Developing an Early Reading Intervention Aligned With the Down Syndrome Behavioral Phenotype

Developing an Early Reading Intervention Aligned With the Down Syndrome Behavioral Phenotype

Christopher J. Lemons, Seth A. King, Kimberly A. Davidson, Cynthia S. Puranik, Stephanie Al Otaiba, Deborah Fulmer, Alicia A. Mrachko, Jane Partanen, and Deborah J. Fidler, 2017

Kate Monahan


The purpose of this study was to evaluate the possibility of effectively developing an early reading intervention to target the behavioral phenotype of Down Syndrome (DS).

The DS Behavioral Phenotype

What is a “behavioral phenotype”?

“A behavioral phenotype is a behavior or set of behaviors presumed to be

genetically determined” (Lemons et al., p. 177, 2017).

Behavioral phenotypes are often viewed as “problematic” and within the specific disorder of Down Syndrome, the domains that contain a behavioral phenotype include:


Language development

Social-emotional functioning

Personality motivation


The reading intervention would be effective with most of the participants, but that their responses would vary.

2. Instructors would be in favor

of the intervention but might

have trouble keeping up with

the intensity of one-on-one


In order to help students with Down Syndrome achieve at reading, phonological awareness and phonics skills, this study looked to create a reading intervention that would target the behaviors of the disability and phenotype that may intervene on student achievement. The researchers hypothesized that…


In order to be eligible to participate in this study, children had to be:

Identified by parents and teachers as a child with Down Syndrome

Between the ages of 5 and 10 years old

Be able to see and hear well enough to receive typically delivered instruction

Use English as a primary language

Participate in a screening, which included listening to directions and completing assessments

Be able to provide 2 correct letter sounds and/or words

Not provide too many correct responses on the screening that show a mastery of 2 or more of the 8 lessons

The final participants included 7 children, two girls and five boys, who were all white and between the ages of 6 and 8 years old.

Setting & Method

The reading intervention was delivered in 7 public elementary schools located in Pittsburgh, PA.

The intervention was individually conducted by school staff.

Staff consisted of 4 special education teachers and 3 paraprofessionals.

There were also “coaches” who were project staff, who supported the teachers and paraprofessionals.

From January to May, instructors delivered the intervention to students in 20-40 min sessions four times per week.

The intervention was done in a special education setting and at a small table or desk that was away from other children to avoid distractions.

The Intervention

There were 8 lessons which consisted of 4-6 steps and focused on decodable key words that were highly imageable and the sound of each initial letter of those key words (ex: pig, sun)

Images were taught alongside pictures, as well as with three other partner words that began with one of the three letters (ex: pup, sub)

The hope was that by pairing these key words with pictures, it would target the visual processing strengths of children with DS and also serve as a foundation to build more skills.

Looking Deeper into the 8 Lessons

Step 1: Key words (5 min) – Students would match key and partner words to pictures and then read the words.

Step 2: Letter sounds (5 min) – Students would say the sound of the first letter in each key word.

Step 3: Phonological Awareness (5 min) – Students isolated the first sound of key words and as they built up their skills they would segment and blend the first sound with the remainder of the word. After the initial part of step 3, students would build words using picture cards, magnetic letters and dry erase boards.

Step 4: High Frequency Words (2 min) – Students would learn to read 2 high frequency words during each lesson and they were introduced using a song and a model sentence.

Step 5: Vocabulary (5 min) – Instruction was focused on teaching the meaning of two words.

Step 6: Writing/Reading Connected Text (10 min)- Activities ranged from tracing letters and saying the sound to writing sentences independently on a dry erase board.

Each lesson consisted of 4 steps and an additional 2 if the instructor felt the child was capable and wouldn’t get frustrated

Considerations for the DS Behavioral Phenotype

Cognition and short term memory

instructors reduced the complexity of instruction


Language & Speech deficits

students were allowed to respond nonverbally to prompts (such as pointing)

easier sounds were introduced first

direct instruction was incorporated into the vocabulary (what, where, first, last)

Social-emotional & Personality-motivation

instructors were trained to ignore student attempts to get out of the lesson

students were redirected back to the lesson

scaffolding each step helped avoid noncompliant behavior

instructors were trained to be able to quickly adjust the level of intervention as needed


For 3 students, a consistent functional relation was established

For 2 students, gains were achieved but functional relation was not

For 2 students, a delayed response was demonstrated and the lessons were not effective

The instructors found that they were able to consistently deliver the instruction and that the intervention was feasible and effective, especially with the use of pictures.

Although the results don’t fully support the impact of the intervention on all students with DS, some students did achieve functional relation and both hypotheses were supported.


Lemons, C. J., King, S. A., Davidson, K. A., Puranik, C. S., Al Otaiba, S., Fulmer, D.,

& … Fidler, D. J. (2017). Developing an Early Reading Intervention Aligned with the Down Syndrome Behavioral Phenotype. Focus On Autism And Other Developmental Disabilities, 32(3), 176-187.

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