Augmentative and Alternative Communication

ISSN: 0743-4618 (Print) 1477-3848 (Online) Journal homepage: http://www.tandfonline.com/loi/iaac20

Core vocabulary of young children with Down

syndrome

Stijn R. J. M. Deckers, Yvonne Van Zaalen, Hans Van Balkom & Ludo
Verhoeven

To cite this article: Stijn R. J. M. Deckers, Yvonne Van Zaalen, Hans Van Balkom & Ludo
Verhoeven (2017) Core vocabulary of young children with Down syndrome, Augmentative and
Alternative Communication, 33:2, 77-86, DOI: 10.1080/07434618.2017.1293730

To link to this article: https://doi.org/10.1080/07434618.2017.1293730

Published online: 02 Mar 2017.

Submit your article to this journal

Article views: 1222

View Crossmark data

Citing articles: 1 View citing articles

Full Terms & Conditions of access and use can be found at

http://www.tandfonline.com/action/journalInformation?journalCode=iaac20
AUGMENTATIVE AND ALTERNATIVE COMMUNICATION, 2017
VOL. 33, NO. 2, 77–86
http://dx.doi.org/10.1080/07434618.2017.1293730

RESEARCH ARTICLE

Core vocabulary of young children with Down syndrome

Stijn R. J. M. Deckersa, Yvonne Van Zaalena, Hans Van Balkomb and Ludo Verhoevenb
a
Center of Expertise Interprofessional Collaboration, Fontys University of Applied Sciences, Eindhoven, the Netherlands; bBehavioural Science
Institute, Radboud University Nijmegen, Nijmegen, the Netherlands

ABSTRACT ARTICLE HISTORY

The aim of this study was to develop a core vocabulary list for young children with intellectual disabil- Received 21 September 2016
ities between 2 and 7 years of age because data from this population are lacking in core vocabulary Revised 27 January 2017
literature. Children with Down syndrome are considered one of the most valid reference groups for Accepted 3 February 2017
researching developmental patterns in children with intellectual disabilities; therefore, spontaneous lan-
guage samples of 30 Dutch children with Down syndrome were collected during three different activ- KEYWORDS
ities with multiple communication partners (free play with parents, lunch- or snack-time at home or at Core vocabulary;
school, and speech therapy sessions). Of these children, 19 used multimodal communication, primarily augmentative and
manual signs and speech. Functional word use in both modalities was transcribed. The 50 most fre- alternative communication;
quently used core words accounted for 67.2% of total word use; 16 words comprised core vocabulary, Down syndrome; children;
based on commonality. These data are consistent with similar studies related to the core vocabularies language sample analysis
of preschoolers and toddlers with typical development, although the number of nouns present on the
core vocabulary list was higher for the children in the present study. This finding can be explained by
manual sign use of the children with Down syndrome and is reflective of their expressive vocabulary
ages.

Introduction (d) words that are cognitively basic or most salient, (e) the
most frequent words for a particular demographic group, (f)
Clinicians need to apply a structured and scientific approach
words that have the most widespread usage across a wide
to augmentative and alternative communication (AAC) inter-
range of genres, situations, and conversational partners, and
ventions aimed at improving quality of life through achieving
(g) words useful for dictionary definitions. In the field of AAC,
the most effective communication possible for individuals
core vocabulary is most often defined as a small set of
who rely on AAC. However, AAC support teams rarely have
approximately 20–50 words for young children and up to
sufficient knowledge and experience to select vocabulary for 200–400 words for adults and used consistently across envi-
functional use for specific contexts, activities, ethnicity, or ronments and between communication partners (Baker, Hill, &
language groups (Beukelman & Mirenda, 2013). Language Devylder, 2000; Chen et al., 2011; Renvall, Nickels, & Davidson,
sample collection and analysis is an historically used evi- 2013; Weighton & Dodd, 2011; Witkowski & Baker, 2012;
dence-based practice (Aitchison, 2003) for selecting vocabu- Yorkston, Dowden, Honsinger, Marriner, & Smith, 1988). Core
lary for AAC systems (Kovacs & Hill, 2015). For vocabulary vocabulary may account for up to 80% of all words used
selection, there appears to be a certain set of core words within communicative contexts. Vocabulary sets described as
that can be widely used in a range of communicative set- core vocabulary consist of high-frequency words and repre-
tings (Banajee, DiCarlo, & Buras Stricklin, 2003). These core sent various parts of natural speech or text (i.e., mostly func-
words can maximize the potential for spontaneous language tion words such as pronouns, conjunctions, prepositions,
generation in spoken, signed, graphic, and/or written (out- auxiliary verbs, modals, determiners, interjections, and adverbs
put) modalities. Incorporating core vocabulary into an AAC (Renvall et al., 2013; Witkowski & Baker, 2012). Effective com-
system may give individuals the opportunity to be engaged munication requires the combination of both core and fringe
in communication and interaction in an appropriate, efficient, vocabulary. Fringe vocabulary items are often large in number,
and relatively quick manner (Hill, Kovacs, & Shin, 2015; change frequently, and are highly individualized (Yorkston,
Weighton & Dodd, 2011). Honsinger, Dowden, & Marriner, 1989). With these fringe
Lee (2001) described a number of features of words char- words, which are often content words, an individual is able to
acterized as core vocabulary. Such words tend to be (a) the reflect on his or her own activities, interests, environments,
most frequent words in language as a whole, (b) words that and personal style (Stuart, Beukelman, & King, 1997).
are most general, unmarked, or central to the language, Spoken language sample studies identifying core vocabu-
(c) the most frequent words in a particular medium; lary are available for a variety of groups with no identified

CONTACT Stijn R. J. M. Deckers [email protected] Center of Expertise Interprofessional Collaboration, School of Allied Health Professions, Fontys
University of Applied Sciences, Eindhoven, the Netherlands.
ß 2017 International Society for Augmentative and Alternative Communication
78 S. R. J. M. DECKERS ET AL.

