Talking to oneself or self-talk is a common thing our loved ones with Down Syndrome do. Lots of people talk to themselves, including myself, but most people do not talk to themselves in public or social situations.

Max, my son born with DS and later diagnosed with autism, engages in self-talk a lot. He will have full on conversations with himself and he doesn’t care where. Max has been known to engage in self-talk in public restrooms, school, parks, restaurants, parties, the dinner table, basically any and all places he goes.

You can imagine the weird stares he/we get or the troubled and on occasion slightly terrified looks of those coming out of a public restroom Max is also using. As he has become older it has become more of an issue.

Luckily I stumbled upon the book Mental Wellness in Adults with Down Syndrome. There’s a first and second edition and I’ve read them both. The authors are the directors of the Adult Down Syndrome Center of Lutheran General Hospital in Park Ridge, Illinois so they know a few things!

I found the book really helpful in understanding why people with Down Syndrome engage in self-talk and how to manage it socially.

These books can be found online for FREE if you want to check them out for yourself. 

Otherwise read on and I’ll walk you through what I learned from the book as well as what I’ve learned from our own personal experience.

It turns out family members become really concerned when their loved one with Down Syndrome talks to themself. They think they’re suffering from a mental illness such as psychosis. Concerned caregivers may take their loved one to a medical professional who may not be familiar with Down Syndrome and antipsychotic medications prescribed.

The good news is self-talk in a person with Down Syndrome is a helpful coping behavior and is rarely a sign of mental illness.

Remember Mama Bears, as with anything on Twenty One Dandelions, you know your child and your family best. Take what works for you and don’t worry about the rest!

What Is Self-Talk?

The authors of Mental Wellness in Adults with Down Syndrome tell us self-talk is a social

behavior. It plays an important role in the development of a new skill as well as the development of mental thought processes. 

As we learn and grow we go through the following steps…

• First we observe or are shown a new task. We then borrow the teacher’s words to talk ourselves through the new task. This is called guided action and it happens over and over with each new task.

• As we learn, we use fewer words when talking to ourselves to get the task done. Eventually we progress to inaudible muttering.

• Next, the self-talk is internalized into our own thoughts or inner speech.

Why Do Teens And Adults With Down Syndrome Talk To Themselves?

Now I realize not every teen and adult with Down Syndrome talks to themselves, but in general many do. Understanding why helps us as caregivers understand our loved ones with DS better. It also allows us to educate the general public and better advocate for our loved ones with Down Syndrome.

So, the authors tell us that research shows most typical children internalize self-talk by the ages of 7 or 8. Those who face challenges such as visual, auditory, or attention challenges may not do so until later. Environmental challenges such as poverty can also push back the age that self-talk becomes internalized.

Our loved ones with DS face many challenges in a variety of areas including communication and learning. It makes sense that they may not internalize self-talk especially if we look at their developmental age rather than their chronological age. Remember too that a child can be at a different developmental age in different areas.

Also, it’s not like adults don’t talk to themselves. 

Adults do still use self-talk typically when learning a new task or doing something they find hard. I can say from my own personal experience when I’m learning something new I talk myself through the process or if I’m following directions I’ll say the directions out loud to myself as I do them or prepare to do them.

Adults, such as myself, are still using self-talk as a tool to help overcome obstacles and learn new skills.

So, like most teens and adults, people with DS are using self-talk to help themselves as they do tasks, but they may not be as aware of the need to hide self-talk around others. Adults without an intellectual disability use self-talk but because we’re more aware of others and don’t want them to hear our inner private conversations we don’t engage in self-talk around others as much.

We’ve observed and the authors also say families they’ve talked with have found our loved ones with Down Syndrome may not realize their self-talk isn’t private.

For example, I’ve asked Max to do something like put the dishes away when he would rather be doing something else. He’ll walk over to the dishwasher and start putting dishes away, engaging in self-talk while doing so, calling me a “poopy head” and expressing his displeasure to himself.

I’m literally 10 feet away and can hear everything he is saying. If I confront him he acts surprised that I was able to hear him! 

The authors conclude people with Down Syndro don’t always understand that they are overheard when engaging in self-talk. In addition, they don’t always understand what is and isn’t private. 

Remember how I said Max engages in self-talk in bathroom stalls in public restrooms? He may think he’s in a private place and others can’t hear him but that’s not the case!

