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Semin Speech Lang 2021; 42(04): 318-329
DOI: 10.1055/s-0041-1730990
Review Article

Mental State Language Use in Children with Down Syndrome and the Role of Caregivers

Marie Moore Channell
1   Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, Illinois
,
Rebekah Bosley
1   Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, Illinois
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Abstract

Children with Down syndrome (DS) have both strengths and difficulties in speech, language, and social communication. Mental state language—the ability to discuss others' perspectives such as their thoughts, feelings, and intentions—represents a foundational social communicative skill that is delayed in many children with DS, even into the school-age years. The purpose of this article is to review the evidence base on mental state language development in school-age children with DS, focusing in particular on assessment and intervention. We discuss assessment procedures that are both age appropriate and developmentally appropriate for this population. We also present preliminary data highlighting the role of caregivers in supporting mental state language development in school-age children with DS through shared storytelling. We propose that interventions aimed at supporting mental state language development in DS should include a focus on caregiver–child shared storybook reading, even in the school-age years. Therefore, we discuss key considerations for clinicians when teaching caregivers strategies for supporting mental state language and social communication in children with DS.

Keywords

Down syndrome - mental state language - social communication - intellectual disability

Disclosures

Financial: No relevant relationships exist for either author.


Nonfinancial: No relevant relationships exist for either author.




