Online Speech & Language Therapy for Down Syndrome and Other Developmental or Genetic Conditions
Children and young people with Down syndrome and other developmental or genetic conditions can have distinctive patterns of strengths and difficulties that affect communication, speech and language.
Understanding these patterns can be useful when planning therapy. However, a diagnosis does not tell us everything about an individual child.
Two children with the same syndrome may communicate very differently, learn in different ways and have completely different interests, personalities, strengths and support needs.
At RoseminSLT, therapy therefore considers what is known about the condition alongside the individual child in front of me.
What could Speech and Language Therapy help my child achieve?
The aim of therapy is to help communication become increasingly useful, effective and independent within everyday life.
Depending on your child’s individual profile, therapy may help them to:
- understand language more successfully
- express their ideas, wants and needs more clearly
- develop clearer speech
- communicate more independently
- make choices and express preferences
- take part more successfully in conversations
- develop communication for friendships and relationships
- participate more confidently in education and community life
- communicate feelings and ask for help
- develop communication skills that support increasing independence
For older children and young people, therapy can also consider the communication skills they will need as they move towards further education, relationships, employment and adult life.
Understanding your child’s individual profile
Some syndromes are associated with particular patterns of development.
For example, many people with Down syndrome show relative strengths in areas of visual learning and gesture, while spoken language and speech clarity can be more difficult. However, there is considerable variation between individuals, so these patterns should guide assessment rather than become assumptions about a particular child.
A child may also have needs affecting other areas of development alongside communication.
For example, some children may experience difficulties with:
- fine motor coordination
- gross motor development
- motor planning
- hearing
- speech production
- learning and remembering spoken information
These factors can influence how easily a child participates in particular activities or learns new communication skills.
Therapy activities should therefore be adapted to what the individual child can access successfully, rather than expecting every child to learn in the same way.
Using visual strengths to support communication
Where visual support is helpful for a child, this can be incorporated into therapy.
For some children with Down syndrome and other developmental conditions, visual information may be easier to retain and process than information presented only verbally. Research on Down syndrome has identified relative strengths in visual memory for many children, alongside greater difficulty with auditory-verbal memory.
This may mean using:
- pictures
- written words
- visual sequences
- demonstrations
- gesture
- signs
- symbols
where these help the individual child understand, learn or communicate.
I have completed Modules 1–4 of the Makaton for Parents and Carers Beginners’ Workshop.
Makaton uses signs and symbols alongside speech to support communication and language. It is used with children and adults with a range of communication and learning difficulties, including Down syndrome and Global Developmental Delay.
Where appropriate to an individual child’s communication system and needs, my knowledge of Makaton can therefore help me incorporate supportive signs and visual communication strategies into therapy.
Supporting clearer speech
Some children with Down syndrome and other developmental conditions may also have persistent difficulties producing clear speech.
The reasons can differ considerably between children.
Speech may be influenced by factors such as hearing, speech-motor development, phonological development, motor planning or the demands involved in producing longer and more complex words.
A child may therefore know exactly what they want to say but find it much harder to make their speech sufficiently clear for other people to understand.
Where appropriate, therapy can support clearer and more intelligible speech while taking account of the child’s individual speech profile.
The goal is not to assume that every child with a particular syndrome needs the same speech exercises.
Assessment helps identify what is making speech difficult for this particular child and what approach is most appropriate.
Therapy personalised around the child and family
Your child’s diagnosis is only one part of therapy planning.
Targets are also shaped by:
- where your child is developmentally
- their current communication skills
- their strengths
- their interests and motivations
- what they find difficult in everyday life
- family priorities
- education needs
- your child’s own wishes as they become older
What matters most may also change over time.
A younger child may currently need to communicate their choices more successfully.
An older child may be working towards participating in conversations more independently.
A teenager may want to become more confident talking to unfamiliar people or develop the communication skills needed for college or employment.
Therapy can adapt as those priorities change.
What does online Speech and Language Therapy look like?
Assessment and therapy take place online through Zoom.
An initial assessment is usually approximately 90 minutes. This includes time with parents or carers to take a detailed case history, followed by time assessing and interacting with your child online.
Existing reports from education, health or other professionals can also help me understand the wider developmental and communication picture.
You can arrange a free 15-minute consultation call beforehand to tell me about your child and discuss whether online assessment and therapy are likely to be suitable.
Online therapy sessions
Online therapy sessions are usually 45 minutes long and are commonly arranged in blocks of six sessions.
Activities are adapted to your child’s abilities, interests and communication needs.
This might mean adapting:
- how information is presented
- how much language is used
- the pace of the activity
- the visual support provided
- the response expected from the child
- the amount of repetition required
- the interests or activities used to motivate them
The aim is not to make the child fit a standard therapy activity.
The therapy is adapted to the child.
A structured therapy plan
When your child begins a block of therapy, you receive a structured therapy plan.
