I thought it would be best to briefly outline the communication disorders that are common in children with CP before diving straight into the latest research work. Lindsay Pennington provides a great overview in her 2008 paper (Paediatrics and Child Health). In my explanations, I mainly refer to her paper.
Communication difficulties are frequently associated with CP: It is estimated that about 50% of children with CP have some form of communication disorder. In most children speech is affected, but language and more general aspects of communication can be compromised as well. Due to the oro-motor problems, feeding difficulties, swallowing problems and drooling are common, too.
The most frequent speech impairment observed in CP is developmental dysarthria. Arising from the motor impairment, it can reduce the functioning and control of the different components required to produce speech i.e. respiration, phonation, nasality and articulation. Depending on the component(s) affected, children’s breathing may be shallow and irregular, and their voice may sound harsh. In addition, the speech sounds they produce may be poorly articulated. Speech problems are associated with all types of CP, but difficulties are more likely to be seen in children with dyskinetic (involuntary movements) than spastic (hypertonic, i.e. stiff muscles) types of CP.
Speech disorders can impact on children’s ability to produce spoken language. Depending on the severity, children may only use vocalisations, produce one word utterances, or very short phrases. This may restrict the range of grammatical structures they can use. Furthermore, delayed language development can derive from the cognitive issues associated with CP, but also be the result of limited interaction with the children’s environment.
In addition to the production of speech, nonverbal communication including facial expression, gestures and body movements may be affected as well. Children with CP often exhibit a delayed development of pragmatic skills and functional aspects of communication. Research suggests that this may be partly due to the fact that conversation with familiar partners follows restricted patterns, showing high levels of partner control. As a result, children with CP are often passive communicators; i.e. they initiate less interaction, they are less responsive and less independent communicators.
Early intervention therefore often targets situations in which the children are required to initiate communication.
…More about intervention approaches will follow here soon…watch this space…
Reference: Pennington, L. (2008). Cerebral palsy and communication. Paediatrics and Child Health 18(9), 405-409.