Publication History

Article published online:
26 July 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 Carpendale JIM, Lewis C. Constructing an understanding of mind: the development of children's social understanding within social interaction. Behav Brain Sci 2004; 27 (01) 79-96 , discussion 96–151
    PubMedGoogle Scholar
  • 2 Symons DK. Mental state discourse, theory of mind, and the internalization of self-other understanding. Dev Rev 2004; 24: 159-188
    CrossrefPubMedGoogle Scholar
  • 3 Cebula KR, Moore DG, Wishart JG. Social cognition in children with Down's syndrome: challenges to research and theory building. J Intellect Disabil Res 2010; 54 (02) 113-134
    CrossrefPubMedGoogle Scholar
  • 4 Abbeduto L, Warren SF, Conners FA. Language development in Down syndrome: from the prelinguistic period to the acquisition of literacy. Ment Retard Dev Disabil Res Rev 2007; 13 (03) 247-261
    CrossrefPubMedGoogle Scholar
  • 5 Grieco J, Pulsifer M, Seligsohn K, Skotko B, Schwartz A. Down syndrome: cognitive and behavioral functioning across the lifespan. Am J Med Genet C Semin Med Genet 2015; 169 (02) 135-149
    CrossrefPubMedGoogle Scholar
  • 6 McDuffie A, Thurman AJ, Channell MM, Abbeduto L. Language disorders in children with intellectual disability of genetic origin. In: Schwartz R. ed. Handbook of Child Language Disorders. 2nd ed.. Taylor & Francis; 2017: 52-81
    Google Scholar
  • 7 Na JY, Wilkinson K, Karny M, Blackstone S, Stifter C. A synthesis of relevant literature on the development of emotional competence: implications for design of augmentative and alternative communication systems. Am J Speech Lang Pathol 2016; 25 (03) 441-452
    CrossrefPubMedGoogle Scholar
  • 8 Denham SA, Blair KA, DeMulder E. et al. Preschool emotional competence: pathway to social competence?. Child Dev 2003; 74 (01) 238-256
    CrossrefPubMedGoogle Scholar
  • 9 Denham SA, Way E, Kalb SC, Warren-Khot HK, Bassett HH. Preschoolers' social information processing and early school success: the challenging situations task. Br J Dev Psychol 2013; 31 (Pt 2): 180-197
    CrossrefPubMedGoogle Scholar
  • 10 Denham SA, Kalb S, Way E, Warren-Khot H, Rhoades BL, Bassett HH. Social and emotional information processing in preschoolers: indicator of early school success?. Early Child Dev Care 2013; 183 (05) 667-688
    CrossrefPubMedGoogle Scholar
  • 11 Ensor R, Hughes C. Content or connectedness? Mother-child talk and early social understanding. Child Dev 2008; 79 (01) 201-216
    CrossrefPubMedGoogle Scholar
  • 12 Izard C, Fine S, Schultz D, Mostow A, Ackerman B, Youngstrom E. Emotion knowledge as a predictor of social behavior and academic competence in children at risk. Psychol Sci 2001; 12 (01) 18-23
    CrossrefPubMedGoogle Scholar
  • 13 Lemerise EA, Arsenio WF. An integrated model of emotion processes and cognition in social information processing. Child Dev 2000; 71 (01) 107-118
    CrossrefPubMedGoogle Scholar
  • 14 Tompkins V, Farrar MJ, Montgomery DE. Speaking your mind: language and narrative in young children's theory of mind development. In: Advances in Child Development and Behavior. Vol 56. Academic Press Inc.; 2019: 109-140
    Google Scholar
  • 15 Bishop S, Farmer C, Kaat A, Georgiades S, Kanne S, Thurm A. The need for a developmentally based measure of social communication skills. J Am Acad Child Adolesc Psychiatry 2019; 58 (06) 555-560
    CrossrefPubMedGoogle Scholar
  • 16 Channell MM. Cross-sectional trajectories of mental state language development in children with Down syndrome. Am J Speech Lang Pathol 2020; 29 (02) 760-775
    CrossrefPubMedGoogle Scholar
  • 17 Channell MM, Loveall SJ, Conners FA, Harvey DJ, Abbeduto L. Narrative language sampling in typical development: implications for clinical trials. Am J Speech Lang Pathol 2018; 27 (01) 123-135
    CrossrefPubMedGoogle Scholar
  • 18 Bretherton I, Beeghly M. Talking about internal states: the acquisition of an explicit theory of mind. Dev Psychol 1982; 18 (06) 906-921
    CrossrefPubMedGoogle Scholar
  • 19 Moore C, Furrow D, Chiasson L, Patriquin M. Developmental relationships between production and comprehension of mental terms. First Lang 1994; 14: 1-17
    CrossrefPubMedGoogle Scholar
  • 20 Bretherton I, Fritz J, Zahn-Waxler C, Ridgeway D. Learning to talk about emotions: a functionalist perspective. Child Dev 1986; 57 (03) 529-548
    CrossrefPubMedGoogle Scholar
