Language Development in Children and Adolescents with Down Syndrome

1
Language Development in Children and Adolescents
with Down Syndrome

• Robin Chapman, Ph.D.
• Waisman Center
• University of Wisconsin-Madison

2
Acknowledgements

• Research supported by NIH grant R01-HD23353 with
  additional support from the National Down
  Syndrome Society. We thank the participants and
  their parents.

3
Thanks to Colleagues

• Dr. Donna Boudreau
• Cynthia Bridge
• Katherine Gigstead
• Dr. Linda J. Hesketh
• Dr. Maura Johnson
• Dr. Mina Johnson-Glenberg
• Dr. Elizabeth Kay-Raining Bird
• Dr. Doris J. Kistler

• Dr. Andrea McDuffie
• Dr. Sally Miles
• Dr. Jon Miller
• Dr. Giuliana Miolo
• Dr. Scott E. Schwartz
• Dr. Hye-Kyeung Seung
• Dr. Elin Thordardottir
• Heidi Sindberg
• Dr. Nadia Teitler
• Dr. Laura Wagner

4

Questions

• Is language acquisition modular or interactive?
• Is there a specific behavioral phenotype in
• children with Down syndrome?
• What is the developmental trajectory of language
• skills?
• What factors predict language production?
• What factors predict language comprehension?
• What factors improve word learning?
• What factors improve storytelling?

5
Modular vs. Interactionist Theory
(Chapman, 2000)

• Modular view of language predicts a specific
  language deficit in both comprehension and
  production
• Interactionist view predicts multiple
  dissociations, including comprehension and
  production, arising developmentally

6
Developmental Emergence of
Language in Down Syndrome Evidence for
Interactionist Position (Chapman, 2004) I.
SOCIAL INTERACTION

• slower emergence of emotional affect
  recognition in DS (spollak_at_wisc.edu) and frequent
  hearing impairment

7
Developmental Emergence of Language II.
OBJECT INTERACTION

More prolonged attention to people than objects
in DS
8
Developmental Emergence of LanguageIII.
CANONICAL BABBLING

• Slower Development of Canonical Babbling,
  Frequent Hearing Impairment, in DS

9
Developmental Emergence of Language IV.
JOINT ATTENTION

• Slower Babbling Development Affective
  Comprehension in Down Syndrome

10
Developmental Emergence of Language V.
COMPREHENSION OF WORDS, COMMUNICATIVE INTENT

• Slower Development of Communicative Requesting
  in Down Syndrome

11
Developmental Emergence of Language VI. USE OF
WORDS

• Slower Development of Expressive Vocabulary in
  Down Syndrome, including Signs

12
Developmental Emergence of Language VII.
SIMPLE SENTENCES

• Slower Development of Sentence Production in
  Down Syndrome

13
Developmental Emergence of Language VIII.
COMPLEX SENTENCES
Person
Sounds Heard


Words
Object

Action

• Slower Development of Complex Syntax Production
  for Complex Events in Down Syndrome

14
The phenotype in infancy

• Learning delays accelerate at ages 2-4
• Slower transition from babbling to speech poorer
  intelligibility
• Delays relative to cognition in nonverbal
  requesting, rate of expressive vocabulary
  development, rate of increase in sentence length
• Comprehension comparable to cognition

15
The phenotype in childhood

• Selective deficits in verbal short-term memory
• Longer period of phonological errors and more
  variability poorer intelligibility
• Expressive language delay relative to
  comprehension and cognition
• Grammatical morphology deficit relative to
  sentence length in production

16
The phenotype in adolescence

• Deficits in both working verbal memory and visual
  short-term memory
• Intelligibility problems more variability in
  fundamental frequency, rate, stress placement
• Expressive language deficit greatest in
  grammatical morphemes, least in vocabulary MLU
  shows longitudinal gain
• Sentence comprehension begins to lag cognition,
  and shows longitudinal loss vocabulary
  comprehension a strength on PPVT

17
The phenotype in young adulthood

• Continuing auditory short-term memory deficit
• Continuing progress in intelligibility
• Continuing progress in expressive syntax MLU
  increase, complex sentence acquisition
• Continuing strengths in size of comprehension
  vocabulary
• Loss of elaborated sentence comprehension

18
Predicted Comprehension for Ages
7.5, 12.5 and 17.5
19
Predicted Comprehension when
Auditory ST Memory Intercept is at
25ile, mean, or 75ile
20
Predicted Comprehension when
Visual S-T Memory Intercept is at
25ile, Mean, or 75ile
21
Predicted MLU when Syntax
Comprehension Intercept is at 25ile,
Mean or 75ile
22
Predicted MLU when Syntax
Comprehension slope is at 25ile, Mean
or 75ile
23
Predictors of individual difference

• For Syntax Comprehension age, auditory
  short-term memory, visual short-term memory
• For Syntax Production (MLU) syntax comprehension
• For Grammatical morpheme comprehension and fast
  mapping of words hearing

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Implications

• Evidence is consistent with an interactionist
  account of language learning,
• Multiple targets for early intervention
• -object play and exploration schemes
• -requesting
• -babbling/speech motor skills
• -intelligible communication (signing)
• -affective comprehension
• -Hearing!

