This book presents an overview of what is understood about development of motor skills in people with Down syndrome. Reviewing the available research, effective activities for promoting the development of motor skills are discussed. This book provides a review of research into the development of motor skills in individuals with Down syndrome. This research is limited but the book discusses what is known about the factors influencing progress and some milestones for attaining gross motor skills (for example, sitting, walking, running) and fine motor skills (for example, using cutlery, managing fastenings, drawing and writing). The book identifies the principles that should guide the development of activities to improve motor skills, based on the evidence currently available and the specific learning profile of children with Down syndrome. "Down Syndrome Issues and Information" is a major series of practical and informative books covering the full range of developmental, health and social issues relating to individuals with Down syndrome. The books have been written by many of the world's leading experts and are based on years of research and hands-on experience.

Teenagers and adults with Down syndrome vary widely in their interest and achievements in number skills and mathematics. There is only a small amount of research in the area and little that provides guidance for effective teaching methods and materials. Typically, the achievements of individuals with Down syndrome in number are at a lower level than their achievements in literacy. However, there is a wide range of progress and while some teenagers find number difficult, others enjoy mathematics. They are helped to do this by understanding the purpose of developing number skills, for example for managing their own money. Research findings indicate that good teaching, using their visual learning strengths, promotes learning and that teenagers with Down syndrome follow the same stages of progression as typically developing young people, although often with more steps and practice needed at each stage. This module describes the steps in learning about number so that teenagers with Down syndrome can receive sufficient teaching and practice for learning these skills while they are at secondary school. It also includes examples of students' work and achievements.
The information and activities cover a range of skills, from basic to advanced, in order to meet the needs of all teenagers, whatever their current level of achievements, and they should be equally relevant in mainstream or special education classrooms. This module links with the overview module which presents and discusses the research on number for children with Down syndrome and the implications for teaching and learning.

Children and adults with Down syndrome vary widely in their achievements and interest in number skills and mathematics. There is only a small amount of research in the area and little that provides guidance for effective teaching methods and materials. Typically, the achievements of individuals with Down syndrome in number are at a lower level than their achievements in literacy. However, there is a wide range of progress and while some children find number difficult, other children with Down syndrome enjoy mathematics. When a pupil is interested, motivated and taught well, he or she may achieve at an age appropriate level in primary school. Research findings indicate that good teaching, using the children's strengths for visual learning, does promote learning and that children with Down syndrome follow similar stages of progression as typically developing children, although often with more steps and practice needed at each stage.
This overview module reviews the development of number and maths skills in typically developing children, research on number and mathematics for children with Down syndrome, the implications for teaching and learning, inclusion in the mathematics curriculum, typical levels of achievement across the age range and the necessity for language teaching. This overview module links with the practical number modules for children aged 3-5 years, 5-11 (primary) and 11-16 years (secondary pupils). These modules contain discussion of the range of achievements, teaching methods and practical activities for each age group.

While the published information on the reading development and reading achievements of individuals with Down syndrome is still limited, many authors now recognise the benefits of teaching children with Down syndrome to read and of involving them in literacy activities. Reading progress and being involved in supported reading and writing influences speech, language and memory skills for all children, including those with Down syndrome. Children with Down syndrome educated in mainstream inclusive classrooms achieve higher levels of literacy than those of similar ability educated in special schools. Children with Down syndrome learn to read in the same way as typically developing children but they make use of their good visual memory skills to read and are slower to be able to use phonics. However, when they have reading skills in the 7 to 8 year level (based on norms for typically developing children), they begin to use their phonic skills independently to read and to spell, like other children.
There are considerable individual differences in rates of literacy progress among children with Down syndrome, but if they have access to good teaching, their reading abilities are, on average, about two years behind their age in primary school, while language and number abilities are often more delayed, therefore reading ability is a strength for many of the children. Recent studies from Australia and the UK indicate that some 60% to 70% of individuals with Down syndrome can achieve functional levels of literacy by adult life. Children introduced to literacy as a language teaching activity in preschool years reach the highest levels of achievement, but individuals may make significant progress at any age into early adulthood, and many late starters do achieve functional levels of literacy. Reading should be taught and pupils involved in the daily use of literacy throughout teenage and adult years, particularly for those individuals who may not have made progress earlier.

