Sandy Alton
Specialist Advisory Teacher, Oxford LEA
Published by: The Down's Syndrome Association (UK)
  Reprinted with the permission of Susannah Seyman, Information Officer
The Down's Syndrome Association (UK)
155 Mitcham Road
London SW17 9PG, UK
0181-682 4001 Fax: 0181-682 4012

Aim of this Booklet:

Many more children with Down's syndrome are now entering mainstream schools. This is the result of several factors. Pressure from parents with support from voluntary organisations led to the 1981 and 1993 Education which encouraged LEAs to integrate children with special needs into mainstream schools if the parents so wished; more recently the 1997 Green Paper, Excellence for All Children: Meeting Special Educational Needs, with its push for inclusion, proposed that more children with SEN should attend mainstream schools.
Inevitably, many teachers will find the idea of including children with Down's syndrome into their classrooms daunting and will initially be apprehensive. However, experience shows that most teachers have the skills to understand these childrens' particular individual needs and are able to teach them effectively and sensitively.
This booklet is to inform teachers about the learning profile typical of children with Down's syndrome and good practice in their education, thus paving the way to successful inclusion.

Why Inclusion

There are many reasons why a child with Down's syndrome should be given the opportunity to attend mainstream school Increasing amounts of research rave been published enhancing knowledge about he capabilities of children with Down's successfully syndrome, and their potential to be successfully included, while parental awareness of the value and the benefits of inclusion has grown. Moreover, inclusion is non-discriminatory and brings both academic and social benefits.



Successful inclusion is a key step towards preparing children with SEN to become full and contributing members of the community, and society as a whole benefits. Typically developing peers gain an understanding about disability, about tolerance and how to care for and support other children with special needs. As David Biunkett writes, in his Foreword to the 1997 Green Paper "[where] all children are included as equal partners in the school community, the benefits are kit by all".

A Positive Attitude

However successful inclusion does not happen automatically: Experience shows that one of the most important ingredients in successfully implementing inclusion for children with special needs is simply the will to make it succeed. The attitude of the whole school is therefore a significant factor a positive attitude solves problems of itself. Schools need a clear and sensitive policy on inclusion and senior management teams which are committed to the policy and supportive towards the staff, helping them develop new skills within their classrooms.

Some Facts about Down's Syndrome

A Specific Learning Profile Not Just Developmental Delay

Children with Down's syndrome are not just generally delayed in their development and therefore merely in need of a diluted curriculum. They have a specific learning profile with characteristic strengths and weaknesses. Being aware of the factors that facilitate and inhibit learning will allow teachers to plan and implement meaningful and relevant activities and programmes of work. The characteristic learning profile and learning styles of the child with Down's syndrome, together with individual needs and variations within that profile, must therefore be considered.
The following factors are typical of many children with Down's syndrome. Some have physical implications; others have cognitive ones. Many have both.

Factors that Facilitate Learning

Strong visual awareness and visual learning skills including:

Factors that Inhibit Learning

A brief account of each of these inhibiting factors follows, with some strategies to address them which make use of the childrens' likely strengths and weaknesses in order to build a successful teaching programme. Many of these strategies will be recognisable as basic good teaching practice and so will be equally suitable for other children in the school.

Visual impairment

Although children with Down's syndrome tend to be very good visual learners and are able to use this strength to access the curriculum, many have some sort of visual impairment: 60-70% being prescribed glasses before the age of seven and it is important to allow for any specific visual impairment they may have.


Hearing impairment

Many children with Down's syndrome experience some hearing loss, especially in the early years. Up to 20% may have a sensorineural loss, caused by developmental defects in the ear and auditory nerves. Over 50% are likely to suffer from a conductive hearing loss due to glue ear caused by frequent upper respiratory tract infections which often occur as a result of smaller sinuses and ear canals. It is particularly important to check childrens' hearing, as this will affect their speech and language.
Clarity in hearing can also fluctuate daily and it is important to ascertain that inconsistencies in response are due to hearing loss rather than lack of understanding or poor attitude.