How Self-Talk Helps People With Down Syndrome

Now that we understand why teens and adults with Down Syndrome talk to themselves let’s talk about how self-talk helps them.

How Self-Talk Helps People With Down Syndrome: Helps Process Events

We’ve noted after a long day of school Max will come home, sit down at his train table, and roll his marbles back and forth while talking to himself.

He’s stimming to self soothe after a day of lots of stimulation and talking to himself to process the events of the day. He’s “thinking out loud” and it’s a helpful strategy for him. Trying to eliminate this or make him feel bad about it would not benefit Max.  I feel it would actually cause harm.

How Self-Talk Helps People With Down Syndrome: Directs Behavior

Self talk helps our kids as they learn new things or go through tasks especially those that may be difficult.

Remember, self-talk plays an essential role in the cognitive development of all children as they grow and learn new tasks. Adults without disabilities still use self-talk particularly when doing tasks they find difficult. We’re just more aware of others and don’t want to make things socially awkward. The authors do note self-talk is relatively common in the elderly and it tends to be more socially acceptable.

Social isolation and an increased difficulty with some tasks may increase self-talk.

This certainly makes sense as often our loved ones with Down Syndrome, similar to the elderly population, do face a certain amount of social isolation and in general, it is harder for them to complete daily tasks.

How Self-Talk Helps People With Down Syndrome: Helps Vent Emotions

My son with Down Syndrome has a lot of emotions and he has a lot to say about them. There’s a misconception in society that people with Down Syndrome are always happy. They most assuredly are not.

Max’s emotions are similar to everyone else’s in our family. Some days he’s in a good mood, some days he’s grumpy, and some days he’s a bit melancholy. He experiences anxiety in new environments and around new people like many others. He experiences joy when seeing loved ones and eating ice cream...many can relate.

We’ve found Max uses self-talk to vent his emotions...good ones and bad ones.

We try to encourage him to go to a private area of the house such as his bedroom because I really don’t want to hear how I’m a poopy head because I asked him to put the dishes away.

How Self-Talk Helps People With Down Syndrome: Entertainment

When Max is bored he engages in more self-talk to entertain himself. Typically, he’ll start re-enacting a dance number from The Wiggles, a WWE fight, or a scene from The Thundermans show.

This often happens when we’re at a party or having some other social gathering where there are lots of people and talking. I have observed that it’s hard for Max to keep up with the conversation and it’s hard for an unfamiliar listener to understand what he is saying. It also takes him longer to respond because, as we know, expressive language is an area where people with Down Syndrome may struggle and Max definitely does.

He understands what others are saying to him but when it’s his turn to respond it takes him longer and he may grapple to find the words to get his point across. An unfamiliar friend or a family member may move on in the conversation rather than wait patiently for his reply.

Max has expressed some anxiety about talking to people he doesn’t know or know well and I believe it’s due to these struggles and so he detaches from the situation and entertains himself with self-talk.

Self-Talk Do’s and Don’ts In People With Down Syndrome

We understand that self-talk in people with Down Syndrome is rarely a sign of psychosis and instead is a useful tool used in a number of ways to help them with their day to day lives.

That being said, self-talk can cause awkward situations such as when Max is in a public restroom or re-enacting a WWE fight he recently watched in the middle of a dinner party.

Treating self-talk like a social skill is a good way to go about things. Just like we have to teach our children when it’s ok to hug and who they can hug, we can also teach them when it’s ok to engage in self-talk and to what degree.

We know self-talk is an important tool used when we’re performing a new or difficult task. In a social setting where they may need to utilize this tool teach your child to whisper or mutter to themselves rather than speaking out loud. Less obvious and more socially acceptable.

Encourage your child to use self-talk in appropriate places, such as their bedroom or their own private bathroom, and discourage it in inappropriate places like a public restrooms, work, or school.

Teach your child a silent signal you can give when out and about to remind them not to use self-talk such as putting your pointer finger to your lips in the “shush” gesture.

In social situations where there’s a lot of talking, try to keep your child engaged in the conversation so they don’t have to use self-talk to entertain themselves.

Sit next to them and quietly paraphrase what others are saying so they may better understand. Make specific comments to help include the person with Down Syndrome in the conversation and encourage others to be patient to allow your child with Down Syndrome enough time to think and respond.