Drawing on available research and personal experience, the experience of families with children with Down syndrome is explored with the aim of identifying the strengths and positive coping strategies used by most families. The evidence shows that almost all families love and value their child with Down syndrome and list the benefits they have gained as a family from raising this special child. Some two-thirds of families lead ordinary lives, with no long term negative effects for other members of the family. These families do experience extra demands and extra stress but they find the resources to cope successfully. Research has identified some of the strategies that families use to cope successfully. One third of families have a more difficult time and the reasons that they experience more stress have been identified. Knowing the causes of additional stress allows families and service providers to pinpoint their difficulties and offer appropriate support and services. Knowing the successful strategies that reduce stress is equally important in helping families to use all the positive resources that they have available to them.
Families are encouraged to evaluate their own situation using this information and to identify any additional resources that they could use. Practitioners are encouraged to use the information to improve their practice and to focus on family centred ways of working, recognising that the family unit is the child's main resource throughout his or her life-time.


This book offers an introduction to the development of teenagers with Down syndrome. Drawing on the latest research and extensive practical experience, it examines many aspects of development during childhood. Presented in an accessible format, it is a useful reference for families and professionals caring for adolescents with Down syndrome. This introductory book provides an overview of development from 11 to 16 years. It provides information about the development of social, motor, language, cognitive, behaviour, self-help, reading and number skills. It also details typical milestones for adolescents with Down syndrome in these areas. The book highlights the importance of increasing community participation and planning for adult life. Individual differences are discussed, as are key health and family issues. Principles for education, community and therapy services are identified, based on the specific needs of children with Down syndrome and research on effectiveness. "Down Syndrome Issues and Information" is a major series of practical and informative books covering the full range of developmental, health and social issues relating to individuals with Down syndrome.
The books have been written by many of the world's leading experts and are based on years of research and hands-on experience.

Teaching reading to teach talking is probably the single most effective intervention for helping children with Down syndrome to overcome their learning difficulties. Reading and writing skills are important for everyday life and for access to the world of literature for all children. They are also powerful tools for teaching speech and language to children with Down syndrome and for mediating their cognitive development. Beginning early, by introducing young children to reading from two years of age, will promote the development of both their spoken language and their literacy skills. This module explains how to teach reading to teach language and how language and literacy teaching can work together to promote the development of children with Down syndrome, beginning in the preschool years. Guidance on teaching methods and examples of activities show parents and teachers how to introduce young children to reading and other literacy activities.
This module is linked with Reading and writing development for individuals with Down syndrome - An overview,[DSii-07-01] which should be read first, to provider the reader with evidence for the benefits of early reading and the rationale behind the programme.

This book provides guidance and advice and describes practical activities to assist the development of number skills for children with Down syndrome. Covering awareness of quantity, size, weight, pattern, shape, time and money and the importance of language for number concepts, it offers practical information in an accessible format. This practical book draws on what is known about the number development of typically developing children to provide guidance and activities to teach number and maths concepts to children with Down syndrome in primary school. The use of multi-sensory materials is encouraged and the need to make activities meaningful by linking them to the child's everyday experience of the use of quantity, size, weight, pattern, shape, time and money is stressed. The language needed for number and maths concepts is identified. This practical book is intended to be used by parents and education professionals. It is designed to be read in conjunction with other books in the "Down Syndrome Issues and Information" series. In particular, it is complemented by the background information provided in "Number Skills for Individuals with Down Syndrome - An Overview".
"Down Syndrome Issues and Information" is a major series of practical and informative books covering the full range of developmental, health and social issues relating to individuals with Down syndrome.

This module provides a programme of activities and advice designed to assist the development of speech and language skills for children with Down syndrome from birth to five years. The advice and activities are based on knowledge of the processes affecting speech and language development in typically developing children, the identified difficulties of children with Down syndrome and current research findings from studies evaluating effective remedial strategies. It also includes checklists for evaluating and recording children's development of interactive communication skills, speech sounds, vocabulary, sentences and grammar. The programme will enable parents, teachers and therapists to help children with Down syndrome to learn to talk, to talk in sentences, and to develop their speech clarity and conversational skills. It starts with activities to develop the foundation skills in infancy that lead on to talking, including the use of gesture and sign to support comprehension, and with an emphasis on speech sound work from infancy.
Building a spoken vocabulary to 400 words by 5 years of age is seen as a priority, in order to develop grammar and phonology, and a recommended vocabulary programme with record sheets is included. The ways in which reading activities should be used to support all aspects of speech and language learning during preschool years are mentioned but the detailed advice on teaching early reading is in the reading module. This module follows on from Speech and language development for individuals with Down syndrome - An overview [DSii-03-01] which should be read first, to provide the reader with an adequate understanding of speech and language development to be successful in using this programme.

