Production of consonants in school-aged children with CP

Detailed descriptions of speech features in children with CP are a prerequisite for providing suitable interventions for children with speech impairments. However, as Ann Nordberg and colleagues point out in their most recent article: thorough descriptions of speech impairment in children with CP are rare - and even non-existent for those with ataxic dysarthria. The aim of their study was therefore to investigate the production of consonants produced by 19 school-aged Swedish-speaking children with CP in order to fill some of the blank spaces.

The children participating in the study were about 11 years old, and - according to medical records -had some form of speech impairment. In addition, 9 of the 19 children were known to have cognitive problems. The children were asked to name 59 pictures of the Swedish Articulation and Nasality Test (SVANTE), which covers the whole range of Swedish oral consonants prone to articulation deficits. Two speech and language therapists then phonetically analysed the consonants to obtain the percentage of correctly articulated consonants, and describe the error patterns. They also rated the severity of the speech impairment, whether the children sounded nasal and whether anything about their breathing, voice quality and prosody was noticeable.

Results showed that more than 50% of the children had severe difficulties with articulation resulting in a mean score of correct consonants that was well below that of typically developing children. The authors also found that children with spastic and dyskinetic dysarthria did better than the kids with ataxic dysarthria. Voicing errors were the most frequent type of errors followed by substitutions and omissions, which might be a result of poorly controlled phonation.

The authors further found that most of the children had mild dysarthria, and nasality – as opposed to previous reports – was not a common feature of the children’s speech. However, 13 children had problems related to breathing including having low energy, being breathless and not having enough air for speech production. The same number of children was also found to have unusual voice features such as high pitch levels, harsh voice and creaky voice. A further 6 of the 19 children were described as having deviant prosodic speech characteristics such as monotonous speech. The authors conclude that these features are equally important for the perception of dysarthria as the articulation deficit, and listeners may rely on the whole range of speech changes when making judgements about the presence and severity of dysarthria.


Nordberg, A., Miniscalco, C. & Lohmander, A. (2014). Consonant production and overall speech characteristics in school-aged children with cerebral palsy and speech impairment. International Journal of Speech-Language Pathology, 16(4), 386-395.