disabilities, including toddlers (Banajee et al., 2003), pre- studies used different research designs and most analyzed
school children (Beukelman, Jones, & Rowan, 1989; Fallon, language use only in one setting; core vocabulary, as previ-
Light, & Paige, 2001; Trembath, Balandin, & Togher, 2007), ously defined, is used consistently within and across environ-
school-aged children (Robillard, Mayer-Crittenden, Minor- ments and over a wide range of communication partners. In
Corriveau, & B
elanger, 2014), adults (Balandin & Iacono, addition, the few studies of individuals with intellectual dis-
1999), and elderly adults (Stuart et al., 1997). Core vocabulary abilities focused mainly on those with mild intellectual dis-
has also been identified for children with specific language abilities or developmental ages of 4 years and above, and
impairments (Robillard et al., 2014); second-language learners populations with chronological ages of 6 and above. To date,
(Boenisch & Soto, 2015); individuals with physical disabilities, no studies exist that focused on children with intellectual dis-
some of whom used AAC (Boenisch & Sachse, 2007; Dark & abilities with chronological ages below school age and devel-
Balandin, 2007; Yorkston, Smith, & Beukelman, 1990); and opmental ages below 4 years.
school-aged children with autism spectrum disorders (Chen Down syndrome is the most common genetic cause of
et al., 2011). Based on these studies, it can be concluded that intellectual disability (Sherman, Allen, Bean, & Freeman,
the core vocabulary of these populations is highly overlap- 2007). Owing to its homogeneous etiology, children with the
ping. Within the clinical field of AAC, the question has often syndrome are considered to be among the most valid refer-
been raised whether core vocabulary sets are also applicable ence groups for researching developmental patterns in indi-
for children, teens, or adults with intellectual or multiple viduals with intellectual disabilities (van Duijn, Dijkxhoorn,
disabilities. Scholte & van Berckelaer-Onnes, 2010). These children are
So far, only three studies have targeted this issue. The first usually delayed in learning to speak (Brady, 2008; Kent &
(Mein & O’Connor, 1960), reported spoken core vocabularies Vorperian, 2013) and even after they begin to speak, may be
of 80 individuals ranging in age from 10 to 30 years, with difficult to understand (Roberts et al., 2005). Compared to
severe intellectual disabilities and a mental age ranging from children with typical development matched on developmen-
3 to 7 years. Words that were used by more than 50% of the tal age and based (primarily) on parental reports, Bello,
participants were indicated as core vocabulary, leading to a Onofrio, and Caselli (2014) found that children with Down
core list of 218 words, which was relatively comparable to syndrome experience delays in the production of nouns,
the core vocabulary of young children with a comparable verbs, and adjectives. Nouns were used significantly more fre-
developmental age in the 1957 study by Burroughs (1957). quently than verbs and adjectives. Other characteristics of
The second study, by Chen, Chen, and Chen (2013), explored spontaneous spoken language of children with Down syn-
the spoken core vocabulary of 15 children with intellectual drome include speaking in one-word utterances using nouns
disabilities and their peers without disabilities in fifth and or verbs, and limited use of question words, articles, and con-
sixth grades during an approximately 30-min dyadic conver- junctions (Abbeduto et al., 2001; Bol & Kuiken, 1989;
sation at school. Chronological ages of the children were Chapman & Kay-Raining Bird, 2012). In addition, these indi-
between 10 and 12 years; IQ scores of the children with intel- viduals may omit grammatical markers and verbs more fre-
lectual disabilities ranged from 55 to 69. There was 94% quently than peers with the same mean length of utterance
overlap for the top 70% most frequently used words in both (Hesketh & Chapman, 1998).
groups. The third study, by Boenisch (2014), compared the Gesture production is considered a strength of children
core vocabulary of German children and teenagers (n ¼ 58) with Down syndrome compared to their spoken language
with typical development with the core vocabulary used by skills and also compared to peers with typical development
children with intellectual disabilities of different etiologies. (Galeote, Sebasti
an, Checa, Rey, & Soto, 2011). In a study by
The children with intellectual disabilities were between the Galeote et al., young children with Down syndrome were
ages of 6 and 16 years, with an IQ below 70, attended spe- found to have comparable vocabulary sizes to those of peers
cial schools for children with intellectual disabilities, and with typical development when the number of gestures was
were able to use natural speech (n ¼ 44). Language samples included in vocabulary counts. This shows the importance of
were obtained throughout the school day. Boenisch found a accounting for multimodal communication in language stud-
very large overlap between the top 20 (95%), top 50 (94%), ies, particularly in those involving children with Down syn-
and top 100 (87%) words most frequently used by both drome. Poor intelligibility and significantly delayed onset of
groups of students. Almost no differences were found speech are two primary reasons to introduce AAC to children
between both groups in the frequency of use of different with Down syndrome (Brady, 2008). In Dutch clinical and
word classes, indicating that the language use of the children educational practice, Sign Supported Dutch (SSD) and man-
and teenagers with intellectual disabilities closely resembles ual key-word signing are commonly used for this population,
that of peers with typical development. as manual sign systems are an important mode of communi-
Van Tilborg and Deckers (2016) reviewed all previously cation, next to or preceding speech (Deckers, Van Zaalen,
mentioned core vocabulary studies and concluded that core Mens, Van Balkom & Verhoeven, 2016; Smith & Grove, 1999).
vocabulary, no matter the modality, seems to be comparable The manual signs in Sign Supported Dutch are iconic or arbi-
for individuals with typical development; monolingual and trary signs that are deliberately taught by parents, teachers,
bilingual individuals with primary language impairments; €
or speech-language pathologists (Ozçalışkan, Adamson,
second language learners; people who rely on text-based Dimitrova, Bailey, & Schmuck, 2016) and are based on Dutch
AAC; and individuals with physical and/or intellectual disabil- Sign Language. Manual signs that are iconic in form depict
ities. However, it should be mentioned that many of the the characteristic actions or attributes of the referent they
 AUGMENTATIVE AND ALTERNATIVE COMMUNICATION 79

