DOWN'S SYNDROME AND STUTTERING

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Introduction

This leaflet is designed to help people who have Downƒ??s syndrome, or who care for and work with people who have Downƒ??s syndrome to understand the problem of dysfluency in speech. People with Downƒ??s syndrome are born with an extra chromosome as a result of a genetic accident before or around the time of conception (1). This results in a certain degree of learning difficulty which can affect the ability to understand and produce speech and language. One of the biggest problems for many people with Downƒ??s syndrome is the unintelligibility of their speech to others. Unintelligibility and disfluency often go hand-in-hand.

People with Downƒ??s syndrome may find some or all of these steps particularly difficult. Ideas may not be clearly formed; the language plan and/or the speech movement plan may not be well established; the actual process of speech may be a problem. As well as this, hearing loss, which is quite common in people with Downƒ??s syndrome, makes learning and understanding language difficult. Also, the individual may lack the social awareness needed to know when or where it is appropriate to say what is wanted.

For all of us it is common to find that, as the pressure to speak and speak well builds, a breakdown in fluency may occur. Imagine that you are trying to plan what to say in a foreign languageƒ??one where you only know a few words! You are likely to have long pauses when you are thinking of words; you might start a word, realize itƒ??s wrong and try another word; you may repeat a word a number of times while you are trying to plan the sentence. In fact you may appear very disfluent!

For a person with Downƒ??s syndrome, wanting to convey messages through a system that does not always work perfectly may lead to:

  1. Repeating whole words or parts of words while trying to think of the next bit of the sentence (itsƒ??itsƒ??its big).
  2. Long pauses in the middle of the sentence when he or she canƒ??t think of what to say next (its aƒ??ƒ??ƒ??ball).
  3. Pauses in unusual places in sentences, often followed by two or three words in a sudden rush that may be hard to understand (Iƒ??m going swimƒ??ƒ??mintƒ??omorrow). This stop- and start speech can be caused by problems in the language program or in the conversion of the language into a speech muscle program. The effect is as if the "bottled up" air is escaping from the lungs in a rather uncontrolled fashion. Fluent speech is dependent on a steady flow of air.
  4. Emphasis being placed on the wrong word in a sentence or on the wrong part of the word. This may occur because the language program is not precisely planned or the control of movements of the speech muscles is not sufficiently well organized (I like to eat apples).
  5. Some struggling to find the right speech sounds to start the word off (aƒ??erƒ??er.iƒ??erƒ??umƒ??over there). Sometimes it may be difficult for the person to start the voice working leading to sudden high pitched or loud sounds.
  6. Possible problems with hearing others and/or with noticing that what has been heard has not been understood. This may lead to hesitant and unsure speech and to communication between the person with Downƒ??s syndrome and the listener breaking down.

It is possible that fluency depends on an equal balance between demands made on the language system and the abilities of the individual to meet these demands (3). Stuttering may occur when demands exceed oneƒ??s abilities.

Demands made on the child or adult