Down Syndrome

1
Down Syndrome and Decoding Skills Training A
Case Study Julie S. St-Pierre, Elizabeth
Kay-Raining Bird, Patricia L. Cleave Dalhousie
University, Halifax, Nova Scotia, Canada

• Follow up 20-week homework period using
  treatment games and
• activities. Maintenance measures were obtained
  at the end (T3).
• Intervention Goals and Targets
• Goals and targets for direct intervention were
  selected based on performance in initial
  assessment.
• Three goals were chosen for training clusters
  digraphs and rime families. Goals were treated
  in the order mentioned.
• Several targets were chosen for training within
  each goal 3 clusters (/bl/, /br/, /st/) 3
  digraphs (th, sh, ch) and 4 rime families
  (/ell/-/all/ /ast/-/est/).

INTRODUCTION
DISCUSSION

• This study provides evidence supporting the
  effectiveness of an intervention targeting
  decoding and orthographic skills in one young
  adult with DS. Overall, gains in the
  participants decoding and orthographic skills
  were modest.
• Progress across PA and general reading measures
  varied (Table 2)
• An increase in syllable segmentation and rhyme
  generation skills was observed from T1 to T3.
• No progress was observed for the Word Attack or
  Word Identification scores over the period of
  study.
• Performance on the 180 word probe improved from
  T1 to T2 and the gains were largely maintained at
  T3. The majority of these gains reflected
  learning of trained words. This may be the
  strongest evidence that shows improvement in
  decoding skills.
• Functional reading performance (i.e. number of
  words read correctly in an excerpt from a book)
  improved from T1 to T3.
• Progress across intervention goals varied (Fig.
  1, 2, 3)
• More progress was made with clusters than
  digraphs and more progress with digraphs than
  with rimes.
• Thus, more progress was made the longer the
  period of intervention was for individual
  targets.
• Progress within intervention goals also varied
  (Fig. 1, 2, 3)
• More progress was made with the /st/ cluster
  than /bl/ and /br/.
• More progress was made with the /ch/ digraph
  than /th/ and /sh/.
• Little progress was made with rimes.
• Progress on the 50 item probe was not maintained
  after intervention ended, despite the use of a
  home program.
• The math probe showed no change over time,
  validating the treatment effects in PA and
  reading measures.

• The ability to use orthographic knowledge to
  decode and spell at the word level is an
  important step in becoming a skilled reader.1
• A number of skills support the ability to decode
  at the word-level, including phonological
  awareness (PA).
• It has been found that decoding skills do not
  keep pace with the development of whole word
  recognition skills in children with Down syndrome
  (DS). Children with DS appear to have difficulty
  acquiring decoding skills. 2
• It has been also observed that the lack of
  decoding skill employed by young adult readers
  with DS contributed to a restricted sight
  vocabulary.3
• The evidence on the effectiveness of direct
  decoding training to improve the reading ability
  of individuals with DS is limited.
• The current study extends previous work
  investigating the effects of teaching decoding
  and orthographic skills in individuals with DS.4

• Treatment
• The treatment program combined drill activities
  with game-based activities for teaching purposes.
  Bingo/lotto cards, Memory, board games, spelling
  tasks, writing, and word sorting tasks are
  examples of such activities.
• The 20-week home program included games and
  activities used in treatment. A recommended
  guideline of 5 games per week was given. A
  schedule was developed to promote adherence to
  the program.
• Measures
• PA and general reading measures were repeated at
  T1, T2 and T3 (Table 2).
• A 50-item word level probe was developed and
  administered bi-weekly to assess and monitor the
  participants progress.
• The probe consisted of mono-syllabic nonsense
  words.
• Each treatment goal was probed five times.
  Generalization for each goal was also probed five
  times using non-treated clusters, digraphs, and
  rime families.
• Raw and percentage scores for each target were
  calculated.
• A math probe was administered bi-weekly and
  served as a control measure for maturation
  effects over time.

Figure 1. Bi-weekly nonsense word probe for
trained cluster targets. Note The coloured
dotted lines indicate the beginning of direct
training. The black dotted line indicates the
end of direct training.
HYPOTHESIS
The reading ability of a young adult with DS
would improve after fourteen weeks of direct
training and that these skills would be
maintained following an additional twenty-week
follow-up period that provided a home program.
METHODS

• Participant
• One female adult (21 6) with DS
• The participants profile, based on cognition
  and language measures, obtained at T1, is
  described with age equivalent (AE) and raw scores
  (RS) in Table 1.
• Table 1
• Assessment Results for Cognitive and Language
  Measures
• 
  T1
• Measure
  RS AE
• SBIS-4th Ed.
• Bead Memory 1
  5 7
• Pattern Analysis 14
  5 7
• CELF-4th Ed.
• Concepts Following 30
  6 2
• Directions

Figure 2. Bi-weekly nonsense word probe for
trained digraph targets. Note The coloured
dotted lines indicate the beginning of direct
training. The black dotted line indicates the
end of direct training.
DIRECTIONS FOR FUTURE RESEARCH
RESULTS

• Greater gains might be observed if
• Fewer targets were used to decrease the learning
  demands.
• The length of intervention was increased.
• The intensity of intervention was increased.
• A bi-weekly functional reading measure was used.
• A different scoring method was used with the 180
  word probe and the 50 item nonsense word probe.
  A concern in this study was that the participant
  did not understand the concept of nonsense words.

Table 2 Assessment Results for PA, Reading
Measures, and Math Probe _________________________
___________________________________________
T1 T2
T3
_______________________________
_______ Measure
RS AE RS AE
RS AE ________________________________
____________________________________ PA
Measures Syllable Segmentation
5/12 -- 6/12
-- 9/12 -- Sound
Segmentation 1/12 --
1/12 -- 3/12 --
AAT
2/40 -- 1/40 --
3/40 -- Rhyme
Task 1 --
0 -- 3
-- Reading Measures WRMT-R
Word Attack 0 5 7
0 5 7 0 5 7
WRMT-R Word Identification 15
6 6 16 6 6 16
6 6 180 Word Reading Probe
4 -- 16 --
14 -- Functional
Reading 44/148
42/148 53/148 Math Probe
10/16
11/16
-- _______________________________________________
_____________________
REFERENCES
1. Torgesen, J. K. (1999). Assessment and
instruction for phonemic awareness and word
recognition skills. In H. W. Catts A. G.
Kamhi (Eds.), Language and reading
disabilities (pp 128- 153). Needham Heights, MA
Allyn and Bacon. 2. Kay-Raining Bird, E.,
Cleave, P. McConnell, L.. (2000). Reading and
phonological awareness in children with
Down syndrome A longitudinal study. American
Journal of Speech-Language Pathology, 9,
319-330. 3. Fowler, A.E., Doherty, B.J.,
Boynton, L. (1995). The basis of reading skill
in young adults with Down syndrome. In L.
Nadel D. Rosenthal (Eds.) Down Syndrome
Living and Learning in the Community (pp.
182-196). New York Wiley-Liss Inc. 4. Spidel,
M Vogan, S. (2004). A reading intervention
program for a child with Down syndrome.
Unpublished masters thesis, Dalhousie
University, Halifax, Nova Scotia, Canada.
Acknowledgement We would like to thank the
participant and family for their participation in
the project.
Figure 3. Bi-weekly nonsense word probe for
trained rime targets. Note The coloured dotted
lines indicate the beginning of direct training.
The black dotted line indicates the end of direct
training.

• Generalization There was no improvement in the
  participants non-treated cluster, digraph, or
  rime probe items at T2 or T3.

Note. Dashes indicate no available measure. AE
Age Equivalent RS Raw Score.