Social and communicative functioning

Undoubtedly there are numerous research questions that remain unanswered regarding the social and communicative abilities of infants, children and adults with Down syndrome. For the purpose of this paper, which is to stimulate discussion regarding urgent research priorities in these topic areas, we have chosen to consider the idea of key questions from a developmental perspective. In part this is because we believe that better understanding the development of these core abilities is most likely to point to effective ways of supporting them. But also it is now much clearer that the early stages of development, when brain functions are most plastic, offer the best opportunities to overcome difficulties that may become much less tractable if addressed later in development, when early difficulties in specific areas may have subsequent wider-ranging effects on linked processes as the brain becomes increasingly 'modularised' and specialised in function. We have chosen to focus on a relatively high-level outcome of early development, because this outcome, attachment to car-egivers, is at the confluence of the many components of social and communicative abilities. There is now solid evidence that attachment security is a key achievement of the first year of life, and that it represents the mutual effects of a range of environmental , genetic and constitutional factors [1]. It is of great significance for subsequent development into later childhood and beyond, as evidenced by links into emotional and cognitive development, and into the formation of later close relationships. Thus it can be taken as a proxy for the many lines of early development that are seen at more fractionated levels of analysis, encompassing attention, communication , memory, executive functions, emotional sensitivity and expressiveness, along with social skills and understand-ings such as mentalising capacities. It is also appropriate to look at attachment in children with Down syndrome because of relative strengths in social functioning [2]. Indeed, strengths in social domains differentiate Down syndrome from many other developmental disorders [3]. While there is general agreement that standard measures of attachment security , notably Ainsworth's Strange Situation , can be carried out and meaningfully analysed with children with Down syndrome , there have been concerns raised that the qualities of attachment security and the form of organisation of attachment related behaviours that are seen in such measures may be different in children with Down syndrome [4]. Thus the pathways to attachment may not necessarily be equivalent to those for …