 181(4), 487-492
Savaşir, I., Sezgin, N. & Erol, N. (2005) Ankara developmental screening inventory manual. Ankara.
Smith, E., Hokstad, S. & Naess, K.-A.B. (2020) Children with Down syndrome can benefit from language interventions: Results from a systematic review and meta-analysis. Journal of Communication Disorders, 105992.
Snowling, M.J., Hulme, C., Bailey, A.M., Stothard, S.E. & Lindsay, G. (2011) Better communication research project: language and literacy attainment of pupils during early years and through KS2-does teacher assessment at five provide a valid measure of children's current and future educational attainments?. Research Report. DFE-RR172a. ERIC.
Stoel-Gammon, C. (2001) Down syndrome phonology: Developmental patterns and intervention strategies. Down Syndrome Research and Practice, 7, 93-100.
Te Kaat-Van Den Os, D.J., Jongmans, M.J., Volman, M. & Lauteslager, P.E. (2017) Parent-implemented language interventions for children with a developmental delay: A systematic review. Journal of Policy and Practice in Intellectual Disabilities, 14, 129-137.
Tomasello, M. (2003) Constructing a language: A usage-based account of language acquisition. Cambridge, MA.
UNICEF (1982) Curriculum de estimulacion precoz. Guatemala, Instituto de la Salud: UNICEF.
Van Bysterveldt, A., Gillon, G. & Foster-Cohen, S. (2014) A phonological awareness intervention case study of a child with Down syndrome. Speech, Language and Hearing, 17, 25-36.
Weller, E.L. & Mahoney, G.J. (1983) A comparison of oral and total communication modalities on the language training of young mentally handicapped children. Communication Modalities, 18, 103-110
Wren, Y., Harding, S., Goldbart, J. & Roulstone, S. (2018) A systematic review and classification of interventions for speech-sound disorder in preschool children. International Journal of Language and Communication Disorders, 53(3), 446-467
Wetherby, A.M. & Prizant, B. (1993) Communication and symbolic behaviour scales (CSBS) manual: Normed edition. Chicago: Riverside
Yoder, P., Woynaroski, T., Fey, M. & Warren, S. (2014) Effects of dose frequency of early communication intervention in young children with and without Down syndrome. American Journal on Intellectual and Developmental Disabilities, 119, 17-32.
Yoder, P.J. & Warren, S.F. (2002) Effects of prelinguistic milieu teaching and parent responsivity education on dyads involving children with intellectual disabilities. Journal of Speech, Language, and Hearing Research, 45, 1158-1174.
Yoder, P.J. & Warren, S.F. (1999) Maternal responsivity mediates the relationship between prelinguistic intentional communication and later language. Journal of Early Intervention, 22, 126-136
Yoder, P.J. & Warren, S.F. (1998) Maternal responsivity predicts the prelinguistic communication intervention that facilitates generalized intentional communication. Journal of Speech, Language, and Hearing Research, 41, 1207-1219.