Book review: Exploring Fluency in Down Syndrome

Braypb2.inddExploring Fluency in Down Syndrome: A Discussion of Speech Dysfluencies for Professionals and Parents by Monica Bray
J&R Press Ltd. March 2016

Review by Erica Ford, Specialist Speech and Language Therapist (Down’s syndrome)

My overall impression of this book is that I might want to change the title. It would be a pity if the reader is misled into thinking that this is just a discussion about stammering in a person with Down’s syndrome.

This book has so much more to offer than the narrow interpretation the title implies.

The author has done a great job of reviewing the latest research and putting it into a readable context, helping us to summarise the lessons we can learn from all this new knowledge. Connections are made for us and we are given ideas, not only about how we could help children and young people achieve more fluency (in the broadest sense of the word), but also about the responsibility of the listeners to do their part as well.

I think all professionals (students and more experienced) can learn a great deal from this book, not just about fluency but about all aspects of communication for people with Down’s syndrome. In fact, much of the research referenced is not confined to people with Down’s syndrome; many of the ideas are pertinent to the wider community experiencing communication difficulties. This is a book I would have appreciated when I was a student, not only for its clear explanation of the latest theories and the implications these have on our approaches to therapy, but also because of the way it puts the work of professionals into a real life, practical context.

Successful functional communication for the young person with Down’s syndrome, by whatever means, should always to be our ultimate aim and this is reinforced throughout.

Exploring Fluency is also aimed at parents and the author acknowledges in her preface that “writing with so many possible readers in mind has been a challenging experience”. In order to be of value to professionals, there needs to be a certain level of jargon and illustrative examples, however, most parents/carers will probably find this quite daunting (in particular, the use of the correct, but confusingly similar, dysfluency and disfluency is off-putting). The glossary and transcribing data sections and the CD do help to a certain extent, but the first few chapters, in particular, could be quite a challenge to some. I would urge parents/carers not to be put off by this. The author had to place these explanations at an early stage in the book to set the scene but the “meat” comes later. No harm would result from those, with a less technical interest, glossing over the transcriptions and some of the more detailed explanations of brain function and models of linguistic functioning. It is, however, worth persisting, as there is a great deal of useful and relevant knowledge, written in an increasingly accessible way, to be gained from the later sections.

As a professional reading this book, I found the style very accessible and the technical data interesting. The drawing together of conclusions and implications for therapy was illuminating and I learnt a great deal. Where information was not new it was certainly interesting to see a different perspective and have it placed in a wider context. One very small issue for me was that Signalong was not mentioned alongside Makaton in the section on “no tech aids” as this signing system is now quite widely used in the UK.

I found the emphasis on the importance of making those early connections between movement and auditory and the implications this has for early input, very interesting. I also applaud the overall view that labelling our young people is not helpful and that we can be more effective if we identify and describe their communication needs instead.

Exploring fluency in Down Syndrome does what it says, it explores issues around fluency, however, it adds much more as well. I recommend it as an invaluable tool for professionals and an informative read for parents.