10 Top Speech Therapy Tips for Children with Down Syndrome

The following list of SALT ideas for young children with Down syndrome might help you and your child develop their oral motor skills.

A few of the speech therapy tools for children with Down syndrome
Every child is a unique individual.  Each one develops at their own pace, responds well to their favourite toys and has their own strengths and areas that need support. This is no less true for children with Down's Syndrome, so trust your instincts.

For us, the first 18 months were spent mainly learning about and coming to terms with Down's syndrome, getting to know Natty, worrying about whether she was well, would survive even, navigating our way through endless hospital appointments for eyes, hearing and heart.  Googling (don't do it!).  Then there were the chest infections, bouts of pneumonia and laryngitis.  I don't think we slept very much at all.

But in the background of all that we focussed on different goals to match her stage of development.  

To start with it was expressing enough breast milk each day to tube feed her.  Then we set about teaching her to breastfeed so that we could take that wretched naso-gastric tube out of her nose.  As she grew stronger we thought mostly about her physical development, and with the guidance of a physiotherapist and portage workers we did exercises to help with head lifting, sitting, crawling and then walking.

After that was achieved (and what an achievement!) the focus shifted.  It all became about communication.  

It had always been important of course, but the urgency seemed to mount at this point.
Now, as a former English teacher for students who are speakers of other languages, I know a thing or two about language acquisition.  Natty's sister is a very eloquent young lady, but Natty needed a more targeted approach.  Here, it is worth pointing out that speech therapy provision varies wildly from country to country, and even within those countries.  A friend recently returned from a year in Canada with tales of weekly targeted speech therapy sessions.  Most of us can only dream of such luxuries.
Your child may have different exercises set by a SALT (Speech and Language Therapist) or Portage worker based on their needs, and what worked for us may not suit you, but here I would like to share a few very practical tools that we were advised to obtain over the years.  Most are inexpensive, but make a big difference.
Some of them may seem more like feeding/drinking gadgets, but if a child's mouth and jaw are in the correct position while they do these activities, the muscles will strengthen and stabilise to enable clearer speech... I wish I had known about all of them 5 years ago.  It would have saved a lot of research time, and money paying for experts.

Do speech therapy exercises with your child with
Down syndrome while looking at their face +Hayley Goleniowska 

1) Breastfeeding not only supplies brain and health-boosting loveliness and promotes a wondrous bond with your child, it strengthens the babies lips and tongue and helps keep that tongue in a good position for talking. (We ideally want it kept in the mouth later on and although Natty is very adept at poking hers out if she's cross with you, it does more or less stay hidden away now).   Some babies will find this a difficult skill to master, and not every mum will be able or want to breastfeed either. Time in hospital and illness is a hurdle, but it can be possible to achieve.

2) Dummies/pacifiers have never been items that I rate highly, but apparently, when used in moderation, they do help achieve a good tongue position in babies with Down's Syndrome.  Natty used hers at sleep and nap times only.

3)  Drinking cups  Natty never did drink from a bottle.  She went from breast to straw.  There are many cups on the market that use a straw system (ours is pictured above).  Using a straw makes you purse your lips into an 'O' shape and even babies can do this.  Perfect.  (Incidentally playing games with blowing bubbles also encourages this mouth shape.)
There are also cups with flared rims that promote good jaw posture.  The only no-no is a typical sports cup with spout that encourages your child to tip her head back and jut her jaw forward to drink. Don't buy these if you can help it.

4)  A cheap alternative is the simple straw I always have one or two in my handbag.  You can also buy complex curly wurly straws, the sort you get in novelty stores.  These are good for increased breath capacity and lung control (important if you want to speak in full sentences) as it is harder to draw the liquid up the length of them.

5) A lip block for straws  This is a small rubber disc that is placed about a centimetre from the top of the straw your child is using (see picture above).  This limits how far forward their bottom lip can slide and the drinking action strengthens the lower jaw muscles whilst in this position.  Try it for yourself to see how it feels.

6) A Doidy cup is great when your child is ready to use an open cup.  It is slanted so they don't have to tip their head back to reach the liquid.  Natty used to gag if she got too much liquid in her mouth, particularly if it was cold.

7) A Chewy Tube  (Red T in photo above). These come in different resistances.  They are placed along the child's back teeth. The child is then asked to bite down 10 times.  Repeat on the other side.  This is a jaw strengthening exercise to prevent and correct a jaw that juts forward.

8)  The Horn Hierachy is a series of little plastic flutes and horns, the kind you see children with at parties.  Each one differs in the amount of breath control required to make a noise, hence the hierarchy bit.  The set is quite expensive to buy, but you could collect your own as you find them in toy shops etc.  I have shown a sample in the photo above.

9)  Use Makaton or baby signing with your child.
It won't prevent them from using spoken language, it will actually speed this process up, as each word becomes more deeply embedded in the brain as it is spoken/heard and signed/seen at the same time.  Children naturally drop signs as they become proficient at saying a word.  There are lovely DVDs and books available from Singing Hands, Dave Benson Phillips and Mr Tumble.

10)  Talk and sing to your baby and child a lot.
It sounds simple, and it is.
Show them the world, point things out, explain what you are doing while you wash up, or dress them, count the stairs, their toes, the plates on a table, point out animals on a car journey and tell them what noises they make, listen to nursery rhymes and phonics on car journeys, sing together, echo back noises your child makes to you, read board books together and talk about the pictures, use short simple sentences in a clear voice and say the same thing in a few different ways..."What a beautiful baby!  Hello beautiful baby.  I love you beautiful baby.  Can I have a kiss from my beautiful baby?", put your face in front of your child's and let them see, even feel your mouth shape. Put that phone and iPad down,

There are many, many simple activities you can try and remember to have fun with your child or baby. 

Use any of the above tools with constant adult supervision and remember to have fun and make it all a game. The majority of the tools mentioned can be obtained online from Talk Tools


  1. Brilliant information

  2. Great information, thanks for posting this.

  3. Very interesting and helpful post.

    1. Thank you. I wanted to share what took a lot of money to find out. It shouldn't be that way, but sadly it is.


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