Williams syndrome (WS) is commonly described as good language versus poor non-verbal abilities (such as block building). Although language abilities generally are a strength in older children and individuals with WS, almost all young children with WS show a significant delay at the start of language development. Our own research has shown that children with WS generally have a very limited vocabulary up until the mental age[1] of 18 months and many children may not say their first word until they are older than two years. There are a number of reasons why language abilities may be delayed in WS. The literature, as well as our own research, suggests that factors such as delayed pointing abilities, gross motor abilities early on in life, delayed theory of mind abilities, poor joint attention, and oromotor-praxis difficulties contribute to the delay observed in many children with WS. In addition, there are a small number of children with WS who never develop language (most of them have very complex needs and often also comorbid disorders) and sometimes language development can be extremely slow: I have worked with children with WS who did not develop language until they were 9 years old!

Not only is language delayed in WS, it is also atypical in that language production abilities are much stronger than language comprehension ones. Many people find this difficult to understand as generally in development children are able to understand something before they are able to do it themselves. In our own research we have seen that individuals with WS across a large age range are very poor at understanding figurative expressions. Yet, when we looked at the language they produced when telling stories from a wordless picture book, they used the same amount of figurative expressions as typically developing children.

So how can they use expressions and words, but without necessarily understanding them? Individuals with WS have very good short-term memory abilities, especially phonological short term memory or memory for sounds, and have very good imitation abilities. This allows them to imitate words and even entire sentences but without necessarily putting any meaning to it. This would also explain why children with WS sometimes use words within a strange context: “I am going to evacuate this glass” (when drinking from a glass). So, even when children obtain a large vocabulary and use full sentences, it is important to check the child’s language comprehension when giving instructions as their language production might deceive you about their understanding!

So if your child is very young and not talking yet, what can you do to support your child’s language development?

• Keep talking to them, name objects and read books, children with WS often need a lot more repetition before the information “sticks”.
• As children with WS gesture and point less than typically developing children, the children themselves create fewer opportunities to receive language input from adults than their peers and thus, adults need to ensure they keep providing language input, even when their child does not explicitly ask for it.
• Most children with WS have an affinity towards music so songs can be a good way to teach children language. For example, you could prompt them to say the final word of the rhyme/song.
• When you talk about something make sure you show the object to them or point but wait until the child has moved his/her attention to it. Young children with WS find it difficult to move their attention from one place to another and need more time and prompting to do so.
• We know that motor development (being able to move around and manipulate the objects) is very important for language development but children with WS often have delayed motor development or fine motor difficulties: so show them the objects from different angles and allow them to explore things as much as possible (e.g. by moving them around or position them in various different positions: viewing an object from the top looks very different to viewing it from the side).
• Help them develop their oral motor skills by pulling funny faces, practice tongue muscles by sticking out tongue in various ways, blowing bubbles etc.
• Access specialist input such as speech and language therapy, music therapy, and physiotherapy