Learning first phrases and learning to read
When children have learned sufficient vocabulary, they can begin to join words together to express new meanings. Learning to read can help children with Down syndrome learn to combine words and phrases when talking.
Learning first phrases
As children first learn to talk, they use single words to communicate. When children can say approximately 50 to 100 words, they begin to combine words to express two ideas together - for example, "all gone", "dog bark", "more dinner", "mummy car".
When we talk to children, we teach them about the relationships between things they can observe - for example, "the baby is sleeping", "the dog is sleeping". These are two keyword phrases. As children learn new words they are learning new concepts and developing their understanding and verbal reasoning abilities.
Keywords are the essential information carrying words (content words). When children first learn to talk they say these and often leave out the grammatical words (function words) - for example, they say "dog sleeping" rather than "the dog is sleeping". Over time, they learn to use the grammatical words. Children with Down syndrome often take longer to learn grammar, and continue to communicate using keywords for longer than typically developing children. There is some evidence to suggest that it is better to talk to children with language delay naturally, using complete sentences when you talk to them - even when the children are still using two keyword phrases to talk.
Before children join two spoken words together, they usually join a gesture and a word. For example, they might at first point to a dog and say "bark", then a few weeks later they might say "dog bark". Children also begin to learn some grammatical markers at this two keyword stage of development, including possessive 's' as in "daddy's shoe", plural 's' as in "ducks swim" and the present progressive tense marker 'ing' as in "dog barking".
Most children begin to join two keywords when they have learned over 50 spoken words - including children with Down syndrome.[4, 5] For some children with Down syndrome, this will be at around 3 years of age, but language development varies widely and for some children it will be later.
Most children with Down syndrome will understand two keyword phrases some time before they use them regularly when talking. A child's ability to join words together is influenced by their speech production abilities. This may be an important factor influencing rates of progress for children with Down syndrome.
Children can express a wide variety of meanings using two keyword phrases, and helping children to communicate in this way is likely to be beneficial. Our experience suggests that most children with Down syndrome need additional support to learn to join words together because of their language delays and speech difficulties.
Learning to read
There has been considerable research looking at how children learn to read and the component skills that children need to master to become good readers. The end goal is to read text effortlessly with the focus on reading for meaning - understanding what you read. It takes children several years to reach this stage. Two main factors underpin being able to read and understand what you read: decoding the printed words on the page and language comprehension. 
There are two ways to learn how to correctly read written words - to memorize what the whole word looks like so that you can recognize it on sight, and to learn the links between letters and sounds so that you can decode an unfamiliar written word by 'sounding it out' - a phonics approach. Both ways of learning words are important.
Research suggests that children first learn to read words 'by sight' - that is by learning to recognize whole words without recognizing the letters that make up whole words. This stage of reading development is called the logographic stage.  Learning a small sight vocabulary enables children to quickly begin to read and to learn what reading is about.
As well as offering a relatively easy way to begin to learn to read, sight word reading is also necessary for learning irregular words - words than cannot be easily decoded by 'sounding them out'. In English, these include words such as yacht, was, cough and through.
While learning words by sight is a helpful way to begin learning to read, research indicates that the faster children learn to 'sound out' words, the faster they learn to read and to spell.
Phonics refers to being able to decode a word from its sounds. To do this, a child must first learn the sounds represented by each individual letter (for example, s, a, t) and some combinations of letters (for example, oo, ee, ay).
Next, children must be able to identify the sounds in words they hear. They need to be able to hear that words like cat, car and cook all start with the same sound; that can and run end with the same sound; and that if we remove the c from cat it will be at, then if we replace c with r it will be rat.
These are all examples of being able to hear and manipulate phonemes - the smallest units of sound in spoken words. This is one aspect of phonological awareness. Identifying syllables in words and rhyming words are other aspects of phonological awareness skills, but are less important for reading than being able to hear and manipulate phonemes. Research links phonological awareness to progress in reading. 
When children understand how letters are linked to sounds in speech and can identify and manipulate phonemes, they can use these skills to decode unfamiliar words. They can 'sound out' the letters in a new word and blend the sounds to make a 'spoken' word. Similarly, they can break apart the sounds in a spoken word to figure out how it might be spelled.
It takes typically developing children several years to progress from learning letter sounds to being able to use phonics independently to read and spell.
Understanding what you read
A sizable number of children learn how to decode words and read the sentences in the book as expected for their age but have difficulty understanding what they are reading. Research suggests that the main reasons for poor comprehension are limited spoken language skills and limited verbal short term memory function. 
