Speech and Language

Children with Down syndrome should receive speech and language therapy in school through the student’s IEP. Some families also choose to have private speech therapy outside of school and pay for it through their insurance. Speech therapy in the school can be done one on one with a therapist (noted as “individual therapy” in IEP) or in small peer-to-peer groups (noted as “group therapy” in IEP). The therapy sessions may happen outside of the classroom and location should be noted in the IEP. Some therapists, especially those in an inclusive school environment, “push in” speech therapy into the classroom (and even during lunchtime to help with social/conversational skills) and even manage certain academic goals in the child’s IEP.

Progress at five years will vary widely between children, with the majority of children with Down syndrome producing two- or three-word utterances and much of this difficult to understand. Most children will have significantly better comprehension than production. Some children will have quite clear production of three or four-word sentences but with grammatical markers missing. Reading activities are an important support for speech and language development throughout the school years.

Goals for speech and language therapists working with 5-11 year olds with Down syndrome:

IEP Goals for Speech
  • Goals should focus on speech, vocabulary, grammar and communication skills. For vocabulary and grammar, have separate targets for comprehension and for production, as comprehension in both areas is typically significantly ahead of production. For speech work, separate targets may be needed for articulation, phonology and intelligibility (pacing, voice, etc.).
  • Therapists can use reading to teach language and to incorporate speech and language targets into literacy activities. The speech therapist should also review oral-motor function, feeding, chewing and drinking patterns and advise accordingly.
  • If your child’s speech is severely delayed, consider asking for an assistive communication audit to see what technologies might assist your child in communicating at school.
  • Be sure to have your child’s hearing and vision checked regularly because if there are underlying issues, speech can be affected.
Resources for speech: