An overview of the development of children with Down syndrome (5 11 years)

Contents
Abstract and Links
Introduction
 Development from five to eleven years
The development of children with Down syndrome
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Meeting the educational and developmental needs of children with Down syndrome

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 Health
Monitoring developmental progress

An overview of the development of children
with Down syndrome (5-11 years)
Sue Buckley and Ben Sacks
Children with Down syndrome usually make significant progress during their primary school years.
In this module, the goals for their development are discussed in the context of the progress in social,
academic and personal independence skills that is seen in typically developing children during the
period from 5 to 11 years. It is argued that the goals for children with Down syndrome should be
age-appropriate and therefore many of the goals should be the same as for other children, although
the child with Down syndrome may not achieve quite the same levels of competence in each area.
This age period begins with settling into full-time school and it is the start of increasing
independence from the family and moving away from the high levels of individual support that
preschool children receive, to being able to be part of a group and to cope in the larger social world

of the school and community. There is consistent evidence that children with Down syndrome gain
significantly from full inclusion in mainstream schools. In particular, they show significant gains in
spoken language, reading, writing and arithmetic. These gains will enhance their adult lives especially the ability to communicate more effectively. However, the special educational needs of
the children should be met wherever they are receiving their education and the key needs and
appropriate adaptations for teaching and learning are described. Children with Down syndrome will
benefit from a partnership between parents, teachers and therapists and specific goals are provided
for parents, teachers, speech and language therapists and physical therapists, based on the research
into the children's specific profile of needs and into effective interventions.
Buckley SJ, Sacks B. An overview of the development of children with Down syndrome (5-11
years). Down Syndrome Issues and Information. 2001.
doi:10.3104/9781903806036


Introduction
The aim of this module is to provide an overview of development during the period from five to
eleven years and to assist the reader in integrating the material covered in the other DSii modules
for this age group. These modules each cover specific aspects of development, i.e. motor, social and
behavioural, speech and language, working memory, reading and numeracy, and family issues, in
detail.
This module is intended to help parents, families, teachers, speech and language therapists, and
other practitioners who work with children in this age range. In the authors' experience, they all
wish to know what developmental and educational progress to expect for a child with Down
syndrome and how to help the child progress as fast as possible.
These two main questions are addressed, with a discussion of the wide range of individual
differences in rates of development of children with Down syndrome. In order to answer the
question of how to help children to progress, the reasons for their developmental profile are outlined
as far as they are known, as this information should help to identify effective therapy and teaching
strategies. The question of how to help also leads to a discussion of the importance of balancing
family needs with the needs of the child with Down syndrome.
In the authors' view, in order to understand the ways in which having Down syndrome affects

children's development it is necessary to consider what is known about the development of typically
developing children. In the last thirty years, there have been considerable advances in our
understanding of the processes of development, particularly in the areas of social learning,
cognition and language. The greater our understanding of typical development, the easier it is to
begin to understand the effects of a disabling condition such as Down syndrome on the processes of
development. As we identify the specific effects of Down syndrome on development, we are in a
better position to develop effective interventions and teaching strategies.
This is the approach taken throughout the DSii modules. We draw on research into the development
of typically developing children, the specific research into the development of children with Down
syndrome and research that has evaluated effective interventions and teaching strategies, where it
exists.

The reasons for having age-appropriate expectations for children with Down
syndrome
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Inclusion in schools and clubs is with same age peers therefore expectations for social skills
and behaviour need to be age-appropriate
Leisure interests, emotional and social needs tend to be age-appropriate
Moving through life - secondary school, puberty, further education, work, partners, leaving
home - tends to be on the basis of age
The challenge for parents and teachers is to treat the child in an age-appropriate manner, to
respect their age, encourage confidence, independence and self-esteem, and facilitate their

inclusion in the community
The challenge for the child or adult with Down syndrome is to participate in life in an ageappropriate way, with limited speech, language and cognitive skills for his or her age


Age-appropriate goals
In addition to using this information to understand the children's developmental and learning
difficulties, we assess the major developmental achievements of typically developing children over
the age span and consider the relevance of these for setting targets for children with Down
syndrome.
If individuals with Down syndrome are to be fully included in the community, as children and as
adults, it is important to recognise that their place in society will be linked to their chronological
age. For example, the child with Down syndrome will join a school at 5 years of age in the UK and
move through school with his or her peers. This means that, despite significant delays in some
aspects of development, such as speech and language and motor skills, the child with Down
syndrome needs to be able to cope with the social demands of the classroom, for example, to sit
still, follow instructions and learn the school routines. Targets for social and behavioural
development therefore need to be age-appropriate and the task for the child is to manage in an ageappropriate social world, with limited language and delayed motor skills. Similarly, if a child with
Down syndrome wishes to join a club such as Brownies or Scouts, he or she will do so at the
appropriate chronological age and, again, will need to be able to cope socially.
As teenagers, children with Down syndrome reach puberty at the same age as other children. As
teenagers they develop typical leisure interests and awareness of sexuality. [4] The point being
stressed is that we believe that it is important to recognise that the social and emotional needs of
children, teenagers and adults are age-appropriate. Their status in the community and their role in
life is mainly determined by their chronological age. Moving through school to college, work and
independent living will happen on the basis of their chronological age.
Therefore the goals for education and social development need to be considered within this
framework, and take account of the child's place in society, based on their age. In the next section,
the developmental achievements for typically developing children from 5 - 11 years are discussed to
provide a baseline for setting targets for children with Down syndrome across this life stage.

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I. Development from five to eleven years
What typically developing children achieve
Between 5 and 11 years, typically developing children make significant progress in all areas of their
development and we have tried to illustrate the significant changes that take place in Figure 1. There
is a wide range of individual differences in achievements in all these areas, with some children
being more socially confident than others, some children making faster academic progress than
others and some children having more difficulty with behaviour control than others.

Figure 1. An overview of developmental progress from five to eleven years in
typically developing children
Perhaps the biggest challenge for children at the start of this age period is settling into school.
Children start full-time school at different ages in different countries but most children will be
spending part or all of each day in a kindergarten or school class by 5 years of age. In the UK, fulltime school starts in the year a child reaches their fifth birthday and formal instruction in reading,
writing and number begins in that school year (Reception class).
Childhood can be seen as a period of preparation for adult life. In preschool years, children are
largely sheltered in their family world and parents determine friendships and social experiences.
Joining full-time school is a big step into the wider community and it provides important
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opportunities for children to learn about the wider community, and to mix with a wider variety of
children and adults. Children's strengths and weaknesses will become more apparent as they leave
the support of their families and have to cope in these larger communities. If children are going to
have some difficulties socially, emotionally or academically, these will become apparent when they
meet the challenges of the typical school environment.
Going to school - social and academic demands
The classroom environment places demands on children's social skills as well as their language and

learning abilities.
The children are part of a large group of children in the classroom, and will have to be able to cope
socially with a range of different children. They have to communicate with one another in the
classroom and the playground. They are beginning to learn about how to get on with others and how
to make and keep friends. These are very important skills for teenage and adult life. They will meet
children whose behaviour and attitudes are different from their own as they experience a wide range
of children in their community from different backgrounds and social circumstances. These
experiences are very important for helping children to develop their social skills.
During the preschool years, children will have had quite a high level of individual support for
learning in their families but in the full-time school classroom they have to be able to be part of a
large group and to follow the teacher's instructions to the whole group. They may also have many
opportunities for small group work and activities, but they will not be able to have much one-to-one
support for their learning in most typical school classrooms. In their first years in the school system,
children are expected to learn to read, write and count, and some will find this easier than others.
The abilities and the aptitudes of children will begin to become apparent to their parents, teachers
and themselves. Children will also develop their learning skills and become increasingly
independent learners.
Speech and language skills
The school environment places a heavy demand on children's speech, language and communication
abilities. Most of the classroom and school instruction is through spoken language. When typically
developing 5 year olds enter school they do not all have the same spoken language skills. Some
children will be much more competent talkers than others, with larger vocabularies and more
advanced grammar and some will be more able listeners than others. Some children will have
difficulty listening to and remembering all the spoken instructions and information given by their
teachers. Studies show that children with delayed speech and language for their age have difficulty
in the classroom and tend to fall behind with their academic progress.[1] Children's language abilities
and learning abilities are also influenced by their working memory skills. Recent research has
shown that children with poorer working memory skills when they enter school have difficulty
keeping up with the academic work.[2]
Children's spoken language skills develop a great deal during the period from 5 to 11 years. Most

typically developing 5 year olds come to school talking in sentences. They have several thousand
words in their vocabulary and they have mastered most of the grammar of their native language.
They do learn some more complex and formal grammar during these school years and they learn a
great deal of new vocabulary (as many as 3000 new words each year from 7 to 16 years). This
progress in vocabulary and grammar has been shown to be influenced by the children's reading
progress. Children who have reading difficulties, and fall behind their peers on reading progress, do
not make typical progress on language or working memory measures. Children also develop their

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ability to enter into conversations, to initiate conversations with other children and adults and to tell
stories or describe events they have taken part in, during this period.
Academic progress
During the primary school years, typically developing children are expected to achieve at least a
basic level of competence in reading, writing and mathematics. Most 5 year olds are beginners,
usually starting school unable to read though they may know some sight words and some letter
names and sounds, and they may be able to write their name and to count to 20. Most children make
steady progress over the next six years and by the age of 11 years can write and spell well enough to
record classroom work and to write a short story. Most will be able to read books for information
and for pleasure. Most will be able to calculate using numbers at least to one thousand, tell the time
and calculate money accurately. Most children will be able to weigh and measure adequately for
everyday applications. Some typically developing children will be more advanced than this, but a
significant number of typically developing children (20-25%) will not have achieved these levels by
11 years of age.[3]
Children will be studying a wide range of subjects on the school curriculum such as science,
geography and history but their literacy skills will influence their progress across all aspects of the
curriculum. Children will also be enjoying music and creative arts, and these areas, along with sport
and music, will not be as influenced by success with literacy. Musical and sporting abilities will be
developing and some children will discover that they have particular abilities in these areas or in

creative arts, including painting, dance and drama.
Out of school - social and practical independence
In the years from 5 to 11, children will be experiencing a wider range of leisure and community
activities. They will be able to join clubs and activities for their age group and they will become
more involved in family tasks such as shopping. Children will begin to establish a wider range of
friendships and visit with friends at their homes to play. They will be invited to parties and outings
with friends and their families.
By the end of this age period, children may be walking to school without parent support and
walking to local shops or to friend's homes. They may also be learning to use buses independently
or with friends by 11 years of age. They will have watches and be able to tell the time. They will
know their names and addresses and know what to do if they have a difficulty when out on their
own. They will be able to use the telephone.
At home - personal independence
At home children will begin to take care of their personal needs over this period. At 5 most children
will still be helped to wash, bath and choose appropriate clothes for the day's activities and weather.
By 11 years, most children will be achieving independence in self-care, able to run a bath or shower
at the right temperature, learning to wash their own hair and cut their own finger and toe nails. They
will choose their own clothes. They will not yet be expected to do their own laundry, although they
may be expected to keep their own rooms clean and tidy.
Most 11 year olds can make simple snacks such as toast and hot drinks, using kettles, toasters,
microwave ovens and possibly cookers and ovens safely for simple meals. Many parents will be
beginning to leave children of this age unsupervised at home for short periods and be confident that
they know what to do in the event of an emergency i.e. they can use the phone and know when to
call a neighbour or phone for a doctor, ambulance, fire engine or policeman.
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In summary
Children progress significantly in all areas of their development during this period from 5 to 11
years and success in these years builds their self-esteem and confidence. Conversely, difficulties in

any of the areas of progress discussed can have a significant negative effect on any child's
confidence and self-esteem.
Children's progress varies widely, even within the range considered to be 'typical development' and
these differences will be in part explained by inherited individual differences in abilities and
aptitudes but it will also be powerfully influenced by the family support and educational
opportunities that they receive.

Influences on development for all children
Development is not fixed by genes at birth
Development is a process, a dynamic, transactional and social process. Most children are born with
the potential to make typical developmental progress in all areas of their development, but to do so
they have to be able to interact with the world, to move, explore, and to have people around them
who talk to them and react to their behaviours. At each step, the child has to be able to store the
information that he or she is gaining from the world and to be able to practise new skills. Later steps
in development are built on earlier ones. A child who is placed in a barren orphanage with no toys
and little human contact will not sit up, smile or talk at the usual ages. At any age, therefore, the
development of a particular child, including those with Down syndrome, is the result of an
interaction between that child's biology and innate learning potential and the social and learning
opportunities that he or she has experienced. It is not fixed in any simple way by genes at birth.
Until recently, children with Down syndrome in all countries grew up in situations of social and
educational deprivation. They were not fully included in the social life of the community. In
particular, they were denied the usual opportunities to play with and learn with typically developing
children. They did not receive any education in most countries until the last 30 years, and then the
education offered was mainly in special schools and classes, in which all the other children were
disabled.
If a child with no disability only had this kind of social and educational experience, he or she would
certainly not show typical development year on year: he or she would show cognitive and social
delay. The progress of individuals with Down syndrome over the past 20 years, if they have had
good social and educational inclusion, illustrates that the same is true for them. Recent studies in
Australia, the USA and the UK document these changes. The development of children with Down

syndrome is as sensitive to the quality of family, social and educational environments as any other
child. At present, children with Down syndrome are progressing faster and achieving much more
than they did 25 years ago.[4,5,6]

Influences on development
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Social learning opportunities at home, at school and in the community
Social support for learning through scaffolding, modelling and teaching
Self-esteem, curiosity and motivation to learn
Biology and experience interact to influence brain structure and brain function throughout
life
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In addition, research on inclusion in education for children with Down syndrome consistently
reports significant speech, language and academic gains (reading, writing and number), with these
teenagers 2 to 3 years ahead of their peers in special schools in all these areas, based on typical rates
of development. [7,8,9] These differences are dramatic, since children with Down syndrome usually
only make about 6 months progress during one year on these measures. They are progressing, but
more slowly than typically developing children who are expected to make 12 months progress in a
year. Measures of expressive language skills of the included teenagers show that their speech
intelligibility has improved significantly. Eight out of ten included teenagers are intelligible to
people they meet in the community, for example in shops or on buses, compared to only four out of
ten teenagers in special schools. [9]
Similarly, children with Down syndrome who have been fully included in social activities with
typically developing peers have more age-appropriate and socially mature behaviour than those who

have only had social experience with peers with disabilities, at school and in the community.
Development is a dynamic, interactive and social process
Further, within a typical social and educational environment, there is much evidence that
development is influenced by the sensitivity and responsiveness of parents and teachers, and by the
quality and range of the learning opportunities available to children. While parents and carers may
not always be aware that they are teaching, they are often engaged in explaining the world to their
children as they talk or read to them and scaffolding their learning as they play. Scaffolding means
supporting a child to succeed at a task that he or she cannot yet complete on their own. This is often
done when helping children to find out what a new toy or computer game can do, helping them to
complete a jigsaw or to count, for example. The adult does not take over, they join in with the child,
just supporting and demonstrating as necessary when the child is not sure what to do next, so that
the child is able to see how to succeed. Therefore, learning is socially mediated - that is, children
learn in social interactions with more competent others in their world, such as parents, brothers and
sisters, grandparents, friends and teachers. A child with a learning disability will need more support
and scaffolding for their learning and development than a typically developing child.
Curiosity, motivation and self-esteem
Children's learning is also influenced by their curiosity and motivation. Children are usually active
explorers of their world from the first months of life and in their play, they seek to find out what
toys can do and explore imaginary roles.
As they develop spoken language, children learn by asking as well as investigating. Children's
learning is influenced by their self-confidence and self-esteem. Children who are confident explore
and learn faster than those who lack confidence. Confidence may be influenced by success but it is
also influenced by children's sense of self-esteem (self-worth), which comes from being secure,
loved and valued. Children's self-esteem influences their social and academic progress in school.
Brain and behaviour
While brain development and brain function underpins all that children do, brain development is a
highly dynamic and ongoing process from birth to adult life and it is influenced by input and
activity. As children learn and develop, so the brain stores that information, and brain structure and
function change as new learning takes place. This means that intervention should take account of
normal developmental milestones and try to ensure that a child who cannot engage in some of the

age-appropriate activities independently is being assisted to experience them and helped towards
achieving them with support and practice. This will ensure that they are at least gaining some of the
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brain stimulation that would be typical for their age. It is also necessary to be very cautious when
interpreting studies of brain structure and function in children and adults with Down syndrome. Any
apparent abnormalities described could be the result of the extra chromosome material and the way
that it has affected the brain's development but they could also be the result of delayed and different
progress in learning and mastering new skills.
Summary
For all children, including those with Down syndrome, their developmental progress at any age is
influenced by their biological make-up and their opportunities to learn and develop throughout their
lives. Throughout childhood, much learning is influenced by the social relationships experienced in
families and by social learning and educational opportunities with other children and adults outside
the family. It is also influenced by children's self-confidence and self-esteem. Brain development is
a process which continues through life and brain function and structure are influenced by learning
and activity.

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The development of children with Down syndrome
Children with Down syndrome make progress in all areas of development, but usually at a slower
pace. Some areas of their development are usually more delayed than others, leading many
researchers to now describe a specific profile of strengths and weaknesses. [10,11]
However, before describing this profile in more detail (see 'A specific developmental profile'), it is
important to stress that any large group of children with Down syndrome will vary as widely in
abilities, behaviour, personality characteristics, size and appearance as any group of 'typically
developing' children. Their development is influenced by their biology and by their social and

learning opportunities, like all other children.
The effect of the extra chromosome on the development of babies with Down syndrome is not the
same for all the infants. For example, nearly half are born with congenital heart defects but the other
half have no heart abnormalities, and while some children have bowel abnormalities, most do not. It
is clear that the effects on physical development vary, for reasons not yet fully understood, and it
can be predicted that the effects on brain development and learning abilities also vary between
children. Some of the individual differences in rates of progress are therefore due to biological
differences at birth. Some children with Down syndrome will have a greater degree of disability
than others, however good their family care and stimulation, their therapy and school services. It is
important to stress this point, as many parents wrongly blame themselves when their child makes
slow progress.

Children with Down syndrome are individuals
Children with Down syndrome are all individuals. The conventional stereotypes are inaccurate and
unhelpful. In physical appearance, they tend to look like their parents and brothers and sisters, just
like all other children. They do have some physical characteristics as a result of having Down
syndrome but they do not all look alike. Similarly, children with Down syndrome vary widely in
personality, from being extroverted, friendly and sociable to being introverted and shy. Some
children are mostly calm, while others are anxious. Some children are flexible and adaptable, others
find change difficult and may have a tendency to be obsessional in their behaviours. Some children
are easy to manage, are happy to be co-operative and to conform at home and in school, while other
children are difficult to manage and like to have their own way, or to be in control, at home and at
school.
Similarly, in all areas of development, children with Down syndrome vary in their progress. Some
children will be fairly slow to achieve the motor milestones of reaching, sitting and walking while
others will show little motor delay, and some children with Down syndrome will have more
difficulty learning to talk than others.
The reasons for these differences will be partly influenced by genetic make-up and partly influenced
by the way in which parents, carers and teachers have been able to help the child to adapt to the
demands of growing up. If a child with Down syndrome is more severely delayed than is typical, it

is particularly important that his or her parents have extra help and support from services and from
parent support groups.
Each child with Down syndrome is an individual and he or she has the same needs as any other
child as well as some specific needs, and it is important that everyone concerned with a child with
Down syndrome remembers this. It is helpful to know about the specific needs that are usually
associated with Down syndrome and these are described in the next section.
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Additional difficulties
It is also important to remember that a child with Down syndrome may have additional difficulties,
like any other child. A small number of children with Down syndrome have additional medical
complications, like seizures or other illnesses, which may affect their development. Similarly, a
small number of children have autistic spectrum disorders, attention deficit or hyperactivity
disorder. These additional difficulties affect less than 10% of children with Down syndrome but
they should be recognised and treated in their own right when they do occur. These difficulties are
discussed in a little more detail in the 'Children with more severe developmental delays' section.
Healthcare needs
Children with Down syndrome are at greater risk for some illnesses and for hearing and visual
difficulties. Any child's developmental progress will be influenced by illness or sensory difficulties,
so that it is important that all healthcare issues are understood and addressed. The Health section of
this module provides a guide to the healthcare needs of children with Down syndrome, explains
assessments and treatments and gives references to further reading. It is perhaps worth noting that
some illnesses will present with obvious symptoms but some may not. For example, a child with
limited language who has an ear ache or a tummy ache may not be able to explain that he or she is
in pain, except by being unhappy and, maybe, irritable or difficult. Therefore it is always important
to consider and rule out illness if a child's mood changes, they stop making progress or they are
difficult, before assuming they are simply being unco-operative or naughty.