Social development includes social interactive skills with children and adults, social understanding and empathy, friendships, play and leisure skills, personal and social independence and socially appropriate behaviour. Each of these areas of development is discussed, drawing on the available research literature. Social understanding, empathy and social interactive skills are strengths for children and adults with Down syndrome, which can be built on throughout life to enhance their social inclusion and quality of life. The opportunity to establish friendships may be affected by social independence and by speech and language and cognitive delay. Parents and teachers need to think about ways of increasing the friendship opportunities of children during primary school and teenage years. The importance of friendships with both typically developing peers and peers with similar disabilities is stressed, as is the need to develop play, leisure and independence skills. Most children and teenagers with Down syndrome have age-appropriate social behaviour, but some children do develop difficult behaviours which cause family stress and affect social and educational inclusion.
Information on the types of behaviour which may cause concern is included and attention is drawn to the high incidence of sleep difficulties as they influence day time behaviour. Strategies for encouraging age-appropriate behaviour are discussed and ways of preventing and changing difficult behaviours are outlined.

Teenagers with Down syndrome have significant delays in speech and language skills which will affect their progress during their secondary school years. The social and emotional effects of limited spoken language abilities become more significant during this life stage, and will affect the quality of life of adults with Down syndrome if they are not addressed. This module includes information on the range of speech and language skills achieved by teenagers and evidence of progress during teenage years, based on available research. This module provides guidelines for the assessment of vocabulary, grammar, speech sound production and interactive communication skills, and also includes activities to progress teenagers' skills across all of these areas. The authors emphasise the importance of improving the quality and quantity of everyday communication experience for teenagers with Down syndrome and the equally essential need to work on specifically targeted activities for both speech and language skills. The majority of speech and language targets can be incorporated into the regular curriculum and daily activities in the classroom.
The activities are equally relevant to special education and mainstream education settings. This module follows on from Speech and language development for individuals with Down syndrome - An overview [DSii-03-01] which should be read first. This will provide the reader with a basic understanding of speech and language development and approaches to therapy.

This module reviews the development of educational provision for children with Down syndrome. It details the research examining the outcomes from special and inclusive schools, and the factors relating to these outcomes. These studies indicate that appropriate education provided in inclusive settings offers the best opportunities for children with Down syndrome. Inclusion in mainstream classrooms produces significant gains for expressive language skills and academic achievements, particularly in literacy. The implication for parents is that they should seek inclusive education placements for their children from preschool years. However, the benefits require successful inclusion from committed educators. Some of the key issues that are relevant to successful inclusion are discussed.

By differentiation the authors mean making changes, from small changes to larger ones, which enable children to learn from the school curriculum, designed for their age group, with their peers in an inclusive schooling system. Curricula in each country differ, but all have been created with the educational needs of children as a priority, to equip them socially and academically to function as a member of their community. In each country the curriculum for all children is likely to be the best guide for teaching the majority of children with Down syndrome of all ages, provided that the curriculum is used flexibly and can be differentiated. A minority of children with highly individual needs may benefit from a reduction in the breadth of their curriculum, making it more focused for meeting their highly specific learning needs. However, differentiation of the curriculum enables children with Down syndrome to learn with their typically developing peers and progress forward in all aspects of their development, as other children do, using the same curriculum as a guide.

This book offers an introduction to the development of infants with Down syndrome. Drawing on the latest research and extensive practical experience, it examines many aspects of development during the early years. Presented in an accessible format, it is a useful reference for families and professionals caring for young children with Down syndrome. This introductory book provides an overview of development from birth. It provides information about the development of social, motor, language, cognitive, play, attention, behaviour and self-help skills. It also details typical milestones for children with Down syndrome in these areas. The book highlights the influence of the family and the social interactive nature of development. Individual differences are discussed, as are key health and family issues. Principles for early intervention, therapy and education services are identified, based on the specific needs of children with Down syndrome and research on effectiveness. "Down Syndrome Issues and Information" is a major series of practical and informative books covering the full range of developmental, health and social issues relating to individuals with Down syndrome.
The books have been written by many of the world's leading experts and are based on years of research and hands-on experience.

Reading and writing skills are important for everyday life and for access to the world of literature. They are also powerful tools for teaching speech and language to children with Down syndrome and for mediating their cognitive development. Reading and writing can support communication, enable children to achieve greater independence and enrich education and academic attainments across the curriculum. This module explains how language and literacy teaching can work together to promote the development of children with Down syndrome. Guidance on teaching methods, expectations and examples of children's work combine to show teachers and parents how to include children in literacy learning programmes, with an understanding of particular issues related to speech, language and memory development.

