The lack of speech therapy can be just as frustrating for service providers as it is for the parents. At Dunmore House in Glenageary, Co Dublin, Anne Gunning has spent the past two years trying to fill a post for a speech and language therapist. She's spent a lot of money on advertising and has even tried to recruit from abroad.

"There is speech therapy needed for many children with learning disabilities, not just children with Down Syndrome," says Gunning, who is director of St John of God's Carmona Services.

Dunmore House has one "sessional" speech and language therapist who does what she can, but she cannot get to everybody. "There's a problem nationwide. St John of God's services in Celbridge and Tallaght have the same problem. It's a simple fact of insufficient posts and personnel," she says.

There are not enough students being taken into the university courses in speech and language therapy, then when those students emerge into the workforce, they are unlikely to want to work with children with learning disabilities, Gunning suggests.

Many prefer to work in rehabilitation with accident victims and so on, where they can get dramatic results. "The impact for personal reward working with children with learning disabilities may not be as great," she says.

Dunmore House offers children with Down Syndrome an early services programme for families which is both home and centre-based.

The programme offers physiotherapy, psychology, visits from a social worker, pre-school services and a respite service - "Angel's Quest".

The goal is to move as many children with Down Syndrome as possible into mainstream schools. But they cannot get there without speech and language therapy.