Achievements at 5 years of age for children with Down syndrome

Most children with Down syndrome can achieve a number of the same developmental goals at 5
years of age as other children. Most five-year-olds are walking, toilet trained, able to feed
themselves and put on at least some of their own clothes.
Most 5-year-olds are able to be part of an age-appropriate group and can conform to the main social
expectations in the classroom. They are able to sit at a table, listen to the story and follow the
teacher's instruction - with some needing no help to do this and others needing some support. Most
children can control their own behaviour and are not anti-social. They have appropriate perception
of the emotions of others, for example, they are able to understand when others are happy, sad or
hurt.
Motor skills, social progress and behaviour are strengths. However, most 5-year-olds with Down
syndrome will have significant delays in spoken language - typically talking in 2 or 3-word phrases,
and the words may be difficult to understand. Some children will have a knowledge of the early
mathematics concepts needed in the classroom, and be starting to count, despite general language
delay. Some children will be reading a sight word vocabulary and know their letter names and
sounds, despite having general language delay.
While many children with Down syndrome will have achieved the skills described above, there will
also be many who have not yet reached these and will need help to do so in their first years in fulltime school. All children move forward through the same steps in each area of development, but
some go at a slower pace for a variety of reasons, some of which have already been discussed.
In the practical modules for 5-11 year olds the authors have tried to take account of this wide range
of development and some of the targets in the 0-5 modules are repeated in the 5-11 modules to
ensure that these cover the needs of most children with Down syndrome as they start school,
whatever their pace of development.
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Achievements during primary school years
The school curriculum for children with Down syndrome may vary according to their school
placement. Children in special education classes or special schools may not receive the same level
of teaching input for literacy and numeracy as the children included in mainstream classrooms.
Similarly the social demands and the social learning opportunities will not be the same in special

education classrooms and schools as in mainstream schools. The speech and language learning
environment may also be different, if the peer group in special education also have significant
speech and language delays.
However, the goals for the children with Down syndrome should be the same in all educational
settings although they may be more difficult to achieve without the support of a typically
developing peer group.[6,7,8]

Figure 2. An overview of developmental progress from five to eleven years in
children with Down syndrome
Social skills and behaviour
Children with Down syndrome should be expected to behave in an age-appropriate and socially
acceptable way at home and at school, and they can achieve this regardless of their level of
cognitive and communication skills. At 5 years of age, a child should be able to sit still and be quiet
in the classroom, to follow the school and classroom rules for playtimes, lunchtimes and assembly,
with some support as necessary but with the same expectations for their behaviour as for the other
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children. It is particularly important that children with Down syndrome are not 'babied' by other
children or by adults. This is a very real risk because they are often small for their age and have
delayed spoken language, and so seem like younger children.

Social development and independence
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Expect and encourage behaviour that is age appropriate for the child's chronological age at
home and at school
Do not 'spoil' or 'baby' a child with Down syndrome. Most children are capable of behaving
in an age-appropriate way. Do not underestimate their ability to do so because they tend to

be small and have language delay.

Similarly at home, children with Down syndrome should be able to behave appropriately at the
meal table and in all family and social situations. They should be going to bed at an age-appropriate
bedtime and sleeping through the night. Their behaviour out in the community, when shopping,
going to the park or in church, for example, should be acceptable. Their social behaviour with other
adults and children should also be socially appropriate.
The targets for the development of social skills and behaviour set out in Figure 1 are not unrealistic
targets for children with Down syndrome, as is illustrated in Figure 2.
While children with Down syndrome should be expected to behave in a chronologically ageappropriate manner and are capable of doing so, it is still not always easy to achieve these goals
with all children. Practical advice on achieving age-appropriate behaviour is provided in the social
development modules.
Speech and language
Speech and language skills should show considerable progress over the period from 5 to 11 years,
but as Figure 2 indicates, this is the most significant area of delay for children with Down
syndrome. Most 5 year olds will begin to join more words together, although still using keyword
phrases, and their speech will become a little more intelligible. Most 5 year olds will be using
spoken words to communicate and may be using signs as well. During the primary years, speech
should become the children's main form of communication and they will steadily learn more
vocabulary and more grammar. By 11 years, some children will be talking in grammatically correct
sentences, with correct word endings and all the little grammatical words in place, while others will
still be using keyword sentences and some will still be using only 2, 3 or 4 words together.
Almost all children with Down syndrome will understand more than they can say during these
years. This can be very frustrating and lead to their ability to understand being underestimated.
Reading, writing and number
Academic progress will be very variable but all children should receive high quality instruction to
progress their reading, writing and number skills from their first year in school. Some children with
Down syndrome will make rapid progress and be able to write short stories, record class work and
read for pleasure at 11 years, while many others will still need full support in the classroom to do
this. These children may understand the main points of the story or the lesson but may need help to

put their words into sentences and to write them down. Some children will be able to calculate with
numbers to 100 or beyond but some will still be mastering counting with numbers to 20.
The important point is that all children progress through the steps of learning to read, write or
calculate in the same order, so each child should be making progress through the same stages, but at
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different rates. Some children with Down syndrome will reach the same levels of competence in
reading, writing and number at 16 years or 20 years that other children with Down syndrome
reached at 11 years. It is the fact of making progress that matters, however slow, and all progress
should be praised and encouraged.
Motor skills
Progress in motor skills and sports will vary between individuals, according to the interests and
aptitudes of the children but will also be much influenced by the opportunities available. Children
who join dancing, swimming or gymnastics groups, for example, can achieve a high level of
competence. Progress in fine motor skills for handwriting and using the computer keyboard for
example vary, but are also influenced by practice. Some children have significantly more motor
skill difficulties than others.
Personal independence
Self-help skills and personal independence should progress steadily, at home and at school, and the
targets for 11 year olds in Figure 1 will be reached by some children with Down syndrome by 11
years, for example, bathing without help and making tea and toast. With appropriate support and
encouragement, most children with Down syndrome will largely achieve personal independence
during their teenage years.
Social independence
Independence in the community will vary. Children with Down syndrome who have been educated
in fairly large mainstream schools will have had the opportunity to learn to find their way around a
large site, to use the canteen for lunch (involving choices and the use of money) and they may be
walking to school with friends, crossing roads or using the bus. Children in special education may
be part of much smaller communities (50 to 70 children rather than 300-400 children), with less

opportunity to achieve these levels of independence. Out of school, children's opportunities will
vary according to the resources of the areas in which they live. Some children may walk to a local
shop or club if they are very close to home, by the time they are 11 years old, but most children with
Down syndrome will become more independent in their communities during their teenage years.
Most children in the 5 to 11 age range will still be fully supervised outside the home.