represent. Different from spontaneous iconic gestures, iconic Communicative Development Inventory: Words and
manual signs are either produced in identical handshape Sentences version (N-CDI), which is recognized as a valuable
form repeatedly by both the communication partner and the and valid measure of expressive vocabulary in children with
child or by the child alone to refer to the same referent Down syndrome (Deckers et al., 2016). The N-CDI is devel-
within an observation session. This similarity of form is never oped to measure the vocabulary size of children with a
€
observed in spontaneous iconic gestures (Ozçalışkan & chronological or mental age of 16–30 months. Three children
Goldin-Meadow, 2011), which makes the interpretation of reached ceiling levels on the N-CDI. Their expressive vocabu-
gestures more subjective than when interpreting manual lary age was therefore assessed with the Expressive One
signs. Word Picture Vocabulary Test (Brownell, 2000). The mean
When manual signs are incorporated in studies of expres- expressive vocabulary age of the children with Down syn-
sive vocabulary development of children with Down syn- drome was 25 months (SD ¼ 7; range: 17–42 months). The
drome, the vocabulary size is relatively comparable to that of participants in the study lived throughout the Netherlands in
peers with typical development matched for developmental different socioeconomic areas. All of the children came from
age (Chan & Iacono, 2001; Te Kaat, 2013; Zampini &
Dutch-speaking households; however, the parents of four of
D’Odorico, 2009). Although several studies show the merits
the children had a Turkish background. Of the 30 children,
of using manual signs, most studies investigating vocabulary
19 attended schools or daycare centers for mainstream edu-
sizes in individuals with Down syndrome only accounted for
cation and 11 attended schools or daycare centers for special
spoken vocabulary and most often relied only on parental
education. At the time of the present study, all of the chil-
reports, not accounting for the use of other modalities of
dren were attending SLP sessions at least once a week. All of
communication. None of the studies focused on functional
the parents indicated that Sign-Supported Dutch was used at
use of language in spontaneous language samples in chil-
dren with Down syndrome. Where noun use seems to be a home by both the parents and the child, and during speech-
relative strength in children with Down syndrome, compared language therapy sessions by both the SLP and the child. All
to other word classes (Bello et al., 2014), it is not known of the children could speak at least one word, and 17 used
whether these noun forms are used consistently within envi- manual signs. No picture communication symbols or other
ronments and between communication partners. The goal of AAC devices were used.
the present study was to determine core vocabulary and the
contribution of content and function words to core vocabu-
lary in young children with Down syndrome with a chrono- Procedure
logical age between 2 and 7 years, by analyzing (spoken and
As defined in the introduction, core vocabulary comprises a
sign supported) spontaneous language samples in different
set of words consistently used within and across environ-
settings and with several communication partners.
ments and between communication partners. In the present
study, participants’ core vocabulary was identified by collect-
Methods ing language samples during interactions in multiple settings
and with multiple communication partners during (a)
Participants
unstructured free play with a parent at home, (b) snack- or
Children with Down syndrome were recruited for this cross- lunch-time with a parent at home or with a teacher at
sectional study from specialized Down syndrome polyclinics school, and (c) speech-language therapy sessions with the
associated with several hospitals in the Netherlands, through SLP. Materials used during free play differed for each child
Stichting Downsyndroom, the Dutch association for parents because the children were allowed to play with their own
with children with Down syndrome; and speech-language toys, although some common material use was observed
pathologists (SLPs) in clinical practice. Because the Berglund, (e.g., dress-up games, toy kitchen with equipment, blocks
Eriksson, and Johansson (2001) study showed that some chil- and art). Parents were instructed to (a) play with their child
dren with Down syndrome do not develop speech by age 5, like they normally would, (b) include toys or games accord-
we decided to include children with a broader age range.
ing to the child’s preference, and (c) allow the child to take
Children were included in the study if they met the following
the initiative to engage in play with other toys. Snack- or
inclusion criteria: (a) developmental age below 48 months, as
lunch-time activities took place at designated tables, where
measured by the Vineland Screener (Van Duijn, Dijkxhoorn,
the children were used to spending their snack- or lunch-
Noens, Scholte, & van Berckelaer-Onnes, 2009), (b) lived in a
Dutch-speaking home environment, and (c) had a diagnosis time (e.g., at a kitchen table at home, at a table in the school
of Down syndrome (trisomy 21). The present study was lunchroom). Parents and teachers were instructed to follow
approved by an institutional review board (NL38926.091.12). the usual mealtime routine. SLPs were instructed to provide
In all, 30 children with Down syndrome participated in the therapy as they normally would but to use the recorded ther-
present study: 14 boys and 16 girls. The participants had a apy session to work specifically on the child’s goals related
mean chronological age of 57 months (SD ¼ 16; range: 28–84 to communication or language in order to evoke sufficient
months) and a mean developmental age of 28 months spontaneous language. The language samples taken during
(SD ¼ 10; range: 12–47 months). Expressive vocabulary ages these 15- to 20-min interactions were audio- and video-
were determined with the Dutch version of the MacArthur recorded. Video recording was chosen to identify manual
80 S. R. J. M. DECKERS ET AL.

signing used by the children and for visual context when transcripts, (approximately 2% of the total transcript), were
speech intelligibility was decreased. reconsidered by the two raters collectively. In all instances,
consensus agreement was reached on appropriate alterations
in the transcriptions. About 10% of all utterances were con-
Data transcription and analysis sidered unintelligible by both transcribers.
For each child, at least the first 10 min of each recorded set- Core vocabulary literature describes several ways to deter-
ting were transcribed. During the transcription process, vid- mine which words are core (Van Tilborg & Deckers, 2016).
eotapes were stopped after each utterance and a verbatim One commonly used metric is to include those words that
transcription was completed of the utterance for both the have an occurrence of at least 0.5 per 1000 words in a sam-
child and his or her communication partners. Both spoken ple (e.g., Balandin & Iacono, 1999; Robillard et al., 2014;
and signed utterances were transcribed. For every word tran- Trembath et al., 2007). However, given the relatively small
scribed, the modality in which that word was produced, language sample of the present study (i.e., 3000 words),
either spoken (Sp) or via a manual sign (Si), was added to applying this threshold would indicate every word used at
the transcript. A sample of 100 words per child was con- least twice to be a core word. Instead, we chose to deter-
structed, ideally consisting of roughly 33 used words (i.e., mine core vocabulary in two ways: (a) As the 50 most fre-
100 words divided by three settings) collected per setting. Of quently used words (Chen et al., 2013) in the total sample of
the 30 participating children, 19 had recordings in all three 3000 words, because Boenisch and Soto (2015) showed a sig-
settings. Not all of the children’s SLPs participated, which nificant drop in frequency of word use after the 50th most
meant that some children took part only in two settings. The used words on core vocabulary lists, and (b) on the basis of
33-word target was not always reached during spontaneous the principle of commonality. Words were determined as
language use during lunch- or snack-time. This was because core vocabulary based on commonality, when a particular
mealtime interactions were sometimes constrained by word was used by 50% or more (i.e., n  15) of the children
parents who did not want their children to talk while eating in the total sample (Robillard et al., 2014; Trembath et al.,
(as noted also by Banajee et al., 2003). Therefore, more words 2007). Applying these two criteria resulted in two word lists
uttered during interactions in the other settings had to be with core vocabulary. For both word lists it was determined
included to reach the 100 words threshold for each child. whether a word was a function (i.e., prepositions, auxiliary
Transcription rules were based on Trembath et al. (2007) verbs, conjunctions, determiners, and pronouns) or a content
as follows: (a) each utterance was transcribed separately and (i.e., nouns, main verbs, adverbs, adjectives, and negatives)
utterance boundaries were defined by intonation or a pause word. Word frequency counts from the transcripts and com-
of longer than 2 s, (b) when sound repetitions and syllable pilation of both the frequency and commonality list were
repetitions occurred, only one whole word was transcribed, conducted with R, a platform for statistical computing and
(c) fillers or interjections (e.g., oh/ooh) and conventional ges- graphics (The R foundation, n.d.)
tures (e.g., waving “hello” and nodding “yes” or shaking the
head “no” that are part of a learned, shared, symbolic sys-
Results
tem) were typed orthographically in a consistent form and
counted as words, (d) different forms of a word (e.g., jump/ The total sample consisted of 3000 words uttered by the 30
jumped) were transcribed as different words, but combined participants, of which 420 words were unique. The number
in the analysis to examine lemma-based words, (e) numbers of unique words equates to the number of different words
were typed as nouns, (f) imitated speech, noises, and signs used in the transcripts, irrespective of their frequency of use
were not included, (g) imitated words, either spoken or in by the children with Down syndrome. Of the total sample,
manual signs, were not included, (h) words used in songs 407 words (i.e., 13.6%) were uttered using a manual sign or
and repetitive games were not included, (i) any comments via a conventional gesture (e.g., yes, no, bye), 49 of which
by the children related to recording equipment were omitted were unique (i.e., 12%). Of these 49, 32 were nouns. During
from transcription, and (j) names were omitted from tran- lunch- or snack-time, 585 words were used, 148 of which
scripts in order to protect confidentiality. were unique (i.e., 25.3%). During sessions with an SLP, 751
We used the principles of inter-judge agreement, which words were used, 199 of which were unique (i.e., 26.5%). In
can be used to measure reliability of transcripts of utterances the play setting with parents, the children uttered 1664
of individuals who have limited speech intelligibility (Kovacs words, 301 of which were unique (i.e., 18.1%). Language sam-
& Hill, 2015). Complete inter-judge agreement is obtained by ple recordings to acquire 100 words per child had a mean
independently transcribing and analyzing a language sample recording time of 23 min (SD ¼ 6; range: 15.24–36.15 min);
and then resolving discrepancies by consensus as needed mean recording time for lunch- or snack-time was 10 min, for
(Hegde, 2003). Agreement is usually 100%, unless the raters sessions with an SLP 7 min, and for play with parents 6 min.
are unable to reach a consensus (Kovacs & Hill, 2015). Given Type-token ratios (i.e., the number of different words divided
known problems with both speech and manual sign intelligi- by the total number of words per setting) were calculated
bility in children with Down syndrome (Kumin, 1994), which for every child (M ¼ .47, SD ¼ .09).
can heavily influence the reliability of transcripts, we chose Table 1 (which includes English translations) shows the
to ensure that all language samples were transcribed by two core vocabulary list based on the 50 Dutch words that were
independent raters. Differences that were found in the most frequently used by the children in the present study
 AUGMENTATIVE AND ALTERNATIVE COMMUNICATION 81