  • 21 Bartsch K, Wellman HM. Children Talk about the Mind. Oxford University Press; 1995
    CrossrefGoogle Scholar
  • 22 Hughes C, Dunn J. Understanding mind and emotion: longitudinal associations with mental-state talk between young friends. Dev Psychol 1998; 34 (05) 1026-1037
    CrossrefPubMedGoogle Scholar
  • 23 Wellman HM. Making Minds: How Theory of Mind Develops. Oxford University Press; 2014
    CrossrefGoogle Scholar
  • 24 Trabasso T, Stein NL, Rodkin PC, Park Munger M, Baughn CR. Knowledge of goals and plans in the on-line narration of events. Cogn Dev 1992; 7 (02) 133-170
    CrossrefPubMedGoogle Scholar
  • 25 Tompkins V, Guo Y, Justice LM. Inference generation, story comprehension, and language skills in the preschool years. Read Writ 2013; 26: 403-429
    CrossrefPubMedGoogle Scholar
  • 26 Tompkins V, Blosser MK, Downing M. False belief understanding and narrative comprehension in the preschool years. Cogn Dev 2020; 56: 100936
    CrossrefPubMedGoogle Scholar
  • 27 Beeghly M, Cicchetti D. Talking about self and other: emergence of an internal state lexicon in young children with Down syndrome. Dev Psychopathol 1997; 9 (04) 729-748
    CrossrefPubMedGoogle Scholar
  • 28 Tager-Flusberg H. Autistic children's talk about psychological states: deficits in the early acquisition of a theory of mind. Child Dev 1992; 63 (01) 161-172
    CrossrefPubMedGoogle Scholar
  • 29 Ashby SA, Channell MM, Abbeduto L. Inferential language use by youth with Down syndrome during narration. Res Dev Disabil 2017; 71: 98-108
    CrossrefPubMedGoogle Scholar
  • 30 Channell MM, Sandstrom LE, Harvey DJ. Factors associated with mental state language development in children with Down syndrome versus typical development. Submitted
    PubMedGoogle Scholar
  • 31 Reilly J, Klima ES, Bellugi U. Once more with feeling: affect and language in atypical populations. Dev Psychopathol 1990; 2: 367-391
    CrossrefPubMedGoogle Scholar
  • 32 Channell MM, Conners FA, Barth JM. Emotion knowledge in children and adolescents with Down syndrome: a new methodological approach. Am J Intellect Dev Disabil 2014; 119 (05) 405-421
    CrossrefPubMedGoogle Scholar
  • 33 Farkas C, del Real MT, Strasser K, Álvarez C, Santelices MP, Sieverson C. Maternal mental state language during storytelling versus free-play contexts and its relation to child language and socioemotional outcomes at 12 and 30 months of age. Cogn Dev 2018; 47: 181-197
    CrossrefPubMedGoogle Scholar
  • 34 LaBounty J, Wellman HM, Olson S, Lagattuta K, Liu D. Mothers' and fathers' use of internal state talk with their young children. Soc Dev 2008; 17 (04) 757-775
    CrossrefPubMedGoogle Scholar
  • 35 Ruffman T, Slade L, Rowlandson K, Rumsey C, Garnham A. How language relates to belief, desire, and emotion understanding. Cogn Dev 2003; 18: 139-158
    CrossrefPubMedGoogle Scholar
  • 36 Taumoepeau M, Ruffman T. Stepping stones to others' minds: maternal talk relates to child mental state language and emotion understanding at 15, 24, and 33 months. Child Dev 2008; 79 (02) 284-302
    CrossrefPubMedGoogle Scholar
  • 37 Adrián JE, Clemente RA, Villanueva L. Mothers' use of cognitive state verbs in picture-book reading and the development of children's understanding of mind: a longitudinal study. Child Dev 2007; 78 (04) 1052-1067
    CrossrefPubMedGoogle Scholar
  • 38 Doan SN, Wang Q. Maternal discussions of mental states and behaviors: relations to emotion situation knowledge in European American and immigrant Chinese children. Child Dev 2010; 81 (05) 1490-1503
    CrossrefPubMedGoogle Scholar
  • 39 Slaughter V, Peterson CC, Mackintosh E. Mind what mother says: narrative input and theory of mind in typical children and those on the autism spectrum. Child Dev 2007; 78 (03) 839-858
    CrossrefPubMedGoogle Scholar
  • 40 Symons DK, Peterson CC, Slaughter V, Roche J, Doyle E. Theory of mind and mental state discourse during book reading and story-telling tasks. Br J Dev Psychol 2005; 23 (01) 81-102
    CrossrefPubMedGoogle Scholar
  • 41 Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 2008; 40 (03) 879-891
    CrossrefPubMedGoogle Scholar
  • 42 Hayes AF. Beyond Baron and Kenny: statistical mediation analysis in the new millennium. Commun Monogr 2009; 76 (04) 408-420
    CrossrefPubMedGoogle Scholar
  • 43 Hayes AF. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. 2nd ed. . Guilford Press; 2018
    Google Scholar