Achievements at 11 years
In summary, many children with Down syndrome will be on the way to independence in personal
care, able to choose their own clothes appropriately for the day, wash and bathe with minimum
help, make a simple snack, answer the telephone and help with household tasks, but some will still
need support for daily activities. Many children will be quite socially confident in school and at
clubs and only need minimal support to function in these settings. However, some children will still
need a high level of support with their personal care and in social situations.
Many children will be progressing with reading, writing and counting, with some children able to
write short stories and record their work in lessons while other children still need full support to do
so. Some children will be calculating with numbers to 100 or beyond but some will still be learning
to count with numbers to 20. Children will be progressing with their understanding of time and
money at varying rates. It is possible for children to benefit from access to the full school
curriculum, differentiated to their needs, whatever their rate of progress, provided that there is
adequate support in schools for this to be achieved.
14


Most children will be enjoying music, dance, drama, art and sporting activities and developing their
skills at varying rates. In these activities, the enthusiasm and creativity of teachers will have
considerable influence on the way in which children with Down syndrome progress. Participation in
these activities is not dependent on good speech and language skills and individuals with Down
syndrome can often show considerable talent if given the opportunity. Mime and dance activities,
for example, allow children to express their understanding of emotions and behaviour in a way they
cannot do in daily life.

Most children with Down syndrome can behave in an age-appropriate and socially acceptable
manner, at home, at school and in the community, regardless of their level of ability, if they are
expected to do so. This is a very important goal, as behaviour influences all aspects of children's
lives, and the lives of their families. During childhood, difficult behaviour causes stress in the
family and reduces children's learning and social opportunities. In adult life, a person who can
behave in a socially acceptable manner can participate fully in community and social activities. In
the authors' experience, less cognitively able adults with good social behaviour will be working and
leading more fulfilling lives than more cognitively able individuals with poor social behaviour.

Individual differences
Parents and teachers of typically developing children have some idea about expected rates of
development, which they can use to decide whether their children are making appropriate progress
or whether they should be worrying about their progress. For parents and teachers of children with
Down syndrome, guidelines are equally important but more difficult to find and to interpret.
In each of the detailed modules, milestone data is included if available, for example, for speech and
language, counting or reading. Children with Down syndrome vary widely in their rates of progress.
Some children make much slower progress than others and it is not possible to predict or explain
these differences fully at the present time.
Typically developing children also show a wide range of rates of progress, due to both different
genetic make-ups and to social and educational learning opportunities and the range for some 8590% of children with Down syndrome is probably due to exactly the same factors. However, the
development of approximately 10% to 15% of children with Down syndrome is being affected by
additional difficulties. This group of children show the greatest developmental delays and may be
significantly more disabled as adults than the majority of individuals with Down syndrome. This is
illustrated in Figure 3. The most common reasons for the more severe levels of developmental delay
seem to be health issues, autism and attention deficit/hyperactivity disorder.

15


Figure 3. The spectrum of abilities in individuals with Down syndrome

Children with more severe developmental delays

Health problems
In a study by the authors of 90 teenagers with Down syndrome[4] it was clear that one reason for
more severe developmental delay was additional health difficulties such as seizures and
neurological damage. However, for some children with severe developmental delay, the reasons
cannot be identified. The prevalence of medical and psychiatric disorders in people with Down
syndrome varies from those which have a lower incidence to those which are relatively common
and some of these are described in the Health section of this module.

Autism

See also:


An overview of less typical developmental issues in Down syndrome

It was once thought that Autistic Spectrum Disorders (ASD) were not found in individuals with
Down syndrome. This is now known to be incorrect, but the incidence of ASD in people with Down
syndrome remains a matter of some debate. It has been estimated to affect some 3-7% of children
and adults. The reason for this uncertainty is that there have been no large scale controlled studies
of this issue and, more importantly, that the diagnosis of ASD is too uncertain to produce reliable
data.
The diagnosis of ASD is based on obtaining the developmental history of the individual and
information about their behavioural patterns. At present there are no objective findings in ASD
which are of diagnostic value. ASD is a spectrum disorder which covers a very wide range and there
are many behavioural features which are associated with this group of conditions. However, many
of these symptoms are non-specific in that they may be found in a large number of other disorders.
Some of the main characteristics of the condition are:








A lack of behaviours in which points of interest are shared with others.
Inappropriate social behaviour which is not understood by other people.
Abnormal interpersonal relationships, expressed as the inability to develop intimate,
reciprocal communication with other people.
Language usage which is not only delayed but abnormal in kind.
Rigid, unimaginative style of thinking and behaviour.
Play patterns which are repetitive, show a lack of understanding of the symbolic meaning of
toys, and inability to pretend.
Obsessional/repetitive behaviours and preoccupations.

A child displaying one of these characteristics, or even two or three, does not necessarily have
autism. In fact, a number of these characteristics are very common in children with Down
syndrome, reflecting slow development of speech, language and play skills or differences in
temperament. For a diagnosis of autism to be appropriate, a majority of these symptoms need to be
present.

Attention Deficit Hyperactivity Disorder (ADHD)
16


This condition is sometimes confused with ASD, especially if the child has severe learning
disabilities. The level of intrinsic activity and liveliness in children varies enormously and the vast
majority of children with Down syndrome are normal boisterous youngsters. However, a small
number are so overactive that their entire pattern of behaviour is disorganised. They are

characterised by their short attention span, impulsiveness, 'silly' social behaviour, clumsiness and
constant movement which is little affected by environmental influences. The response of children
with ADHD to the commonly used medications is interesting because they become calmer and more
capable when prescribed drugs which are pharmacological stimulants.
The management of this condition consists of a combination of behaviour modification and drugs.
If parents and/or carers observe behaviours in a child with Down syndrome which are similar to
those described above it is important to obtain a diagnostic assessment from a specialist
paediatrician or a child psychiatrist with experience of children with learning difficulties to find out
if the child has additional problems.

