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Cross-Domain Therapy Effects in Children with Down Syndrome
AdvisorBass, Lori A
Speech Pathology and Audiology
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Children with Down syndrome (DS) often demonstrate greater delays in speech and language development than their general developmental levels would predict. Research into the types of errors made by children with DS indicate their oral language systems resemble those of much younger, typically-developing children and children with language impairments. However, to date, very little research has been conducted investigating the most effective techniques to improve the oral language skills of school-age children with DS. To that end, the present study was a preliminary investigation of the effects of two instructional language techniques shown to be effective with typically developing children with phonological (speech sound) or grammatical impairments. The language instruction employed structural priming (Leonard et al., 2000, 2002) and was designed to teach children to ask fully formed questions or negated statements. Structural priming activities were embedded into children's storybooks. The phonological instruction consisted of a non-developmental linguistically-based approache focused on teaching English consonants that were excluded from children's phonological systems. Six children with Down syndrome between the ages of 5:0 and 7:11 (years: months) were recruited as participants. All children communicated verbally using primarily two- to three-word utterances prior to their participation in the study. Children were randomly assigned to one of two instructional conditions: (1) the morphosyntactic instructional condition; or (2) the phonological instructional condition. A multiple baseline design across behaviors was used to determine if the assigned instructional condition was related to changes in children's language skills and if instruction in one language domain was related to changes in the other domain. Four children received the morphosyntactic instructional condition. Two participants received instruction on Wh-questions while the other participants received instruction on negated statements. The remaining two participants were randomly assigned to the phonological instructional condition. Children participated in twice-weekly 30-minutes sessions over 8 weeks. Changes in language skills were monitored through the use of weekly morphosyntactic and phonological probes and tracking changes in daily instructional data. Results indicated both instructional conditions were effective in causing change in the targeted language skills. All four children who received the morphosyntactic instruction demonstrated gains in the targeted morphosyntactic skill as well as marked gains in phonological skill (i.e., cross-domain effects). For these participants, growth in oral language skill was apparent when comparing pre- and post-instructional performance on the Goldman-Fristoe Test of Articulation, Second Edition and the BE/DO probe from the Rice-Wexler Test of Early Grammatical Impairment. Children assigned to the phonological instructional condition demonstrated very large gains in productive phonological skill as a result of their participation in the study. However, little to no growth in morphosyntactic skill was observed on the weekly or standardized morphosyntax measures. These results indicate that cross-domain effects could be detected on phonology for children who received the morphosyntax instruction but no effects on morphosyntax were present for children who received the phonological instruction. The clinical implications of these findings are discussed.