Research suggests that effective reading programs link the learning of sight words and phonics to successful book reading from the start so that the child quickly has the successful experience of reading, understanding and enjoying books.  If children enjoy books and can read for meaning from the outset, then they will understand why we want them to learn sight words and understand phonics.
Reading development for children with Down syndrome
A number of research studies have shown that reading can be a relative strength for many children with Down syndrome.  By 'strength', we mean that the children's reading skills are better than would be predicted from their language skills or cognitive skills.
Many children with Down syndrome can start to learn to read at an early age  and studies suggest some 10% of children with Down syndrome can achieve word reading skills equal to those of typically developing children of the same age. 
Although many children with Down syndrome can learn to read words by sight relatively well, studies suggest they are less successful at learning phonics. The children's hearing, speech production and verbal short term memory difficulties may be reasons why learning phonics is more difficult. It is also possible that children with Down syndrome are not provided with sufficient support for learning phonics. Evidence suggests that (as for typically developing children) children with Down syndrome with better phonics skills are better readers.
Learning a core sight word vocabulary may be an important first step before learning phonics. One study has reported that children with Down syndrome with larger sight word vocabularies made more progress learning phonics.
In our experience, teaching young children with Down syndrome about letters and letter sounds before they have begun to read whole words and understand that we read for meaning can be confusing. Some children will learn to say the individual letter sounds (for example, c-a-t) but struggle to combine them to read a whole word (cat). We therefore recommend teaching sight words at first, and then begin to teach phonics skills when the child has learned a basic sight vocabulary of approximately 30 to 40 words and can read and understand simple books.
Teaching reading to support language development
See and Learn Language and Reading introduces children with Down syndrome to early sight words to support the development of language skills. Research suggests that learning spoken language just from listening to it is hard for most children with Down syndrome,  but if we support their learning using pictures and print they can make faster progress. [16, 17]
See and Learn Language and Reading engages children in book reading as soon as the first written words are introduced. Simple books are used to illustrate and contrast short phrases and sentences containing the sight words being taught with matching and selecting activities.
Throughout See and Learn Language and Reading, we encourage parents and teachers to monitor the children's progress and check that they understand the words, phrases and sentences that they are learning to read. The goal is to teach children to read for meaning - not simply to recite sight words.
New words and phrases are introduced to support the typical progression of language development - from single words, through various two keyword constructions and then three keyword sentences. The written words and phrases first taught in See and Learn Language and Reading are therefore selected to match these early stages of language learning.
As the children continue to develop their language skills, supported by learning early sight words and phrases, See and Learn Language and Reading then introduces phonics activities to support the development of foundational literacy skills including letter sound knowledge and blending.
See and Learn Language and Reading is designed primarily to teach language and then early reading skills - and the goals are to teach the meanings of spoken and written words and phrases. Many children with Down syndrome will learn the meanings of words and phrases much faster than they will learn to say them. We encourage parents and teachers to continue to support the children's language development at a pace that reflects their level of understanding - and not to let their speech production difficulties slow their language learning.
Of course, it is also important to continue to encourage the children to say new words and phrases that they understand and to offer lots of opportunities to practice saying them. We encourage this throughout every activity in each step of See and Learn Language and Reading.
Teaching speech skills
Many children will also benefit from a structured approach to developing speech skills - from early sound discrimination and production, through simple sound combinations to saying whole words clearly. Some children will receive regular input from a speech and language therapist or pathologist to support the development of speech production and language skills.
The See and Learn Speech program is designed to supplement the language teaching activities in See and Learn Language and Reading with activities focused on improving speech clarity. See and Learn Speech can be used under the guidance of a speech and language therapist/pathologist, but is also designed to be easy for parents and educators to use independently. Children with Down syndrome are likely to benefit from regular, structured speech practice incorporated into daily life at home and at school.
Speech, language and reading skills all influence each other. The more children understand, the more they can say. Learning to read can help to teach words that cannot be pictured. The more children talk, the clearer their speech is likely to become. The clearer their speech becomes, the more likely people are to engage them in conversations and the more practice they get at speaking and the more opportunities they have to learn new words.
Later literacy and language development
Almost all children with Down syndrome are likely to need additional support to learn language and develop literacy skills throughout their primary/elementary and secondary/high school years.
Evidence suggests that children with Down syndrome in primary/elementary schools can benefit from a structured approach to reading instruction that combines training in letter-sound knowledge, phoneme awareness and the application of these to reading and spelling (phonics), and sight word learning, in the context of book reading - together with explicit language teaching. 
One such intervention was designed and evaluated in a landmark randomized controlled trial involving 50 schools in the UK. [19, 20] Further information about the Reading and Language Intervention for Children with Down Syndrome (RLI) and the trial is available on our web site.
