Language Development in Children and Adolescents with Down Syndrome

1. Language Development in Children and Adolescents with Down Syndrome Robin Chapman, Ph.D. Waisman Center University of Wisconsin-Madison

2. Acknowledgements Research supported by NIH grant R01-HD23353 with additional support from the National Down Syndrome Society. We thank the participants and their parents.

3. Dr. Donna Boudreau Cynthia Bridge Katherine Gigstead Dr. Linda J. Hesketh Dr. Maura Johnson Dr. Mina Johnson-Glenberg Dr. Elizabeth Kay-Raining Bird Dr. Doris J. Kistler Dr. Andrea McDuffie Dr. Sally Miles Dr. Jon Miller Dr. Giuliana Miolo Dr. Scott E. Schwartz Dr. Hye-Kyeung Seung Dr. Elin Thordardottir Heidi Sindberg Dr. Nadia Teitler Dr. Laura Wagner Thanks to Colleagues:

4. Is language acquisition modular or interactive? Is there a specific behavioral phenotype in children with Down syndrome? What is the developmental trajectory of language skills? What factors predict language production? What factors predict language comprehension? What factors improve word learning? What factors improve storytelling? Questions:

5. Modular vs. Interactionist Theory(Chapman, 2000) • Modular view of language predicts a specific language deficit in both comprehension and production • Interactionist view predicts multiple dissociations, including comprehension and production, arising developmentally

6. Person Sounds Heard Babble Object Action Developmental Emergence of Language in Down Syndrome: Evidence for Interactionist Position (Chapman, 2004) I. SOCIAL INTERACTION * *slower emergence of emotional affect recognition in DS (spollak@wisc.edu) and frequent hearing impairment

7. Developmental Emergence of Language II. OBJECT INTERACTION Person Sounds Heard Babble Object Action * *More prolonged attention to people than objects in DS

8. Person Sounds Heard Babble Object Action Developmental Emergence of LanguageIII. CANONICAL BABBLING * * Slower Development of Canonical Babbling, & Frequent Hearing Impairment, in DS

9. Person Sounds Heard Babble Object Action Developmental Emergence of Language IV. JOINT ATTENTION * * Slower Babbling Development & Affective Comprehension in Down Syndrome

10. Person Sounds Heard Words Object Action Developmental Emergence of Language V. COMPREHENSION OF WORDS, COMMUNICATIVE INTENT * * * Slower Development of Communicative Requesting in Down Syndrome

11. Person Sounds Heard Words Object Action Developmental Emergence of Language VI. USE OF WORDS * * * Slower Development of Expressive Vocabulary in Down Syndrome, including Signs

12. Person Sounds Heard Words Object Action Developmental Emergence of Language VII. SIMPLE SENTENCES * * * Slower Development of Sentence Production in Down Syndrome ** *

13. Person Sounds Heard Developmental Emergence of Language VIII. COMPLEX SENTENCES * * Words Object * Slower Development of Complex Syntax Production for Complex Events in Down Syndrome * Action

14. The phenotype in infancy • Learning delays accelerate at ages 2-4 • Slower transition from babbling to speech; poorer intelligibility • Delays relative to cognition in nonverbal requesting, rate of expressive vocabulary development, rate of increase in sentence length • Comprehension comparable to cognition

15. The phenotype in childhood • Selective deficits in verbal short-term memory • Longer period of phonological errors and more variability; poorer intelligibility • Expressive language delay relative to comprehension and cognition • Grammatical morphology deficit relative to sentence length in production

16. The phenotype in adolescence • Deficits in both working verbal memory and visual short-term memory • Intelligibility problems; more variability in fundamental frequency, rate, stress placement • Expressive language deficit greatest in grammatical morphemes, least in vocabulary; MLU shows longitudinal gain • Sentence comprehension begins to lag cognition, and shows longitudinal loss; vocabulary comprehension a strength on PPVT

17. The phenotype in young adulthood • Continuing auditory short-term memory deficit • Continuing progress in intelligibility • Continuing progress in expressive syntax: MLU increase, complex sentence acquisition • Continuing strengths in size of comprehension vocabulary • Loss of elaborated sentence comprehension

18. Predicted Comprehension for Ages 7.5, 12.5 and 17.5

19. Predicted Comprehension when Auditory ST Memory Intercept is at 25%ile, mean, or 75%ile

20. Predicted Comprehension when Visual S-T Memory Intercept is at 25%ile, Mean, or 75%ile

21. Predicted MLU when Syntax Comprehension Intercept is at 25%ile, Mean or 75%ile

22. Predicted MLU when Syntax Comprehension slope is at 25%ile, Mean or 75%ile

23. Predictors of individual difference: • For Syntax Comprehension: age, auditory short-term memory, visual short-term memory • For Syntax Production (MLU): syntax comprehension • For Grammatical morpheme comprehension and fast mapping of words: hearing

24. Implications • Evidence is consistent with an interactionist account of language learning, • Multipletargets for early intervention -object play and exploration schemes -requesting -babbling/speech motor skills -intelligible communication (signing) -affective comprehension -Hearing!

