Speech refers to the sound that people can make with their vocal cords. It is distinct from language, which refers to the words people know and use. Speech development is a complex area for students with Down syndrome. Many of the systemic body differences that affect people with Down syndrome due to trisomy 21 have knock-on effects on speech development. 

The development of speech is affected by hearing, muscle tone, facial shape differences, and challenges with learning and memory. Possible additional diagnoses such as epilepsy, neurological differences, or autism spectrum disorder also complicate this development. The physical and cognitive components listed above mean that speech is almost always delayed for children with Down syndrome. It takes longer for them to learn to coordinate their speech muscles and develop the accuracy needed for speaking. Other speech differences parents or supporters might notice include: 

  • Speech that is hard to understand by family members or classmates 
  • Completely missing sounds e.g. student cannot say the ‘k’ sound in any context 
  • Sounds missing in specific contexts e.g. the student leaves the last sound off words 
  • Stuttering or other dysfluencies e.g. the words sound stuck or jumbled or repeated 
  • The student can imitate a word, but can’t say it independently or on command 

It is not unusual for speech development to lag behind language development for students with Down syndrome. Children who use sign language or another form of augmentative and alternative communication such as a communication app can often express complex ideas with whole sentences, despite being unable to produce those ideas verbally.

Many students with Down syndrome learn to talk using their voice when given time and targeted practice opportunities. However, students often rely on augmentative and alternative forms of communication to express their ideas clearly. For this reason, the DSRF advocates for the use of augmentative and alternative communication (AAC) along with speech practice. By providing access to language through AAC in tandem with speech practice, the student and their family can avoid a great deal of frustration and behavioural challenges. Families can consult with a speech-language pathologist to address their concerns for speech and language. A therapist can help the family identify communication goals and explain strategies for learning and reducing frustration. 

DSRF Resources

The LowDOWN Podcast, Episode 4-3: Kate Dixon, RSLP: Crystal Clear: Fluency and Stuttering in Individuals with Down Syndrome (Sept. 15, 2021)

Other Resources

Teach Me to Talk

Signing Time

Selective Mutism

Estimates of the prevalence of speech and motor speech disorders in adolescents with Down syndrome

Speech therapy in adolescents with Down syndrome: In pursuit of communication as a fundamental human right