Speech & Language First 2 Years

Speech and Language Development in the First Two Years

Children begin life with some general knowledge about what language is like, but no knowledge of any specific language. As they are exposed to language they make sense of the structure of the language they are learning. The biological make up of a child and their opportunities to learn will impact on the development and progression of their speech and language skills.

To understand how to help a child with Down syndrome to progress through the stages of speech and language development it is important

  • To be aware of the stages/milestones of development for children with Down syndrome.
  • To be aware that a child needs opportunities to develop his/her language
  • To know that a child goes through phases and periods of language growth; that development is predictable
  • To know that each child is unique and development differs greatly for each child.

There is more knowledge available now on the speech and language development of children with Down syndrome following research and Professor Sue Buckley and her colleagues have a developmental profile available on http://www.down-syndrome.org/information/development for children with Down syndrome. The age ranges given below for a child with Down syndrome showing attainment of skill are taken from the Down Syndrome Educational International.

Communication is the process whereby one person formulates a message and sends it to another person, who then figures out the meaning of the message. It is a symbolic code in which symbols represent objects.

Specifically, language is a type of communication. It is a structured symbolic code that is used for communication purposes and the symbols catalogue objects, relations and events within a culture.

Speech is one of the ways that language is encoded and expressed. It is the process of producing sounds and combining them into words. It is a more specific form of communication.

In order to develop certain speech and language skills, children need certain fundamental sensory and perceptual skills. Sensory skills include the abilities to see, hear, touch, taste, or smell objects and people in the environment. Perceptual skills give meaning to the sensory input. Obviously, children need to be able to hear what is being said in their environment in order to learn speech and language.

Children must hear sounds; listen and develop their awareness of sounds both speech and non-speech sounds e.g. doorbell. Hearing loss that fluctuates (which is common for children with Down syndrome) will affect a child's sound development, listening and auditory awareness. Regular hearing assessment is very important.

Pre-linguistic Development

When a child is preparing to talk there are milestones for this stage of pre-linguistic development. These milestones focus on the various sounds produced by infants and they are based on the notion that this is a special period of practicing prior to 'real speech'.

In the first six months a child is often referred to as an examiner

It is during this phase that a child explores their environment with their eyes and their ears. During this phase of communication development, the caregiver works hard to interpret their child's sounds.

Shortly after birth, the baby becomes actively involved in the interactive process with the mother- by 1 month the infant engages in participant exchanges, interactional sequences that began shortly after birth – when awake and in the appropriate position with the adult, the child will gaze at the adult's face and vocalise. In turn the infant responds to the adult's vocalisations and movements. Parents often interpret what their child may be intending to say e.g. if the child is crying they may say 'Are you sleepy?' A young child's communication is not purposeful; it reflects feelings of hunger, discomfort or pleasure.

Child with Down syndrome

  • Reacts to sounds at approximately 1 month (range .5 months to 1.5 months)
  • Responds vocally to the speech of others at approximately 4 months (range 1.5mths to 8.5mths)
  • Turns head to sound of voice at approximately 6 months (range 3 months to 8 months)
  • Smiles at person speaking to him/her at approximately 4 months
  • Enjoys social interaction and shows this through smiling and making cooing sounds
In the second six months a child is often referred to as an experimenter

During the second six months of life the infant begins to assert more control within the infant-caregiver interaction. He/she begins to communicate intentions more clearly and effectively. The ways an infant does this is through gestures and vocalisations.

  • Development of intentional communication

 

  • Using communication functions:
    • Commenting
    • Requesting
    • Rejecting
    • Vocalises to toys
    • Responds to name
    • Experiments with sounds
    • Varies volume
    • Vocalises pleasure and displeasure
    • Follows simple motor instructions e.g. bye bye by approximately 8mths
    • Reacts to 'no' intonation
    • Uses strings of syllables produced with stress and intonation that mimic real speech.
By 7 months the infant begins to respond differentially to his or her interactional partner, staying close to the caregiver, following her movements, and becoming distressed if she leaves.