17


Meeting the educational and developmental needs of children with
Down syndrome
During the primary school years, children with Down syndrome usually make significant progress.
They will start school and benefit from the quality of the teaching and educational environment.
Their speech and language abilities and motor skills will be the areas of greatest delay and
therefore, they will continue to benefit from speech and language therapy and from occupational
and physiotherapy.
It is important that parents, teachers and therapists work together as a team if possible, with
professionals recognising that the most important influences on any child's development come from
the family and respecting the fact that parents know their child better than anyone else. This
partnership will enable children to make optimal progress and help to support families. Later in this
section, specific goals have been identified for parents and for the key professionals, reflecting their
different roles and expertise. Parents tend to be very knowledgeable about Down syndrome by the
time their child is five years old.
This section begins with an overview of the health needs of children with Down syndrome and their
specific profile of cognitive and developmental strengths and weaknesses, as an understanding of
this profile is essential for planning effective teaching and therapy. This leads to a brief discussion

of education research and goals for teachers, followed by goals for speech and language therapists,
occupational therapists and physiotherapists. The final section discusses family perspectives and
provides goals for families.

Health and sensory impairments
All developmental progress will be affected by illness or ongoing health problems. The common
health issues for parents and teachers of children to be aware of are dealt with in the Health section.
It is particularly important to be alert to hearing difficulties as they affect some 80% of preschoolers
and even mild conductive losses can have a significant effect on the children's development. Many
school age children with Down syndrome have hearing losses and teachers need to be aware of this.
Many children also have visual impairments, and clearly any hearing and visual difficulties will
influence progress in the classroom. If children have hearing aids, it is important that they are
properly maintained and adjusted. If children have glasses, they will need to be kept clean during
the day.

A specific developmental profile
Over the last 15 to 20 years, researchers have made progress in understanding the effects of having
Down syndrome on development, though there is still much more to learn in order to fully
understand how to help the children. Research has identified a specific profile of developmental
strengths and weaknesses.[10,11] This profile is specific to children with Down syndrome, and makes
their learning needs different from most other children with similar levels of cognitive abilities.
However, while this profile is typically associated with Down syndrome, the degree to which any
individual with Down syndrome shows this pattern will vary. It is helpful as a guide to
understanding any child's developmental needs and learning profile. He or she may have all or none
of these characteristics and if he or she does have some, the degree to which they show any strength
or weakness will need to be assessed in order to develop appropriate teaching programmes and
therapy.

18

While children with Down syndrome experience some delays in all areas of development, the extent
of the delay is not the same across all areas of development.

The specific developmental profile associated with Down syndrome
Children with Down syndrome are all individuals and vary in their rates of progress - however, they
tend to have a specific profile of strengths and weaknesses:









Social development and social learning are strengths - the children enjoy and learn from
social interaction with adults and peers
Motor development is usually delayed and may hold back progress in self-help skills,
joining in games, handling equipment and in writing, though the use of gesture to
communicate is a strength
Speech and language development is usually the children's area of most significant delay - it
is more delayed than non-verbal abilities. Most children understand more than they can say
and signing is an important bridge to speaking. Speech intelligibility is usually a difficulty. A
high incidence of hearing difficulties is contributing to speech and language delay.
Working memory development is specifically delayed relative to non-verbal abilities,
particularly the verbal short-term memory component - so that learning from listening is
difficult for the children. Working memory also supports thinking, problem solving and
reasoning. Visual and spatial processing and memory are relative strengths - so that the
children learn effectively from visual information - they can be thought of as visual learners.

Social behaviour- the children have strengths in social skills and in developing ageappropriate social behaviour, if this is encouraged and expected. However, their good social
understanding and empathy leads them to pick up on non-verbal emotional cues, such as
those for anxiety or disapproval, very quickly. They are therefore sensitive to failure and
may use behavioural strategies to avoid difficult situations.

Social understanding and social interactive skills are a relative strength and less delayed than
speech and language skills. Most children with Down syndrome make eye-contact, smile and
interact by cooing and babbling from the first months of life, and show little delay in social
interactive skills. They are socially sensitive and understand the non-verbal cues to emotions, such
as facial expression, tones of voice and body postures, from the first year of life. By school age
most children continue to show good empathy and good understanding of social behaviours, but
they will not have the language abilities to explain how they feel or to negotiate social situations.
Motor skills, including reaching, sitting and walking, are delayed but the main milestones are
steadily achieved and most children become mobile and independent in self-help skills, such as
feeding and dressing, which require motor skills. By school age gross and fine motor skills will be
delayed. This will affect taking part in games and physical education. It will also affect learning to
write. The advice of an occupational therapist will be beneficial for most children. Fine and gross
motor skills will steadily improve with practice, and most children can use the mouse to operate a
computer at 5 years of age.
The authors encourage all parents to find activities for children in the community for sports such as
swimming, gymnastics, horse-riding, dancing or football. These sporting activities contribute to
health and motor skills development - and a sporting skill developed in childhood provides
teenagers and adults with increased leisure activities and social opportunities.
Speech and language skills are more delayed than the children's non-verbal understanding and
reasoning abilities. This is therefore a pattern of specific language impairment. Most children with
Down syndrome understand more language than they can use as a result of specific speech
19


production difficulties. For this reason, learning to sign will help the majority of children to

communicate, to show their understanding and reduce their frustration. Hearing difficulties, usually
due to 'glue ear' are common (see 'Hearing disorders' section) and contribute to speech and language
difficulties.
For most children with Down syndrome, the most serious delay that they experience is in learning
to talk. This is not only frustrating but it has serious consequences for all other aspects of their
social and cognitive development.

See also:



Speech and language development for individuals with Down syndrome - An overview
and
Speech and language development for children with Down syndrome (5-11 years)

As children learn to talk, each new word that they learn is a new concept or piece of information
about their world. Once they can string words together, speech becomes a powerful tool for learning
and for communicating with everyone in their world, and it also becomes a tool for thinking,
remembering and reasoning. We carry out these mental activities using silent speech in our minds.
While we can also use visual imagery to imagine and recall events, reasoning with the use of
language is considerably more powerful. It follows that a serious delay in learning to understand
and to use language will lead to delay in all aspects of mental or cognitive development.
Conversely, if we can improve the rate at which children learn language, this should benefit all
areas of their social and cognitive development.
Children of 5 to 11 years should be receiving regular speech and language therapy targeting
phonology and articulation work as well as vocabulary and grammar development. However,
learning to talk is a daily activity and is mostly learned with parents. The speech and language
modules and checklists are designed to be used by parents, ideally with the support of a therapist,
but on their own if necessary.

See also:


Memory development for individuals with Down syndrome

Working memory development, particularly verbal short-term memory, seems to be specifically
impaired - again not progressing as fast as would be expected for non-verbal abilities - and this has
consequences for the children's ability to learn a spoken language and to process information. All
teaching in the classroom needs to take account of the children's working memory difficulties.
Visual memory and visual processing are relative strengths, while auditory processing and auditory
memory are more impaired. This means that children with Down syndrome should be thought of as
visual learners and all teaching supported with visual materials.

