Down Syndrome Today Spring 1993, Vol. 2, No. 2, p. 22-3 Marita R. Hopmann, Ph.D. Research, Demonstration & Evaluation Administration on Children, Youth & Families Department of Health & Human Services 330 C. Street, S.W. - Room 2117 Washington, DC 20447 (202) 205-8398; Fax: (202) 205-9721

Printed with the permission of Marita R. Hopmann, Ph.D. and Darlynne A. Devenny, Ph.D.

   Although we currently lack a large body of research about the use of sign language with children with Down syndrome, a number of reports, together with many clinical observations, provide initial support for this intervention, often called Total Communication. Let me share with your some of our observations, along with information from research findings, presented as responses to the questions parents have often asked.

   My child isn't deaf. Why signing? Signs may be useful for children with Down syndrome for a variety of reasons. The primary motivation involves language production, often called "language expression." Creating signs comes earlier for many children than saying the corresponding word, both for children with Down syndrome and normally developing youngsters. Perhaps the oral motor planning required for talking is more complex than instructions for the hands in signing. It might also help that one can assist a child in forming signs—called "hand over hand."

   A second purpose involves comprehension, or understanding what someone says. While your child may not have any hearing loss at this time, hearing loss is common among children with Down syndrome; these children may benefit by seeing what someone is saying when they are having problems hearing it. In addition, spoken language occurs very quickly; one can often "hold" at least part of a sign in place so that a child who needs extra time can inspect and re-inspect the signal.

   Why should I ask my child who hasn't learned to speak any English to learn an additional language? All children deserve to have means to communicate. Manual signs may provide a way of communicating a message at a time when the child does not yet have the oral motor coordination necessary to say a word.

   Why not just wait for the child to talk? Language is learned in the give-and-take of conversations. Signing can provide a means of taking part in these conversational exchanges, and can move the child into the arena of learning language and participating in the goings on of others. In addition, frustrations resulting from inability to express oneself can be reduced by providing the child a way of communicating his or her interests and wishes.

   What is the difference between Total Communication and Sign Language? In sign language, vocabulary and syntax are represented by hand movements. It is a complete language unto itself. Total Communication (TC) refers to the philosophy that individuals are encouraged to use oral language and other means (including sign language, gestures, signs, pictures, writing) to communicate as fully as possible what is on their minds, and understand what others are communicating. It puts the emphasis on the most important issue, communication.

   From a practical point of view, TC for youngsters with Down syndrome typically means the simultaneous use by the adults of a spoken word together with the sign for that word. Parental anxiety should be eased by knowing that the child will be hearing the spoken word as often as if only spoken language were used.

   Usually children with Down syndrome are taught signing as a transitional phenomenon, to assist them to become oral communicators. As they gain competence at oral communication ("talking"), the use of signs diminishes in importance, whether because of the children's greater interest in learning to talk, or because of the adults' reduced use of signs.

   Will the use of signs delay or interfere with my child's interest and/or skills at talking? Much of the concern that children will prefer signing over talking because "it is easier" is misplaced. The emphasis on Total Communication should serve as a reminder that one is not using signing as an alternative to oral language, but presenting both simultaneously and guiding the child to effective communication. There is no evidence that this use of signing interferes with the development of speaking. In fact, there are many reports of children following a progression of signing, then signing and speaking a word, and finally only speaking the term. Our research and that of Dr. Jon Miller at the University of Wisconsin shows that few words are spoken and signed at the same time; it's possible that the period of time that words are simultaneously signed and spoken may be quite brief, so that our information, based on a particular point in time, may miss many of these events.

   Appropriate attention should also be spent on ways of helping children who have oral motor planning difficulties gain competence at voluntary control of their voices, tongues, lips. An ultimate goal is always to assist the child to learn to speak so that the child's message will be understood by both strangers and those familiar with him or her.

   How do I pick the signs to teach my child? Deciding which concepts to sign is a process that should involve the speech pathologist, family members, and other frequent caregivers. Initially, one should encourage the use of "natural gestures" waving bye-bye, holding up one's arm to be picked up, saying the words clearly as the child (and adult) make the motions.

   To select vocabulary to sign, one first thinks about things children want/need to tell the people around them - that they want more food or drink, that they're all done with their meal, that they do not want to do what you want them to do! In addition to learning names for people, things, and actions, children need vocabulary to communicate expressions of politeness (please, thank you) as well as their feelings. Children also need to have ways to describe things (for example, pretty, big, hot). The most useful general guide for selecting a child's sign vocabulary is probably to look carefully at what the child is doing and is interested in. At the 1991 Convention of the National Down Syndrome Congress, Betsy Gibbs and Ann Springer listed as the 15 "starter signs" eat, drink, bed, more, finish/all done, cracker, bottle, mother, daddy, music, block, boat, ball, cat, and dog.

   Do kids learn many signs? In our work, and that of Dr. Miller, one sees a wide range in the use of signing by infants with Down syndrome. The families we've studied have varied considerably in the parents' enthusiasm at signing and the amount of support they have received from Early Intervention to provide signs for their children. Overall, when the children reached a mental age of one year, they produced a similar number of oral and signed words, producing a similar size vocabulary to that of normally-developing children. In this simple way, we see that their ability to communicate with signing doubles what they can say.

   Should I be concerned that my child isn't making the signs properly? When children start using signs they show similar patterns to children starting to talk, with many of their first attempts "off the mark" of the target word. Think of a typical child's way of saying the color yellow - at first it often sounds like "lellow". As with the child's mispronunciations, the best way of helping your child learn the target sign is to use it when he or she is paying attention to what the word stands for (for example, teach the sign ball when the child is playing with one); when your child signs the word to you, repeat what the child has done, then say or sign it "correctly" and add another sign. In this way a child is encouraged to communicate and learns the way others are using words and signs in a cheerful atmosphere.

   In summary, the use of signs as part of a Total Communication environment seems like a sensible approach to early communication development for many children with Down syndrome. The goal is always to teach children to be as effective as possible in communicating a wide range of ideas to others, and to understand what others are trying to communicate to them.

For further reading on Total Communication Dr. Hopmann suggests:

Gibbs, E.D., & Carswell, L.E. (1991). Using Total Communication with young children with Down syndrome: A literature review and case study. Early Education and Development, 2, 306-320.

Miller, J.F. (1992). Development of speech and language in children with Down syndrome. In I.T. Lott & E.E. McCoy (Eds.), Down syndrome: Advances in medical care (pp.39-50). New York: Wiley-Liss.