Table 1. The 50 most frequently used words by Dutch children with Down Table 2. Core vocabulary based on commonality.
syndrome across three settings. Words in Dutch Translation n
Words in Dutch Translation Percentage 1 Jaa,c Yes 30
1 Jaa,c Yes 11.20 2 Diea,c This, that 29
2 Neea,c No 7.80 3 Neea,c No 28
3 Diea,c This, that 5.10 4 Mamab,c Mama, mom 26
4 Daara,c There 3.83 5 Daara,c There 24
5 Mamab,c Mama, mom 3.47 6 Ika,c I 22
6 Ika,c I 3.10 7 Zoa So 22
7 Eena,b A, one 2.00 8 Eena,b A, one 21
8 Klaarb,c Ready, finished 1.67 9 Klaarb,c Ready, finished 20
9 Zoa So 1.43 10 Hiera Here 18
10 Jija,c You 1.30 11 Papab,c Papa, dad 18
11 Hiera Here 1.17 12 Nietb,c Not 17
12 Noga,c More 1.17 13 Noga,c More 17
13 Nietb,c Not 1.13 14 Opa On, all done 16
14 Papab,c Papa, dad 1.10 15 Dezea This, these 15
15 Dezea This, these 1.03 16 Kijk(t), kijkenb To look 15
16 Ben, Is, Zijna To be 1.00 a
Function word.
17 Opa On, all done 1.00 b
Content word.
18 Dea The 0.90 c
Word uttered in both spoken and signed modalities.
19 Kijk(t), Kijkenb To look 0.90 n: number of children that uttered a particular word.
20 Ena And 0.77
21 Wegb Away 0.77
22 Ina In 0.73
23 Oh/Ooha Oh 0.70 in Table 1, 22 words were uttered in both spoken and signed
24 Wil/Wiltb To want 0.70 modalities, seven of which were function words and 15 of
25 Dag/Doeib,c Bye 0.67
26 Hallo, Hoib Hello 0.67 which were content words.
27 Ooka Also, as well 0.67 Table 2 shows the list of words that achieved a common-
28 Pop(je), Poppenb,c Doll, puppet 0.63
29 Mij, Mijna My, mine 0.60
ality score of at least 15, indicating the words that were used
30 Nou, Nua Now 0.60 by at least half of the children in the present study. Sixteen
31 Dita This 0.57 unique words were used by at least half of the children, of
32 Kaasb Cheese 0.57
33 Paardb,c Horse 0.57
which only mom and dad are nouns. These core words based
34 Doen, Doeta To do 0.53 on commonality account for 47.1% of the total word use.
35 Koeb,c Cow 0.53 Ten of these core words based on commonality were uttered
36 Lekkerb,c Yummy, tasty 0.53
37 Meisjeb,c Girl 0.50 in both spoken and signed modalities.
38 Data That 0.47
39 Hondb,c Dog 0.47
40 Voora,b In front of, for 0.47 Discussion
41 Appelb,c Apple 0.43
42 Aua Ouch 0.43 The present study is the first to identify the core vocabulary
43 Drieb Three 0.43
44 Geel, Geleb Yellow 0.43
of young children with Down syndrome (i.e., chronological
45 Huisb,c House 0.43 age between 2;4 (years/months) and 7 years) and a develop-
46 Maga,c To may 0.43 mental age below 4 years. Developmental ages of the partici-
47 Openb Open 0.43
48 Banaanb,c Banana 0.40 pants were between 1 to 4 years (M ¼ 2;4), reflecting a
49 Heb, Heefta,b To have 0.40 period of early language and communication development.
50 Blauwb Blue 0.37 Language samples of 100 words per child were collected
a
Function word. across several settings and with different communication
b
Content word.
c
Word is uttered in both spoken and signed modalities. partners, resulting in a total language sample of 3000 spoken
and signed words. The 50 most frequently used words
accounted for more than 67% of the total sample, indicating
that a small set of words, i.e., a core vocabulary, can be iden-
across all three settings. These 50 words account for 67.2% tified for young children with Down syndrome. Of the
of total word use, and the 100 most frequently used words 50 core words, 16 were used by at least half of the partici-
account for 80.3% of total word use. Also indicated in the pating children. When comparing core words of children in
table is whether a word is a content or function word. Of the the present study with those of toddlers (Banajee et al.,
50 core words, 27 can be considered function words and 25 2003) and preschool children (Beukelman et al. 1989; Fallon
as content words. Three words – hebben (to have), een (a, et al., 2001; Trembath et al., 2007), it can be concluded that,
one), and voor (in front of, for) – are counted as both func- based on spoken and signed modalities, the core vocabulary
tion and content words. To have was used as both an auxil- of young children with Down syndrome and intellectual dis-
iary and a verb. It is important to note that some Dutch abilities, closely resembles the core vocabulary of young
words have multiple meanings, such as the word een, which peers with typical development. Recent studies (e.g., S.R.J.M.
may be the article a or the numerical one; and voor, which Deckers, Y. Van Zaalen, H. Van Balkom, L. Verhoeven, per-
may function as an adverb (in front of) or a preposition, as in sonal communication; Polisensk
a & Kapalkov
a, 2014) showed
this is for you (i.e., dit is voor jou). Of the 50 core words listed that the language development of children with Down
82 S. R. J. M. DECKERS ET AL.

