The project evaluated the effectiveness of using Total Communication (simultaneous use of sign language and speech) with six infants with Down syndrome as a means of fostering communication while verbal skills and articulatory proficiency develop. Each child was seen within the home environment every second week through 24 months of age and once a month from 25 through 30 months of age. Parents were taught signs for common toys and objects as well as common activities. Subjects were frequently evaluated for comprehension (17 to 24 months of age) and expressive language (through 30 months of age) and parents were asked to keep a language diary of their child's vocabulary development in both signs and words. Results were quite variable among the children, stressing the importance of individual differences. Findings suggest therapists should consider the following factors in deciding whether to use a Total Communication approach: (1) the degree to which the child is exhibiting a verbal expressive language delay relative to his/her receptive language at 12 months and 24 months; (2) the status of the child's middle ear function and hearing acuity; (3) the child's oral-motor status or extent of difficulty in the area of feeding; and (4) the parent's comfort level and ability to use Total Communication consistently. Test results for each child are presented graphically in the appendixes. Includes nine references. (DB)