scholarly journals Communication Modes and Functions in Children With Cerebral Palsy

2020 ◽  
Vol 63 (6) ◽  
pp. 1776-1792
Author(s):  
Emily D. McFadd ◽  
Katherine C. Hustad
Keyword(s):  
Cerebral Palsy ◽  
Language Comprehension ◽  
Augmentative And Alternative Communication ◽  
Motor Impairment ◽  
Linear Regression Models ◽  
Alternative Communication ◽  
Children With Cerebral Palsy ◽  
Communication Devices ◽  
Communication Modes ◽  
Speech Motor

Purpose This study seeks to determine how speech-language impairments relate to the frequency and diversity of communication modes and functions produced by children with cerebral palsy (CP) during interactions with their mothers. Method We studied 40 children with CP ( M age = 62 months) comprising three groups: those who were unable to speak and had anarthria ( n = 15), those with speech motor impairment and language comprehension impairment (SMI-LCI; n = 15), and those with speech motor impairment and typical language comprehension (SMI-LCT; n = 10). Mother–child play interactions were coded for child modes and functions. Generalized linear regression models were used to examine the relationship between profile group and frequencies of communication modes and functions. Results Results indicated groups SMI-LCI and SMI-LCT had significantly higher mean frequencies of vocalizations, vocalizations + gestures, comments, initiations, and requests than the group of those who were unable to speak and had anarthria. All children used vocalizations primarily, though these vocalizations were often not understood. SMI-LCI and SMI-LCT differed on two measures: frequency of gestures and frequency of initiations. The majority of children in this sample did not have access to augmentative and alternative communication devices. Conclusion Results of this study highlight the need for parent-mediated interventions for children with CP that emphasize multimodal communication tailored to impairment profiles. Supplemental Material https://doi.org/10.23641/asha.12354704

scholarly journals Longitudinal Growth in Single-Word Intelligibility Among Children With Cerebral Palsy From 24 to 96 Months of Age: Effects of Speech-Language Profile Group Membership on Outcomes

2020 ◽  
Vol 63 (1) ◽  
pp. 32-48 ◽  
Author(s):  
Katherine C. Hustad ◽  
Tristan J. Mahr ◽  
Aimee Teo Broman ◽  
Paul J. Rathouz
Keyword(s):  
Cerebral Palsy ◽  
Language Comprehension ◽  
Group Intervention ◽  
Augmentative And Alternative Communication ◽  
Group Membership ◽  
Motor Impairment ◽  
Alternative Communication ◽  
Time Points ◽  
Children With Cerebral Palsy ◽  
Speech Motor

Purpose We examined whether there were differences among speech-language profile groups of children with cerebral palsy (CP) in age of crossing 25%, 50%, and 75% intelligibility thresholds; age of greatest intelligibility growth; rate of intelligibility growth; maximum attained intelligibility at 8 years; and how well intelligibility at 36 months predicts intelligibility at 96 months when group membership is accounted for. Profile groups were children with no speech motor impairment (NSMI), those with speech motor impairment and language comprehension that is typically developing (SMI-LCT), and those with speech motor impairment and language comprehension impairment (SMI-LCI). Method Sixty-eight children with CP were followed longitudinally between 24 and 96 months of age. A total of 564 time points were examined across children ( M = 8.3 time points per child, SD = 2.6). We fitted a nonlinear random effects model for longitudinal observations, allowing for differences between profile groups. We used the fitted model trajectories to generate descriptive analyses of intelligibility growth by group and to generate simulations to analyze how well 36-month intelligibility data predicted 96-month data accounting for profile groups. Results Children with CP who have NSMI have different growth and better intelligibility outcomes than those with speech motor impairment. Children with SMI-LCT tend to have better outcomes but similar intelligibility growth as children with SMI-LCI. There may be a subset of children that cut across SMI-LCI and SMI-LCT groups who have severe speech motor involvement and show limited growth in intelligibility. Conclusions Intelligibility outcomes for children with CP are affected by profile group membership. Intelligibility growth tends to be delayed in children with speech motor impairment. Intelligibility at 3 years is highly predictive of later outcomes regardless of profile group. Intervention decision making should include consideration of early intelligibility, and treatment directions should include consideration of augmentative and alternative communication.

