The case for early, time-sensitive speech, language, and communication interventions for young children with Down syndrome or other intellectual and developmental disabilities

Abstract

The aim of this chapter is to stress the importance for speech, language, and communication interventions to begin in the first year of life for children with intellectual and developmental disabilities (IDD). In the chapter, we review the early foundations and development of neurotypical children’s speech, language, and communication skills. While patterns of development vary for children with IDD, all children tend to build their communication skills in much the same developmental order. Therefore, we argue that a sound knowledge of neurotypical development is the basis for understanding the challenges of those with IDD and designing tailored interventions. We identify that learning to communicate is not just influenced by the child’s abilities or challenges, but by the learning environment that they are in, including their daily communication interactions with caregivers. Thus, it is imperative to involve caregivers in the delivery of early interventions.We illustrate our viewpoint by considering the example of children with Down syndrome whose speech, language, and communication difficulties are extensively documented. We provide a review of their challenges and of the evidence for early interventions to date. We then present two examples of interventions, both starting in the first year of life, that have been piloted to improve outcomes for this group of children. Both projects focus on supporting parents to implement the interventions and make use of digital technologies.We present these as models, which illustrate the possibilities for starting interventions early and suggest they could be used with many other children with IDD known to be at risk for speech, language, and communication difficulties. We identify how they fit with expert recommendations for early and intensive interventions, how they can be upscaled with limited resources, and how they illustrate a ‘precision and individualized medicine’ approach.