Speech and communication in cerebral palsy

Abstract

Abstract. Children communicate using speech, vocalisation,facial expression, gesture and body movement. The motor disorders of cerebralpalsy (CP) may affect the movements needed to produce any type of communicationsignal. Movements intended to be the same may vary in range, speed, strengthand accuracy and as a result communication signals may be difficult tounderstand. Children’s communication development may also be affected bycognitive or sensory disturbances, which are also common in CP (1). This paperwill describe the speech and communication difficulties often experienced bychildren with CP and will summarise the interventions that have been found tobe clinically effective with this population of children.Key words:Cerebral palsy, speech, communication, language, children

Keywords

• Cerebral palsy, speech, communication, language, children

References

1. Rosenbaum P, Paneth N, Leviton A, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007; 109: 8-14.
2. Bax M, Tydeman C, Flodmark O. Clinical and MRI correlates of cerebral palsy: the European Cerebral Palsy Study. JAMA 2006; 296: 1602-1608.
3. Love RJ, Childhood motor speech disability, Boston: Allyn & Bacon 1992.
4. Kennes J, Rosenbaum P, Hanna SE, et al. Health status of school-aged children with cerebral palsy: information from a population-based sample. Dev Med Child Neurol 2002; 44: 240-247.
5. Workinger MS, Kent RD. Perceptual analysis of the dysarthrias in children with athetoid and spastic cerebral palsy, in Dysarthria and apraxia of speech: perspectives on management, C.A. Moore, K.M. Yorkston, and D.R. Beukelman, Editors. Paul Brookes: Baltimore 1991p. 109-126.
6. Solomon NP, Charron S. Speech breathing in able
7. bodied children and children with cerebral palsy: A review of the literature and implications for clinical intervention. American Journal of Speech-Language Pathology 1998; 7: 61-78.
8. Patel R. Acoustic characteristics of the question- statement contrast in severe dysarthria due to cerebral palsy. J Speech Lang Hear Res 2003; 46: 1401-1415.