Prevalence of Speech Problems and the Use of Augmentative and Alternative Communication in Children With Cerebral Palsy: A Registry-Based Study in Norway

2010 ◽  
Vol 19 (1) ◽  
pp. 12-20 ◽  
Author(s):  
Guro Andersen ◽  
Tone R. Mjøen ◽  
Torstein Vik
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Gestational Age ◽  
Augmentative And Alternative Communication ◽  
Alternative Communication ◽  
Gross Motor ◽  
Gross Motor Function ◽  
Children With Cerebral Palsy ◽  
Communicative Abilities ◽  
Normal Speech

Abstract This study describes the prevalence of speech problems and the use of augmentative and alternative communication (AAC) in children with cerebral palsy (CP) in Norway. Information on the communicative abilities of 564 children with CP born 1996–2003, recorded in the Norwegian CP Registry, was collected. A total of 270 children (48%) had normal speech, 90 (16%) had slightly indistinct speech, 52 (9%) had indistinct speech, 35 (6%) had very indistinct speech, 110 children (19%) had no speech, and 7 (1%) were unknown. Speech problems were most common in children with dyskinetic CP (92 %), in children with the most severe gross motor function impairments and among children being totally dependent on assistance in feeding or tube-fed children. A higher proportion of children born at term had speech problems when compared with children born before 32 weeks of gestational age 32 (p > 0.001). Among the 197 children with speech problems only, 106 (54%) used AAC in some form. Approximately 20% of children had no verbal speech, whereas ~15% had significant speech problems. Among children with either significant speech problems or no speech, only 54% used AAC in any form.

scholarly journals Video Visual Scene Displays With Dynamic Text: Effect on Single-Word Reading by an Adolescent With Cerebral Palsy

2020 ◽  
Vol 5 (5) ◽  
pp. 1272-1281
Author(s):  
Kelsey Mandak ◽  
Janice Light ◽  
David McNaughton
Keyword(s):  
Cerebral Palsy ◽  
Augmentative And Alternative Communication ◽  
Word Reading ◽  
Visual Scene ◽  
Single Subject ◽  
Academic Vocabulary ◽  
Single Word ◽  
Alternative Communication ◽  
Communication Devices ◽  
Single Word Reading

Purpose The purpose of this study was to investigate the effect of the Transition to Literacy (T2L) feature within video visual scene displays (VSDs) on the single-word reading of academic vocabulary concepts (i.e., weather concepts) by a preliterate adolescent with cerebral palsy and minimal speech. Method A single-subject, multiple-probe, across-word-sets design was used to evaluate the effects of the intervention. The intervention used an augmentative and alternative communication app programmed with video VSDs embedded with hot spots with the T2L feature to teach the adolescent 12 academic vocabulary words. Results The adolescent acquired all target words successfully with only minimal exposure to the written words through the app and was able to generalize her learning to two novel tasks. Using Tau-U to evaluate the size of the observed effects, there were very large effects across all word sets. Conclusions The findings from this study demonstrate the effectiveness of the T2L feature to improve single-word reading in preliterate individuals with minimal speech. The use of video VSDs and T2L technology together may offer professionals a unique way to complement current augmentative and alternative communication devices and literacy instruction for adolescents with minimal speech who are preliterate.

scholarly journals Utility of the Intelligibility in Context Scale for Predicting Speech Intelligibility of Children with Cerebral Palsy

