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Signing Smart
Why do we encourage parents to use signing with their babies?
Sue Buckley
Abstract - We have been advocating the use of signing to develop the communication skills of babies and children with Down syndrome since the early 1980's. Since that time, our experience with several hundred children has convinced us that it is beneficial and that the children exposed to sign from the early months of life have more advanced speech and language skills later. There are a number of reasons why this may be so.
Keywords - Down Syndrome, Language, Sign, Children
We have been advocating the use of signing to develop the communication skills of babies and children with Down syndrome since the early 1980’s, when contact with Pat Le Prevost first drew my attention to the possible benefits. At that time, Pat had been working with one little girl whose parents had been willing to see what effect the use of sign to support speech might have for a child with Down syndrome. I heard Pat talk about her experience with this little girl and saw videotapes of her progress. She was signing first words at 18 months of age, which was much earlier than we would have expected first spoken words from a child with Down syndrome at that time. I realised that a number of the observations that Pat had made fitted with my own experience based on watching the progress of 15 children in our own work from 1980 to 1983.
The little girl Pat was working with showed cognitive ability that was ahead of her language ability and a comprehension for speech that was ahead of her ability to produce speech. This fitted our observations too. Pat also noted that this little girl could not always discriminate between two similar sounding words. Pat realised that this little girl, because she could sign, was showing us where she was having difficulty with learning to understand and to use speech, and that this was likely to apply to other children with Down syndrome. Pat published this case study in 1983 (Le Prevost, 1983).
In our work at that time, we were observing three and four year old children trying to tell us about interesting things that they had experienced by using a mixture of single words and gestures that they made up for themselves. They made us understand exactly what had happened, so they had remembered and understood the event but could not put their knowledge into words or sentences. I discussed my hypothesis, that the children had more understanding than spoken language ability, with Cliff Cunningham in 1983, and he and colleagues in Manchester published a paper in 1985 demonstrating that this was true (Cunningham et al., 1985).
Our experience of signing
We began to encourage parents to try signing in 1983 and since that time, our experience with several hundred children has convinced us that it is beneficial and that the children exposed to sign from the early months of life have more advanced speech and language skills later. There are a number of reasons why this may be so.
1. Gap between comprehension and expression
Some children have a considerable gap between their understanding of speech and their ability to produce clear words. In other words, their expressive ability lags way behind their level of understanding. The work of Jon Miller in the USA has demonstrated that this is typical of three quarters of children with Down syndrome. This leads to considerable frustration for the child unless they can sign to communicate.
2. Hearing and auditory discrimination
For children with hearing loss or auditory discrimination difficulties, learning to understand speech is very difficult. Imagine how strange the language must seem to a child who only hears "olly" for lolly and dolly, or "ed" for red and bread, or "orse" for horse and sauce. The adults in his world seem to use the same word for very different things! These are the real difficulties of one of our local children, who has a hearing loss and who could tell us he was having these confusions only because he could sign and was trying to use one sign for the two items in each example, but demonstrating correct knowledge of the two concepts in each case.
As the problems of distinguishing between one word and another and the high risk of hearing difficulties are very common in all children with Down syndrome, and we feel that we cannot afford to wait until these are accurately assessed, we encourage all parents to consider learning to sign in the first year of the babies’ life.
3. Importance of communication
The reason we feel that we cannot wait, is that language learning is so important for children’s cognitive and social development. When parents and children can sign to each other they can keep communication going at a reasonably normal rate. They are often able to sign keyword phrases of up to three or four signs to one another and we then see longer utterances in the speech of these children at four and five years of age.
4. Parents' perceptions of value
Because parents tell us how valuable signing has been for their child and we rate parent’s observations highly. Thirty years experience of working with parents has taught me that they are almost always right and certainly much more often right than professionals! Recently I have seen a number of children with very good speech and language skills when they have visited the Sarah Duffen Centre for assessments. I always take a history of early development and in every case the parents had signed early with the child. When I asked why they thought it had helped, in each case the first reason was that it had changed their view of their child’s ability to learn. When the baby clearly understood and began to imitate signs it raised parents expectations of their child’s ability and they changed the way they talked to their child accordingly.
5. Research evidence
Research is beginning to confirm our experience. Most studies of signing only involve small numbers of children but tend to confirm that it accelerates speech and language development. For example, in one recent careful study, a speech and language therapist compared two ways of teaching new words, with and without sign, to three pre-school children with Down syndrome. All three learned faster when speech and sign were used. (Reilly, personal communication). Jon Miller and his team have shown that sign teaching does increase total communicative vocabularies in a study of 20 children with Down syndrome in the USA (Miller et al 1992).
How to evaluate new ideas
Practitioners and parents cannot wait for research to be conducted and inform their decisions when new ideas appear. They need to know how to help their children now. How do we try to proceed and choose ways to remediate before we have convincing published evidence of effectiveness?
At the Centre we ask the following questions:
Does this way of intervening seem to be tackling any of the reasons for the developmental delays, as we understand them at present? If so, at least we can justify the hypothesis that it may be effective and is worth trying.
For signing the answer is YES. Signing will help overcome the effects of deafness and speech delay.
Does this way of intervening fit with what we can learn from typical development? We are unlikely to do harm if we are encouraging something that is part of ordinary development.
For signing the answer is YES. All children use gesture to communicate, before and with speech.
Does it work?
KEEP RECORDS. When trying a new approach, we need to try to evaluate as objectively as we can for each individual child and groups of children and always be ready to admit we are wrong and need to think again.
For signing, after 15 years we would say the evidence is YES. Case experience and research evidence support its effectiveness, but we need more research studies to untangle all the possible positive or negative consequences.
References
1. Cunningham, C.C., Glenn, S.M., Wilkinson, P. and Sloper, P. (1985). Mental ability, symbolic play and receptive expressive language of young children with Down’s syndrome. Journal of Child Psychololgy and Psychiatry, 26 (2) 255-265.
2. Le Prevost, P.A., (1983). Using the Makaton vocabulary in early language training, Mental Handicap, 11 (1), 29-30.
3. Miller, J. Sedey, A., Miolo, G., Rosin, M., Murray-Branch, J. (1992). Vocabulary acquisition in young children with Down syndrome: Speech and sign. Paper presented at the 9th World Congress of the International Association for the Scientific Study of Mental Deficienty, Queensland, Australia, August 1992.
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