language learning in down syndrome: the speech and language profile

Language Learning in Down Language Learning in Down Syndrome: The speech and Syndrome: The speech and

language profilelanguage profile

Robin S. Chapman, Ph.D.Robin S. Chapman, Ph.D.Principal InvestigatorPrincipal Investigator

Waisman CenterWaisman CenterUniversity of Wisconsin-Madison,USAUniversity of Wisconsin-Madison,USA

AcknowledgmentsAcknowledgments Research supported by NIH grant R01-Research supported by NIH grant R01-

HD23353 with additional support from the HD23353 with additional support from the National Down Syndrome Society. We thank the National Down Syndrome Society. We thank the participants and their parents. participants and their parents.

Thanks to ColleaguesThanks to Colleagues Dr. Donna M. BeaudreauDr. Donna M. Beaudreau Cynthia BridgeCynthia Bridge Katherine GigsteadKatherine Gigstead Dr. Linda J. HeskethDr. Linda J. Hesketh Dr. Maura JohnsonDr. Maura Johnson Dr. Mina Johnson-Dr. Mina Johnson-

GlenbergGlenberg Dr. Elizabeth Kay-Raining Dr. Elizabeth Kay-Raining

BirdBird Dr. Doris J. KistlerDr. Doris J. Kistler

Dr. Andrea McDuffieDr. Andrea McDuffie Dr. Sally MilesDr. Sally Miles Dr. Giuliana MioloDr. Giuliana Miolo Dr. Scott E. SchwartzDr. Scott E. Schwartz Dr. Hye-Kyeung SeungDr. Hye-Kyeung Seung Dr. Elin ThordardottirDr. Elin Thordardottir Heidi SindbergHeidi Sindberg Dr. Nadia TeitlerDr. Nadia Teitler Dr. Laura WagnerDr. Laura Wagner

OutlineOutline

Developmental Emergence of Speech- Developmental Emergence of Speech- Language PhenotypeLanguage Phenotype Predictors of Individual DifferencePredictors of Individual Difference Implications for InterventionImplications for Intervention Evidence for Specificity of PhenotypeEvidence for Specificity of Phenotype New Findings in NarrativeNew Findings in Narrative

Modular vs. Interactionist TheoryModular vs. Interactionist Theory(Chapman, 2000)(Chapman, 2000)

Modular view of language predicts a Modular view of language predicts a specific language deficit in both specific language deficit in both comprehension and productioncomprehension and production

Interactionist view predicts multiple Interactionist view predicts multiple dissociations, including comprehension dissociations, including comprehension and production, arising developmentallyand production, arising developmentally

Developmental Emergence of Language in Down Syndrome: Evidence for Interactionist Position

(Chapman, 2004)I. SOCIAL INTERACTION

*slower emergence of emotional affect recognition in DS (spollak@wisc.edu) and frequent hearing impairment

Person SoundsHeard

Babble

Action

Object

Person SoundsHeard

Babble

Action

Object

Developmental Emergence of Language II. OBJECT INTERACTION

*More prolonged attention to people than objects in DS

Developmental Emergence of LanguageIII. CANONICAL BABBLING

* Slower Development of Canonical Babbling, & Frequent Hearing Impairment, in DS

Person SoundsHeard

Babble

Action

Object

*

Developmental Emergence of Language IV. JOINT ATTENTION

* Slower Babbling Development & Affective Comprehension in Down Syndrome

Person SoundsHeard

Babble

Action

Object

*

Developmental Emergence of Language V. COMPREHENSION OF WORDS, COMMUNICATIVE INTENT

* Slower Development of Communicative Requesting in Down Syndrome

Person SoundsHeard

Words

Action

Object

* *

Developmental Emergence of Language VI. USE OF WORDS

* Slower Development of Expressive Vocabulary in Down Syndrome, including Signs

Person SoundsHeard

Words

Action

Object

**

Developmental Emergence of Language VII. SIMPLE SENTENCES

* Slower Development of Sentence Production in Down Syndrome

Person SoundsHeard

Words

Action

Object

**

*

Developmental Emergence of Language VIII. COMPLEX SENTENCES

* Slower Development of Complex Syntax Production for Complex Events in Down Syndrome

Person SoundsHeard

Words

Action

Object

*

* *

The phenotype in infancy

• Learning delays accelerate at ages 2-4• Slower transition from babbling to speech;

poorer intelligibility• Delays relative to cognition in nonverbal

requesting, rate of expressive vocabulary development, rate of increase in sentence length

• Comprehension comparable to cognition

The phenotype in childhood

• Selective deficits in verbal short-term memory

• Longer period of phonological errors and more variability; poorer intelligibility