Fine and gross motor skills

Many children with Down's syndrome have poor muscle tone and loose joints, (hypotonia), affecting their motor co-ordination. This can delay mile stones in motor development, restricting early years experiences and delaying cognative development. In the classroom, the delay in development in writing skills is particularly affected.


Children may have more difficulty participating in team games and small group or partner activities with set objectives may need to be provided. In the classroom, the ability and speed at which children with Down's syndrome can write can be particularly affected. (See section on Writing Skills).

Speech and language difficulties

Children with Down's syndrome typically have a speech and language impairment and should be seen regularly by a Speech and Language Therapist who can suggest individualised activities to promote their speech and language development.
The language delay is caused by a combination of factors, some of which are physical and some due more to perceptual and cognitive problems. Any delay in learning to understand and use language is likely to lead to cognitive delay. The level of knowledge and understanding and thus the ability to access the curriculum will inevitably be affected. Receptive skills are greater than expressive skills. This means that children with Down's syndrome understand language better than they are able to speak it. As a result, their cognitive skills are often underestimated.

Common Features of Delay in Language Acquisition:

In addition, the combination of having a smaller mouth cavity and weaker mouth and tongue muscles makes it harder to physically form words; and the longer the sentence, the greater the articulation problems become.
Speech and language problems for these children often mean that they actually receive fewer opportunities to engage in language and conversation. It is more difficult for them to ask for information or help. Adults tend to ask closed questions or finish a sentence off for the child without giving them much needed time or help to do it themselves.
This results in the pupil getting:


Poor auditory short-term memory and auditory processing skills

Other speech and language problems in children with Down's syndrome stem from difficulties with their auditory short-term memory and processing skills. The auditory short-term memory is the memory store used to hold, process, understand and assimilate spoken language long enough to respond to it. Any deficit in short-term auditory memory will greatly affect childrens' ability to respond to the spoken word or learn from any situation entirely reliant on their auditory skills. In addition, they will find it more difficult to follow and remember verbal instructions.


Shorter concentration span

Many children with Down's syndrome have a short concentration span and are easily distracted. In addition, the intensity of supported learning, especially in a one-to-one situation, is much higher and the child tires much more easily than an unsupported child.


Generalisation, thinking and reasoning

Where any child has a speech and language impairment, thinking and reasoning skills are inevitably affected. They find it more difficult to transfer skills from one situation to another. Abstract concepts/subjects can be particularly difficult to understand and problem solving may be affected.


Consolidation and retention

Pupils with Down's syndrome generally take longer to learn and to consolidate new skills and the ability to learn and retain can fluctuate from day to day.


Structure and routine

Many children with Down's syndrome thrive on routine, structure and clearly focused activities. Unstructured and informal situations are often more difficult for them. Equally, they can be easily thrown by any change. They may need more preparation and may take longer to adapt to changes in the classroom and to transitions.


Social Inclusion

The prime aim for any five-year-old entering mainstream school is social inclusion. As with any child, it is much harder to make progress in cognitive areas until they are able to behave and interact with others in a socially acceptable way and to understand and respond appropriately to the immediate environment. All children with Down's syndrome benefit from mixing with typically developing peers. They are often very keen to do the same as their peers and generally use them as role models for appropriate social behaviour and motivation for learning. This type of social experience, where the other children are setting normal expectations for age-appropriate behaviour and achievement, is extremely important for children with Down's syndrome who find their world more confusing and are less emotionally and socially mature. Even so, many often need additional help and support in learning the rules for normal and appropriate social behaviour. They do not learn well from incidental learning and will not pick up conventions intuitively, as do their peers. They will take longer to "learn the rules" than their typically developing peers. The focus of additional help and support in the early years should be on learning the rules for normal and appropriate social behaviour.


