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Jennifer Nock looks at how children with Down syndrome understand the world and provides useful strategies to promote their learning

Children with Down syndrome develop in a similar way to their typically developing peers, but development is slower, with a particular set of cognitive and learning difficulties. A specific obstacle to learning is the difficulty that many children with Down syndrome experience in acquiring and consolidating strong conceptual knowledge. Failure to address this can have far reaching implications for learning in all areas, as early conceptual knowledge forms the building blocks for later learning, particularly in numeracy, literacy and science. See the list below for concepts a child should know between the ages of 2.5 to five years of age. The list is not exhaustive; it presents a general list of concepts developing in the early childhood years and the concepts have a variety of age ranges for mastery.

Some examples of basic concepts that educators anticipate children will have when they start school

Some early maths concepts

  • Classification, for example, matching and sorting.
  • Predicting, guessing what will happen, based on previous experiences: on hearing the sound of a car on the drive, they may “predict” that mum has arrived home.
  • Understanding size, shape, and space.
  • Ability to count verbally: rote counting, then meaningful counting.
  • Cause and effect predictions.
  • Recognising numerals.
  • Identifying more and less of a quantity.
  • Estimating.
  • Understanding one-to-one correspondence: matching sets, or knowing which group has four and which has five.
  • Understanding “same” and “different”.
  • Identifying and making patterns and sequences.
  • Time: days, weeks, anniversaries and celebrations.
  • Money: recognising that coins and notes have value and are used for purchasing goods and services.
  • Problem solving.

Some early literacy concepts

  • Narrative skills: being able to describe things, actions and events, and to tell stories.
  • Vocabulary: knowing the names of things, actions, and feelings.
  • Print interest: being motivated to interact with and enjoy books.
  • Print awareness: noticing print, knowing how to handle and use a book, and knowing how to follow words on a page.
  • Letter knowledge: understanding that letters are different from each other, knowing their names and sounds, and recognising letters in the environment.
  • Phonological awareness: being able to hear, experiment and play with the smaller sounds in words.
  • Fact and fiction: some stories are “true”, while others are “made up”.
  • Different forms of literacy: songs, poems and nursery rhymes can all tell stories.
  • Role play and pretending: playing out events they have experienced or imagined.

Some early science concepts

A basic awareness and understanding of:

  • animals and humans are living things
  • plants and their life cycle
  • forces, motion and magnets
  • floating and sinking
  • everyday materials and their properties, recognising the differences between solids, liquids and gases
  • earth and space, time, seasons, and weather
  • light and darkness
  • electricity
  • sound
  • changing materials
  • temperature
  • colour, light and shadows
  • dinosaurs and basic concepts of evolution; knowing that some kinds of organisms that once lived on Earth have completely disappeared.

Understanding concepts


A concept is a mental representation, image or idea of tangible and concrete objects and intangible ideas and feelings, such as colours, emotions. There are three concept types. Concrete concepts are objects or things that are tangible, for example, a “spoon” and a “bed”. Semi-concrete concepts relate to an action, colour, position, or something that can be demonstrated but not held in the hand, for example, “jumping”, “behind” and “yellow”. Abstract concepts include feelings, philosophical ideas and cultural expectations, for example, “love”, “nervousness”, “evil” and “beauty”.

Concepts are tools and have powerful implications for children’s reasoning and problem solving. They provide a proficient way of organising experience and learning in the well-organised “filing cabinets” of the brain. If children were unable to categorise, their experiences would be chaotic, filled with sensations, events, objects and properties, too numerous to either hold in memory or recall. 

Consider the baby in the womb who has a concept of “mother” even before birth; the unborn baby recognises mother’s voice, smell and the pattern of her heart beat. After birth, the baby is hit with an explosion of sensory experiences, and many of these are channelled through close proximity to the caregivers. As the baby develops, he or she begins to explore the world and the range and depth of conceptual knowledge expands exponentially. Before they have even begun to speak, infants form categories of faces, sounds, food, smells, speech sounds, emotional expressions, tools, colours, objects, plants, animals and vehicles, to name but a few.

