Rhythm & Articulation in Patients with Down Syndrome

Rhythm & Articulation in Patients with Down Syndrome


Activity Write-Up


Rhythm and Articulation


Materials Needed- Djembe (fit to size of client), Djembe for therapist, and one other rhythm instrument (sticks, shakers, etc) for high adaptation


Population- Down Syndrome


Domains- Communication: Articulation


 Gross Motor: Bilateral Hand Coordination


Reasoning- Many clients struggle with maintaining a specific rhythmic pattern for an extended period. This could be due to various things, such as low muscle tone, high muscle tone, lack of coordination, and fine/gross motor delay. These traits are often found in a client with Down Syndrome, but can be adapted to fit clients with other developmental delay. This activity assists with coordination as well as with clear, precise articulation.



  • For this activity, it is important to know your client well. You will be choosing words and phrases that are highly motivating and interesting to your client. It can be ANYTHING! With one of my clients, we often practice countries while doing this activity, which is a good reinforcement for academic skills.
  • Facilitate a warm-up on the djembes. Use bilateral as well as unilateral methods to get muscles firing and warmed up.
  • Tell the client to choose an area of interest. Be prepared for something bizzare, such as food items, but that is ok! Engage in conversation about this interest to get ideas about what kind of words and phrases might be good to use in the activity.
  • Based on their level of functioning, you can have the client choose the words, or you can have them choose. The more excited they are about it, the better. (And, it usually isn’t hard to find a strong area of interest for a client with Down Syndrome ? )
  • Depending on level of functioning, break down the word(s) into its syllables. For example, PEPPERONI PIZZA breaks down into PEP-PER-O-NI PI-ZZA (dotted eighth-sixteenth patterns). Use those syllables to create a rhythm on the drum that corresponds with the sound of the phrase.
  • Model the pattern for the client, and then have them join you. It is important to pair the syllables with the drum pattern to enforce the rhythm as well as clear articulation. Higher volume can help with proper articulation. Make it as fun and silly as possible to keep their interest.
  • When appropriate, back off on your level of prompting/modeling and see if they can sustain the rhythm on their own. Encourage them to keep saying the phrase while they drum. Encourage independence and sense of accomplishment.  
  • High adaptation- when the client has mastered some easier phrases and can carry them on independently, use another rhythm instrument for yourself to complement their rhythm. The added auditory input serves as a good way for the client to practice focusing on their rhythm only, without changing to match what you are playing. This is a transferable skill to many other settings in life.
  • Low adaptation- use single-syllable words and bilateral drumming until the client is ready for more complicated patterns.


Shanna DeJoseph

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