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Presented at ISEC 2000

The Reading Skills of Children with Down Syndrome

Pam Bayliss - University of York, UK

Contributions from: Maggie Snowling and Peter Hatcher


Previous research has found that children with Down's syndrome are able to learn to read. Their reading is at an early stage and typically consists of up to 100 common words. They have difficulty in developing phonologically based reading and comprehension skills. As a result, they have difficulties in accessing a mainstream curriculum.

The purposes of this study are to:


The population is children with Down's Syndrome who attend either mainstream primary and secondary schools in three Yorkshire Local Education Authorities, or special schools. The first group of children have attended mainstream schools for at least two years and are all from Key Stage 2 or secondary school age groups.

A sub-set of children will be used in a longitudinal study to evaluate the effects of the intervention.

This is an ongoing study. It is anticipated that the results will be available by July, 2000.


This talk deals with current research on the reading skills of a group of children with Down Syndrome attending mainstream schools in a northern education authority As an introduction the characteristics of children with Down Syndrome will be discussed.

In addition a brief review of 2 previous studies into the reading skills of children with Down Syndrome will be given. The current study will then be discussed and preliminary results of the 1st stage of the study will be presented.

Wishart (1996) summarised the characteristics of children with Down Syndrome as the following:-

Based on these characteristics Buckley, Bird and Byrne (1996) from the Sarah Duffen Centre at Portsmouth University (Portsmouth group) ask the questions:-

1) What levels of literacy skills can we expect children with Down's Syndrome to achieve?

2) Are they using the same cognitive strategies to read as other typically developing children?

The Portsmouth group distinguish between 3 reading strategies: visual phonological context. On the basis of their studies they conclude that 'Down' children are:-

They base their reading studies on the model developed by Frith (1985) which can be summarised as:

3 stages of reading development

logographic (sight words )

alphabetic (words sounded out)

orthographic (automatic identification)

The conclusions from the Portsmouth group are that children with Down Syndrome use the same strategies as normal children but move on from each stage at a much slower rate.

What can be expected in terms of reading skill for children with Down Syndrome?

Fowler (1995) put forward the hypothesis that successful readers with Down Syndrome should meet the same prerequisites for reading that have been established in reading research of normal children. Normal children who learn to read have skills in : *phonological awareness *verbal short term memory *word retrieval. The focus of this talk is to look at the phonological skills shown by readers with Down Syndrome.

What is Phonological Awareness?

Fowler et al (1995) defines it as:

oral language ability to consciously attend to sound structure of the language without regard to its meaning.

It is a skill needed to : 1) detect rhyme 2) segment words 3) categorise words (develop awareness of sounds within words)at the level of : syllable onset/rime phoneme

Phoneme awareness is linked to

- decoding which is linked to
- word recognition Phonological Awareness is 'positively correlated with the acquisition of literacy in the normal child.' (Bryant and Goswami 1987)

Do Children with Down Syndrome show evidence of phonological awareness in their reading?

Studies carried out by Cossu et al in (1990)and (1993) appear to indicate they do not. The 1990 paper was a case study of an Italian boy with low IQ who learned to read text and single words but had no conscious phonological awareness.

The second Cossu et al study(1993) had 10 Italian children with Down Syndrome matched for reading ability with 10 younger normal children Down's Syndrome:

age 8.0-15.8 IQ 40-56 (WISC)
normals age 6.9-7.9 IQ 99-136 (WISC)

The tasks:

1) reading single words: 2) 4 metalinguistic tasks: phoneme segmentation (phoneme counting) phoneme deletion oral spelling: phonemic synthesis (blending)


showed that DS children had learned to read to an approx. reading age of 8 but had very poor performance on phonological tasks.


The Paper takes the view that individuals with Down Syndrome can learn to read single words but, due to their poor performance on several tasks designed to show the presence of phonological awareness, they do so in the absence of such skills.

'reading should be taught by teaching reading skills (including letter-sound correspondence) and not phonological awareness training'.

When evaluating the results of this study the following should be considered:-

1) The IQ difference between subject groups
2) The emphasis on auditory skills - an area with which children with Down Syndrome have particular difficulty.
3) The memory load of tasks.
4) The speech production requirement of the tasks.

Other researchers have also commented on this study, their findings are summarised as follows:-

Byrne (1993)

1) other factors e.g. attention /working memory may mask the true levels of phonological awareness. Down children may have fragmentary phonological awareness. 2) No phonological awareness measures were taken before reading instruction began.

Morton and Frith (1993)

1) Down children had an equivalent mental age of normal 5 year olds. Cossu states that a normal 5 year old would not be able to do the tasks either so shouldn't be surprised if the Down's group failed.
2) Down syndrome children may lack 'some process that underlies metalinguistic ability' and as a result acquire their grapheme-phoneme representation system in a different way.

