Early Communication Skills for Children With Down Syndrome: a Guide for Parents and Professionals, ed 2.

Early Communication Skills for Children With Down Syndrome: A Guide for Parents and Professionals, ed 2 Kumin L. Bethesda, MD 20817, Woodbine House, 2003, paperback, 381 pp, illus, ISBN: 1-890627-27-5, $19.95.

Written primarily for parents and health care professionals such as speech-language pathologists, occupational therapists, and early interventionists who work closely with the family, this textbook focuses on how to maximize the speech and language development of young children with Down syndrome, from infancy through 5 or 6 years of age. Interestingly, the book does not identify physical therapists as being among the health care professionals who might utilize its content. The book is an updated and expanded version of the first edition, which was published in 1994.

The book focuses on speech and language development in infants and children who have a typical development pattern, but it also intersperses information on differences noted in children with Down syndrome. Chapter 2, which initially presents speech and language characteristics of children with Down syndrome, provides the foundation for later chapters. This particular chapter has several tables that clearly present the development of early communication skills by children with Down syndrome and how certain physical characteristics may affect speech and language. Definitions are given in this chapter so that parents and other caregivers can understand terminology used by the medical and educational community. Chapters 3 and 4 focus on early communication skills, including precursor skills such as feeding, respiratory, oral-motor, visual and auditory attending, and early cognitive skills. These 2 chapters provide suggested home activities that could be done with the child to improve early precursor skills. Parents are given information on normal development and references are provided for further reading.

Chapters 5 through 7 address issues related to the production of the first words by children with Down syndrome and through the stage of making 3-word phrases, which often occurs around the ages of 5 and 6. The author again provides information about the typical development of communication skills but describes how the development may be different in children with Down syndrome. The author suggests ways to aid communication with children who have Down syndrome, using transitional communication systems such as sign language systems, communication boards, picture exchange communication systems, and electronic devices. Each of the chapters provides families with home activities to incorporate language learning into play. The author also incorporates the latest research on Down syndrome and communication development in each chapter.

Problems with speech intelligibility and articulation are presented in chapters 8 through 10. Like previous chapters, problems noted in children with Down syndrome are related to difficulties noted in speech production. In this new edition, childhood verbal apraxia is addressed as an increasingly common diagnosis for children with Down syndrome. Suggestions are offered on developing oral-motor coordination and foundational skills for articulation. Chapter 11 presents a description of augmentative and alternative communication (AAC) systems that might be appropriate for some children with Down syndrome. The chapter also discusses the general reasons for using AAC systems and issues to consider when deciding if AAC is appropriate. The final chapters explain how to prepare for and understand the results of a speech-language assessment as well as what to expect during speech-language treatment programs.

Overall, the book is well written, it follows a logical sequence, and it provides excellent information for parents and health care professionals. The text does not go into great detail for each topic but provides the information necessary to make parents more knowledgeable about communication problems that their child might have. Research findings are incorporated into each section, and references to further reading are provided for health care professionals. The home activities are presented clearly and can be incorporated into the family's daily routine. Although the author does not include physical therapists as potential users of this book, it would be an excellent resource for physical therapists who provide care for children with Down syndrome and their families.

Barbara H Connolly, PT, EdD, FAPTA 

University of Tennessee Health Science Center 

Memphis, Tenn

Dr Connolly is Professor and Chair in the Department of Physical Therapy. She currently is President of the Section on Pediatrics of the APTA. She has written numerous research articles on the treatment of children with Down syndrome and edited several books on the management of children with developmental disabilities.