2021 ◽  
Vol 11 (11) ◽  
pp. 1540
Author(s):  
Jennifer U. Soriano ◽  
Abby Olivieri ◽  
Katherine C. Hustad
Keyword(s):  
Cerebral Palsy ◽  
Speech Intelligibility ◽  
Motor Impairment ◽  
Children With Cerebral Palsy ◽  
Potential Clinical Utility ◽  
Item Scores ◽  
Speech Transcription ◽  
Composite Scores ◽  
The Relationship ◽  
Speech Motor

The Intelligibility in Context Scale (ICS) is a widely used, efficient tool for describing a child’s speech intelligibility. Few studies have explored the relationship between ICS scores and transcription intelligibility scores, which are the gold standard for clinical measurement. This study examined how well ICS composite scores predicted transcription intelligibility scores among children with cerebral palsy (CP), how well individual questions from the ICS differentially predicted transcription intelligibility scores, and how well the ICS composite scores differentiated between children with and without speech motor impairment. Parents of 48 children with CP, who were approximately 13 years of age, completed the ICS. Ninety-six adult naïve listeners provided orthographic transcriptions of children’s speech. Transcription intelligibility scores were regressed on ICS composite scores and individual item scores. Dysarthria status was regressed on ICS composite scores. Results indicated that ICS composite scores were moderately strong predictors of transcription intelligibility scores. One individual ICS item differentially predicted transcription intelligibility scores, and dysarthria severity influenced how well ICS composite scores differentiated between children with and without speech motor impairment. Findings suggest that the ICS has potential clinical utility for children with CP, especially when used with other objective measures of speech intelligibility.

Preliminary Investigation of the Perspectives of Parents of Children With Cerebral Palsy on the Supports, Challenges, and Realities of Integrating Augmentative and Alternative Communication Into Everyday Life

2020 ◽  
Vol 29 (1) ◽  
pp. 238-254
Author(s):  
Tara O'Neill ◽  
Krista M. Wilkinson
Keyword(s):  
Cerebral Palsy ◽  
Everyday Life ◽  
Augmentative And Alternative Communication ◽  
Effective Interaction ◽  
Preliminary Investigation ◽  
Leisure Activities ◽  
Future Research ◽  
Alternative Communication ◽  
Environmental Controls ◽  
Children With Cerebral Palsy

Purpose To ensure long-term adoption and use of augmentative and alternative communication (AAC) technologies, they must be designed to support children to participate within everyday activities and routines that are prioritized by families. The aim of this study was to gain parent perspectives on how AAC technologies were integrated into everyday life. Method Nine parents of children with cerebral palsy who used AAC technologies participated in semistructured interviews to provide their perspectives on how AAC technologies were integrated into the functional contexts of everyday life. Results Five major themes emerged from the discussions: (a) integrating AAC into life, (b) AAC technologies, (c) child needs and skills, (d) parent responsibilities and priorities, and (e) AAC process and decision making. Children were able to use AAC technologies within a variety of everyday contexts with various partners; however, challenges included access to technologies within care routines and outdoor activities as well as partners who lacked knowledge regarding operational competencies and effective interaction strategies. To integrate AAC technologies into life, parents prioritized technology features including ease of programming, improved physical design, features to enhance efficiency and ease of access, and availability of multiple functions and features (e.g., games and leisure activities, environmental controls). Conclusion AAC manufacturers and mainstream technology developers should work to ensure that technologies are responsive to the supports, limitations, and ideal features identified by parents. Future research should seek input from a larger group of stakeholders and use longitudinal methods to examine perceptions of AAC technologies over time. Supplemental Material https://doi.org/10.23641/asha.11625543

scholarly journals Differentiating Typical From Atypical Speech Production in 5-Year-Old Children With Cerebral Palsy: A Comparative Analysis

2019 ◽  
Vol 28 (2S) ◽  
pp. 807-817 ◽  
Author(s):  
Katherine C. Hustad ◽  
Ashley Sakash ◽  
Aimee Teo Broman ◽  
Paul J. Rathouz
Keyword(s):  
Cerebral Palsy ◽  
Receiver Operating Characteristic ◽  
Speech Production ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Motor Impairment ◽  
Speech Disorders ◽  
Children With Cerebral Palsy ◽  
Speech Motor ◽  
Receiver Operating