Bertelson (1993)

Tasks too difficult for Down children
Poor design

A different study, again with an emphasis on phonological awareness was carried out by Mercer, Snowling and Hulme (1997) in York (England) This study involved 30 individuals with Down Syndrome and 30 normal readers acted as controls , matched on reading level. The subjects were assessed on a large battery of reading and phonological measures. Down Syndrome: age range: 6:11-17:06 Normal readers: age range: 4:06-6:05

The conclusions from this study were :-

1) reading skills are related to phonological awareness
2) Down Syndrome participants had a poorer knowledge of letter sounds than names.
3) Down Syndrome participants had significant difficulty with rhyming skills. It was difficult to disentangle the effects of teaching.

Comments on the York study:

1) Didn't distinguish between mainstream school and special school.
2) Special schools traditionally teach reading using a look-say method
3) Mainstream schools teach through an initial sight recognition approach but then teach letter sounds and names, and then phonological representations of 'onset and rhyme.'
4) The control group was much younger and would have received less reading instruction than the Down's group.

What is the current study?

The current study has been designed to address the difficulties with the Cossu and York studies. The aims are to:

1) To replicate findings from Mercer et al 1997.
2) To survey the reading skills of a population of children with Down Syndrome who are attending mainstream schools. The hypothesis is that they will show evidence of phonological awareness as they have been exposed to the same forms of reading instruction as normally developing children.
3) To carry out 2 teaching intervention strategies on a sample of the children in an attempt to boost reading skills and phonological awareness.

The hypothesis is that the intervention based on phonological awareness will bring about the most improvement.

The initial assessment battery has been devised to provide a description of the reading skills of the children with Down Syndrome .

It takes account of the auditory and memory difficulties such children may have and attempts to provide a 'visual prop' without invalidating the test scores.

The battery has so far been administered to a group of 34 children with Down Syndrome attending 25 mainstream primary and secondary schools in 1 northern education authority. The assessment battery can be divided into :

Reading measures:

BAS reading Hatcher Early Word Reading [a test of 42 most commonly found words in English reading schemes and correlated with the BAS] Test of environmental print [30 logos of print in the environment e.g 'Tesco' 'Mars' 'Heinz' were trialled in a nursery school. The 12 most commonly recognised were incorporated into a test.] Reading accuracy [50 words from the child's current reading book were placed on a grid and a measure of reading accuracy was obtained by counting the number of words correctly read]

Phonological Measures

Nursery rhyme [ a nursery rhyme was represented pictorially. The nursery rhyme was recited and the child asked to give the missing word.] Letter knowledge test (from PAT) [ each letter was individually presented on a card. The child was asked to provide the name or sound of the letter either was acceptable.] Rhyme detection (from PAT) [a target picture and 3 stimulus picture were presented. The child had to point to the picture that rhymed with the target picture. E.g. Cat: fish. hat. Word completion -syllables (from PAT) [pictures were shown individually. The picture was named , then repeated , the child was required to give the end syllable of a 2 syllable word] Simplified word completion [ an identical test to the above which contained compound words e.g. 'football'] Non-word reading ( a modified Snowling) [initial letter sounds, 2 letter vowel/ consonant, 1 syllable non-words, 2 syllable non-words were all presented individually to the child who read them aloud.]

Cognitive Measures:

BPVS receptive vocabulary [the child was asked to select from a choice of 4, a picture that represented a target word e.g. wooden] WISC picture completion [the child was asked to point to what was missing from a picture] WISC object assembly [the child was asked to assemble pieces to make a shape e.g. horse] WISC block design [ child was asked to copy a pattern using bi-coloured blocks] (These scores gave a composite Performance IQ score) Bus Story [a test of narrative speech, the child is read a story with a picture book and then re-tells it]


Based on 34 children All in mainstream primary and high (School Years 2-13)

Age range: 7.0-16.5 years

Mean age 10 yrs.10m

ST D 2.81

Reading measures

Test Mean ST.D Range
BAS 20.91 19.05 0-61
Hatcher EWR 27.29 13.81 2-42
Environmental P 8.5 2.68 2-12
Reading Acc. 87.3 20.8 10-100

Phonological measures:

Test Mean ST.D Range
Nursery Rhyme 7.71 2.70 1-10
Letter K'ledge 20.62 7.04 0-26
Rhyme Det. 3.76 2.20 0-10
Non-word Read. 13.68 11.14 0-39
Cmp. Wd Compl 13.53 6.24 0-20

Cognitive Measures:

Test Mean ST.D Range
BPVS (raw) 45.50 12.57 22-73
Perf IQ (Wisc) 50.76 5.84 46-62
Bus Story 17.85 8.45 1-37


1) The WISC scores do not reflect the true skill of individual children because of the possibility of scoring within a range for each sub-test. A child who obtained a score of 0 and a child who obtained a score of 15 for a test would have received the same scale score of 1 even though their performances were different. An IQ of 46 was the lowest score obtainable.