9. Ansel BM, Kent RD. Acoustic-phonetic contrasts and intelligibility in the dysarthria associated with mixed cerebral palsy. J Speech Hear Res 1992; 35: 296-308.
10. Platt LJ, Andrews G, Young M, Quinn PT. Dysarthria of adult cerebral palsy: I. Intelligibility and articulatory impairment. J Speech Hear Res 1980; 23: 28-40.
11. Platt LJ, Andrews G, Howie PM. Dysarthria of adult cerebral palsy: II. Phonemic analysis of articulation errors. J Speech Hear Res 1980; 23: 41-55.
12. Kent RD, Netsell R. Articulatory abnormalities in athetoid cerebral palsy. Journal of Speech and Hearing Disorders 1978; 43: 353-373.
13. Dickinson HO, Parkinson KN, Ravens-Sieberer U, et al. Self-reported quality of life of 8-12-year-old children with cerebral palsy: a cross-sectional European study. Lancet 2007; 369: 2171-2178.
14. Arnaud C, White-Koning M, Michelsen SI, et al. Parent-reported quality of life of children with cerebral palsy in Europe. Pediatrics 2008; 121: 54-64.
15. Fauconnier J, Dickinson HO, Beckung E, et al. Participation in life situations of 8-12 year old children with cerebral palsy: cross sectional European study. BMJ 2009; 338: 1458.
16. Wilson EM, Green JR, Yunusova Y, Moore CA. Task specificity in early oral motor development. Semin Speech Lang 2008; 29: 257-266.
17. Schmidt RA, Lee TD. Motor Control and Learning: A Behavioral Emphasis. 4th ed 2005, Leeds: Human Kinetics Europe Ltd.
18. Hodge MM, Wellman L. Management of dysarthria in children, in Clinical management of motor speech disorders in childhood, A.J. Caruso and E. Strand, Editors Thieme: New York 1999p. 209-280.
19. Strand EA. Treatment of motor speech disorders in children. Seminars in Speech and Language 1995; 16: 126-139.
20. Yorkston KM. Management of motor speech disorders in chidlren and adults Austin: Pro-ed. 1999.
21. Pennington L, Smallman CE, Farrier F. Intensive dysarthria therapy for older children with cerebral palsy: findings from six cases. Child Language Teaching & Therapy 2006; 22: 255-273.
22. Pennington L. Speech and language therapy for older children with cerebral palsy: a systems approach. Developmental Medicine & Child Neurology, 2009. Published Online: Sep 16 2009 4:48AM; DOI: 10.1111/j.1469-8749.2009.03366.x.
23. Schmidt RA, Wulf G. Continuous concurrent feedback degrades skill learning: implications for training and simulation. Hum Factors 1997; 39: 509-525.
24. Shea CH, Lai Q, Wright DL, Immink M, Black C. Consistent and variable practice conditions: effects on relative and absolute timing. J Mot Behav 2001; 33: 139-152.
25. Wulf G, Lee TD, Schmidt RA. Reducing Knowledge of Results About Relative Versus Absolute Timing: Differential Effects on Learning. J Mot Behav 1994; 26: 362-369.
26. Wulf G, Shea JB, Rice M. Type of KR and KR frequency effects on motor learning. Journal of Human Movement Science 1996; 30: 1-18.
27. Boliek C. Changes in trunk muscle activation and respiratory kinematics during speech following intensive voice treatment (LSVT-Loud) for chidlren with spastic cerebral palsy, in Motor Disorders Symposium 2009 Paris.
28. Fox CM, Boliek C, Ramig LO, et al. Intensive voice treatment (LSVTR LOUD) for children with spastic cerebral palsy. Movement Disorders 2008; 23: 378.
29. Robson S. Associations between speech intelligibility of children with cerebral palsy and the loudness and clarity of their voice, in Royal College of Speech and Language Therapists Conference 2008, London.
30. Hidecker MJC. Building the evidence for
31. communication interventions. Developmental Medicine & Child Neurology 2009.
32. Yorkston KM. Evidence-based practice guidelines for dysarthria: management of velopharyngeal function. Journal of Medical Speech-Language Pathology 2001; 9: 257-273.
33. Gibbon FE, Wood SE. Using electropalatography (EPG) to diagnose and treat articulation disorders associated with mild cerebral palsy: a case study. Clin Linguist Phon 2003; 17: 365-374.
34. Hodge MM. Interventions for children with developmental dysarthria, in Treatment of speech sound disorders in children, L. Williams, R. McCauley, and S. MacLeod, Editors. 2010, Brookes Ltd: Baltimore, MD.
35. Dunst CJ. Infant learning: A cognitive-linguistic intervention strategy. 1982, Hingham, MA: Teaching Resources Corp.
36. Pennington L, McConachie H. Mother-child
37. interaction revisited: communication with non- speaking physically disabled children. Int J Lang Commun Disord 1999; 34: 391-416.
38. Pennington L, McConachie H. Interaction between children with cerebral palsy and their mothers: the effects of speech intelligibility. Int J Lang Commun Disord 2001; 36: 371-393.
39. Dahlgren-Sandberg A, Liliedahl M. Patterns in early interaction between young preschool children with severe speech and physical impairments and their parents. Child Language Teaching and Therapy 2008; 24: 9-30.
40. Clarke-Stewart KA, Hevey CM. Longitudinal relations in repeated observations of mother-child interaction between 1 and 2 1/2 years. Developmental Psychology 1981; 17: 127-145.
41. Pennington L. Assessing the communication skills of children with cerebral palsy: does speech intelligibility make a difference? Child Language Teaching & Therapy 1999; 15: 159-169.
42. McConachie H, Ciccognani A. "What's in the box?" Assessing physically disabled children's communication skills. Child Language Teaching and Therapy 1995; 11: 253-263.
43. Schlosser RW, Sigafoos J. Selecting graphic symbols for an initial request lexicon: An integretive review. Augmentative and Alternative Communication 2002; 18: 102-123.
44. Pinder GL, Olswang LB. Development of
45. communicative intent in young children with cerebral palsy: a treatment efficacy study. Infant Toddler Intervention 1995; 5: 51-69.
46. McCollum JA. Social interaction between parents and babies: Validation of an intervention procedure. Child: Care, Health and Development 1984; 10: 301- 315.
47. Pennington L, Thomson K, James P, Martin L, McNally R. Effects of it takes two to talk--the hanen program for parents of preschool children with cerebral palsy: findings from an exploratory study. J Speech Lang Hear Res 2009; 52: 1121-1138.
48. Pepper J, Weitzman E. It Takes Two to Talk: A practical guide for parents of children with language delays. 2004, Toronto: The Hanen Centre.
49. Cockerill H. Carroll-Few L. eds. Communicating without speech: Practical Augementative and Alternative Communication 2001, MacKeith Press: London.
50. Collier B. Communicating Matters: A training guide for personal attendants working with people who have enhanced communication needs 2000, Baltimore: Paul H. Brookes.
51. Light J, Beukelman D, Reichle J. Communicative competence for individuals who use AAC: From research to effective practice 2003, Baltimore: Paul H. Brookes.
52. Light J, Binger C. Building communicative competence with individuals who use augmentative and alternative communication 1998, Baltimore: Paul H. Brooks.
53. Reichle J, Beukelman D, Light J. Exemplary practices for beginning communicators: Implications for AAC 2002, Baltimore: Paul H. Brookes.
54. Schlosser RW. ed. The efficacy of augmentative and alternative communication: toward evidence-based practice. Augmentative and alternative communication perspectives, ed. L.L. Lloyd 2003, Academic Press: San Diego.
55. Schlosser RW, Wendt O. Effects of augmentative and alternative communication intervention on speech production in children with autism: a systematic review. Am J Speech Lang Pathol 2008; 17: 212-230.
56. Marshall J, Goldbart J. 'Communication is everything I think.' Parenting a child who needs Augmentative and Alternative Communication (AAC). International Journal of Language and Communication Disorders 2008; 43: 77-98.
57. Lund SK, Light J. Long-term outcomes for individuals who use augmentative and alternative communication: Part III--contributing factors. Augment Altern Commun 2007; 23: 323-335.