syndrome, when measured in both spoken and signed language skills, and interpreted these results as a maternal
modalities, is delayed rather than deviant relative to patterns simplification strategy to prevent the child from being over-
of typical development. Combined with the results of these loaded with verbal information, which may be the case when
recent studies, the findings in the present study may provide asking more closed questions. Zampini, Fasolo, and
additional evidence that the lexical development of children D’Odorico (2011) found that the frequency of maternal utter-
with Down syndrome seems to closely resemble that of chil- ances towards children with Down syndrome was influenced
dren who are developing typically, differing only in the use by the children’s linguistic skills. Mothers tended to talk more
of multimodal communication. when their children’s communicative ability was limited,
The core vocabularies of children in the current study mostly filling in the pauses in their interaction. They grad-
serve several syntactic, semantic, and pragmatic functions ually reduced their utterance frequency as the child’s ability
(see also Banajee et al., 2003; Miller, 1989). Core vocabulary to interact increased, and asked different and more open
words contained demonstratives (that, these), verbs (to be, to questions, reflective of a growth in conversational coherence.
want), pronouns (my), prepositions (on), and articles (the). In most core vocabulary studies (see Van Tilborg and
Semantic functions included use of agents (I), objects (you), Deckers, 2016, for a comprehensive overview) nouns are
labeling objects (that), actions (to look), possession (my, underrepresented or even absent in core vocabulary lists. In
mine), affirmation (yes), negation (no), location (in), and ter- comparison, the core vocabulary list of children with Down
mination (finished, ready). Pragmatic functions included ini- syndrome in the current study consisted of slightly more
tiating interaction by attracting attention (you), maintaining nouns (i.e., 11 out of 50 core words) than core vocabulary
joint attention (this, that, these), indicating recurrence (more), lists of peers with typical development. This result may be
and terminating interaction (finished, ready). The types of due to the expressive language ages of the children, with a
words in the core vocabulary of participants in the present mean around 2-years of age, and the use of many one-word
study appear to be similar in terms of syntax, semantic, and utterances, in which a noun is more often used by a child to
pragmatic functions to those core words identified by previ- provide content to the utterance. Also, manual signs were
ous research with other populations, as mentioned in the counted in the spontaneous language samples in the current
introduction. Similarities of the present results to this past study. It is important to note that not every spoken word has
research help strengthen the definition of core vocabulary a direct translation into a manual sign, especially when it
and show the application of core vocabulary across activities, comes to function words such as articles (Bolier, 2010) or
environments, and communication partners, for individuals manual signs of nouns taught during speech-language ther-
with typical development as well as children with Down syn- apy or AAC interventions (Adamson, Romski, Deffebach, &
drome and intellectual disabilities. Having access to core Sevcik, 1992). In the current study, of the 49 unique words in
vocabulary enables young children with intellectual disabil- the total language sample uttered via manual signs, 32 were
ities to meet a variety of syntactic, semantic, and pragmatic nouns, and 10 of these made it to the core vocabulary list of
functions (Banajee et al., 2003). 50 most frequently used words. In Sign Supported Dutch,
As in most clinical core vocabulary studies, the words yes manual signs are learned in the immediate everyday context
and no are frequently used by children with Down syndrome. of repeated one-to-one communication with a communica-
In the current study, these two words alone made up 19% of tion partner. Manual signs are most often used to support
the total word sample. Investigating the transcripts in closer speech about an object or action. This creates a highly scaf-
detail, the overrepresentation of affirmations and negations folded, interactive routing centered on referent-symbol map-
seems to be due to the fact that communication partners fre- €
pings (Ozçalışkan et al., 2016). Children with Down syndrome
quently ask yes/no questions of children with Down syn- may, therefore, rely on manual signs in particular to convey
drome. Parents of young children with typical development information about objects and actions in their immediate
with language and developmental ages similar to the chil- €
environment (Dimitrova, Ozçalışkan, & Adamson, 2016),
dren in the current study, ask many yes/no questions during explaining the number of signed nouns. The language level
interactions with their young child (Eriksson, 2014). This fea- of the children and the use of manual signs as an AAC strat-
ture is also observed by van Balkom, Verhoeven, Van egy are thus possible reasons for the increased number of
Weerdenburg, and Stoep (2010) in the communication nouns on the core vocabulary list in the present study.
between children with developmental language delay (i.e., A parent or SLP might make a link between a novel word
late talkers) and their mothers. These interactions showed and referent more transparent by calling attention to an
lower levels of conversational coherence (i.e., the way both object and then stating its name or producing the sound it
communication partners cooperate to maintain the thread of makes, or following the child’s lead and producing labels for
the conversation), indicating difficulties in fine-tuning and objects only after they have entered the child’s field of atten-
mother’s adjusting their language input to the developmen- tion (Adamson, Bakeman, & Brandon, 2015). These strategies
tal level of their child to establish a coherent conversational are more easily related to concrete concepts or content
context. Iverson, Longobardi, Spampinato, and Caselli (2006) words, such as nouns or nouns used as action verbs (e.g.,
analyzed child-directed language produced by five mothers bike), than to most function words, which often do not have
of children with Down syndrome during a 30 min free-play a concrete direct referent in the child’s environment. Mothers
session. They found that these mothers produced signifi- of children with Down syndrome talk significantly more
cantly fewer utterances than mothers of younger children about objects, using nouns, than mothers of children with
with typical development and comparable expressive language impairments (Kay-Raining Bird & Cleave, 2016).
 AUGMENTATIVE AND ALTERNATIVE COMMUNICATION 83