Play Times

Some additional help in including young children with Down's syndrome during playtime may be needed. However, any adult support the child has, if not used sensitively, can act as barrier to other children which, combined with speech and language difficulties, can make it much harder for children with Down's syndrome to:



There are no behaviour problems unique to children with Down's syndrome. However, much of their behaviour will be related to their level of development. So, when problems occur, they are generally similar to those seen in typically developing children of a younger age.
In addition, children with Down's syndrome have grown up having to cope with more difficulties than many of their peers. Much of what they are expected to do in their everyday lives will have been much harder to accomplish due to problems with their speech and language, auditory short-term memory, motor co-ordination, shorter concentration span, and learning difficulties. The thresholds that trigger problem behaviours may therefore be lower than with their typically developing peers, i.e. they are likely to become frustrated or anxious more easily. Therefore, a child's having Down's syndrome does not lead inevitably to behavioural problems; but the nature of the difficulty makes them more vulnerable to the development of behaviour problems.
A particular aspect of problem behaviour is the use of avoidance strategies. Research has shown that, like many pupils with special needs, pupils with Down's syndrome tend to adopt such strategies, which undermine the progress of their learning. Some pupils tend to use social behaviours to distract adult attention and avoid learning and seem prepared to work only on tasks which fall within a very narrowly defined cognitive range.
It is important to remain alive to the possibility of avoidance, to separate immature behaviour from deliberately bad behaviour, and to ensure that the child's developmental, not chronological, age is taken into account, together with their level of oral understanding. Any reward offered also has to take account of these factors.



Most children with Down's syndrome in mainstream schools will need additional support. This is commonly provided through a Learning Support Assistant (LSA*). However, the type of support the child receives can have a tremendous impact on the effectiveness of the inclusion and it is important that the role of the LSA is carefully established.
The following are useful guidelines when considering the role of the LSA:

In Terms of the Child:

In Terms of the Teacher:

It is also important that the LSA is seen as belonging to the whole class, giving help to all children in need of it, and not seen, as only belonging to the child with Down's syndrome. In this way, other children in the class can benefit from extra help and care too. The teacher must not abdicate responsibility for the child with Down's syndrome to the LSA.

One-to-One & Withdrawal

In addition, support should not consist only or even primarily of the LSA working with the child in a one-to-one situation, especially if it involves withdrawal from the class, which should be avoided if possible. Although there will be times when some one-to-one is needed, this should be given only when absolutely necessary and should be within the classroom whenever possible.


Be aware that too much one-to-one support can result in the child failing:

How many LSAs?

Generally speaking, it is not advisable to have one LSA to support a child. This can create over familiarity and over-dependency on one adult and is very intense for both the child and the LSA. Consider having two LSAs instead of one, perhaps splitting the time between a.m. and p.m. This can also make it easier to replace one LSA if another is absent.

Planning support

SenCos, class teachers, learning support coordinators and support staff, need to meet regularly to plan, communicate, feedback and monitor progress. A communication book for all involved to record lesson plans, ideas, notes and feedback is often invaluable, especially where more than one LSA is involved with the child.
When planning support, it is vital to decide: The class teacher or SenCo is ultimately responsible for differentiating activities but many LSAs are capable of adapting the activities further, if and when necessary. However, any extra time that this involves must come out of the LSA's support hours and time should be allocated for this to happen.

The Curriculum

Although there will be a continuing need for targeting independence and social behaviour, the prime social inclusion targets should be achieved in the early years. More attention can be given towards accessing the curriculum as the child with Down's syndrome progresses through Key Stages 1 and 2.
However, as for all children, activities will need to be modified and adapted to suit the child's particular level of learning and development. In some cases this may mean that a new concept, topic or skill will have to be pared down to a very basic level with a tight focus on one particular aim that you wish the child to learn and understand. Although, in some cases, this may mean that the child with Down's syndrome may be working at a very different level, it does not mean that the actual subject or topic that the child is working within is different from the other children. With forward planning and liaison with the LSA(s) this breadth of differentiation can be achieved successfully in many cases.
Supporting the Target Setting Process, DfEE, (1998) is a useful booklet to help schools set targets and assess achievement for pupils with SEN who are working below Level 1 and between Levels 1 and 2 of the National Curriculum in English and Mathematics. Performance criteria in personal and social development are also included.

