Assessing pragmatic communication in children with Down syndrome.

PURPOSE: Successful communication depends on language content, language form, and language use (pragmatics). Children with Down syndrome (DS) experience communication difficulties, however little is known about their pragmatic profile, particularly during early school years. The purpose of the present study was to explore the nature of pragmatic communication in children with DS.

METHOD: Twenty-nine six-year-old children with DS were assessed, in the areas of 1) initiation, 2) scripted language, 3) understanding context and 4) nonverbal communication, as reported by children's parents via the Children's Communication Checklist-2 (Bishop, 2003). Additionally, the relationships between pragmatics and measures of vocabulary, nonverbal mental ability and social functioning were explored.

RESULTS: Children with DS were impaired relative to norms from typically developing children in all areas of pragmatics. A profile of relative strengths and weaknesses was found in the children with DS; the area of nonverbal communication was significantly stronger, while the area of understanding context was significantly poorer, relative to the other areas of pragmatics assessed in these children. Relationships between areas of pragmatics and other linguistic areas, as well as aspects of vocabulary and social functioning were observed.

CONCLUSIONS: By the age of six children with DS experience significantly impaired pragmatic communication, with a clear profile of relative strengths and weaknesses. The study highlights the need to teach children with DS pragmatic skills as a component of communication, alongside language content and form.