Babble Boot Camp for Infants With Down Syndrome: Piloting a Proactive, Caregiver-Led Intervention Designed to Boost Earliest Speech and Language Skills

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PURPOSE: Down syndrome (DS) is associated with lifelong difficulties with verbal communication, beginning in infancy when vocalizations are sparse and first words emerge late. Because DS is diagnosed at or even before birth, these difficulties can be anticipated, yet there have been limited developments of systematic, proactive interventions. The purpose of the pilot study described here was to investigate feasibility and potential benefits of such an intervention toward a fully powered clinical trial. METHOD: We piloted Babble Boot Camp (BBC), a proactive, parent-led speech and language intervention, with 10 children with DS ages 4-16 months. Each family participated in weekly sessions via telehealth for 10 months. A pediatric speech-language pathologist coached parents to implement daily routines and activities at home, designed to foster child target behaviors and skills (e.g., increased vocalization rates, babble complexity, word productions) toward building resilience against anticipated challenges. Parents provided daylong audio recordings and questionnaire data at regular intervals. RESULTS: Parent participation and compliance metrics in the intervention were high. All rated the intervention as acceptable, convenient, and helpful, whereas three sets of parents found aspects of the data collection time consuming. Children's linguistic environments resembled those of typical controls in terms of child utterance rates, adult word counts, and conversational turns. Babble complexity and receptive and expressive vocabularies increased over time. First words emerged earlier than expected. CONCLUSION: High feasibility metrics and suggestive benefits motivate a larger study to determine more specifically how the various BBC components can improve long-term outcomes for children with DS. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.28655222.

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