Still, children are able to learn and use more abstract func- rely on AAC should at least include the 16 core words based
tion words, as reflected in the core vocabulary of children on commonality found in the present study.
with Down syndrome in the current study. In his theory on
modeling and vicarious processes, Bandura (1969) states that
Limitations
individuals acquire words and syntactic structures by expos-
ure to verbalizing models. Some amount of modeling is Three possible limitations of the present study require con-
therefore indispensable for language acquisition. According sideration. First the sample size is relatively low, at just
to this theory, language is learned from models in the envir- 30 participants. Although small sample sizes are common in
onment, and as such, children will have many experiences core vocabulary studies and the recruitment of participants
with and will learn from language used by communication with Down syndrome is not easy, this restriction may limit
partners in daily life (Tomasello, 2003). Therefore, children the generalizability of the findings of this study. In small sam-
encounter core vocabulary used by communication partners ple sizes, wide variability in performance, as reflected in the
from early in their language development. Children are more range of both developmental age and expressive vocabulary
extensively exposed to specific function words than to spe- scores in the present study, may limit conclusions about
cific content words (Segalowitz & Lane, 2000), because these development of children with Down syndrome as a group
words are more often used by all of the child’s communica- (Patterson, Rapsey & Glue, 2013). However, the wide variabil-
tion partners across several activities and settings. ity between children is found to be common in the vocabu-
Without any known focus on teaching core vocabulary lary development of children with Down syndrome (Galeote
within speech-language therapy, these core words seem to et al., 2008), indicating that our research group may closely
emerge in the spontaneous interactions of the children with resemble the characteristics of the Down syndrome
Down syndrome in the current study, either in spoken or in population.
signed modalities. This may not be the case in other children A second limitation is the relatively small language sam-
with complex communication needs, who rely on significant ples collected – 100 words per child – although influential
others to add core vocabulary to their AAC devices. As stated studies such as Banajee et al. (2003) collected only 150 words
by Banajee et al. (2003), some words might be difficult to per child. Given the delayed vocabulary development and
represent visually either through graphic symbols or manual increased degree of unintelligible speech common in young
sign, which may result in SLPs not teaching children to use children with Down syndrome (Brady, 2008), collecting and
these words during intervention. However, words that are transcribing reliable language samples is time consuming.
difficult to represent graphically may be taught to young Thus, in order to include the same number of words in the
children by modelling the use of these words within activ- total sample for every child, we chose the 100-word thresh-
ities, as implied by Bandura’s theory of language acquisition. old. The children with higher expressive vocabulary scores
Based on clinical evidence, Van Tatenhove (2009) suggests reached this threshold after about 15 min of recording, while
that, in clinical practice, the balance of core to fringe vocabu- others did not reach threshold until 35 min or more.
lary should be at least four to one in AAC systems or on lan- Nevertheless, given that the present study is the first to focus
guage activity cards. For example, a child with Down on children with intellectual disabilities and developmental
syndrome who relies on AAC is engaged in a sandpit activity ages below 4 years, the results provide important insights
in a classroom. The child’s AAC system is a communication into core vocabulary and functional vocabulary use in this
board with, following the examples of Van Tatenhove (2009), participant group. In addition, the results are highly compar-
up to 50 core vocabulary words. Attached along the top of able with core vocabulary lists of studies in other popula-
this core vocabulary board is a spiral bound row of 20 strips, tions. Future studies should investigate the core vocabulary
each displaying 10 specific activity, place, topic, or partner- of this group in more detail, including participants whose
specific, fringe vocabulary words. In one of the rows, sandpit intellectual disability is not related to Down syndrome.
vocabulary (i.e., fringe vocabulary), such as sand, water, A final limitation is the uneven distribution of words
scoop, castle, and bucket, is accessible. Once the activity is uttered in the three different settings. Although language
finished, the fringe vocabulary can be exchanged with fringe samples in different settings and with different communica-
vocabulary for a subsequent activity. The core vocabulary on tion partners were collected, about 50% of the total sample
the communication board never changes and, following the of words were uttered in the play setting with parents and
findings of the present study and the larger research base in under 20% of the words were uttered in the lunch- or snack-
core vocabulary, would be the same for other children in the time. Lunch- or snack-time settings may evoke fewer utteran-
classroom as well. The fringe vocabulary should be individu- ces among children because they are discouraged from talk-
alized to the person’s needs, wants, and communication ing and eating at the same time. Future studies of core
environment. Vocabulary, core and fringe combined, must vocabulary in children with intellectual disabilities should
reflect children’s changing and evolving communication consider other contexts as well (e.g., pre-school classrooms,
needs and contexts, in order to allow for successful interac- activities with siblings or peers) in order to identify common-
tions in a variety of contexts and maintain sensitivity to the ality of vocabulary use over a range of contexts and commu-
child’s current and future developmental language abilities nication partners. Nonetheless, given the definition of core
and skills (Marvin, Beukelman, & Bilyeu, 1994). The core vocabulary as a small set of words, used consistently across
vocabulary list for young children with Down syndrome who environments and communication partners, and that changes
84 S. R. J. M. DECKERS ET AL.

little over time (Baker et al., 2000; Chen et al., 2011; Renvall Balandin, S., & Iacono, T. (1999). Crews, wusses, and whoppas: Core and
et al., 2013; Weighton & Dodd, 2011; Witkowski & Baker, fringe vocabularies of Australian meal-break conversations in the
workplace. Augmentative and Alternative Communication, 15, 95–109.
2012; Yorkston et al., 1988), we hypothesize results will be
doi:10.1080/07434619912331278605
comparable to the results of the present study. Banajee, M., Dicarlo, C., & Buras Stricklin, S. (2003). Core vocabulary deter-
mination for toddlers. Augmentative and Alternative Communication,
19, 67–73. doi:10.1080/0743461031000112034
Conclusions Bandura, A. (1969). Principles of behavior modification. New York, NY:
Holt, Rinehart & Winston.
The goal of the present study was to determine core vocabu- Bello, A., Onofrio, D., & Caselli, M.C. (2014). Nouns and predicates com-
lary in children with Down syndrome and a developmental prehension and production in children with Down syndrome.
age below 4 years, by analyzing spontaneous language sam- Research in Developmental Disabilities, 35, 761–775. doi:10.1016/j.ridd.
ples in different settings and with several communication 2014.01.023
partners. The 50 most frequently used core words accounted Berglund, E., Eriksson, M., & Johansson, I. (2001). Parental reports of spo-
ken language skills in children with Down syndrome. Journal of
for 67.2% of total word use; 16 words were determined to be Speech, Language and Hearing Research, 44, 179–191. doi:10.1044/
core vocabulary based on a commonality criterion (i.e., a 1092-4388(2001/016)
word was used by at least half of the participants). Words in Beukelman, D., Jones, R., & Rowan, M. (1989). Frequency of word usage
the core vocabulary of young children with Down syndrome by nondisabled peers in integrated preschool classrooms.
appear to be similar in syntactic semantic, and pragmatic Augmentative and Alternative Communication, 5, 243–248. doi:10.
1080/07434618912331275296
functions to core words identified by research into other Beukelman, D.R., & Mirenda, P. (2013). Augmentative and alternative com-
populations, although the contribution of content words to munication: Supporting children and adults with complex communica-
the core vocabulary of the children with Down syndrome tion needs (4th ed.). Baltimore, MD: Paul H. Brookes.
seems higher than in other groups. As reflected in the pre- Boenisch, J. (2014). Kernvokabular im Kindes-und Jugendalter. UK &
sent study, AAC use and vocabulary selection during AAC Forschung, 3, 4–23.
Boenisch, J., & Sachse, S. (2007). Zum Einsats von Kern-in der fr€ uhen
intervention, such as the overrepresentation of noun use in Fo€rderung [The use of core vocabulary in the early development].
Sign Supported Dutch, influences functional word use and Unterst€utzte Kommunikation, 3, 12–20.
determination of core vocabulary lists. A higher number of Boenisch, J., & Soto, G. (2015). The oral core vocabulary of typically
content words, relative to function words, may also reflect developing English-speaking school-aged children: Implications for
the expressive vocabulary age of the children with Down AAC practice. Augmentative and Alternative Communication, 31, 77–84.
doi:10.3109/07434618.2014.1001521
syndrome in the present study. The results of the present
Bol, G., & Kuiken, F. (1989). Handleiding GRAMAT. Methode voor het diag-
study strengthen the definition and applicability of core nosticeren en kwalificeren van taalontwikkelingsstoornissen [Instruction
vocabulary as a construct for the field of AAC. To achieve the manual GRAMAT. Method for diagnostics and qualifying specific lan-
most effective communication possible, vocabulary selection guage impairments]. Lisse: Swets B.V
in AAC should best be based on the emerging evidence Bolier, W. (2010). Communicatie in Nederlands met Gebaren in het speci-
aal onderwijs aan dove, slechthorende en ESM-kinderen
relating to functional language use of children with intellec-
[Communication in Sign Supported Dutch in special education for
tual disabilities. deaf, hard of hearing children and children with specific language
impairments]. VHZ Artikelen, 6, 14–18.
Brady, N.C. (2008). AAC for children with Down syndrome and children
Disclosure statement with Fragile X syndrome. In J.E. Roberts, R.S. Chapman, & S.F. Warren
(Eds.), Speech and language development and intervention in Down syn-
The authors report no conflicts of interest. The authors alone are respon-
drome and Fragile X syndrome (pp. 255–274). Baltimore, MD: Paul H.
sible for the content and writing of this article.
Brookes.
Brownell, R. (2000). Expressive One-Word Picture Vocabulary Test. Novado,
CA: Academic Therapy Publications.
References
Burroughs, G.E.R. (1957). A study of the vocabulary of young children.
Abbeduto, L., Pavetto, M., Kesin, E., Weissman, M., Karadottir, S., O’brien, Birmingham: Oliver and Boyd.
A., & Cawthon, S. (2001). The linguistic and cognitive profile of Down Chan, J., & Iacono, T. (2001). Gesture and word production in children
syndrome: Evidence from a comparison with fragile X syndrome. with Down syndrome. Augmentative and Alternative Communication,
Down Syndrome Research Practice, 7, 9–15. doi:10.3104/reports.109 17, 73–87. doi:10.1080/aac.17.2.73.87
Adamson, L.B., Bakeman, R., & Brandon, B. (2015). How parents introduce Chapman, R.S., & Kay-Raining Bird, E. (2012). Language development in
new words to young children: The influence of development and childhood, adolescence, and young adulthood in persons with Down
developmental disorders. Infant Behaviour & Development, 39, syndrome. In J.A. Burack, R.M. Hodapp, G. Iarocci, & E. Zigler (Eds.),
148–158. doi:10.1016/j.infbeh.2015.02.008 The Oxford handbook of intellectual disability and development (pp.
Adamson, L.B., Romski, M., Deffebach, K., & Sevcik, R.A. (1992). Symbol 167–183). Oxford: Oxford University Press.
vocabulary and the focus of conversations: Augmenting language Chen, M., Chen, Y., & Chen, C. (2013). Do they need specific language
development for youth with mental retardation. Journal of Speech and training content?: Results of core vocabulary investigation from children
Hearing Research, 35, 1333–1343. doi:10.1044/jshr.3506.1333 with/without intellectual disabilities in Taiwan. Paper presented at the
Aitchison, J. (2003). Words in the mind. An introduction to the mental lexi- Proceedings of the 7th International Convention on Rehabilitation
con. Maiden, MA: Blackwell. Engineering and Assistive Technology, Singapore.
Baker, B., Hill, K., & Devylder, R. (2000). Core vocabulary is the same across Chen, M.C., Hsu, S.C., Chi, P.H., Ko, C.C., Lin, Y.L., & Huang, Q.Y. (2011). Do
environments. Paper presented at the California State University at they narrate in the same vocabulary? The result of core vocabulary
Northridge Conference on Disabilities, Los Angeles, CA. Abstract investigation from children with/without Asperger syndrome in
retrieved from http://minspeak.com/students/documents/2000CSUN. Taiwan. International Convention on Rehabilitation Engineering and
pdf Assistive Technology, pp. 57–60.
 AUGMENTATIVE AND ALTERNATIVE COMMUNICATION 85

