Associate Professor, Arizona State University
2009 New Century Scholars Research Grant recipient
2023 Clinical Research Grant recipient
Babble Boot Camp for Infants with Down Syndrome: Improving Speech and Language Outcomes via a Proactive, Parent-led Intervention
What originally sparked your interest in your research?
This goes back to the 2009 award. I’m not only trained as a speech-language pathologist with a PhD in speech and hearing sciences, but I also completed three years of postdoctoral training in medical genetics. From the very beginning, I’ve been fascinated by how genetic changes influence how children learn to talk. That interest led me to study genotype-phenotype associations in communication disorders. It was during my postdoc in medical genetics that I received the 2009 ASHFoundation New Century Scholars Research Grant.
During my PhD program at the University of Washington, each year we had to give a talk in front of our peers and faculty members about our work and answer the question, “Who cares?”. That really pushed me to think about the clinical impact. At one point, I had a conversation with a physician who mentioned that my work fits within the framework of Precision Medicine, which aims to tailor interventions using biological and environmental factors. That concept—especially the ideas of prevention and personalization—shaped the direction of my research.
In 2014, I began wondering whether speech and language disorders could be prevented using knowledge of genetic risks. By this time, I had encountered many children whose speech disorders were so severe that in some cases even their parents had a hard time understanding what they said. I remembered a talk by Nancy Potter, PhD, about classic galactosemia, a metabolic condition associated with severe apraxia of speech, which is diagnosed via newborn screening. Bingo! It was the perfect population to figure out if prevention can work. I reached out and asked, “What if we try to prevent apraxia in babies with galactosemia?”
She said yes and we received seed funding from Arizona State University and enrolled a small group of infants with classic galactosemia. That’s how the first version of Babble Boot Camp started.
What problem are you hoping your work will solve? How could this potentially affect clinicians, caregivers, and/or individuals affected by communication challenges?
With our ASHFoundation research grant, we’re focused on improving speech and language outcomes in babies with Down syndrome, starting as early as possible. We wanted to know if we could help speed up the timing of their first words. Early findings suggest we can.
Parents in our study have shared that under standard care, their children don’t receive much speech and language support in the first few years. The priority is often on immediate medical needs, like feeding, and communication typically isn't addressed until much later.
Babble Boot Camp was designed to change that. We asked ourselves what could be done when a baby is just two months old. The answer is: quite a bit. Simple actions like responding to vocalizations, making eye contact, and ensuring the baby can see your face when you talk all make a difference.
This work could make an impact by equipping clinicians and families with early tools to support communication. We call it “Vitamin P”—the power of parents—to take advantage of early neuroplasticity and lay the foundation for clearer speech, stronger language skills, and deeper self-expression.
Today, Babble Boot Camp is already reaching many families whose babies have various predictable risk types. Nancy Potter spearheaded an online training course that anyone can complete and use the principles in their own homes or with their clients. We are hoping that this prophylactic approach will replace the conventional one that addresses deficits after they emerge.
How are you approaching this work? In what ways is your approach to this work innovative?
Babble Boot Camp started with a seed grant and a small pilot study involving babies with classic galactosemia, followed by a clinical trial funded by the National Institutes of Health. Families were placed into two groups: one received weekly virtual training sessions with a speech-language pathologist starting at child ages under 6 months, and the other received an alternate motor intervention to begin with, then switched to speech and language at 15 months. The results were promising.
Now, with support from the ASHFoundation, we’re working with babies who have Down syndrome. Because their developmental profiles are different, we’re learning how to adapt the intervention to better meet their needs.
What’s specifically new in this study is that we’re testing two different approaches of delivering the program. Some families are receiving individual virtual coaching like in the original version, while others participate in group sessions with other parents and an SLP. This is the first time we’ve tried a group model, and we’re interested to see how it compares in terms of both outcomes and parent engagement.
What specific obstacles were/are there in getting this research started? How has ASHFoundation funding been instrumental in launching this research?
After our initial success with the galactosemia study, we were encouraged by the potential but wanted to make a broader impact. Then, in 2022, I received an email from Sue Buckley, founder of Down Syndrome Education International. She read one of our papers and asked if I’d be interested in adapting the approach for babies with Down syndrome. I was thrilled. She is a world-renowned researcher who has spent her career improving educational outcomes and quality of life for people with Down syndrome.
Our team was able to gather a small amount of local funding to conduct a pilot study with a first cohort, just to see if families would be interested and to determine whether the model would work for this population.
But to really move the work forward, we needed to grow. That’s where the ASHFoundation came in. Their support gave us the launchpad we needed. It helped us go beyond a small pilot and build the foundation for a future large-scale clinical trial. It was the next critical step.