  • 44 van Bysterveldt A, Gillon G, Foster-Cohen S. Literacy environments for children with Down syndrome: What's happening at home?. Down Syndr Res Pract 2010; 12 (02) 98-102
    PubMedGoogle Scholar
  • 45 Trenholm B, Mirenda P. Home and community literacy experiences of individuals with Down syndrome. Downs Syndr Res Pract 2006; 10 (01) 30-40
    CrossrefPubMedGoogle Scholar
  • 46 Guralnick MJ. Early intervention for children with intellectual disabilities: an update. J Appl Res Intellect Disabil 2017; 30 (02) 211-229
    CrossrefPubMedGoogle Scholar
  • 47 Karaaslan O, Mahoney G. Effectiveness of responsive teaching with children with Down syndrome. Intellect Dev Disabil 2013; 51 (06) 458-469
    CrossrefPubMedGoogle Scholar
  • 48 Arnold DH, Lonigan CJ, Whitehurst GJ, Epstein JN. Accelerating language development through picture book reading: replication and extension to a videotape training format. J Educ Psychol 1994; 86 (02) 235-243
    CrossrefPubMedGoogle Scholar
  • 49 Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, DHHS. (2010). Developing Early Literacy: Report of the National Early Literacy Panel (NA). Washington, DC: U.S. Government Printing Office
    PubMed
  • 50 Zevenbergen AA, Whitehurst GJ. Dialogic reading: a shared picture book reading intervention for preschoolers. In: van Kleeck A, Stahl SA, Bauer EB. eds. On Reading Books to Children: Parents and Teachers. Lawrence Erlbaum; 2003: 177-200
    Google Scholar
  • 51 Burgoyne K, Cain K. The effect of prompts on the shared reading interactions of parents and children with Down syndrome. Int J Disabil Dev Educ 2020; •••: 1-15
    CrossrefPubMedGoogle Scholar
  • 52 O'Toole C, Lee ASY, Gibbon FE, van Bysterveldt AK, Hart NJ. Parent-mediated interventions for promoting communication and language development in young children with Down syndrome. Cochrane Database Syst Rev 2018; 10 (10) CD012089
    PubMedGoogle Scholar
  • 53 Nelson S, McDuffie A, Banasik A, Tempero Feigles R, Thurman AJ, Abbeduto L. Inferential language use by school-aged boys with fragile X syndrome: effects of a parent-implemented spoken language intervention. J Commun Disord 2018; 72: 64-76
    CrossrefPubMedGoogle Scholar
  • 54 Whalon K, Martinez JR, Shannon D, Butcher C, Hanline MF. The impact of reading to engage children with autism in language and learning (RECALL). Top Early Child Spec Educ 2015; 35 (02) 102-115
    CrossrefPubMedGoogle Scholar
  • 55 Channell MM, McDuffie AS, Bullard LM, Abbeduto L. Narrative language competence in children and adolescents with Down syndrome. Front Behav Neurosci 2015; 9 (October): 283
    CrossrefPubMedGoogle Scholar
  • 56 Finestack LH, Palmer M, Abbeduto L. Macrostructural narrative language of adolescents and young adults with Down syndrome or fragile X syndrome. Am J Speech Lang Pathol 2012; 21 (01) 29-46
    CrossrefPubMedGoogle Scholar
  • 57 Abbeduto L, Seltzer MM, Shattuck P, Krauss MW, Orsmond G, Murphy MM. Psychological well-being and coping in mothers of youths with autism, Down syndrome, or fragile X syndrome. Am J Ment Retard 2004; 109 (03) 237-254
    CrossrefPubMedGoogle Scholar
  • 58 Brady N, Warren SF, Sterling A. Interventions aimed at improving child language by improving maternal responsivity. Int Rev Res Ment Retard 2009; 37 (C): 333-357
    CrossrefPubMedGoogle Scholar
  • 59 Lewis P, Abbeduto L, Murphy M. et al. Psychological well-being of mothers of youth with fragile X syndrome: syndrome specificity and within-syndrome variability. J Intellect Disabil Res 2006; 50 (Pt 12): 894-904
    CrossrefPubMedGoogle Scholar
  • 60 Warren SF, Brady NC. The role of maternal responsivity in the development of children with intellectual disabilities. Ment Retard Dev Disabil Res Rev 2007; 13 (04) 330-338
    CrossrefPubMedGoogle Scholar
  • 61 Channell MM, Loveall SJ. Assessment and intervention of cognitive and social functioning in adolescents, young adults, and older individuals with Down syndrome. In: Wilkinson KM, Finestack LH. eds. Multimodal AAC for Individuals with Down Syndrome. Paul H. Brookes Publishing Co.; 2021: 185-204
    Google Scholar
  • 62 Na JY, Wilkinson K, Liang J. Early development of emotional competence (EDEC) assessment tool for children with complex communication needs: development and evidence. Am J Speech Lang Pathol 2018; 27 (01) 24-36
    CrossrefPubMedGoogle Scholar
  • 63 Na JY, Wilkinson KM. Communication about emotions during storybook reading: effects of an instruction programme for children with Down syndrome. Int J Speech Lang Pathol 2018; 20 (07) 745-755