Many pupils with Down syndrome experience difficulties in acquiring concepts, particularly abstract concepts. In order to address these difficulties we need to understand how concepts are developed. All concepts are built on received information which comes from the environment we encounter, including people and ideas within that environment. To build robust concepts, this information must be accurate, held in working memory (including auditory memory) long enough to be fully processed, then transferred and stored in the long-term memory and available for retrieval when required to learn new and associated concepts.

Challenges to learning


These four key factors all hold challenges for children with Down syndrome.

The environment

Children with Down syndrome are usually delayed in the acquisition of both gross and fine motor skills; this means that they usually do not begin to explore their environments until later than their typically developing peers. Thus, they may not have had appropriate or sufficient experience to develop conceptual thought when educators first encounter them, regardless of their age.

Information accuracy

Children with Down syndrome frequently have specific health related problems, including visual problems and mild to moderate hearing loss. This can have a serious impact on their ability to process the visual and auditory environment, including the school environment. They may be unable to see or hear clearly if they do not have an up-to-date diagnosis and prescriptions. Additionally, they may be non-compliant in the wearing of glasses and hearing aids, and the more learning delayed they are, the more likely this is to be the case.

Working (short term) memory
Working memory is made up of three components: the central executive, which is part of the system responsible for processing information; the phonological loop, which is responsible for the short-term storage of verbal material; and the visuospatial scratch pad, which is responsible for the short-term storage of visual and spatial information.

Children with Down syndrome have a specific impairment in the phonological loop, making the processing of verbal information and, therefore, learning from listening, particularly difficult. There are usually high levels of auditory input in most school environments.

Storage and retrieval from long-term memory (LTM)

The reliability of LTM depends upon the ability to store, retain and retrieve knowledge and understanding. There is an abundance of research evidence to suggest that the LTM abilities of people with Down syndrome are impaired. Possible reasons for this can be found in the neuropsychological literature, which deals with specific brain regions and their function. Storage in LTM can also be affected by deficits in working memory. If information is not sufficiently processed and understood in working memory, it is unlikely to transfer accurately, or even at all, to LTM, so the previously described working memory deficits in Down syndrome impact upon storage in and retrieval from LTM.

Conceptual development


A number of other factors play a part in the difficulties associated with conceptual development in Down syndrome. Developmental delay is always present for these children. The ability to acquire meaning from new sources and experiences, such as sensory exploration, motor manipulation, questioning, pictorial mass media and reading depends on maturational readiness, and those living with Down syndrome usually acquire these skills at a much later stage than their typically developing peers.

Speech and language in children with Down syndrome is delayed relative to non-verbal mental abilities. Typically developing children have what is termed a “vocabulary explosion” at around eighteen months of age, and their scope for learning about the world grows enormously. As adults talk to them about present, past and future and create narratives around multiple experiences, children begin to develop frameworks and schemas to organise the information they are acquiring into strong concepts. They begin to talk about what they are going to do and what they did yesterday or last week. Adults explain to them about things outside their own experiences, such as what astronauts do or why it is cold in winter and hot in summer. Children begin to form basic concepts around, for example, movement, appearance, position, number, sensory effects, sequence, dimension, size and similarities and differences, and other attributes, and these concepts are encoded in language. Many psychologists stress the importance of language for teaching concepts, and any child with a delay in learning to communicate in a language will be seriously disadvantaged in being able to gain knowledge and understanding of the world.

Some children with Down syndrome have shorter attention and concentration spans than their typically developing peers. They can be more easily distracted and thus, may not focus long enough for information to be adequately processed and stored in LTM.

Executive function difficulties including short- and long-term memory, concentration and attention, intellectual challenges, delayed development and limited exploration of their world before starting school means that supporting the development of conceptual knowledge and understanding must be the single, most important area to target in children with Down syndrome.

Promoting learning


As described above, many children with Down syndrome have not experienced the world to the same degree as their typically developing peers. Most children acquire basic concepts at home, long before they start formal schooling through exploring and learning about objects, through cause and effect experiences and relational play and building. They develop object knowledge by shaking and hitting against different surfaces, and by feeling, dropping and throwing. They learn about properties such as thick and thin, rough and smooth, hard and soft, full and empty, and discover what objects can and cannot do. These experiences underpin conceptual thought and form the architecture on which all future learning depends.

