Is there a link between communication and motor skills in 2 year-olds with CP?

This is the question Andrea Coleman and colleagues posed, and explored, in a recent study published in Archives of Physical Medicine and Rehabilitation. Whilst this is not the first time that this link is the focus of an investigation, Coleman and colleagues add a new dimension: Assessing very young children and using a standardised language assessment.

Their main aim was to explore the communication skills of 24-months old children with CP to identify those who might benefit from early intervention. At the same time, they were interested in exploring the relationship to general motor skills as well as risk factors for communication problems.

124 two-year old children with CP living in Australia were recruited to the study over a period of 4.5 years. Parents were asked to fill in a questionnaire about their children’s communicative development. This infant toddler checklist covered aspects of social communication such as gestures and gaze, expressive language as well as symbolic play. Two physiotherapists judged the children’s motor skills, and medical notes were consulted to obtain further information on children’s health.

Findings showed that 15% of the children did not yet use words or gesture to communicate; a further 10% employed gestures only. Another 23% used single words and 52% used two word combinations. The study also revealed that - based on the assessment - 62% of children were found to have communication problems that would meet the criteria for further, more extensive language assessment. This percentage is in stark contrast to the reported norms for typically developing children (20%) who were assessed using the same checklist. The authors conclude that children with CP do have higher communication needs than their typically developing peers, and would benefit from an early communication screening.

With regard to the question posed above, Coleman and colleagues found that communication problems were strongly associated with motor skills: Children with more severe motor problems were more likely to have delayed communication development, whereas children with mild motor impairment were less likely to have problems with verbal communication. At the same time, the authors found that poorer communication was more likely in children who were either born full-term or suffered from seizures. Overall, the study highlights the need to monitor language development in children with CP from an early age to identify those who will benefit from intervention...This, though, poses another series of questions: Where are we in terms of intervention? Where do we want to go, and how are we going to get there???

Coleman, A., Weir, K. A., Ware, R. S. & Boyd, R. N. (2013). Relationship between Communication Skills and Gross Motor Function in Preschool-Aged Children With Cerebral Palsy. Archives of Physical Medicine and Rehabilitation, 94, 2210-2217.