Advocate for your child by increasing understanding in others who come into contact with your child by explaining self-talk and how it helps them.

While your loved one with Down Syndrome is learning to manage self-talk in a public setting the authors of Mental Wellness in Teens and Adults with Down Syndrome suggest disguising it by having them use a cell phone or place earbuds in their ears. It’s not a long term solution for sure and while talking on your cell phone in public can be considered rude by some it’s not a sign of mental illness.

Don’t try to eliminate self-talk.

Don’t make your child with Down Syndrome feel bad because they use self-talk.

When To Worry About Self-Talk In People With Down Syndrome

You know your child best. If you notice a marked increase in self-talk especially if it’s threatening and there has been a change in tone, be concerned. Also if it’s dominated by self demeaning comments or really self critical comments that’s a red flag.

That being said, take into account what your loved one with Down Syndrome has been watching.

If they’ve been watching shows that are violent, scary, or have characters that are disparaging to others they simply could be reenacting scenes or processing what they see on TV because they find it upsetting. Our loved ones with Down Syndrome have great visual memories. If this is the case then try to limit their exposure to these things.

Max was watching these YouTube videos depicting parents of kids with Down Syndrome crying and talking about the struggles of being a parent to a child with Down Syndrome as well as their emotions around receiving the diagnosis. Shortly thereafter his self-talk became sad, emotional, and distressing. He expressed sadness at having Down Syndrome.

Immediately we knew these videos were the culprit. We limited his exposure to these types of videos and instead had him watch very positive videos about DS. We talked about him having Down Syndrome, the good parts and the hard parts in a matter of fact way with no pity because Max doesn’t need our pity. He needs our support. Soon enough his self-talk went back to his usual tone and content.

Also take into account what’s going on in your own home. If there’s fighting and turmoil in the house and your child with Down Syndrome has a front row seat this could be the reason for the change in self-talk.

If you can’t come up with a reason for the change in your child’s self-talk, ask them if something is bothering them. You can also check with school staff, support staff, and co-workers to try and figure out why there’s been a change.

Usually you’ll find some reason such as a co-worker who may be less than friendly, a boss who isn’t as understanding, a classmate that’s disruptive and perhaps bullying. Sometimes it’s because there’s been a change and there’s a new stressor such as adjusting to a new living situation.

You can also find clues by listening to your child’s self-talk. Are they mentioning names or places? Can you deduce what happened? As previously mentioned, people with Down Syndrome have great visual memories so they could be reenacting something that happened years ago or that morning.

Sometimes a positive and helpful tool such as self-talk can become an impediment. 

Perhaps your child is coming home from school and staying in their bedroom all night talking to themselves or your loved one is no longer in school and spends the majority of their day engaging in self-talk. In this case try to limit their self-talk by engaging with them more. Let them come home from school, go to their room, and self-talk for an hour or so but have them come down for dinner and interact with family. Also, sign them up for various things to help get them out and about and engaged. Remember social isolation can lead to more self-talk.

Conclusions On Self-Talk In People With Down Syndrome

Self-talk is an important part of human development with children engaging in self-talk regularly before gradually internalizing it. Even as adults we engage in self-talk usually when doing tasks we find difficult but we limit this when around others and in social settings.

Teens and adults with Down Syndrome engage in self-talk due to a variety of reasons which I reviewed in this post. Keep in mind too, if we take into account their developmental age, it may be developmentally appropriate for them.

Self-talk is an important adaptive tool which serves to help people with DS do a variety of things such as direct their behavior, process events, vent emotions, and entertain themselves. We should not try to eliminate self-talk but we should treat it as a social skill by teaching our children when and where it’s appropriate to help eliminate problems they may encounter if they engage in self-talk publicly.

If the tone of your child’s self-talk becomes predominantly negative this is a cause for concern and you should look into why the change occurred and address it accordingly. In addition, if your child’s self-talk becomes excessive and impedes their desire or ability to engage in activities of daily living or engaging with others then that also should be addressed.

Mama Bears I hope you found this post helpful. If you did enjoy this post then consider checking out…

6 Brain Differences In Your Child With Down Syndrome And How It Impacts Behavior

7 Common Behavior Issues In Children With Down Syndrome And Tips To Manage Them

15 Best Behavior Hacks For Your Child With Down Syndrome

Let’s rock this special life! 

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