Reading skills are often a strength for teenagers with Down syndrome. Teenagers can often read at a higher level than would be predicted from their general cognitive and language abilities. Those who have not achieved reading success in their primary years may make significant progress during their teenage years. Reading and writing skills are important for everyday life and for access to the world of literature. They are also powerful tools for developing the speech and language of teenagers with Down syndrome and for mediating their cognitive development. Reading and writing can support communication, enable teenagers to achieve greater independence and enrich education and academic attainments across the curriculum. This module explains how language and literacy teaching can work together to promote the development of teenagers with Down syndrome. Guidance on teaching methods, expectations and examples of teenagers' work combine to show teachers and parents how to include teenagers in literacy learning programmes, with an understanding of particular issues related to speech, language and memory development.
This module should be read in conjunction with Reading and writing for individuals with Down syndrome: An overview,[DSii-07-01] as the overview provides important background information on how individuals learn to read, the adaptations that will help pupils with Down syndrome, and the benefits of being involved in reading instruction.

The mathematics curriculum in primary school includes learning about number and calculation, shape, size, quantity and measurement, time and money. Learning in children's pre-school years introduces them to the ideas and language for helping them to learn about mathematics. Young children's first understanding of number and other mathematical concepts comes from their experiences with people and items in their environment. Language is an essential part of learning about mathematics as it provides the tools for thinking about, comparing and manipulating sets of objects and activities, and relating these to a number system. Young children with Down syndrome experience delay in language learning, in auditory short term memory development and may have less experience of manipulating or playing with objects, but have strengths in learning visually. With focused language teaching, repetition and visual teaching approaches, they can learn the language for numbers and mathematics. Number games should be interesting and allow for exploration and fun, making number skills meaningful to everyday life and the child's environment.
Some children will learn in very small steps, with each aspect broken down for them, taught and practised, other children will develop skills more quickly, after they have been helped to learn about numbers using visual aids, through good teaching and from multi-sensory learning experiences. This module provides examples for everyday social interaction, language teaching and games that can help to develop early number and maths skills, beginning with nursery rhymes, songs, play and words, introducing activities from one year of age up until the child goes to school. Vocabulary lists for maths concepts that will be useful for parents of children to early school age are included. This module should be read in conjunction with Number skills for individuals with Down syndrome - An overview.[DSii-09-01]

Working memory is the system in the brain that supports the daily processing of visual and verbal information as individuals go about their lives. It has been described as 'a mental workplace', as it is not only essential for language processing, it also supports activities which involve holding and manipulating information such as reading a text with comprehension, planning and writing text or messages, doing mental arithmetic, and holding temporary information like a telephone number while dialling it. In addition to being a temporary storage and processing system essential to everyday functioning and to mental abilities, part of the working memory system which is specialised for holding verbal information - the phonological loop - is thought to be essential for learning a spoken language. The phonological loop holds the sound patterns for words. In order to learn a first language a child has to be able to store accurate representations of the sound patterns of words in order to link them to meaning and in order to be able to copy or produce the word when talking. If the phonological loop does not function well, speech and language will be delayed.
There is evidence that there is a basic impairment in phonological loop functioning in children with Down syndrome. This is probably a major reason for their speech and language delays and difficulties and it also affects their ability to process spoken language and carry out cognitive tasks. Memory training studies indicate that it is possible to improve the short-term memory skills of children with Down syndrome. However, the biggest gains in short-term memory skills reported are linked to reading instruction and to being in a mainstream school. Reading activities may provide auditory training experiences which actually improve phonological coding (the accurate representation of the sound patterns of words) in the phonological loop. Memory training activities and support for weak auditory memory skills are discussed. However, a range of activities to improve speech sound and word discrimination are included, as they may improve basic phonological loop function and therefore result in the greatest gains for spoken language abilities and working memory.

Children with Down syndrome have significant delays in speech and language skills which will affect their progress during their primary school years. This module provides guidelines for the assessment of vocabulary, grammar, speech sound production and interactive communication skills, and activities to progress children's skills across all of these areas. The authors emphasise the importance of improving the quality and quantity of everyday communication experience for children with Down syndrome and the equally essential need to work on targeted activities for both speech and language skills. The majority of speech and language targets can be incorporated into the regular curriculum and daily activities in the classroom. This module follows on from Speech and language development for individuals with Down syndrome - An overview [DSii-03-01] which should be read first, to provide the reader with an adequate understanding of speech and language development to be successful in using this programme.