25. Implications, cont’d • Shifting intervention targets with development • Need for continuing language intervention in adolescence, including complex syntax & literacy • Need to target BOTH comprehension and production, at different levels • Importance of hearing status for intelligibility & grammatical morpheme comprehension

26. Evidence for specificity of phenotype in adolescence: DS vs. CI (Chapman, 2006) • Comprehension deficits in DS vs. CI of unknown origin (nonverbal MA/CA match) • Production deficit in DS in adolescence in interview language sample • Phonological working memory plays an important role in comprehension and production performance by both groups * NRT (long-term knowledge) is more important for DS * digit span & visual short-term memory more important for CI • Hearing status affects DS grammatical morpheme comprehension and interview-MLU

27. Fast mapping of novel words • DS children & adolescents= MA match (Chapman, Kay-Raining Bird & Schwartz, 1990; Kay-Raining Bird, E., Chapman, R.S., & Schwartz, S.E. (2004). • With multiple words, DS=MA in comprehension but DS<MA in production (Chapman, 2003) • DS adolescents = syntax comprehension TD match in using speaker intent to infer object referent McDuffie, A., Sindberg, H., Hesketh, L., & Chapman, R. (in press). • Repeated mention of words speeds access in comprehension, for DS (Chapman, Sindberg, Bridge, Gigstead, & Hesketh, 2006)

28. Narratives in children & adolescents • Event content of remembered silent film: DS = MA controls despite shorter MLU (Boudreau & Chapman, 2000) • Plot line & theme elements of wordless picturebooks: DS > MLU comparison group; DS = syntax comprehension group (Miles & Chapman, 2002) • Presence (vs. absence) of picture support: increases DS MLU to syntax comprehension group level (Seung & Chapman, 2002; Miles, Chapman, & Sindberg,2006)

29. Repeated Narratives • Repeated retellings of a wordless picture book lead to increases in plot line/theme expression and MLU (Miles & Chapman 2005) • Examiner scaffolding with questions yields higher MLU & improves expression of location setting information (Miles, Sindberg, Bridge & Chapman, 2002) and number of different words used (Miles 2005) • Storytelling strategies (Miles, Chapman & Sindberg, 2004): -task approached as retelling of related events -evaluations and character speech used by both DS & syntax comprehension controls -use of inference increased across sessions -more multiple utterances in DS group

30. Plot line/Theme Content of Repeated Narratives, DS vs. Syntax comprehension matched group(Miles & Chapman, 2005)

31. MLU of Repeated Narratives, DS vs. Syntax comprehension matched group (Miles & Chapman, 2005)

32. Answers: • Language acquisition is interactive, emergent, non-modular • Children with Down syndrome show a Specific Language Impairment • Trajectory: MLU and complex syntax increase with age: No evidence of a critical period • Trajectory: Syntax comprehension declines in late adolescence and young adulthood

33. Answers, continued • Language comprehension predicts language production • Auditory and visual short-term memory predict language comprehension • hearing also predicts grammatical morphology & intelligibility

34. Implications for Language Intervention • Need for language intervention in adolescence, including literacy • Need to target both comprehension and production, at different levels • Repeated mention of novel word in play improves speed of its comprehension

35. Implications for Intervention , cont’d • Need to provide hearing support for intelligibility and grammatical morpheme comprehension • Helpfulness of picture support for narrative content & MLU • Helpfulness of narrative practice for MLU

36. Methodological implications • Comprehension Assessment -Vocabulary: frequency vs. concept (PPVT vs TACL-voc) -Past use of PPVT as MA match has mismatched TD groups and overestimated adolescent DS MA -Syntax: differential effects of hearing on morphology & sentence structure • Language Samples -Conversation vs. narration -Visual support for narration

37. Some Thoughts about Future Research • Importance of modeling individual differences in studying DD populations • Imaging: to illuminate short-term memory contributions • Genome variation: to predict IDs in longitudinal language & cognitive trajectories • Genetic dissection of learning will remap our dissection of phenotype

