Case Study

Jeffrey: A Toddler with Down Syndrome

Jeffrey was 14 months when I met him. He was born with Down syndrome and a congenital heart defect and had open heart surgery when he was 6 months old. Jeffrey often got ear infections and had recently had a set of pressure-equalizing (PE) ear tubes placed. Jeffrey was not walking and was not yet crawling. Children with Down syndrome do learn to crawl and walk and talk; it just takes longer. Recent research and clinical experience suggests that, with regard to talking, these children benefit from early oral stimulation, oral-motor awareness and multiple experiences with oral sensory stimulation. As soon as I met Jeffrey, we began working on “mouth wakeup” activities, stimulating his teeth, lips, gums, hard and soft palate, inside cheeks, and outside jaw muscles with a variety of toys and tools, including vibrators. We taught his parents to do the same at home. Another part of getting ready to talk is stimulating receptive language (language comprehension). In speech therapy visits we began using short descriptive sentences to describe toys Jeffrey picked up (he was in a high chair initially). We dropped direct questions during these periods of indirect language stimulation and encouraged the parents to do the same. After two to three weeks, Jeffrey’s mother became adept at these techniques and began describing his activities as he did them so that he could hear them and associate the object he had with the words he heard. Her continuing work in this area made a very significant difference in Jeffrey’s getting ready to talk.

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