Classroom Practice

Many pupils with Down's syndrome, as with other pupils with SEN, do not cope well with a number of common classroom practices: whole class teaching, learning through listening, and follow-up work based on the completion of unmodified text activities or worksheets. Therefore, teachers may need to look at their classroom practice and the whole learning environment of the class, so that activities, materials and pupil groupings are all taken into account. For some purposes, ability will be less important than pupils' learning styles. It is important, for example, to utilise the motivation and opportunity to learn from good role models that arise when grouping children with Down's syndrome with their typically developing peers.
*Note: in Scotland new funding has created a new staffing level whose job it is to prepare resources for the teacher "learning support/ancillary".
In addition, research has shown not only that pupils with SEN prefer to work in groups but also that co-operative group work actually fosters learning.


Decide when the child should work: And when the child is to be:


There is much research outlining the strong links between reading and language development in children with Down's syndrome and reading is an area of the curriculum where many of these children can often excel. As the written word makes language visual, print overcomes any difficulties with "learning through listening".
Reading can thus be used: However, it is important to be aware of how children with Down's syndrome learn to read, as this differs in some ways from the strategies recommended in the National Literacy Strategy. A key factor when teaching a child with Down's syndrome to read is the use of a whole word approach and many children are able to build up a sight vocabulary of familiar and meaningful words in this way.
This of course presents a particular problem given the insistence on the use of phonics in the Literacy Strategy. Using phonics to decode words can be more difficult for young children with Down's syndrome because it involves accurate hearing and discrimination of sounds as well as problem-solving skills. However, a basic knowledge of phonics can be gained by many children with Down's syndrome and should be introduced as they build up their sight vocabulary.
There may therefore need to be specific attention to differentiation for reading and other activities during the Literacy Hour.

Writing Skills

Producing any form of written work is a highly complex task. Difficulties in short term auditory memory, speech and language, fine motor skills and the organising and sequencing of information make a considerable impact on the acquisition and development of writing skills for many pupils with Down's syndrome.

Particular Areas of Difficulty:



As with reading, it is unwise to rely exclusively on phonics to address weaknesses in spelling, as many children with Down's syndrome will be spelling words purely from visual memory. However, in order to develop and expand their reading skills, they will need to learn some phonic skills but development in this area may be slower than that of their peers.


Due to delayed speech and language skills and limited vocabulary it is important to:

Communication with Parents/Carers

Although many parents will come into schools regularly, a home-school communication book is ideal as a way of communicating daily news. This is invaluable where the child's own speech and language skills are not developed sufficiently for them to convey their news clearly. Take care not to use this as a means of just conveying bad news.

Transition to Seconday School

Transition from primary to secondary can be traumatic for many pupils and many issues will affect all children whether or not they have special needs. However, transition for children with special needs can be particularly traumatic. A positive attitude from the receiving school is essential. In addition a good and well-prepared transition plan needs to be set in place to pave the way for it to be as smooth and trouble free as possible for pupil, staff and parents.
The first consideration that parents will have to think about is "which school?" In many cases there is one main secondary school which most of the primary pupils feed in to. For pupils with Down's syndrome, this is by far the most sensible option to go for socially, as they will be well supported by the peers that they have grown up with. However, sometimes there are overriding reasons for this not to happen and the pupil has to transfer to a different secondary school without the support of familiar peers from the feeder school. The transition plan must take into account the actual situation.


*Note: in Scotland SenCos have the titles Principle Teacher Learning Support in Secondary and Learning Support Co-ordinators in Primary schools.


A regular feature of transition procedures is a programme of visits. Because many children with Down's syndrome are thrown by change and find it more difficult to adapt to new surroundings without extra help and preparation, this is an aspect that deserves separate consideration.


Pupil Profile

The receiving secondary school needs to understand the philosophy of the parents and the role which education plays in their life-plan for the pupil. One method of communication, which has proved very successful in aiding transition, is for the primary school and parents to prepare a profile of the child to be given to the secondary school during the process of transition. The profile is a little like a simplified Record of Achievement, in that it aims to give information about the child's background, achievements, interests, strengths and weaknesses, presented in a fair but positive light. Contributions should be sought from all those significantly involved in the development of the child: parents, year 6 class teacher, SenCo and speech and language therapist etc. Importantly, to give the child ownership, they should also have considerable input.

