Orofacial myofunctional disorder characteristics in cerebral palsy and their treatment methods

Relevance. The variety of clinical manifestations of orofacial myofunctional disorders in cerebral palsy determines the need to improve diagnosis and treatment approaches. According to the authors, the planning of rehabilitation measures for children with cerebral palsy and orofacial pathology should be individual.Materials and methods. 120 children (mean age 8.7 years) with cerebral palsy and orofacial myofunctional disorders participated in the study with subsequent assessment of dental and neurological statuses during treatment, prevention and rehabilitation.Results. The study established correlations between general motor pathology, malocclusion and changes in the speech organs depending on the clinical form of cerebral palsy. Spastic dysarthria and anarthria were detected in 82 cases, age-appropriate speech and language development - in 38. Occlusion assessment revealed malocclusion in 88 subjects, neutral occlusion – in 32.Conclusions. Modern approaches to the treatment of malocclusion and orofacial myofunctional disorders in children with cerebral palsy allow increasing the effectiveness and quality of rehabilitation, organizing the sequence and continuity of specialist actions in a multidisciplinary rehabilitation team.

Diagnostic value of computer stabilometry in children with movement disorders in their first twelve months of life

Computer stabilometry is a modern highly informative method for the functional diagnostics of the motor pathology, which had age restrictions (for children over 2 years). Purpose: to develop new methods for diagnosing motor development disorders and the formation of cerebral palsy in children in the first six months of life based on a quantitative assessment of the ability to maintain the first antigravity postures. The authors presented their own technique of computer stabilometry in children of six months old in a supine position with support on the forearm or palm on a stable platform with high sensitivity for low weight. They demonstrate the results of the analysis of stabilometric indicators in children of 3–6 months of age with motor disorders compared with healthy children. The article describes new methods for diagnosing motor development disorders and the formation of cerebral palsy in children of six month old using the indicators of computer stabilometry. The developed methods are characterized by high diagnostic significance.

Entrainment and Modulation of Gesture-Speech Synchrony under Delayed Auditory Feedback

Gesture-speech synchrony re-stabilizes when hand movement or speech is disrupted by a delayed feedback manipulation, suggesting strong bidirectional coupling between gesture and speech. Yet, it has also been argued from case studies in perceptual-motor pathology, that hand gestures are a special kind of action that do not require closed-loop re-afferent feedback to maintain synchrony with speech. In the current pre-registered within-subject study, we used motion tracking to conceptually replicate McNeill’s (1992) classic study on gesture-speech synchrony under normal and 150ms delayed auditory feedback of speech conditions (NO DAF vs. DAF). Consistent with, and extending McNeill’s original results, we obtain strong evidence that: a) gesture-speech synchrony is more stable under DAF versus NO DAF (i.e., increased coupling effect), b) that gesture and speech variably entrain to the external auditory delay as indicated by a consistent shift in gesture-speech synchrony offsets (i.e., entrainment effect), and c) that the coupling effect and the entrainment effect are co-dependent. We suggest, therefore, that gesture-speech synchrony provides a way for the cognitive system to stabilize rhythmic activity under interfering conditions.

Effects of delayed auditory feedback on gesture-speech synchrony: Pre-registration and exploratory study

Research on co-speech gestures has shown that gesture-speech synchrony is stable when hand movement or speech is disrupted by a delayed feedback manipulation, suggesting strong bidirectional feedback between gesture and speech. Yet, it has also been argued from case studies in perceptuo-motor pathology, that hand gestures are a special kind of action that do not require closed-loop control mechanisms (e.g., efferent feedback) to function properly in synchrony with speech. In the current pilot study utilizing motion-tracking methods, we reassessed gesture-speech synchrony under conditions of delayed auditory feedback (DAF; 130-150 ms delay) leading to speech disruption. The pilot study indicated that gesture-speech synchrony was indeed stable under DAF, even to a higher degree than the control condition. We also find a promising indication that gesture-speech dynamics does entrain to the external auditory delay as indicated by a consistent shift in gesture-speech synchrony offsets. This pilot study forms the basis for the current pre-registration of a larger-scale study.

Specialized Rehabilitation Center of Pediatric Orthopaedics and Traumatology

Issues of the organization of the work on the rehabilitation of children with loco-motor pathology are reviewed on the example of St. Petersburg Rehabilitation Center "Ogonyok". The tasks of such centres include the conservative treatment of children with loco-motor system pathology with simultaneous provision of education process. The structure, list of members of staff as well as characteristics of the material and technical basis including therapeutic and diagnostic units are presented. The advantages of the rehabilitation centers over specialized health centers are shown.