This explains what we are currently working towards and includes practical advice and strategies for supporting those goals outside the therapy session.
You can share the plan with your child’s:
- SENCO
- teacher
- teaching assistant
- key worker
- other relevant professionals
if you wish.
This means that the people around your child can understand what is being taught and reinforce similar strategies across different environments.
Repetition and carryover
For some children with developmental or genetic conditions, learning a new communication skill may take longer and require considerably more repetition.
A child may first demonstrate a skill during therapy but need many opportunities to practise it before it becomes familiar enough to use spontaneously elsewhere.
This makes carryover into everyday life particularly important.
Parents, carers and key workers can play an important role by helping the child practise developing skills naturally within:
- everyday routines
- play
- conversation
- school activities
- community situations
- interactions with other people
The aim is for a developing skill to move beyond the therapy session and become something the child can actually use.
Parents can be closely involved
One of the advantages of online therapy from home is that parents can be much closer to the therapy process.
You can see what is being taught, understand how activities are being approached and learn how strategies can be incorporated into everyday life.
The final few minutes of a session can also provide an opportunity to:
- discuss progress
- explain what has been worked on
- suggest carryover activities
- answer questions
- discuss concerns that have arisen between sessions
For some children, more substantial parent participation may be useful throughout the session.
This will depend on the child’s age, developmental level and individual needs.
Why online therapy can work well
Online therapy removes the additional demands of travelling to and from a clinic.
It can offer:
- therapy from a familiar home environment
- no journey or waiting room
- less disruption to established routines
- close involvement of parents or carers
- easier opportunities to link therapy with everyday life
- the ability to return immediately to family routines once the session ends
For children who need repetition and support to transfer skills into everyday situations, having parents nearby can also make it easier for them to understand how to reinforce therapy targets between appointments.
Looking towards adulthood
For older children and young people, Speech and Language Therapy can increasingly consider what communication will mean for their future.
Families of children with additional needs have hopes and ambitions for their children just like any other family.
You may be thinking about:
How independently might they communicate?
How will they make choices and express preferences?
Could they attend college?
How will they manage relationships?
Could they work or take part in supported employment?
How will they communicate when something is wrong?
These can feel like very large goals.
Where appropriate, we can look at the longer-term outcome and break it down into small, achievable stages, working towards it gradually at your child’s own pace.
Holistic and independent support
I consider your child’s communication within the context of their whole life.
Family priorities, cultural expectations, education, relationships, independence and emotional wellbeing can all influence what meaningful progress looks like.
My recommendations are based on my clinical assessment, professional judgement, the information available to me and what appears appropriate for the individual child — not simply on what a particular service happens to be able to provide.
Where relevant, I can collaborate with schools and other professionals while remaining focused on your child’s individual Speech and Language Therapy needs.
Respecting culture, language and family values
Families differ in the way they understand independence, relationships, education, adulthood and family responsibilities.
These differences matter.
I take account of religious, cultural and linguistic considerations when working with families and developing meaningful goals.
As a Muslim therapist from a South Asian background myself, I also understand some of the practical and cultural challenges families can encounter when navigating support for a child with additional needs.
RoseminSLT works with families from a wide range of ethnic, linguistic, religious and cultural backgrounds.
EHCP annual review support
For children and young people with an Education, Health and Care Plan (EHCP), I can provide Speech and Language Therapy input to the annual review process where appropriate.
This may include:
- a comprehensive Speech and Language Therapy annual review report
- reviewing current communication needs
- reporting progress
- recommendations for strategies and ongoing support
- consideration of future communication outcomes
- online attendance at annual review meetings
Reports provide a clear professional account of your child’s current communication profile, progress and recommendations.
Transition support
Communication needs can change as children move into different stages of education and towards adulthood.
Where appropriate, I can provide assessment and reporting to help clarify Speech and Language Therapy needs during important transitions, including:
- moving to secondary school
- post-16 education
- specialist college
- preparation for adulthood
- community independence
- employment or supported employment
My role is to provide an independent Speech and Language Therapy opinion about communication needs and appropriate support. I cannot guarantee that a particular placement, provision or funding decision will be agreed.
Experience and professional background
I am a UCL graduate Speech and Language Therapist with more than 16 years’ experience working with children and young people.
My professional training and clinical experience have included working with children and young people whose speech, language and communication needs are associated with a range of developmental, genetic and medical conditions.
Although particular syndromes may have recognised communication profiles, my approach is always to assess and support the individual child rather than treating the diagnosis as a therapy programme.
Not sure whether online therapy would suit your child?
Every child is different, and online therapy will not be suitable for every communication profile.
You can arrange a free 15-minute telephone consultation to tell me about your child’s communication, current needs and your priorities as a family.
We can then discuss whether an online assessment or therapy through RoseminSLT may be an appropriate next step.