Learning about cause and effect is another fundamental skill as they become aware that they can influence objects and their environment. When they play with toys and objects they begin to learn that their actions produce effects. They learn that pressing a button on a toy or pressing a part of an object brings about a noise or a moving part. They may pull at a mobile to cause it to chime or push a roly-poly duck off the table to see and hear it fall. They squeeze their soft toys to generate sounds. As they repeat these actions, young children begin to remember and learn how to make interesting things happen.

Children test how objects can be used in relation to other objects, such as putting objects into a box or filling empty containers. They discover that some things fit and others don’t. They experiment and make comparisons between size, weight, shape and how things need to be placed in order to work and fit together. As children play with more than one object they learn to combine them, begin to build simple structures and towers to knock down. As their fine motor skills develop they are able to use smaller more complex pieces and move on to using construction toys. As a result they consolidate concepts of size, weight, shape and three-dimensional objects. These comparisons and experiences are the building blocks for conceptual thought and mathematical thinking.

Children with Down syndrome grasp all these basic, but essential concepts much more slowly than their typically developing peers due to their delayed motor skills. Regardless of age, children with Down syndrome may need a daily intervention programme to develop conceptual knowledge. See the list below for some suggestions.

Strategies and activities to support conceptual development

Object knowledge

  • Provide toys that are large and easy to handle to begin with, then progressively reduce the size.
  • Provide a wide variety of toys and other objects that have many different properties, for instance, textures, shapes, colours and those that make a variety of sounds.
  • Use kitchen utensils, fabrics and containers filled with different materials such as liquids, powders, sand or coloured beads.
  • Offer small world toys in categories: vehicles – airport, garage, emergency services; animals – polar, zoo, rain forest. 
  • Utilise percussion instruments, bought and home-made, made from clear and opaque containers filled with an extensive variety of materials, such as rice, dried peas, marbles and coins.

Cause and effect

  • Provide a wide variety of experiences of different objects and toys with many effects and ensure the toys and objects respond easily to a light touch.
  • Provide books with lift up flaps or windows to peek through.
  • Provide toys that pop up, have push or slide buttons that light up and make interesting sounds.
  • Create opportunities to compare the reactions and sound effects when dropping and throwing different objects, for example, comparing dropping a feather and dropping a ball.
  • Use bubbles, water pistols and other water based activities.
  • Provide simple wind-up toys, which are motivating and fun.

Relational play and building 

  • Provide as many activities and materials as it takes to motivate the child.
  • Place one object on top of another using a small object on top of a much larger object.
  • Progressively increase the level of difficulty by introducing objects of different shapes.
  • Develop the concepts and language of “above”, “below”, “under” and “on top of”.
  • Make generalisations by providing a variety of different objects of different shapes and sizes.
  • Floor play, such as building with shoe (or larger) boxes,  cushions and pillows.
  • Build dens, indoor and outdoor.
  • Roll and slide objects such as marbles, cars and balls of different sizes down slopes, through tubes and tunnels, varying the slope angle to alter the speed of the object.

Any and all activities to improve concentration, attention and memory should be utilised.

In terms of working memory, the visual-spatial short-term memory is better than verbal memory, making visual processing and learning a real strength in the learning profile. This can and should be used to support weaker auditory processing abilities, so always support learning by using approaches that do not put an excessive demand on verbal short-term memory skills. Teaching will be more effective when information is presented with the support of pictures, gestures or objects.

Always include sensory, gross and fine motor activities into any intervention programme. Remember that children learn first and foremost through their bodily and sensory experiences. Children with Down syndrome need to be engaged in as many three dimensional and multi-sensory activities as possible.

Finally, children with Down syndrome often have particular difficulties developing mathematical concepts. All of the above suggestions will have a beneficial effect on learning and enjoyment of learning, and because many children who have developmental delay are only able to use the manipulative mode for extended periods, maths activities must use concrete objects to teach numeracy awareness. Many children are exposed too early to abstract symbols, before they have progressed through the manipulative mode, let alone the mental image mode and consequently, become “stuck” in their learning. Maths through play, then is essential, and real life maths is best.

Further information


Dr Jennifer Nock is a chartered psychologist and educator who has worked for over three decades in a wide range of education and SEN settings. She provides bespoke training in SEN and inclusive practice:

www.jennifernocktrainingandconsultancy.com


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