• Expressive language delay relative to comprehension and cognition

• Grammatical morphology deficit relative to sentence length in production

The phenotype in adolescence• Deficits in both working verbal memory and

visual short-term memory• Intelligibility problems; more variability in

fundamental frequency, rate, stress placement• Expressive language deficit greatest in

grammatical morphemes, least in vocabulary; MLU shows longitudinal gain

• Sentence comprehension begins to lag cognition, and shows longitudinal loss; vocabulary comprehension a strength on PPVT

Predicted Performance for Ages 7.5, 12.5 and 17.5

Predicted Performance when Auditory Short-term Memory Intercept is at the 25%ile,

Mean, or 75%ile

Predicted Performance when Visual Short-term Memory Intercept is at the 25%ile,

Mean, or 75%ile

Predicted Performance when Syntax Comprehension Intercept is at the 25%ile,

Mean or 75%ile

Predicted Performance when Syntax Comprehension slope is at the 25%ile, Mean

or 75%ile

Predictors of individual difference:

• For Syntax Comprehension: age, auditory short-term memory, visual short-term memory

• For Syntax Production (MLU): syntax comprehension

• For Grammatical morpheme comprehension and fast mapping of words: hearing

ImplicationsImplications Evidence is consistent with an interactionist Evidence is consistent with an interactionist

account of language learning, account of language learning, MultipleMultiple targets for early interventiontargets for early intervention

-object play and exploration schemes-object play and exploration schemes -requesting-requesting -babbling/speech motor skills-babbling/speech motor skills

-intelligible communication (signing)-intelligible communication (signing) -affective comprehension-affective comprehension -Hearing!-Hearing!

Implications, continuedImplications, continued Shifting intervention targets with developmentShifting intervention targets with development Need for continuing language intervention in Need for continuing language intervention in

adolescence, including complex syntax & adolescence, including complex syntax & literacyliteracy

Need to target BOTH comprehension and Need to target BOTH comprehension and production, at different levelsproduction, at different levels

Importance of hearing status for intelligibilityImportance of hearing status for intelligibility & grammatical morpheme comprehension& grammatical morpheme comprehension

Evidence for specificity of phenotype in Evidence for specificity of phenotype in adolescenceadolescence

Adolescents with Down syndrome (n=20) compared to Adolescents with Down syndrome (n=20) compared to individuals with Cognitive Impairment of unknown origin (n=16)individuals with Cognitive Impairment of unknown origin (n=16)

Matched on age (12-18 yrs; X=16) and nonverbal visual Matched on age (12-18 yrs; X=16) and nonverbal visual cognition (X=5.1 & 5.5 yrs)cognition (X=5.1 & 5.5 yrs)

Language Samples: interview and wordless picturebook Language Samples: interview and wordless picturebook narratives narratives

Language Comprehension Tests: PPVT-3 & TACL-3Language Comprehension Tests: PPVT-3 & TACL-3 Working memory measures: Digit Span (K-ABC), Nonword Working memory measures: Digit Span (K-ABC), Nonword

Repetition Test, Visual short-term memory (no differences; Repetition Test, Visual short-term memory (no differences; greater variability in CI)greater variability in CI)

Working Memory Working Memory (no signif. Differences)(no signif. Differences)

Visual short-term memoryVisual short-term memory DS: 4.65 (1.19) CI: 5.23 (2.29) DS: 4.65 (1.19) CI: 5.23 (2.29)

Phonological working memory Phonological working memory Digit spanDigit span DS: 4.38 (1.68) CI: 5.67 (2.36) DS: 4.38 (1.68) CI: 5.67 (2.36) Nonword Repetition Test:Nonword Repetition Test:

DS: 55.75 (13.47) CI: 61.94 (24.45)DS: 55.75 (13.47) CI: 61.94 (24.45)

Table 1: Language PerformanceTable 1: Language Performance (*p<.05, (*p<.05, multivariate tests of comprehension & production raw scores)multivariate tests of comprehension & production raw scores)

DS (n=20) CI (n=16)DS (n=20) CI (n=16)Comprehension * Comprehension * PPVT vocab 6.09 (1.76) 8.10 (2.58) *PPVT vocab 6.09 (1.76) 8.10 (2.58) * TACL vocab 5.16 (1.47) 6.77 (1.83) *TACL vocab 5.16 (1.47) 6.77 (1.83) *

gram morph 4.86 (1.16) 6.47 (1.71) *gram morph 4.86 (1.16) 6.47 (1.71) * syntax 5.15 (1.23) 6.34 (1.35) *syntax 5.15 (1.23) 6.34 (1.35) * Production *Production * Interview MLU 5.09 (1.57) 5.56 (2.30) *Interview MLU 5.09 (1.57) 5.56 (2.30) * Narrative MLU 6.35 (2.45) 7.63 (2.11) Narrative MLU 6.35 (2.45) 7.63 (2.11)

