Children with Down syndrome improved developmental quotient scores through responsive teaching in small RCT



There are relatively few randomised controlled trials in interventions to support people with learning disabilities. There are often significant difficulties in design in multi-element real-life interventions, along with a range of ethical issues to consider.

The researchers in this Turkish study however were keen to use the methodology to look at responsive teaching for pre-school children with Down syndrome.

Responsive teaching describes a set of processes that enable teachers to ‘step in and out of a learning activity’ in a way that is responsive to where the child is at. It involves careful observation of students and then focuses attention on where students want to get with their learning and helping the, to get there by helping to focus attention, structuring tasks and modelling.


What they did was to work with a sample of 15 Turkish preschool-aged children with Down syndrome (DS) and their mothers over six months. In this approach to responsive teaching, it was parents who were encouraged to be the responders, structuring and modelling with their pre-school children.

The children were randomly assigned to one of two treatment conditions. In the responsive teaching group, there were twice weekly responsive teaching parent-child sessions in addition to standard services that the children received.

In the control group, the children received standard preschool classroom services.


What they found was that the mothers in the responsive teaching group made significantly greater increases in their responsiveness and affect as well as showing more decreases in directiveness than those found in the control group mothers.

They also found there were significant group differences in the children’s interactive engagement and development.

The children in the responsive teaching group improved their developmental quotient scores by an average of 47% compared to only 7% for the children in the control group. The developmental quotient measures the rate of a child’s development, and offers a way of arithmetically representing this rate. A developmental quotient of 100 represents the mean rate of development, so a developmental quotient of less than 70 would represent a significant developmental delay.

Conclusion and comment

Responsive teaching sits conceptually in a partnership framework and an inclusive approach. It is based on an iterative approach, where teaching strategies grow out of close observation and response to the goals, approach and pace of the individual. It would seem to fit very neatly within the current approach to best practice in supporting people with learning disabilities.

This trial had some very impressive results in terms of developmental quotient scores, but they must be treated with some caution as the trial is very small, with only fifteen subjects randomised between the two groups.


Effectiveness of Responsive Teaching With Children With Down Syndrome, in Intellectual and Developmental Disabilities, Karaaslan O & Mahoney G in Intellectual and Developmental Disabilities, 51, 6, 458-469

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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