38. References • Abbeduto, L. & Chapman, R.S. (2005). Language and communication skills in children with Down syndrome and Fragile x. In P. Fletcher & J. Miller, Eds., Trends in language acquisition research, vol 4: Developmental theory and language disorders. Amsterdam, NL: John Benjamins. • Boudreau, D. & Chapman, R.S. (2000).The relationship between event representation and linguistic skill in narratives of children and adolescents with Down syndrome. Journal of Speech, Language, and Hearing Research, 43, 1146-1159. • Chapman, R.S. (1999). Language and cognitive development in children and adolescents with Down syndrome. In J.F. Miller, L.A. Leavitt, and M. Leddy, Eds., Improving the communication of people with Down syndrome. (Pp. 41-60). Baltimore: Brookes. • Chapman, R.S. (2000). Childrens’ language learning: An interactionist perspective. Journal of Child Psychology and Psychiatry, 41, 33-54.

39. References, ctd. • Chapman, R.S. (2003). Language and communication in individuals with Down syndrome. (pp. 1-34) In L. Abbeduto (Ed.,), International Review of Research in Mental Retardation: Language and Communication, vol. 27. Academic Press. • Chapman, R.S. (2006). Language learning in Down syndrome: the speech and language profile compared to adolescents with cognitive impairment of unknown origin.Downs Syndrome Research & Practice, 10, 61-66. • Chapman, R.S., & Hesketh, L.J. (2000). Behavioral phenotype of individuals with Down syndrome. Mental Retardation and Developmental Disability Research Reviews, 6, 84-95. • Chapman, R.S. & Hesketh, L.J. (2001). Language, cognition, and short-term memory in individuals with Down syndrome. Down Syndrome Research and Practice, 7, 1-7.

40. References, ctd. • Chapman, R.S., Hesketh, L.J., & Kistler, D. (2002). Predicting longitudinal change in language production and comprehension in individuals with Down syndrome: Hierarchical linear modeling. Journal of Speech, Language, and Hearing Research, 45, 902-915. • Chapman, R.S., Seung, H-K., Schwartz, S.E. & Kay-Raining Bird, E. (2000). Predicting language development in children and adolescents with Down syndrome: The role of comprehension. Journal of Speech, Language, and Hearing Research, 43, 340-350. • Chapman, R.S., Sindberg, H., Bridge, C., Gigstead, K. & Hesketh, L.J. (2006). Effect of memory support and elicited production on fast mapping of new words by adolescents with Down syndrome. Journal of Speech, Language, & Hearing Research, 49, 3-15. • Johnson-Glenberg, M.C. & Chapman, R.S. (2004). Predictors of parent-child language during novel task play: A comparison between children who are typically developing and individuals with Down syndrome. Journal of Intellectual Disabilities Research., 48, 225-38.

41. References, ctd. • Kay-Raining Bird, E., Chapman, R.S., & Schwartz, S.E. (2004). Fast mapping of words and story recall by children with Down syndrome. Journal of Speech, Language, and Hearing Research, 47, 1286-1300. • McDuffie, A., Sindberg, H., Hesketh, L., & Chapman, R. (in press). Use of speaker intent and grammatical cues in fast-mapping by adolescents with DS. Journal of Speech, Language, and Hearing Research. • Miles, S. & Chapman, R.S. (2005). The relationship between adult scaffolding and narrative expression by adolescents with Down syndrome. Poster presented at the Symposium on Research in Child Language Disorders, Madison, WI, June 10. • Miles, S. & Chapman, R.S. (2002). Narrative content as described by individuals with Down syndrome and typically developing children. Journal of Speech, Language, and Hearing Research, 45, 175-189.

42. References, ctd. • Miles, S., Chapman, R.S. & Sindberg, H. (2006). Sampling context affects MLU in the language of adolescents with Down syndrome.Journal of Speech, Language, and Hearing Research, 49, 325-227. • Miolo, G., Chapman, R.S., & Sindberg, H. (2005). Sentence comprehension in adolescents with Down syndrome and typically developing children: Role of sentence voice, visual context, and auditory-verbal short-term memory. Journal of Speech, Language, and Hearing Research, 48, 172-188. • Seung, H-K. & Chapman, R.S. (2000). Digit span in individuals with Down syndrome and typically developing children: Temporal aspects. Journal of Speech, Language, and Hearing Research, 43, 609-620.. • Seung, H.K., & Chapman, R. S. (2003). The effect of story presentation rates on story retelling by individuals with Down syndrome. Applied Psycholinguistics, 24, 601-618.

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