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Comprehension of spoken language in non‐speaking children with severe cerebral palsy: an explorative study on associations with motor type and disabilities
Author(s) -
Geytenbeek Joke J M,
Vermeulen R Jeroen,
Becher Jules G,
Oostrom Kim J
Publication year - 2015
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/dmcn.12619
Subject(s) - cerebral palsy , gross motor function classification system , comprehension , spastic , spoken language , psychology , audiology , gestational age , physical therapy , pediatrics , medicine , linguistics , pregnancy , philosophy , biology , genetics
Aim To assess spoken language comprehension in non‐speaking children with severe cerebral palsy ( CP ) and to explore possible associations with motor type and disability. Method Eighty‐seven non‐speaking children (44 males, 43 females, mean age 6y 8mo, SD 2y 1mo) with spastic (54%) or dyskinetic (46%) CP (Gross Motor Function Classification System [ GMFCS ] levels IV [39%] and V [61%]) underwent spoken language comprehension assessment with the computer‐based instrument for low motor language testing (C‐Bi LLT ), a new and validated diagnostic instrument. A multiple linear regression model was used to investigate which variables explained the variation in C‐Bi LLT scores. Associations between spoken language comprehension abilities (expressed in z ‐score or age‐equivalent score) and motor type of CP , GMFCS and Manual Ability Classification System ( MACS ) levels, gestational age, and epilepsy were analysed with Fisher's exact test. A p ‐value <0.05 was considered statistically significant. Results Chronological age, motor type, and GMFCS classification explained 33% ( R =0.577, R 2 =0.33) of the variance in spoken language comprehension. Of the children aged younger than 6 years 6 months, 52.4% of the children with dyskinetic CP attained comprehension scores within the average range ( z ‐score ≥−1.6) as opposed to none of the children with spastic CP . Of the children aged older than 6 years 6 months, 32% of the children with dyskinetic CP reached the highest achievable age‐equivalent score compared to 4% of the children with spastic CP . No significant difference in disability was found between CP ‐related variables ( MACS levels, gestational age, epilepsy), with the exception of GMFCS which showed a significant difference in children aged younger than 6 years 6 months ( p =0.043). Interpretation Despite communication disabilities in children with severe CP , particularly in dyskinetic CP , spoken language comprehension may show no or only moderate delay. These findings emphasize the importance of introducing alternative and/or augmentative communication devices from early childhood.