Defining Expressive Language Benchmarks for Children with Down Syndrome

Abstract

Establishing expressive language benchmarks (ELBs) for children with Down syndrome (DS), as developed by Tager-Flusberg et al. for children with autism, is critically needed to inform the development of novel treatments, identify individualized treatment targets, and promote accurate monitoring of progress. In the present study, we assessed ELB assignments in three language domains (phonology, vocabulary, and grammar) for 53 young children with DS (CA range: 2.50–7.99 years) using standardized assessments. The participants were classified into one of four ELB levels (preverbal, first words, word combinations, and sentences) in each language domain. Associations with additional measures of language, chronological age, nonverbal cognition, and verbal short-term memory were considered. Analyses of individual ELB profiles indicated substantial variability across the three language domains, with six different patterns of variation across domains emerging. At the same time, the ELB categories were significantly associated with independent language measures and broader developmental domains. Moreover, ELB changes were observed in a small sample of children with DS reassessed 18–24 months after the initial visit. Results from the present study suggest the procedures outlined by Tager-Flusberg et al. for defining ELBs are a potentially useful tool for describing the language abilities of children with DS.

Cross-Sectional Analysis of Caregiver-Reported Expressive Language Profiles and Associated Covariates in Individuals with Down Syndrome

“…12 A recent meta-analysis of predictors of language outcomes for children with DS across 170 children in 9 separate studies revealed that adaptive functioning, vocabulary, maternal education, communicative intent, phonological awareness, parental translation of gesture, baby sign, nonverbal mental ability, and joint attention were predictive of later language, although this study did not include other patient-specific health or environmental characteristics. 13 In a recent study by Thurman et al, 14 it was demonstrated that children with DS do have significant variability in expressive language benchmarks by age, although that study was limited to children between the ages of 2.50 and 7.99 years. There are hypotheses regarding the drivers of poor expressive language outcomes, but these have not been evaluated in a large sample to examine potential variables of impact across a cohort of children and young adults with DS.…”