Table1: correlations between age + cognitive and phonological assessment tasks:

AGE   0.364 -0.425 0.431 0.214 0.214 0.107 0.233 0.507 AGE
BPVS     0.048 0.629 0.352 0.373 -0.142 0.352 0.643 BPVS
PERF IQ       0.185 0.104 0.299 0.010 0.22 0.016 PERF IQ
BUS ST         0.569 0.547 0.093 0.401 0.629 BUS ST
NRS R           0.462 0.176 0.247 0.541 NRS R
LET KN             0.285 0.585 0.66 LET KN
RHY DET               0.269 0.186 RHY DET
NWR                 0.607 NWR
WD CPL                   WD CPL

Table 2: Correlation between age +reading and phonological assessment tasks:

AGE       -0.112 0.214 0.214 0.107 0.233 0.507 AGE
BAS       0.427 0.379 0.575 0.135 0.898 0.585 BAS
HAT EWR       0.523 0.390 0.726 0.232 0.788 0.625 HAT EWR
ENV PRT       0.275 0.142 0.530 0.113 0.677 0.528 ENV PRT
RD ACC         -0.057 0.448 0.050 0.417 0.144 RD ACC
NRS R           0.462 0.176 0.247 0.541 NRS R
LET KN             0.285 0.585 0.66 LET KN
RHY DET               0.269 0.186 RHY DET
NWR                 0.607 NWR
WD CPL                   WD CPL

From the correlation tables it can be seen that rhyme detection does not correlate with any other task.

The children found this test difficult due to the complexity of the test material. For example in a picture with a target word sock showing the picture of a sock and 3 other pictures, clown, shoe and clock.

Some children chose a picture of shoe This was because sock and shoe are a paired associate.

However where there was no obvious paired associate e.g. target word bell showing the picture of a bell and 3 other pictures, bottle, dress and shell.

More children chose the picture shell From the reading scores it is possible to divide the children into 3 groups

Group 1: Emergent Readers:11

Name Chron. Age BAS (raw) Hatcher
EWR (42)
Enviro Print (12) Read
Age Bk.
Acc. %
Ri 10.03 1 13 9 5.6 -5.11 98
Jn 10.3 4 4 10 6-6.5 68
Js 8.2 0 9 2 5-5.06 90
Je 7.9 5 11 5 5.6-5.11 82
Ch 2 9.1 4 5 6 6.6-6.11 86
Da 8.5 0 3 7 5-5.06 50
Na 9.11 0 2 4 5.6-5.11 10
Za 11.10 4 16 8 6-6.5 68
My 15.11 4 22 9 5-5.06 30
Rb 16.6 7 13 6 6.6-6.11 66
Ad 7.0 8 19 8 5-5.06 64

Group 2 Developing readers: 11

Name Chron. Age BAS (raw) Hatcher
EWR (42)
Environ Print. Reading
Age Bk.
Read Acc %
Kry 12.6 26 39 10 6.6-6.11 100
Cl 12.9 17 35 7 6.-6.5 100
Dav 16.6 29 37 11 7.6-7.11 100
Dev 13.3 14 22 8 5.-5.6 98
Is 7.8 5 20 3 5.6-5.11 100
Le 8.2 6 24 6 5.6-5.11 84
Ai 9.7 5 20 10 6-6.5 84
Jp 8.10 17 34 9 6.6-6.11 95
Mt 8.11 17 34 9 6.6-6.11 94
Ch 8.10 9 29 7 7.6-7.11 98
Ky 7.10 24 37 10 5.6-5.11 96

Group 3 Proficient Readers: 12

Name Chron. Age BAS (raw) Hatcher EWR (42) Enviro Print (12) Read Age Bk. Read Acc %
Sc 13.8 45 41 12 7.6-7.11 68
Ch 1 15.1 35 42 12 7.6-7.11 100
B 16.6 49 41 12 7.6-7.11 100
Th 11.1 25 39 9 8.-8.5 100
R 11.2 41 42 8 7.6-7.11 94
Ni 11.3 42 42 11 8.5-8.11 98
M 12.11 29 42 10 7.-7.5 100
Bec 9.5 59 41 12 7.6-7.11 100
Kell 9.3 28 38 7 7.-7.5 94
Kir 9.10 31 41 9 7.6-7.11 98
Reb 9.6 59 42 12 8.6-8.11 100
An 9.6 61 41 12 7.6-7.11 100

An analysis of variance was carried out using composite Z scores for reading and phonology with age and IQ This model assumes that independent variables affect the dependent variable-reading. The calculation shows how much of the variance can be accounted by the other variables. In this case the variable 'phonological awareness' accounts for 35% of the variance. Age and IQ account for 20% of the variance.