See and Learn Language and Reading can provide a firm foundation for later language and literacy development before using RLI in school.
See and Learn Language and Reading can also be used to support older children who are still learning early language and foundational reading skills and some of the early reading steps are recommended for beginning readers starting RLI in primary/elementary schools.
- Mervis, C.B. & Becerra, A. M. (2003). Lexical development and intervention. In J.A. Rondal & S. Buckley (eds.) Speech and Language Intervention in Down syndrome. (pp. 63-85). London; Whurr.
- Venker, C.E., Bolt, D.M., Meyer, A., Sindberg, H., Ellis Weismer, S. & Tager-Flusberg, H. (2015). Parent telegraphic speech use and spoken language in pre-schoolers with ASD. Journal of Speech, Language and Hearing Research, 58, 1733-1746.
- Clark, E.C. (2009). First language acquisition. Cambridge, UK: Cambridge University Press.
- Berglund, E., Eriksson, M. & Johansson, I. (2001). Parental reports of spoken language skills in children with Down syndrome. Journal of Speech, Language and Hearing Research, 44, 179-191.
- Galeote, M., Soto, P., Sebastian, E., Checa, E. & Sanchez- Palacios, C. (2014) Early grammatical development in Spanish children with Down syndrome. Journal of Child Language, 41, 111-131. doi:10.1017/S0305000912000591
- Buckley, S.J. (in press). Teaching children with Down syndrome to talk. Kirkby Lonsdale, UK: Down Syndrome Education International.
- Stuart, M. & Stainthorp, R. (2016) Reading development and Teaching. London, UK: Sage
- Frith, U. (1985) Beneath the surface of developmental dyslexia. In K. Patterson, M. Coltheart & J. Marshall (Eds.) Surface Dyslexia (pp. 301-330) Cambridge, UK: Academic
- Oakhill, J., Cain, K. & Elbro, C. (2015) Understanding and teaching reading comprehension. London, UK: Routledge
- Carroll, J.M., Bowyer-Crane, C., Duff, F.J., Hulme, C. & Snowling, M. J. (2010). Developing Language and Literacy: Effective Intervention in the Early Years. Chichester, UK: Wiley Blackwell.
- Snowling, M., Nash, H. & Henderson, L. (2008) The development of literacy skills for children with Down syndrome: implications for intervention. Down Syndrome Research and Practice. https://library.down-syndrome.org/reviews/2066/
- Buckley, S. J. (1985). Attaining basic educational skills: reading, writing and number. In D. Lane & B. Stratford (Eds.), Current approaches to Down's syndrome. (pp. 315-343) Eastbourne: Holt, Rinehart & Winston.
- Burgoyne, K., Baxter, R. & Buckley, S. (2014). Supporting the literacy skills of children with Down syndrome. Chapter in R. Faragher and B. Clarke (Eds.), Educating learners with Down syndrome. (pp 195-220). Oxford, UK; Routledge Education
- Lemons, C.J. & Fuchs, D. (2010b) Modelling response to reading intervention in children with Down syndrome: an examination of predictors of differential growth. Reading Research Quarterly, 45, 134-168.
- Abbeduto, L., Warren, S.F. & Conners, F.A. (2007) Language development in Down syndrome: from the prelinguistic period to the acquisition of literacy. Mental Retardation and Developmental Disabilities Research Reviews, 13: 247-261.
- Buckley, S.J., Bird, G., & Sacks, B. (2006). Evidence that we can change the profile from a study of inclusive education. Down Syndrome Research and Practice, 9(3), 51-53. https://library.down-syndrome.org/essays/294/
- Buckley, S.J., Bird, G., Sacks, B. & Archer, T (2006). A comparison of mainstream and special school education for teenagers with Down syndrome: Implications for parents and teachers. Down Syndrome Research and Practice, 9(3), 54-67. https://library.down-syndrome.org/reports/295/
- Goetz, K., Hulme, C., Brigstocke, S., Carroll, J.M., Nasir, L. & Snowling, M. (2008) Training reading and phoneme awareness skills in children with Down syndrome. Reading and Writing, 21, 395-412.
- Burgoyne, Duff, Clarke, Snowling, Buckley, Hulme (2012) Efficacy of a reading and language intervention for children with Down syndrome: an RCT. Journal of Child Psychology and Psychiatry, 53, 1044-1053. doi:10.1111/j.14697610.2012.02557.x
- Burgoyne, K., Duff, F., Clarke, P., Smith, G., Buckley, S., Snowling, M. & Hulme, C. (2012). A reading and language intervention for children with Down syndrome: Teacher's handbook. Kirkby Lonsdale, UK: Down Syndrome Education International.