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Implications, contd

• Shifting intervention targets with development
• Need for continuing language intervention in
  adolescence, including complex syntax literacy
• Need to target BOTH comprehension and production,
  at different levels
• Importance of hearing status for intelligibility
  grammatical morpheme comprehension

26
Evidence for specificity of phenotype
in adolescence DS vs. CI
(Chapman, 2006)

• Comprehension deficits in DS vs. CI of unknown
  origin
• (nonverbal MA/CA match)
• Production deficit in DS in adolescence in
  interview language sample
• Phonological working memory plays an important
  role in comprehension and production performance
  by both groups
• NRT (long-term knowledge) is more
  important for DS
• digit span visual short-term memory
  more important
• for CI
• Hearing status affects DS grammatical morpheme
  comprehension and
  interview-MLU

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Fast mapping of novel words

• DS children adolescents MA match
  (Chapman, Kay-Raining Bird Schwartz, 1990
  Kay-Raining Bird, E., Chapman, R.S., Schwartz,
  S.E. (2004).
• With multiple words, DSMA in comprehension but
  DSltMA in production
  (Chapman, 2003)
• DS adolescents syntax comprehension TD match in
  using speaker intent to infer object referent
• McDuffie, A., Sindberg, H., Hesketh, L.,
  Chapman, R. (in press).
• Repeated mention of words speeds access in
  comprehension, for DS
• (Chapman, Sindberg, Bridge, Gigstead,
  Hesketh, 2006)

28
Narratives in children
adolescents

• Event content of remembered silent film
• DS MA controls despite shorter MLU
• 
  (Boudreau Chapman, 2000)
• Plot line theme elements of wordless
  picturebooks
• DS gt MLU comparison group
• DS syntax comprehension group
• (Miles
  Chapman, 2002)
• Presence (vs. absence) of picture support
• increases DS MLU to syntax
  comprehension group level
• (Seung Chapman, 2002 Miles,
  Chapman, Sindberg,2006)

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Repeated Narratives

• Repeated retellings of a wordless picture book
  lead to
• increases in plot line/theme expression and
  MLU (Miles
• Chapman 2005)
• Examiner scaffolding with questions yields
  higher MLU improves
• expression of location setting information
  (Miles, Sindberg, Bridge
• Chapman, 2002) and number of different
  words used (Miles 2005)
• Storytelling strategies (Miles, Chapman
  Sindberg, 2004)
• -task approached as retelling of related
  events
• -evaluations and character speech used by
  both DS syntax
• comprehension controls
• -use of inference increased across
  sessions
• -more multiple utterances in DS group

30
Plot line/Theme Content of
Repeated Narratives, DS vs. Syntax
comprehension matched group (Miles
Chapman, 2005)
31
MLU of Repeated Narratives, DS vs.
Syntax comprehension matched group
(Miles Chapman, 2005)
32
Answers

• Language acquisition is interactive, emergent,
• non-modular
• Children with Down syndrome show a Specific
• Language Impairment
• Trajectory MLU and complex syntax increase
• with age No evidence of a critical
  period
• Trajectory Syntax comprehension declines in
• late adolescence and young adulthood

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Answers, continued

• Language comprehension
• predicts language production
• Auditory and visual short-term memory predict
• language comprehension
• hearing also predicts
• grammatical morphology
  intelligibility

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Implications for Language Intervention

• Need for language intervention in adolescence,
  including literacy
• Need to target both comprehension and production,
  at different levels
• Repeated mention of novel word in play improves
  speed of its comprehension

35
Implications for Intervention ,
contd

• Need to provide hearing support for
  intelligibility and grammatical morpheme
  comprehension
• Helpfulness of picture support for narrative
  content MLU
• Helpfulness of narrative practice for MLU

36
Methodological implications

• Comprehension Assessment
• -Vocabulary frequency vs. concept (PPVT vs
  TACL-voc)
• -Past use of PPVT as MA match has mismatched
  TD groups
• and overestimated adolescent DS MA
• -Syntax differential effects of hearing on
  morphology
• sentence structure
• Language Samples
• -Conversation vs. narration
• -Visual support for narration

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Some Thoughts about Future Research

• Importance of modeling individual differences in
  studying DD populations
• Imaging to illuminate short-term memory
  contributions
• Genome variation to predict IDs in longitudinal
  language cognitive trajectories
• Genetic dissection of learning will remap our
  dissection of phenotype

