Using Total Communication With Young Children With Down Syndrome: A Literature Review and Case Study

This paper presents a literature review regarding language abilities of children with Down syndrome and presents a case study concerning the effectiveness of using Total Communication with a young child with Down syndrome. The prevalence of expressive language delays in children with Down syndrome highlights the need to develop early interventions to promote language development. The existing literature on the usefulness of Total Communication as an intervention method with children and adults with special needs is documented and a rationale for the use of Total Communication with children with Down syndrome is presented. In the case study, a single subject simultaneous treatment design was used which involved introducing 20 words during free play (10 oral and 10 Total Communication), which were matched on phonetic complexity and reinforcement value. Results indicated that comprehension was not differentially affected by the type of communication approach used. However, expressively the child was able to use manual signs many months before any understandable words were produced. The use of manual signs did not inhibit use of speech. The results of this case study suggest that the early use of Total Communication can be an effective transitional mode of communication for at least some children with Down syndrome. Further research is needed to explore individual differences between children with Down syndrome and to identify factors that predict those children who benefit most from the use of Total Communication.