Dark, L., & Balandin, S. (2007). Prediction and selection of vocabulary for vocabulary in children with Down syndrome. Journal of Child
two leisure activities. Augmentative and Alternative Communication, 23, Language, 43, 948–963. doi:10.1017/S030500091500029X
288–299. doi:10.1080/07434610601152140 €
Ozçalışkan, Ş., & Goldin-Meadow, S. (2011). Is there an iconic gesture
Deckers, S.R.J.M., Van Zaalen, Y., Mens, E.J.M., Van Balkom, H., & spurt at 26 months. In G. Stam and M. Ishino (Eds.), Integrating ges-
Verhoeven, L. (2016). The concurrent and predictive validity of the tures: The interdisciplinary nature of gesture (pp. 163–174). Amsterdam:
Dutch version of the Communicative Development Inventory in chil- John Benjamins.
dren with Down syndrome for the assessment of expressive vocabu- Patterson, T., Rapsey, C.M., & Glue, P. (2013). Systematic review of cogni-
lary in verbal and signed modalities. Research in Developmental tive development across childhood in Down syndrome: Implications
Disabilities, 56, 99–107. doi:10.1016/j.ridd.2016.05.017 for treatment interventions. Journal of Intellectual Disability Research,
€
Dimitrova, N., Ozçalışkan, Ş., & Adamson, L.B. (2016). Parents’ translations 57, 306–318. doi:10.1111/jir.12037
of child gesture facilitate word learning in children with autism, Down Polisensk
a, K., & Kapalkov
a, S. (2014). Language profiles in children with
syndrome and typical development. Journal of Autism and Down syndrome and children with language impairment: Implications
Developmental Disorders, 46, 221–231. doi:10.1007/s10803-015-2566-7 for early intervention. Research in Developmental Disabilities, 35,
Eriksson, C.C. (2014). Children’s vocabulary development. The role of paren- 373–382. doi:10.1016/j.ridd.2013.11.022
tal input, vocabulary composition and early communicative skills. Renvall, K., Nickels, L., & Davidson, B. (2013). Functionally relevant items
Stockholm: Department of Special Education, Stockholm University. in the treatment of aphasia (part I): Challenges for current practice.
Fallon, K.A., Light, J.C., & Paige, T.K. (2001). Enhancing vocabulary selec- Aphasiology, 27, 636–650. doi:10.1080/02687038.2013.786804
tion for preschoolers who require augmentative and alternative com- Roberts, J., Long, S.H., Malkin, C., Barnes, E., Skinner, M., Hennon, E.A., &
munication (AAC). American Journal of Speech-Language Pathology, 10, Anderson, K. (2005). A comparison of phonological skills of boys with
81–94. doi:10.1044/1058-0360(2001/010) fragile X syndrome and Down syndrome. Journal of Speech, Language,
Galeote, M., Sebasti
an, E., Checa, E., Rey, R., & Soto, P. (2011). The devel- and Hearing Research, 48, 980–995. doi:10.1044/1092-4388(2005/067)
opment of vocabulary in Spanish children with Down syndrome: Robillard, M., Mayer-Crittenden, C., Minor-Corriveau, M., & B
elanger, R.
Comprehension, production, and gestures. Journal of Intellectual and (2014). Monolingual and bilingual children with and without primary
Developmental Disability, 36, 184–196. doi:10.3109/13668250.2011. language impairment: Core vocabulary comparison. Augmentative and
599317 Alternative Communication, 30, 267–278. doi:10.3109/07434618.2014.
Galeote, M., Soto, P., Checa, E., Go
mez, A., & Lamela, E. (2008). The acqui- 921240
sition of productive vocabulary in Spanish children with Down syn- Segalowitz, S.J., & Lane, K.C. (2000). Lexical access of function versus con-
drome. Journal of Intellectual and Developmental Disability, 33, tent words. Brain and Language, 75, 376–389. doi:10.1006/brln.2000.
292–302. doi:10.1080/13668250802441870 2361
Hegde, M.N. (2003). Clinical research in communicative disorders: Principles Sherman, S.L., Allen, E.G., Bean, L.H., & Freeman, S.B. (2007).
and strategies (3rd ed.). Austin, TX: PRO-ED, Inc. Epidemiology of Down syndrome. Mental Retardation and
Hesketh, L.J., & Chapman, R.S. (1998). Verb use by individuals with Down Developmental Disabilities Research Reviews, 13, 221–227. doi:10.1002/
syndrome. American Journal on Mental Retardation, 103, 288–304. mrdd.20157
doi:10.1352/0895-8017(1998)103 < 0288:VUBIWD >2.0.CO;2 Smith, M., & Grove, N. (1999). The bimodal situation of children learning
Hill, K., Kovacs, T., & Shin, S. (2015). Critical issues using brain-computer language using manual and graphic signs. In F. Loncke, J. Clibbens, H.
interfaces for augmentative and alternative communication. Archives Arvidson, & L. Loyd (Eds.), Augmentative and alternative communica-
of Physical Medicine and Rehabilitation, 96, S8–S15. doi:10.1016/j. tion: New directions in research and practice (pp. 8–30). London: Whurr.
apmr.2014.01.034 Stuart, S., Beukelman, D., & King, J. (1997). Vocabulary use
Iverson, J.M., Longobardi, E., Spampinato, K., & Caselli, C.M. (2006). during extended conversations by two cohorts of older adults.
Gesture and speech in maternal input to children with Down's syn- Augmentative and Alternative Communication, 13, 40–47. doi:10.1080/
drome. International Journal of Language & Communication Disorders, 07434619712331277828
41, 235–251. doi:10.1080/13682820500312151 Te Kaat, D.J.A., (2013). Expressieve woordenschat bij Downsyndroom
Kay-Raining Bird, E., & Cleave, P. (2016). Mothers’ talk to children with [Expressive vocabulary in Down syndrome]. Nederlands Tijdschrift Voor
Down Syndrome, language impairment, or typical development about Logopedie, 8, 6–10.
familiar and unfamiliar nouns and verbs. Journal of Child Language, The R Foundation (n.d.). The R project for statistical computing.
43, 1072–1102. doi:10.1017/S0305000915000434 Retrieved from https://www.r-project.org/
Kent, R.D., & Vorperian, H.K. (2013). Speech impairment in Down syn- Tomasello, M. (2003). Constructing a language: A usage-based theory of
drome: A review. Journal of Speech, Language, and Hearing Research, language acquisition. Cambridge: Harvard University Press.
56, 178–210. doi:10.1044/1092-4388(2012/12-0148) Trembath, D., Balandin, S., & Togher, L. (2007). Vocabulary selection for
Kovacs, T., & Hill, K. (2015). A tutorial on reliability testing in AAC lan- Australian children who use augmentative and alternative communi-
guage sample transcription and analysis. Augmentative and Alternative cation. Journal of Intellectual and Developmental Disability, 32,
Communication, 31, 11–11. doi:10.3109/07434618.2015.1036118 291–301. doi:10.1080/13668250701689298
Kumin, L. (1994). Intelligibility of speech in children with Down syndrome Van Balkom, H., Verhoeven, L., Van Weerdenburg, M., & Stoep, J. (2010).
in natural settings: Parents' perspective. Perceptual and Motor Skills, Effects of parent-based video home training in children with develop-
78, 307–313. doi:10.2466/pms.1994.78.1.307 mental language delay. Child Language Teaching and Therapy, 26,
Lee, D.Y.W. (2001). Defining core vocabulary and tracking its distribution 221–237. doi:10.1177/0265659009349978
across spoken and written genres. Evidence of a gradience of vari- Van Duijn, G., Dijkxhoorn, Y., Noens, I., Scholte, E., & van Berckelaer-
ation from the British national corpus. Journal of English Linguistics, Onnes, I. (2009). Vineland Screener 0–12 years research version (NL).
29, 250–278. doi:10.1177/00754240122005369 Constructing a screening instrument to assess adaptive behaviour.
Marvin, C., Beukelman, D., & Bilyeu, D. (1994). Vocabulary-use patterns in International Journal of Methods in Psychiatric Research, 18, 110–117.
preschool children: Effects of context and time sampling. doi:10.1002/mpr.282
Augmentative and Alternative Communication, 10, 224–236. doi:10. Van Duijn, G., Dijkxhoorn, Y., Scholte, E.M., & van Berckelaer-Onnes, I.
1080/07434619412331276930 (2010). The development of adaptive skills in young people with
Mein, R., & O’connor, N. (1960). A study of the oral vocabularies of Down syndrome. Journal of Intellectual Disability Research, 54,
severely subnormal patients. Journal of Intellectual Disability Research, 943–954. doi:10.1111/j.1365-2788.2010.01316.x
4, 130–143. doi:10.1111/j.1365-2788.1960.tb00761.x Van Tatenhove, G. (2009). The Pixon language and learning activity note-
Miller, J. (1989). Assessing language production in children. Baltimore: book. In G. Van Tatenhove (Ed.), Pixon project kit. Wooster, OH:
University Park Press. Prentke-Romich Company.
€
Ozçalışkan, S., Adamson, L.B., Dimitrova, N., Bailey, J., & Schmuck, L., Van Tilborg, A., & Deckers, S.R.J. (2016). Vocabulary selection in AAC:
(2016). Baby sign but not spontaneous gesture predicts later Application of core vocabulary in atypical populations. ASHA SIG 12:
86 S. R. J. M. DECKERS ET AL.

