Because Down syndrome children have a degree of mental and physical retardation, they are recipients of early intervention services that can enhance early development (Spiker and Hopman, 1997). Many early intervention programs have been designed to help facilitate people with developmental delay into mainstream schools. Early intervention can be defined as "a systematic program of physical therapy, exercise and activity designed to remedy developmental delays that may be experienced by children with Down syndrome. In many instances, the program is individualized to meet the specific needs of each child, and to help all infants and children reach growth milestones in every area of development" (NDSS, 1995-2003). These programs encompass several different areas such as cognitive development, language and communication, alternative communication, parent-child interactions and treatment to enhance motor and physical development. Currently, formal education for those with Down syndrome usually begins at infancy and continues through highschool (Van Riper and Cohen, 2001). .
Early intervention not only benefits infants with Down syndrome but also provides training and support for parents. "The hope seems to be that, if early development proceeds at a faster rate, more closely approximating a typical developmental course, higher final levels of cognitive, linguistic, adaptive, academic, and other skills can be attained" (Spiker and Hopman, 1997). .
Although there is an array of developmental areas to focus on, speech and language present many challenges for children with Down syndrome. More than 95% of children with Down syndrome will use speech as their primary communication system" (NDSS, 1995-2003). Many children may need assistance as they learn to use speech and language and some will use total communication until they can be transitioned into using just speech. Total communication combines speech and gestures together using sign language, pictures and other tools as a means of communication.