Table 2. Down syndrome (n=20): Correlations Table 2. Down syndrome (n=20): Correlations

Measures Measures Working Memory: Hearing Working Memory: Hearing K-ABC NRT K-ABC NRT

TACL-vocabTACL-vocab .39 .49* .37 .39 .49* .37 TACL-gram morphemesTACL-gram morphemes .39 .21 .39 .21 .51* .51* TACL-elab phrasesTACL-elab phrases .25 .58** .30 .25 .58** .30 PPVTPPVT .32 .28 .18 .32 .28 .18

MLU Narrative .57** .58** .18MLU Narrative .57** .58** .18 MLU InterviewMLU Interview .59** .54* .33 .59** .54* .33

*p<.05 **p<.01*p<.05 **p<.01

Table 3: Cognitive impairment of unknown origin (n=16): Table 3: Cognitive impairment of unknown origin (n=16): Correlations Correlations

Measures Measures Working Memory: Nonverbal Working Memory: Nonverbal Cognition:Cognition:

K-ABC NRT Bead K-ABC NRT Bead PatternPattern

TACL-vocabTACL-vocab .50*a .23 .50*a .30 .50*a .23 .50*a .30 aa

TACL-gram morphemesTACL-gram morphemes.78**b .51*a .54* .51 a.78**b .51*a .54* .51 a TACL-elab phrasesTACL-elab phrases .73**a .47 .49 .35 .73**a .47 .49 .35

aa PPVTPPVT .65** .35 .28 .51*.65** .35 .28 .51* MLU Narrative .60*c .57* b .41 .45 bMLU Narrative .60*c .57* b .41 .45 b MLU InterviewMLU Interview .52 c .42 b .32 b .41 b.52 c .42 b .32 b .41 b

a n=15; b n=14; c n=13; *p<.05 **p<.01, 2-taileda n=15; b n=14; c n=13; *p<.05 **p<.01, 2-tailed

DS vs. CI ProfilesDS vs. CI Profiles Comprehension deficits in DS in adolescence, compared Comprehension deficits in DS in adolescence, compared

to CIto CI Production deficit in DS in adolescence in interview onlyProduction deficit in DS in adolescence in interview only Phonological working memory plays an important role in Phonological working memory plays an important role in

comprehension and production performance by both comprehension and production performance by both groupsgroups

NRT (long-term knowledge) is more important for the DS NRT (long-term knowledge) is more important for the DS groupgroup

K-ABC digit span & visual short-term memory more K-ABC digit span & visual short-term memory more important in the CI group important in the CI group

Additionally, hearing status affects DS grammatical Additionally, hearing status affects DS grammatical morpheme comprehension and interview-MLUmorpheme comprehension and interview-MLU

Narratives: Recent FindingsNarratives: Recent Findings

1.1. Event content of DS narratives of a remembered Event content of DS narratives of a remembered wordless film = mental age controls despite shorter wordless film = mental age controls despite shorter MLU (Boudreau & Chapman, 2000) MLU (Boudreau & Chapman, 2000)

2.2. More plot line and theme elements expressed in DS More plot line and theme elements expressed in DS narratives than in MLU comparison groups (Miles & narratives than in MLU comparison groups (Miles & Chapman,2002)Chapman,2002)

3.3. Picture support increases DS MLU to CI and syntax Picture support increases DS MLU to CI and syntax comprehension control levels (Seung & Chapman, comprehension control levels (Seung & Chapman, 2002; Miles, Chapman, & Sindberg, in press)2002; Miles, Chapman, & Sindberg, in press)

Narratives: Recent findings, cont.Narratives: Recent findings, cont.

4. Repeated retellings of a wordless picture book lead to increases in plot 4. Repeated retellings of a wordless picture book lead to increases in plot line/theme expression and MLU (Miles, 2005)line/theme expression and MLU (Miles, 2005)

5. Examiner scaffolding with questions yields higher MLU & improves 5. Examiner scaffolding with questions yields higher MLU & improves expression of location setting information (Miles, Sindberg, Bridge & expression of location setting information (Miles, Sindberg, Bridge & Chapman, 2002) and later number of different words used (Miles 2005)Chapman, 2002) and later number of different words used (Miles 2005)

6. Storytelling strategies (Miles, Chapman & Sindberg, 2004): 6. Storytelling strategies (Miles, Chapman & Sindberg, 2004): -task approached as retelling of related events-task approached as retelling of related events -evaluations and character speech used by both DS & syntax -evaluations and character speech used by both DS & syntax

comprehension controlscomprehension controls -Use of inference increased across sessions -Use of inference increased across sessions -More multiple utterances in DS group-More multiple utterances in DS group

Implications for Narrative Skill Implications for Narrative Skill LearningLearning