Hierarchical Regression Predicting Reading Skill.

  R2 change P _
1. Age
.203 .033
2. Phonological awareness .353 <.001


From the 34 children assessed so far it can be seen that phonological awareness is contributing to their reading skills.

The next phase of the study:

The next phase of the study will involve:-

1) designing a teaching intervention schedule based on 2 methods of teaching reading, both multi-sensory, 1 focusing on a whole word visual approach and the second on a phonological awareness approach. The children will be assigned to 1 of the intervention groups and taught individually for 3 ¾ hour sessions a week for 5 weeks. A new test battery to include visual measures, comprehension and memory tasks as well as more in-depth phonological awareness tasks will be developed and administered pre and post intervention. It is expected that the children assigned to the phonological awareness approach will make the most sustained progress.

2) In addition a group of children with a statement of moderate learning difficulties from special and mainstream schools will be assessed on the first assessment schedule to provide a contrast group to the children with Down Syndrome group. Both have intellectual impairments but do they learn to read in the same way?

The results divide the participans into 3 groups:

1. Emergent readers: 1.1

  BAS EWR Env. Pt Reading age of book
range 0 - 8 2 -22 2-10 5. -6.11

2. Developing readres: 11

  BAS EWR Env. Pt Reading
range 2-9 20-39 3-11 5.0-6.11

3. Proficient Redares: 12

  BAS EWR Env. Pt Reading age of book
range 25 - 61 37-42 7-12 7.0-8.11

Next Phase

1) Continue to assess Leeds DS children (15) 2) Begin to assess York DS children (10) 3) Begin to assess York moderate learning difficulties children to form a contrast group. (30) 4) 5) Select children for 2 intervention groups. 6) Case-study approach for exception readers (5). 7) Longitudinal approach to young subjects (10).


1) Wishart J G, (1996) 'Learning in Young Children with Down's Syndrome: Developmental Trends. In Rondal JA, Perera J, Nadel L Comblain A (eds) 'Down's Syndrome Psychological Psychobiological and Socio-Educational Perspectives 'chapter 6.p81-96.London Whurr.

2) Buckley S, Bird G, Byrne A, (1996) 'The Practical and Theoretical Significance of Teaching Literacy Skills to Children with Down's Syndrome In Rondal JA, Perera J, Nadel L Comblain A (eds) 'Down's Syndrome Psychological Psychobiological and Socio-Educational Perspectives 'chapter8 p119-128.London: Whurr.

3) Frith U, (1985) 'Beneath the Surface of Developmental Dyslexia. In In Patterson K E, Marshall JC Coltheart M (eds.) 'Surface Dyslexia' Hove.UK : Erlbaum .

4) Fowler A E, Doherty BJ,Boynton L (1995) , 'The Basis of Reading Skill in Young Adults with Down's Syndrome.' In Nadel L, RosenthalD (eds) 'Down Syndrome: Living and Learning in the Community' p182-196,New York: Wiley-Liss .

5) Bryant P, Goswami U (1987) 'Phonological Awarenss and Learning to Read : In Beech J, Colley A, (eds) 'Cognitive Approaches to Reading (pp213-243): Chichester: Wiley

6) Cossu G, Marshall JC, (1990) 'Are cognitive skills a prerequisite for learning to read and write?: Cognitive Neuropsychology 7:p21-40

7) Cossu G, Rossini F,Marshall JC (1993) 'When Reading is acquired but phonemic awareness is not: A study of literacy in Down Syndrome: Cognition 46:p129-138

8) Byrne B, (1993) 'Learning to read in the absence of phonemic awareness? A comment on Cossu, Rossini, and Marshall (1993): Cognition 48: p285-288.

9) Morton J Frith U ,(1993) 'What lessons for dyslexia from Down's Syndrome? A Comment on Cossu, Rossini, and Marshall (1993): Cognition 48: p285-288.

10) Bertelson P (1993) 'Reading acquisition and phonemic awareness testing: how conclusive are data from Down's syndrome? Remarks on Cossu, Rossini, and Marshall (1993): Cognition 48: p281-283.

11) Mercer R, Snowling M, Hulme C (1997) 'Phonological Skills and Learning to Read' (unpublished thesis)

Pamela Baylis B.Sc.(Econ.), P.G.C.E., Dip. Sp.L.D., M.Ed. July 2000. [supervised by Prof Maggie Snowling /Dr. Peter Hatcher]

Contact Address: The Centre for Reading and Language , Department of Psychology, University of York, Heslington, YO 15DD: Tel: 01904 43436





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