Babble Boot Camp for infants with Down syndrome (Peter et al., 2025)
Purpose: Down syndrome (DS) is associated with lifelong difficulties with verbal communication, beginning in infancy when vocalizations are sparse and first words emerge late. Because DS is diagnosed at or even before birth, these difficulties can be anticipated, yet there have been limited developments of systematic, proactive interventions. The purpose of the pilot study described here was to investigate feasibility and potential benefits of such an intervention toward a fully powered clinical trial.
Method: We piloted Babble Boot Camp (BBC), a proactive, parent-led speech and language intervention, with 10 children with DS ages 4–16 months. Each family participated in weekly sessions via telehealth for 10 months. A pediatric speech-language pathologist coached parents to implement daily routines and activities at home, designed to foster child target behaviors and skills (e.g., increased vocalization rates, babble complexity, word productions) toward building resilience against anticipated challenges. Parents provided daylong audio recordings and questionnaire data at regular intervals.
Results: Parent participation and compliance metrics in the intervention were high. All rated the intervention as acceptable, convenient, and helpful, whereas three sets of parents found aspects of the data collection time consuming. Children’s linguistic environments resembled those of typical controls in terms of child utterance rates, adult word counts, and conversational turns. Babble complexity and receptive and expressive vocabularies increased over time. First words emerged earlier than expected.
Conclusion: High feasibility metrics and suggestive benefits motivate a larger study to determine more specifically how the various BBC components can improve long-term outcomes for children with DS.
Supplemental Material S1. TIDieR (Template for Intervention Description and Replication) checklist.
Supplemental Table S1. Adult word count rate per hour linear regression trendline equations.
Supplemental Table S2. Child utterance rate per hour linear regression trendline equations.
Supplemental Table S3. Conversational turns linear regression trendline equations.
Supplemental Table S4. Mean babbling level linear regression trendline equations.
Supplemental Table S5. ASQ-3 scores for five domains by age in months.
Supplemental Table S6. Results of caregiver satisfaction surveys.
Supplemental Figure S1. Receptive vocabulary size as measured with the MBCDI-2 as a function of child age.
Supplemental Figure S2. Expressive vocabulary size as measured with the MBCDI-2 as a function of child age.
Supplemental Figure S3. Physical Health Summary scores for children as a function of child age.
Supplemental Figure S4. Psychosocial Health Summary scores for children as a function of child age.
Supplemental Figure S5. Emotional, social, and cognitive PedsQL Psychosocial Health Summary subscores for children as a function of child age.
Peter, B., Finestack, L., Loveall, S., Thompson, L., Bruce, L., Scherer, N., Stoel-Gammon, C., Davis, J., Potter, N., VanDam, M., Eng, L., & Buckley, S. (2025). Babble Boot Camp for infants with Down syndrome: Piloting a proactive, caregiver-led intervention designed to boost earliest speech and language skills. American Journal of Speech-Language Pathology. Advance online publication. https://doi.org/10.1044/2024_AJSLP-24-00271
Funding
The original Babble Boot Camp clinical trial was funded with a local grant from the Arizona State University Institute for Social Science Research (B. Peter) and a National Institute of Child Health and Human Development grant (R01HD098253) to B. Peter, M. VanDam, and N. Potter. The present project was funded with Research Incentive Distribution funding from Arizona State University (B. Peter) and private donations to the Arizona State University Foundation Gift Account “Babble Boot Camp” (B. Peter). It was also supported by Down Syndrome Education International.
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