At about 8-9 months the infant begins to develop intentionality or goal directedness and the ability to share goals with others. Up to this point the child has focused primarily on either objects or people. Complex action sequences are really a series of discrete behaviours directed toward one or the other e.g. the child might look at a person, smile, and touch. Intention develops when the child becomes aware that he/she can affect his/her environment and that movements and sounds can stand for feelings, needs and desires.

For the first time, she considers the audience- may touch, gain eye contact, then gesture towards an object. The child's use of these signals are called communication functions and are expressed primarily through gestures- requesting, commenting, rejecting are first fulfilled by pre-linguistic communicative means and only later by language.

There is a major transition towards the end of first year of life as infants recognise the communication value of their behaviour.

  • calling/greeting the caregiver
  • requesting action from the caregiver
  • protesting an action proposed or initiated by the caregiver
  • repeating/practicing a response

Vocal play

  • Refers to the longer strings of syllables
  • Reduplicated babbling: the syllable is duplicated in strings of repetitive syllables eg /da da da da/ by 11 months (range 7 months to 18 months)
  • Non-reduplicated babbling/variegated babbling: the strings of syllables are more varied e.g. /gabida/ by 18months (range 12months to 30 months)

 

Second year of life

Infants' vocal behaviours are strongly influenced by their language environment. Hearing loss does however affect the number and variety of consonants in the pre-speech vocalisations of infants.

They may want, often desperately, to communicate something but often cannot. However, that does not deter them from making the effort as they follow what seems to be an inborn desire to communicate. Neither does it mean that we cannot understand the messages children try to send until they are using adult words. We use their actions, gestures, tones of voices, and our knowledge of their immediate or more distant pasts to interpret-or at least to make a good guess at their intended meanings.

As children gradually add words and phrases to their communicative repertoire, the problem of insufficient information diminishes: but for much of the first two to three years of their life, conversations are crucially dependent upon facial expressions, hand gestures, objects, and people their environments.

Gestures

to

Gestures + vocalisations

to

Gestures/signs + words

 

A child will use gestures first, for example, pointing, or hands up, waving, reaching.

Then progress to gestures plus sounds.

Then use gestures/signs plus words.

When a word is intelligible the child will say the word only.

 

The child's understanding of language is developing

Recognises own name and familiar words by 13mths (range 10months to 18months)

Responds to simple instructions by 16months (range 12months to 24 months)

First words

Typically first words emerge between 12 and 18 months. For a child with Down syndrome first words emerge at 18months (range 13mths 36 months) (Down Syndrome Educational International). A true first word is one that is produced consistently in the presence of the same person, object, or event. Whereas the infant's earlier productions of mama or dada are exciting events, but if they are isolated or random productions they are not true words.

First 50 words

Not surprisingly, these words tend to be ones closely connected with the child's everyday world.

  • Nouns general :50% e.g. milk, dog, car
  • Nouns specific :11% e.g. mama dada, pet names
  • Action words: 19% e.g. give, do, up.
  • Modifiers: 10% e.g. mine, no, dirty.
  • Personal social: 10% e.g. no, please.
Nelson (1973) found that the first objects named by children tended to be those which were small and easily handled by children. Shoe and sock tended to be acquired before pants and nappy. Early words also tended to name things which move, made a noise, or changed in some way….animals, vehicles and people.

 

A word simply refers to or stands for a particular object, event, or relationship. Initially a child's production of doggy refers to the particular furry creature that lives in their house. Later, a child can produce doggy in response to similar creatures in the neighbourhood. Next the child will associate words based on the, for example, pet's location or noisiness producing doggy and house, or doggy and bark,

(Owens 2008: 199).

How fast do first words grow?