    CrossrefPubMedGoogle Scholar
  • 64 McDuffie A, Machalicek W, Bullard L. et al. A spoken language intervention for school-aged boys with fragile X syndrome. Am J Intellect Dev Disabil 2016; 121 (03) 236-265
    CrossrefPubMedGoogle Scholar
  • 65 McDuffie A, Banasik A, Bullard L. et al. Distance delivery of a spoken language intervention for school-aged and adolescent boys with fragile X syndrome. Dev Neurorehabil 2018; 21 (01) 48-63
    CrossrefPubMedGoogle Scholar
  • 66 Di Nuovo S, Buono S. Behavioral phenotypes of genetic syndromes with intellectual disability: comparison of adaptive profiles. Psychiatry Res 2011; 189 (03) 440-445
    CrossrefPubMedGoogle Scholar
  • 67 Einfeld S, Tonge B, Turner G, Parmenter T, Smith A. Longitudinal course of behavioural and emotional problems of young persons with Prader-Willi, fragile X, Williams and Down syndromes. J Intellect Dev Disabil 1999; 24 (04) 349-354
    CrossrefPubMedGoogle Scholar
  • 68 Gilmore L, Cuskelly M. Mastery motivation in children with Down syndrome: promoting and sustaining interest in learning. In: Educating Learners with Down Syndrome: Research, Theory, and Practice with Children and Adolescents. Taylor & Francis; 2014: 60-82
    Google Scholar
  • 69 Scope of Practice in Speech-Language Pathology [Scope of Practice].. American Speech-Language-Hearing Association. 2016 . Accessed May 15, 2021 at: www.asha.org/policy/
    PubMedGoogle Scholar
  • 70 Cultural Competence [Practice Portal]. American Speech-Language-Hearing Association. Accessed May 15, 2021 at: https://www.asha.org/practice-portal/professional-issues/cultural-competence/#collapse_1
    PubMedGoogle Scholar
  • 71 Kaderavek J, Justice LM. Shared storybook reading as an intervention context: practices and potential pitfalls. Am J Speech Lang Pathol 2002; 11: 395-406
    CrossrefPubMedGoogle Scholar
  • 72 Doan SN, Lee HY, Wang Q. Maternal mental state language is associated with trajectories of Chinese immigrant children's emotion situation knowledge. Int J Behav Dev 2019; 43 (01) 43-52
    CrossrefPubMedGoogle Scholar
  • 73 Harris PL. Children's understanding of emotion. In: Lewis M, Haviland-Jones JM, Barrett LF. eds. Handbook of Emotions. 3rd ed.. Guilford Press; 2008: 320-331
    Google Scholar
  • 74 Saarni C. The Development of Emotional Competence. Guilford Press; 1999
    Google Scholar
  • 75 Wang Q, Doan SN, Song Q. Talking about internal states in mother-child reminiscing influences children's self-representations: a cross-cultural study. Cogn Dev 2010; 25 (04) 380-393
    CrossrefPubMedGoogle Scholar
  • 76 Feldman R, Masalha S. Parent-child and triadic antecedents of children's social competence: cultural specificity, shared process. Dev Psychol 2010; 46 (02) 455-467
    CrossrefPubMedGoogle Scholar
  • 77 Blacher J, Neece CL, Paczkowski E. Families and intellectual disability. Curr Opin Psychiatry 2005; 18 (05) 507-513
    CrossrefPubMedGoogle Scholar
  • 78 Povee K, Roberts L, Bourke J, Leonard H. Family functioning in families with a child with Down syndrome: a mixed methods approach. J Intellect Disabil Res 2012; 56 (10) 961-973
    CrossrefPubMedGoogle Scholar
  • 79 Paulick J, Quinn AM, Kibler AK, Palacios N, Hill T. Lessons for teachers: a wordless picture book in the hands of one Mexican immigrant family. TESOL J 2020; 11 (03) e00513
    CrossrefPubMedGoogle Scholar
  • 80 Hammer CS, Nimmo D, Cohen R, Draheim HC, Johnson AA. Book reading interactions between African American and Puerto Rican Head Start children and their mothers. J Early Child Literacy 2005; 5 (03) 195-227
    CrossrefPubMedGoogle Scholar
  • 81 Melzi G, Caspe M. Variations in maternal narrative styles during book reading interactions. Narrative Inq 2005; 15 (01) 101-125
    CrossrefPubMedGoogle Scholar
  • 82 Leyva D, von Suchodoletz A, Shroff D, Hinojo A, Kärtner J. Maternal book-sharing styles and goals and children's verbal contributions in three communities. Early Child Res Q 2021; 54: 228-238
    CrossrefPubMedGoogle Scholar
  • 83 Rochanavibhata S, Marian V. Cross-cultural differences in mother-preschooler book sharing practices in the United States and Thailand. J Child Lang 2020; 1-24
    PubMedGoogle Scholar
  • 84 Kucirkova N, Tompkins V. Personalization in mother-child emotion talk across three contexts. Infant Child Dev 2014; 23 (02) 153-169
    CrossrefPubMedGoogle Scholar