See also:



Reading and writing for individuals with Down syndrome - An overview
Reading and writing for children with Down syndrome (5-11 years)

and

Reading ability is often a strength from as early as two years of age, perhaps because it builds on
visual memory skills, and reading activities can be used to teach spoken language from this time.
During the primary school years the teaching of reading should be a daily priority, with teachers
aware that reading activities can be designed to improve the children's spoken language. Recent
research studies have demonstrated that reading activities may be the most effective way to improve
20

the spoken language of children with Down syndrome and the most effective way to improve their
working memories. [21,22]

See also:



Number skills for individuals with Down syndrome - An overview
Number skills for children with Down syndrome (5-11 years)

and

Number seems to be relatively more difficult for children with Down syndrome and their number
skills are often delayed relative to reading skills. Current research indicates that for children with
Down syndrome, their early number abilities keep up with their non-verbal mental abilities.
Teaching materials should make maximum use of visual supports and materials such as Numicon.[20]
Social behaviour is a strength as children with Down syndrome are less likely to develop difficult
behaviours than other children with similar levels of cognitive delay. However, children with Down
syndrome are, as a group, more likely to develop difficult behaviours than non-disabled children of
their age.

See also:



Social development for individuals with Down syndrome
Social development for children with Down syndrome (5-11 years)

Most children with Down syndrome are socially sensitive and understand the non-verbal cues to
emotions, such as facial expression, tones of voice and body postures, from the first year of life.

They can behave appropriately in showing concern, or becoming upset. However, this sensitivity
can also make the children vulnerable as they will quickly pick up on negative emotions such as
anger, dislike or rejection. As they are usually not able to explain how they feel, their distress will
be expressed in behaviour. Some children with Down syndrome can be quite naughty and difficult
to manage at times, at home or at school, and they may use their understanding of people's
behaviour to be unco-operative and the centre of attention. It is always possible to change behaviour
and to encourage and teach age appropriate behaviour. However, it is not easy to change difficult
behaviours that have become habits, and most difficult behaviours can be avoided with calm
routines and good control from infancy.
In order to provide detailed overviews of the research and practical advice relevant to the
development of children with Down syndrome in this modular series, individual modules address
social development and behaviour, and motor development, and four cognitive areas - 1) speech,
language and communication, 2) reading and writing, 3) number and 4) working memory skills.
This division is somewhat arbitrary and reflects the focus of the team of authors. Self-help skills are
covered in social development and behaviour.

Education
It can be argued that the most important influence on a child's progress between 5 and 11 years is
their school experience and this is equally true for children with Down syndrome. Finding the right
school place will usually be more difficult for parents of a child with Down syndrome than for
parents of typically developing children.

Inclusive or special education

21


Education for children with Down syndrome







all teachers need to know about the specific cognitive profile associated with Down
syndrome, and adapt their teaching appropriately
inclusive education leads to very significant gains in spoken language abilities
inclusive education leads to equally significant gains in reading, writing and arithmetic
personal independence skills and behaviour progress similarly in special or inclusive
education
the development of friendship skills needs further research, especially for teenagers, who
may lose out on close and mutual friendships in inclusive settings

The significant benefits of inclusive schooling have been mentioned earlier in this module. The
available studies all indicate very significant positive effects of inclusion in school on the spoken
language development of children and teenagers and on their academic progress, particularly for
reading, writing and arithmetic. [7,8,9] The personal independence, social independence and behaviour
of the included children have been reported to be either the same or better when compared with
equally able peers in special education settings. These benefits result from being immersed in the
typical social world and the normal spoken language world of the mainstream school as well as the
increased support for learning and access to the same curriculum as the other children. The authors
and their colleagues have been directly involved in the support of children with Down syndrome in
mainstream schools for the past 13 years and they believe that the level of daily support for reading
and writing and the access to the full curriculum, alongside non-disabled peers in the classroom, has
played a significant part in the speech and language progress of the children. It is not possible to
create the same learning environment in a special class or special school, however dedicated the
teachers. The typically developing peer group is essential for an optimum educational environment.
At present, the social aspects of inclusion in the UK are not as good as they could be in two ways.
Firstly, schools are not yet as confident in promoting social inclusion as they are in providing good
access to the curriculum. Many schools have yet to recognise that the main resource that they have

to support the social inclusion of children with disabilities is all the other children in school. The
peer group could usually be much more actively involved in supporting other children, but this
requires planning and support. All children need to have the opportunity to discuss disability issues
and to be actively supported in learning how to support children with significant disabilities. North
American schools tend to be further advanced on this front and therefore children with disabilities
are more fully part of the school and the home communities.

See also:



Education for individuals with Down syndrome - An overview
Education for individuals with Down syndrome - whole school issues

Secondly, the child with a specific or significant disability may not have the benefit of a peer group
of disabled children, and, in the authors' view this peer group is important. It is good to have some
opportunities to play with friends on the basis of equality of skills and understanding. Friendships
with non-disabled peers are not quite the same and are often 'helping' in nature rather than fun and
mutually supportive relationships. Identity issues become important towards the end of the primary
school years and in adolescence. Successful adult adjustment, for everyone, requires a realistic
appraisal of who we are and our strengths and weaknesses. It is important for children with
disabilities to have friends with similar disabilities for mutual support and understanding. It is good
to know that you are not the only one facing the world with your particular difficulties. It is
important to know adults with similar disabilities to provide positive support and realistic role
models for adult life. It is also important to be able to form close and mutually supportive
friendships and partnerships and successful ones are usually based on similar abilities and interests.
22


These peer group issues would not exist in a fully inclusive school system, with all children with

moderate or severe learning difficulties in neighbourhood schools, but at present, in the UK and in
other countries, children with Down syndrome are likely to be included in mainstream schools
while their learning disabled peer group are still in segregated schools or classes. Given the
recorded benefits of inclusive education, everyone interested in the welfare of children with Down
syndrome should be working towards ensuring that school systems become fully inclusive.
Choosing a mainstream placement will not be straightforward, as parents often have to battle for a
place and then may be faced with a school situation where the teachers are not confident about
meeting their child's needs. There is still much education and training needed in most countries if
teachers are to feel well equipped to teach in fully inclusive school systems. Parents of a child in a
mainstream placement will also find that they have to be more involved and take more
responsibility for supporting the education of their child, going to regular meetings and working
closely with the teachers and Learning Support Assistants. Teachers in mainstream schools will find
that they need to develop a close partnership with parents when teaching a child with a disability
such as Down syndrome.