Objective Early diagnosis of speech disorders in children with cerebral palsy (CP) is of critical importance. A key problem is differentiating those with borderline or mild speech motor deficits from those who are within an age-appropriate range of variability. We sought to quantify how well functional speech measures differentiated typically developing (TD) children from children with CP. Method We studied speech production in 45 children with CP (26 with clinical speech motor impairment [SMI] and 19 with no evidence of speech motor impairment [NSMI]) and in 29 TD children of the same age. Speech elicitation tasks were used. Intelligibility, speech rate, and intelligible words per minute were examined. Results All measures differentiated between all 3 groups of children with considerable precision based on area under the receiver operating characteristic curve (AUC) data. AUC was highest for overall intelligibility, which ranged from .88 to .99. Intelligible words per minute also yielded very strong AUCs, ranging from .81 to .99. In each of the receiver operating characteristic models, discrimination between groups was highest for children with speech motor impairment versus TD children. Data indicated that 90% of TD children had overall intelligibility above 87% at 5 years of age, but that no child was 100% intelligible. Furthermore, 90% children with SMI had intelligibility below 72%. Conclusion Findings suggest that functional speech measures differentiate very clearly between children with and without CP and that even children who do not show evidence of speech motor impairment have functional differences in their speech production ability relative to TD peers.

scholarly journals The Use of Computers and Augmentative and Alternative Communication Devices by Children and Young With Cerebral Palsy

2011 ◽  
Vol 23 (3) ◽  
pp. 135-149 ◽  
Author(s):  
Thais Pousada García ◽  
Javier Pereira Loureiro ◽  
Betania Groba González ◽  
Laura Nieto Riveiro ◽  
Alejandro Pazos Sierra
Keyword(s):  
Cerebral Palsy ◽  
Augmentative And Alternative Communication ◽  
Alternative Communication ◽  
Communication Devices

scholarly journals Longitudinal Growth in Intelligibility of Connected Speech From 2 to 8 Years in Children With Cerebral Palsy: A Novel Bayesian Approach

2020 ◽  
Vol 63 (9) ◽  
pp. 2880-2893
Author(s):  
Tristan J. Mahr ◽  
Paul J. Rathouz ◽  
Katherine C. Hustad
Keyword(s):  
Cerebral Palsy ◽  
Language Comprehension ◽  
Motor Impairment ◽  
Maximum Growth ◽  
Maximum Growth Rate ◽  
Longitudinal Growth ◽  
Growth Trajectories ◽  
Connected Speech ◽  
Nonlinear Mixed Effects Model ◽  
Children With Cerebral Palsy

Aim The aim of the study was to examine longitudinal growth in intelligibility in connected speech from 2 to 8 years of age in children with cerebral palsy. Method Sixty-five children with cerebral palsy participated in the longitudinal study. Children were classified into speech-language profile groups using age-4 data: no speech motor impairment (SMI), SMI with typical language comprehension, and SMI with impaired language comprehension. We fit a Bayesian nonlinear mixed-effects model of intelligibility growth at the child and group levels. We compared groups by age of steepest growth, maximum growth rate, and predicted intelligibility at 8 years of age. Results The no SMI group showed earlier and steeper intelligibility growth and higher average outcomes compared to the SMI groups. The SMI groups had more variable growth trajectories, but the SMI with typical language comprehension group had higher age-8 outcomes and steeper rates of maximum growth than the SMI with impaired language comprehension group. Language comprehension impairment at age of 4 years predicted lower intelligibility outcomes at age of 8 years, compared to typical language at age of 4 years. Interpretation Children with SMI at age of 4 years show highly variable intelligibility growth trajectories, and comorbid language comprehension impairment predicts lower intelligibility outcomes. Supplemental Material https://doi.org/10.23641/asha.12777659

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