Perspectives on Augmentative and Alternative Communication, 1, Alternative Communication, 5, 101–108. doi:10.1080/

125–138. doi:10.1044/persp1.SIG12.125 07434618912331275076
Weighton, C., & Dodd, S. (2011). Treloar vocabulary: A project to meet Yorkston, K.M., Smith, K., & Beukelman, D. (1990). Extended com-
the AAC needs of teenagers and young adults. Communication munication samples of augmented communicators I: A compari-
Matters, 29, 7–9. son of individualized versus standard single-word vocabularies.
Witkowski, D., & Baker, B. (2012). Addressing the content vocabulary with Journal of Speech and Hearing Disorders, 55, 217–224. doi:10.
core: Theory and practice for nonliterate or emerging literate stu- 1044/jshd.5502.217
dents. Perspectives on Augmentative and Alternative Communication, Zampini, L., & D’Odorico, L. (2009). Communicative gestures
21, 74–81. doi:10.1044/aac21.3.74 and vocabulary development in 36-month-old children with Down
Yorkston, K., Dowden, P., Honsinger, M., Marriner, N., & Smith, K. (1988). syndrome. International Journal of Language & Communication
A comparison of standard and user vocabulary lists. Augmentative Disorders, 44, 1063–1073. doi:10.1080/13682820802398288
and Alternative Communication, 4, 189–210. doi:10.1080/ Zampini, L., Fasolo, M., & D’Odorico, L. (2011). Characteristics of maternal
07434618812331274807 input to children with Down syndrome: A comparison with vocabulary
Yorkston, K.M., Honsinger, M.J., Dowden, P.A., & Marriner, N. (1989). size and chronological age-matched groups. First Language, 32, 1–19.
Vocabulary selection: A case report. Augmentative and doi:10.1177/0142723711410780