Meeting the specific educational needs associated with Down syndrome in special or
mainstream classes

See also:


Accessing the curriculum - Strategies for differentiation for pupils with Down syndrome

The educational needs of children with Down syndrome are the same whether they are in
mainstream or special classes. Their special educational needs should be met, taking account of
priorities and adaptations to teaching methods in all classrooms. The key goals are set out in the list
below and developed more fully in the specific topic modules for this age range.

Goals for teachers of 5-11 year olds with Down syndrome













to involve the child in all aspects of school life and school routines
to support social independence in school and the development of friendships with peers
to support the development of play skills and inclusion with peers in break and lunchtimes
to encourage, model and expect age-appropriate, socially acceptable behaviour at all times
to be familiar with the research findings which demonstrate a specific cognitive profile
associated with Down syndrome (see 'A specific developmental profile' section) and to adapt
teaching methods appropriately
to provide access to all areas of the school curriculum at a level appropriate for the
individual child
to recognise the importance of teaching reading and writing daily, to develop speech,
language and working memory skills as well as literacy skills
to have clear targets for speech and language work for each child, and identify how these
can be absorbed into all aspects of the curriculum
to facilitate independent learning and the ability to work and to learn as part of a group
to make full use of computer aided learning, with appropriate software for individual and
group work

Approaches to teaching

23


Approaches to teaching and learning
Children learn in a variety of ways:








through play and supported play
through everyday experiences during daily life
through modelling and scaffolding during play and daily activities
through planned, structured teaching, when tasks are broken into small steps, modelled and
practised
practice is needed to ensure a skill is learned and remembered
practice leads to consolidation of skills and their flexible use in new situations
practice leads to 'automatisation' of skills, so that they become easily available as part of
more complex tasks

In addition to stressing these goals it may be useful to draw attention to teaching methods which
will help children with Down syndrome and to the importance of practice and automatisation for
their progress. All children with significant learning difficulties need tasks to be broken down into
smaller steps, and each step mastered before attempting the next, in order to learn successfully.
They may also need help with generalisation - that is, explicit demonstrations of how to apply the
new skill in situations other than the one in which it was learned. In addition, as all children master
new skills, practise until the skill is overlearned is very important. This leads to the skill becoming

automatic (can be carried out without conscious control and effort). This will reduce the load on
working memory and free up working memory capacity for other aspects of a complex task.
Structured teaching and learning
There are various ways in which children can be helped to learn and there are debates about the
advantages and disadvantages of different approaches. Some observers stress that for most children,
progress is by natural learning through play and everyday social experience and therefore structured
teaching programmes may not be an appropriate way to help children.
However, children with learning difficulties and delayed development often do not have the skills
that are needed to learn in the more natural ways - for example, the motor skills to grasp or turn
parts of toys, or the spoken language skills to join in a game or a conversation - so their ability to
create their own learning experiences is reduced. In addition, they may need more examples of an
association (for example hearing 'cat' and seeing the cat) before they learn, or more practice at a
task (for example drinking from a cup, posting shapes into a box) before they master it. These extra
learning opportunities will only happen if they are planned. The ideal compromise is to try to
provide the extra learning experiences within ordinary daily activities and play as much as possible.
The authors contributing to these modules believe that, in order for children with Down syndrome
to make progress as fast as they are able to, they need to experience good parenting and stimulating
everyday lives and they need some special structured teaching sessions each day.
The structured teaching sessions should try to combine natural learning approaches with more
structured ones. In the natural learning situations, parents, teachers, brothers and sisters and
grandparents use modelling, imitation and scaffolding, to show children how to do things and all
these strategies will help children with Down syndrome. In addition, structured teaching will
provide simplified and repeated opportunities to learn new skills, which can then be practised and
mastered when they occur in everyday contexts. The dividing line between everyday learning and
structured teaching is a fine one. For example, reading books together provides an ideal opportunity
to teach new words and concepts to children, and can be used deliberately to increase learning
opportunities by choosing books for vocabulary teaching, or shapes, colour or number. In other
24

words book reading is being developed more consciously as a structured learning opportunity but it
is a natural one as well.
Structured teaching may be taken a step further when the task to be learned is broken down into
small steps and an errorless learning approach is used. Errorless learning simply means that the
teacher prompts the child at each step as necessary, so that they successfully complete the task. This
allows the child to learn how to succeed by imitation and practice rather than by trial and error. The
teacher waits to allow the child to do the steps that he or she can without help but offers support
before the child makes a mistake - a rather more deliberate form of natural scaffolding of children's
learning. The advantages of errorless learning are that the child can succeed every time and be
praised for this and the child is practising the correct steps to success each time. If left alone, the
child may not be able to work out how to do the task and fail every time. The disadvantage of
errorless learning is that the child does not learn how to solve the problem or how to experiment and
try new strategies. In the authors' view, teaching and learning should be seen as a process over time
and the skill of the successful teacher is in knowing when to provide maximum help using errorless
learning techniques (at the start of learning a new task), how to slowly reduce that help (when the
child can complete the practised task unaided) and when to encourage some problem solving or
'trial and error' learning. The successful teacher will find similar tasks for the child to tackle, to
generalise their learning to new situations and to ensure that the skill is practised, consolidated and
understood.
Practice
Practice is an extremely important concept in children's development. All learning involves being a
novice and making mistakes, becoming successful at the task but only with thought and effort, and
then mastering the task through practice until it becomes quick and easy to do successfully. At this
stage the task has often become automated - that is, it can be carried out without the need to
consciously think or plan the action. Practice also continues to increase the skill and efficiency with
which the task can be carried out.
It is easy to see how this applies to learning and perfecting motor skills such as drinking from a cup,
using a knife and fork, dressing, writing, dancing, playing a musical instrument, playing tennis or
driving a car, but it also applies to mental skills such as thinking, talking, and reading. As children
learn to talk, the words that they produce only approximate to the sounds of adult words. As they

practice, the words become more and more quickly and accurately spoken. As children learn to
read, word recognition is effortful and each word has to be thought about. As children practice read the same words over and over - word recognition becomes quick and automatic. Therefore, as
children progress year by year, the improvement that they show is affected by the amount of
practice that they have in the ordinary use of the skill (as in talking) or in the teaching and learning
situations in preschool or school classroom. The faster children learn at the early stages of
mastering a new skill, the more practice they have over the next weeks and months. Children who
learn to talk with ease and start early, chatter away everyday from 14 or 15 months of age - getting a
great deal of practice to improve their speech clarity, to put their thoughts into words and to be
communication partners. Children who learn to read with ease in the first months in school, read
more books and get much more reading practice than children who are struggling, leading to even
bigger gaps between the progress of the fast and slower learners. It is the slower learners who need
more practice to succeed and the usual effect of their difficulties is that they get less practice.
Automatisation
Automatisation of skills through practice leads to them being established in the brain and easy to
access. Brain imaging studies can track this progress from effortful to automatic processing and the
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