Practice helps everyonePractice helps everyone Picture support especially helpful to DSPicture support especially helpful to DS Communicative Scaffolding: Communicative Scaffolding:

encouragement, confirmation, questioningencouragement, confirmation, questioning Expect: increased independence, content, Expect: increased independence, content,

MLU, lexical diversityMLU, lexical diversity

ReferencesReferences

Abbeduto, L. & Chapman, R.S. (2005). Language and communication skills in Abbeduto, L. & Chapman, R.S. (2005). Language and communication skills in children with Down syndrome and Fragile x. In P. Fletcher & J. Miller, Eds., children with Down syndrome and Fragile x. In P. Fletcher & J. Miller, Eds., Trends in Trends in language acquisition research, vol 4: Developmental theory and language disorders. language acquisition research, vol 4: Developmental theory and language disorders. Amsterdam, NL: John Benjamins. Amsterdam, NL: John Benjamins.

Boudreau, D. & Chapman, R.S. (2000).The relationship between event Boudreau, D. & Chapman, R.S. (2000).The relationship between event representation and linguistic skill in narratives of children and adolescents with Down representation and linguistic skill in narratives of children and adolescents with Down syndrome. syndrome. Journal of Speech, Language, and Hearing Research, 43,Journal of Speech, Language, and Hearing Research, 43, 1146-1159. 1146-1159.

Chapman, R.S. (1999). Language and cognitive development in children and Chapman, R.S. (1999). Language and cognitive development in children and adolescents with Down syndrome. In J.F. Miller, L.A. Leavitt, and M. Leddy, Eds.,adolescents with Down syndrome. In J.F. Miller, L.A. Leavitt, and M. Leddy, Eds., Improving the communication of people with Down syndromeImproving the communication of people with Down syndrome. (Pp. 41-60). Baltimore: . (Pp. 41-60). Baltimore: Brookes.Brookes.

Chapman, R.S. (2000). Childrens’ language learning: An interactionist Chapman, R.S. (2000). Childrens’ language learning: An interactionist perspective. perspective. Journal of Child Psychology and Psychiatry, 41, Journal of Child Psychology and Psychiatry, 41, 33-5433-54..

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Chapman, R.S. (2003). Language and communication in individuals with Down Chapman, R.S. (2003). Language and communication in individuals with Down syndrome. (pp. 1-34) In L. Abbeduto (Ed.,), syndrome. (pp. 1-34) In L. Abbeduto (Ed.,), International Review of Research in International Review of Research in Mental Retardation: Language and Communication, vol. 27. Mental Retardation: Language and Communication, vol. 27. Academic Press.Academic Press.

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Chapman, R.S., Hesketh, L.J., & Kistler, D. (2002). Predicting longitudinal Chapman, R.S., Hesketh, L.J., & Kistler, D. (2002). Predicting longitudinal change in language production and comprehension in individuals with Down change in language production and comprehension in individuals with Down syndrome: Hierarchical linear modeling.syndrome: Hierarchical linear modeling. Journal of Speech, Language, and Hearing Journal of Speech, Language, and Hearing ResearchResearch, , 4545, 902-915., 902-915.

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Miles, S. & Chapman, R.S. (2002). Narrative content as described by Miles, S. & Chapman, R.S. (2002). Narrative content as described by individuals with Down syndrome and typically developing children. individuals with Down syndrome and typically developing children. Journal of Journal of Speech, Language, and Hearing ResearchSpeech, Language, and Hearing Research, , 4545, 175-189. , 175-189.

Miles, S., Sindberg, H., Bridge, C. & Chapman, R.S. ( in press). Discourse Miles, S., Sindberg, H., Bridge, C. & Chapman, R.S. ( in press). Discourse context and transcription method affect MLU in sampling language of adolescents context and transcription method affect MLU in sampling language of adolescents and young adults with Down syndrome. and young adults with Down syndrome. Journal of Speech, Language, and Journal of Speech, Language, and Hearing Research. Hearing Research.

Miolo, G., Chapman, R.S., & Sindberg, H. (2005). Sentence comprehension Miolo, G., Chapman, R.S., & Sindberg, H. (2005). Sentence comprehension in adolescents with Down syndrome and typically developing children: Role of in adolescents with Down syndrome and typically developing children: Role of sentence voice, visual context, and auditory-verbal short-term memory. sentence voice, visual context, and auditory-verbal short-term memory. Journal of Journal of Speech, Language, and Hearing Research, 48,Speech, Language, and Hearing Research, 48, 172-188. 172-188.

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Thordardottir, E., Chapman, R., & Wagner, L. (2002). Complex sentence Thordardottir, E., Chapman, R., & Wagner, L. (2002). Complex sentence production by adolescents with Down syndrome. production by adolescents with Down syndrome. Applied PsycholinguisticsApplied Psycholinguistics, , 2424, 163-, 163-183.183.