In individuals with Down syndrome or severe intellectual disability, how are language problems typically characterized?

• A. Only expressive language is delayed
• B. Receptive language is typically unaffected
• C. Both expressive and receptive language are delayed
• D. Language is not affected

Answer: (C)

Language difficulties in individuals with Down syndrome or severe intellectual disability tend to span both understanding and speaking. Global delays in language development mean challenges in receptive language—understanding words, instructions, and concepts—and in expressive language—vocabulary, grammar, and clear speech. While some profiles may show relatively stronger comprehension compared to production, the overall pattern is that both domains are affected, which is why the best description is that both expressive and receptive language are delayed. This dual impact guides assessment and intervention toward improving understanding and the ability to express thoughts, using clear explanations, visual supports, and explicit teaching of vocabulary and grammar.