A Short Bibliography

ALTON, S. (1998) Differentiation not Discrimination: Delivering the Curriculum for children with Down's syndrome in mainstream schools. Support for Learning 13(4), 167-173.
BRUNI, M. (1998) Fine Motor Skills Children with Down Syndrome, A Guide for Parents and Professionals. Woodbine House.
BRYAN, J. (1998) Living with Down's Syndrome. Wayland.
BUCKLEY, S. and BIRD, G. (1994) Meeting the Educational Needs of Children with Down's Syndrome: A Handbook for Teachers. Portsmouth: University of Portsmouth.
BUCKLEY, S. and BIRD, G. (1993) Teaching Children with Down's Syndrome to Read. Down's Syndrome: Research and Practice 1(1) 34-41.
BUCKLEY, S. and BIRD, G. (1998) Including Children with Down Syndrome. Down Syndrome News and Update, Vol 1(1) 5-13.
BUCKLEY, S. and BIRD, G. (1998) Including Children with Down Syndrome (Part 2). Down Syndrome News and Update, Vol 1(2) 60-66.
BUCKLEY, S. (1995) Teaching Reading to Teach Talking: Important New Evidence. Portsmouth Down's Syndrome Trust Newsletter 5(5) 1-6.
BUCKLEY, S. (1999) Improving the Speech and Language Skills of Children and Teenagers with Down Syndrome. Down Syndrome News and Update, Vol 1(3) 111-128.
DEPARTMENT for EDUCATION and EMPLOYMENT (1997) Excellence for All Children: Meeting Special Educational Needs. London, HMSO.
DEPARTMENT for EDUCATION and EMPLOYMENT (1998) Supporting the Target Setting Process (Guidance for effective target setting for pupils with SEN). London, HMSO.
FLYNN, M. and P. (1998) Think About Having a Leaming Disability. Belitha Press.
GROSS, J. (1995) Special Educational Needs in the Primary School - A Practical Guide. OUP.
LAWS, G., BUCKLEY, S., BIRD, G., McDonald, J., and BROADLEY, I. (1995) The Influence of Reading Instruction on Language and Memory in Children with Down's Syndrome. Down's Syndrome: Research and Practice 3(2) 59-64.
LEWIS, A. (1995) Primary Special Needs and the National Curriculum. Routledge.
LORENZ, S. (1998) Children with Down's Syndrome. A Guide For Teachers and Learning Support Assistants in Mainstream Primary and Secondary Schools. David Fulton.
LORENZ, S. (1999) Supporting Support Assistants. Downright Press.
LORENZ, S. (1999) The Support Assistant's Survival Guide. Downright Press.
OELWEIN, P. (1995) Teaching Reading to Children with Down Syndrome, A Guide for Parents and Teachers. Woodbine House.
SCHOEDER, A. (1997) Socially Speaking, A Pragmatic Social Skills Programme for Pupils with Mild to Moderate Learning Disabilities. LDA.
SELIKOWITZ, M. (1997) Down Syndrome The Facts. OUP.
STAKES, R. and HORNBY, G. (1988) Meeting Special Needs in Mainstream Schools, A Practical Guide for Teachers. David Fulton.
STRATFORD, B. and GUNN, P. (1996) New Approaches to Down Syndrome. Cassell.
TILSTONE, C., FLORIAN, L. and ROSE, R. (1998) Promoting Inclusive Practice. Routledge.


JANE BEADMAN, Educational Psychologist, Devon LEA.
GILLIAN BIRD, Psychologist and Director for Consultancy and Education, The Down Syndrome Educational Trust, Portsmouth.
BOB BLACK, Education Information Officer, DSA.
PROFESSOR SUE BUCKLEY, Professor of Developmental Disability, Department of Psychology at the University of Portsmouth and Director for Research and Publishing at The Down Syndrome Educational Trust, Portsmouth.
DR. STEPHANIE LORENZ, Independent Educational Psychologist, Manchester.
CECILIE MACKINNON, Education Liaison Officer, SDSA.
ERIC NICHOLAS, Development Officer, DSA.