38
References

• Abbeduto, L. Chapman, R.S. (2005). Language and
  communication skills in children with Down
  syndrome and Fragile x. In P. Fletcher J.
  Miller, Eds., Trends in language acquisition
  research, vol 4 Developmental theory and
  language disorders. Amsterdam, NL John
  Benjamins.
• Boudreau, D. Chapman, R.S. (2000).The
  relationship between event representation and
  linguistic skill in narratives of children and
  adolescents with Down syndrome. Journal of
  Speech, Language, and Hearing Research, 43,
  1146-1159.
• Chapman, R.S. (1999). Language and cognitive
  development in children and adolescents with Down
  syndrome. In J.F. Miller, L.A. Leavitt, and M.
  Leddy, Eds., Improving the communication of
  people with Down syndrome. (Pp. 41-60).
  Baltimore Brookes.
• Chapman, R.S. (2000). Childrens language
  learning An interactionist perspective. Journal
  of Child Psychology and Psychiatry, 41, 33-54.

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References, ctd.

• Chapman, R.S. (2003). Language and communication
  in individuals with Down syndrome. (pp. 1-34) In
  L. Abbeduto (Ed.,), International Review of
  Research in Mental Retardation Language and
  Communication, vol. 27. Academic Press.
• Chapman, R.S. (2006). Language learning in Down
  syndrome the speech and language profile
  compared to adolescents with cognitive impairment
  of unknown origin.Downs Syndrome Research
  Practice, 10, 61-66.
• Chapman, R.S., Hesketh, L.J. (2000).
  Behavioral phenotype of individuals with Down
  syndrome. Mental Retardation and Developmental
  Disability Research Reviews, 6, 84-95.
• Chapman, R.S. Hesketh, L.J. (2001). Language,
  cognition, and short-term memory in individuals
  with Down syndrome. Down Syndrome Research and
  Practice, 7, 1-7.

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References, ctd.

• Chapman, R.S., Hesketh, L.J., Kistler, D.
  (2002). Predicting longitudinal change in
  language production and comprehension in
  individuals with Down syndrome Hierarchical
  linear modeling. Journal of Speech, Language, and
  Hearing Research, 45, 902-915.
• Chapman, R.S., Seung, H-K., Schwartz, S.E.
  Kay-Raining Bird, E. (2000). Predicting language
  development in children and adolescents with Down
  syndrome The role of comprehension. Journal of
  Speech, Language, and Hearing Research, 43,
  340-350.
• Chapman, R.S., Sindberg, H., Bridge, C.,
  Gigstead, K. Hesketh, L.J. (2006). Effect of
  memory support and elicited production on fast
  mapping of new words by adolescents with Down
  syndrome. Journal of Speech, Language, Hearing
  Research, 49, 3-15.
• Johnson-Glenberg, M.C. Chapman, R.S. (2004).
  Predictors of parent-child language during novel
  task play A comparison between children who are
  typically developing and individuals with Down
  syndrome. Journal of Intellectual Disabilities
  Research., 48, 225-38.

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References, ctd.

• Kay-Raining Bird, E., Chapman, R.S., Schwartz,
  S.E. (2004). Fast mapping of words and story
  recall by children with Down syndrome. Journal of
  Speech, Language, and Hearing Research, 47,
  1286-1300.
• McDuffie, A., Sindberg, H., Hesketh, L.,
  Chapman, R. (in press). Use of speaker intent and
  grammatical cues in fast-mapping by adolescents
  with DS. Journal of Speech, Language, and Hearing
  Research.
• Miles, S. Chapman, R.S. (2005). The
  relationship between adult scaffolding and
  narrative expression by adolescents with Down
  syndrome. Poster presented at the Symposium on
  Research in Child Language Disorders, Madison,
  WI, June 10.
• Miles, S. Chapman, R.S. (2002). Narrative
  content as described by individuals with Down
  syndrome and typically developing children.
  Journal of Speech, Language, and Hearing
  Research, 45, 175-189.

42
References, ctd.

• Miles, S., Chapman, R.S. Sindberg, H. (2006).
  Sampling context affects MLU in the language of
  adolescents with Down syndrome.Journal of
  Speech, Language, and Hearing Research, 49,
  325-227.
• Miolo, G., Chapman, R.S., Sindberg, H. (2005).
  Sentence comprehension in adolescents with Down
  syndrome and typically developing children Role
  of sentence voice, visual context, and
  auditory-verbal short-term memory. Journal of
  Speech, Language, and Hearing Research, 48,
  172-188.
• Seung, H-K. Chapman, R.S. (2000). Digit span in
  individuals with Down syndrome and typically
  developing children Temporal aspects. Journal of
  Speech, Language, and Hearing Research, 43,
  609-620..
• Seung, H.K., Chapman, R. S. (2003). The effect
  of story presentation rates on story retelling by
  individuals with Down syndrome. Applied
  Psycholinguistics, 24, 601-618.

43
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