  • Traditionally typical development suggests: first word at approximately 12 months and 50 words by 18 months of age.
  • For a child with Down syndrome first words emerge at approximately 18 months, however using words spontaneously and to communicate can range from between 18months and 6 years.
  • It is generally accepted that receptive vocabulary grows faster than expressive vocabulary.
  • The overall growth rate will vary across individual children and may even vary for a given child, with bursts and plateaus in learning new words.
  • Two word sentences can emerge at 30 months (range 18months to 60months+)

Differences in rate of growth across toddlers may relate to various factors such as differences in experiences and exposure to language and the child's own ability to interact, hear, listen and learn the language used around them

In relation to speech, language and communication, speech is by far the most difficult for children with Down syndrome. However, it is important to note that although children with Down syndrome have speech difficulties, they can still communicate their intentions very well.

Intelligibility of speech refers to:

  • Speaker's ability to speak in a recognised, accurate and clear form
  • How well a speaker can do this
  • The extent to which a 'listener' can recognise words

What do first words sound like?

  • Usually common words in the child's everyday routines
  • Most words contain one or two syllable
  • VC (vowel + consonant) – up, eat...
  • CV (consonant + vowel) - no
  • CVCV (consonant + vowel + consonant + vowel) – mama, dada, wawa for water
  • CVCV2 (consonant + vowel1 + consonant + vowel2) - doggie
  • Substitution - where one sound is substituted for another, for example, 'see' is pronounced as 'tea'
  • Assimilation - where a sound changes to become more like the one next to it, for example, 'dog' is pronounced as 'dod'
  • Reduction - where a sound is deleted, for example 'ball' becomes 'ba'
  • Open syllables – where 'blanket' becomes backie (ending in a vowel)

New words composed of sounds already used by a child are more easily learned than words with sounds absent from a child's sound system.

In terms of syllable structure, words that consist of reduplicated syllables are generally learned more quickly than words consisting of non-reduplicated syllables.

When we talk about expressive language we are concerned with

  • Phonology (speech sounds)
  • Motor planning (knowledge of how to sequence the sounds and words)
  • Articulation (coordination of lips, tongue, jaw, respiration)
  • An opportunity to use language.

All these components are needed for a child to express language successfully. The child must also know the social rules for language use, for example, turn taking, initiating a conversation, and responding. The child must also know what it is they want to say which relies on their understanding of language and their cognitive abilities.

 

Alternative & Augmentative Communication Systems (AAC)

From an early age children will be watching and learning and children with Down syndrome are visual learners so therefore you can use gestures, pictures and photographs to facilitate their learning of language and to express their needs. Children with Down syndrome begin to respond to gestures at approximately 13.5 months (range 10months to 18months) and to use gestures to demonstrate their needs by approximately 22months (range 14months to 30months).

Discussions with your speech and language therapist will help you understand the use of augmentative communication systems

Signing systems e.g.

  • Natural gestures, for, example, holding your hands up to signal up.
  • Lamh (sign language used in Ireland to support a child getting there verbal message across. See www.lamh.org
Communication aids
  • Switches
  • Symbol systems e.g.
  • Pictures/photographs/objects/written word
  • Mayer-Johnson symbols Boardmaker
  • Picture Exchange Communication System (PECS)
Other areas of Development

As your child's gross motor development progresses they begin to explore their environment more and interact with different toys and activities. Their fine motor development also allows him/her to explore with pen and paper and turn pages in a book and repeat daily routines.

 

References

Typical child development

Owens, R.E. (2008). Language development: An introduction. 7th Ed. Pearson Educational International.

McLaughlin, S. (2006). Introduction to language development. London: Singular. 2nd Ed.

Development and Down syndrome and learning disability

Grant, G., Goward, P., Richardson, M., & Ramcharan, P. (Eds) (2005). Learning disability: a life cycle approach to valuing people. Maidenhead; New York: Open University Press

http://www.down-syndrome.org/information/development for on line information

http://wwwdownsed.org for Down Syndrome Issues and Information Packs, for example,

An overview of the development of infants with Down syndrome (0-5 years)

Speech and language development for infants with Down syndrome (0-5 years)

 

Written by Clare Carroll, B.Sc., M.Sc., MIASLT, MRCSLT.

Lecturer, Discipline of Speech and Language Therapy

School of Health Sciences, NUI Galway