SpeechPathology.com Phone: 800-242-5183


EDU Healthcare Opportunities

Expression of Wants/Needs for Patient with Down Syndrome

Lauren Nelson, Ph.D

July 25, 2005

Share:

Question

I have a 12-year-old patient with Down Syndrome. He is performing on a 2-year-old level according to the evaluation completed in November, 2004. The parent expressed concerns regarding his articulation. She wanted him to be able to tell her if "someone ev

Answer

Although we have limited information about this 12-year-old, he appears to have several potential means for communication. Picture symbols and speech were specifically identified, and one might expect that he also uses natural gestures to some degree (e.g., nodding head for yes or waiving for goodbye). In developing therapy goals and making decisions about when to terminate therapy we need to take into account short term and long term needs. In the short term, we should determine whether his current communication means allow him to participate fully in his routine daily activities and whether we have addressed the parent's concern about telling her if he has been hurt by someone. In looking at communication participation in daily activities, we want to determine if there are discrepancies in what he is able to communicate and what his peers are able to communicate in the same situation (Beukelman & Mirenda, 1998). To address any discrepancies, we could develop therapy goals to improve one of his current communication means. For example we could teach additional picture symbols, work to improve intelligibility of specific, communicatively "powerful" spoken words, or identify natural gestures which would convey the message.

The current focus of therapy is on requesting toys or activities with picture symbols. This type of communication has been called expression of wants/needs (Light, 1988), and often is an early focus for children communicating with picture symbols. Expressing a want is a powerful form of communication because the message specifies its own natural consequence (e.g., receiving a preferred toy or activity). However, Light (1988) identified four social purposes for communication. These four included the expression of needs/wants, but also information transfer, social closeness, and social etiquette. The parents concern about telling her if he has been hurt falls under the second of these purposes, information transfer. Telling about feelings might be an appropriate starting point for learning to share information. Fallon, Light, and Paige (2001) developed a vocabulary selection questionnaire for preschool children that might be adapted for use with this patient. They included a category for emotions/feelings and listed words such as afraid, happy, hurt, mad, sad, sick, and so forth. Use of words for feelings/emotions could be taught in a message such as, "I feel (emotion)," that parallels the kind of message he is learning for requesting toys/activities. Another strategy for teaching information transfer is to begin a routine of sending a message home to his parent, either in a notebook or on a communication page, that allows him to communicate something about his school day. He could select a picture symbol representing an activity he did at school, and use the symbol to complete a message such as, "Today at school I (activity)." When he gets home his parent could ask to see the message and talk about what he did.

A final part to this question is when to terminate therapy. As noted above, determining how he communicates in routine daily activities and deciding if you have done as much as you can to assure his full participation are important considerations. However, for this 12-year-old, I also think you will need to begin transition planning soon . What are the family's plans for his future when he exits the school environment? Although this change is several years away, he may need new communication skills when his daily routine changes, and it may take a few years for him to learn those skills. It will be important for his family to begin thinking about his future and for his speech-language pathologist to be a part of the planning process.

References

Beukelman, D.R., & Mirenda, P. (1988). Augmentative and alternative communication: Management of severe communication disorders in children and adults (2nd ed.). Baltimore, MD: Paul H. Brookes.

Fallon, K.A., Light, J.C., & Paige, T. K. (2001). Enhancing vocabulary selection for preschoolers who require augmentative and alternative communication (AAC). American Journal of Speech-Language Pathology, 10, 81-94.

Light, J. (1988). Interaction involving individuals using augmentative and alternative communication systems. State of the art and future directions. Augmentative and Alternative Communication, 4, 66-82.

Dr. Lauren K. Nelson began her career as a speech-language pathologist in 1978. She has been on the faculty at the University of Northern Iowa in Cedar Falls, Iowa since 1990. Dr. Nelson can be reached at lauren.nelson@uni.edu


lauren nelson

Lauren Nelson, Ph.D


Related Courses

Treatment Approach Considerations for School-Aged Children with Speech Sound Disorders
Presented by Kathryn Cabbage, PhD, CCC-SLP
Video

Presenter

Kathryn Cabbage, PhD, CCC-SLP
Course: #9472Level: Intermediate1 Hour
  'Excellent handout - I wish I had this well organized information in college! Great overview of the various approaches'   Read Reviews
This course will address the theoretical underpinnings and research base related to differential diagnosis and treatment of articulation and phonological deficits in children with speech sound disorders. Special considerations for how to tailor evaluation and intervention to meet the needs of school-age children will be discussed.

The Ripple Effect of Stuttering: A Community-Based Approach
Presented by Craig Coleman, MA, CCC-SLP, BCS-F, ASHA Fellow, Mary Weidner, PhD, CCC-SLP
Video

Presenters

Craig Coleman, MA, CCC-SLP, BCS-F, ASHA FellowMary Weidner, PhD, CCC-SLP
Course: #9217Level: Intermediate2 Hours
  'Great information!'   Read Reviews
This is Part 2 of a four-part series. The stuttering experience has a ripple effect that extends far beyond the child who stutters. Parents, teachers, peers, and others must possess both knowledge and skills to best support children who stutter. This course will highlight new clinical tools and resources to provide a community-based treatment approach for stuttering. (Part 1 - Course 9278, Part 3 - Course 9301, Part 4 - Course 9304)

Behavioral Frameworks for Dementia Management
Presented by Mary Beth Mason, PhD, CCC-SLP, Robert W. Serianni, MS, CCC-SLP, FNAP
Video

Presenters

Mary Beth Mason, PhD, CCC-SLPRobert W. Serianni, MS, CCC-SLP, FNAP
Course: #9473Level: Intermediate1 Hour
  'Instructors provided detailed examples and researched information'   Read Reviews
This course will focus on cognitive-communication intervention strategies for various dementia presentations and will provide a review of evidence-based treatment. Behavioral frameworks along with their rationales will be introduced and applied across several dementia types and mild, moderate and severe levels of impairment.

20Q: Infection Control Strategies for SLPs
Presented by A.U. Bankaitis Smith, PhD
Text

Presenter

A.U. Bankaitis Smith, PhD
Course: #9729Level: Intermediate1 Hour
  'difficult reading and text organization was difficult'   Read Reviews
Speech-language pathologists are expected by policy authorities to apply appropriate measures to protect patients, co-workers and themselves in clinical situations that may expose individuals to infectious microbes. This article provides practical guidelines for implementing infection control principles within the context of the COVID-19 pandemic, including discussion of personal protective equipment (PPE) and disinfecting and cleaning products.

Thickened Liquids in Clinical Practice: The Plot “Thickens”
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S
Video

Presenter

Angela Mansolillo, MA, CCC-SLP, BCS-S
Course: #10497Level: Intermediate1 Hour
  'Appreciated a presentation that agreed with I have felt over many years of clinical practice'   Read Reviews
Clinicians who utilize thickened liquids in their clinical practice are aware of their benefits, but what about the risks and contraindications? Advantages and disadvantages of thickened liquids are reviewed in this course with a focus on clinical outcomes, including impacts on medication administration, lung health, and hydration. Product types are evaluated to facilitate appropriate choices for individual clients.

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.