My ds is 10 and down syndrome among other medical, neurological and physical issues. His speech from my perspective is quite good, when copying words he is very clear. When talking himself he can miss beginnings off words, it's not very clear. He can't make or hold conversation. A year ago he had a receptive understanding of a 4/5 yo and the expressive was that of a 2/3 yo done by bibic. He also has literal thinking and echolalia. From a speech therapist pov what should he be getting and doing?? Don't worry if you can't help, Take care.