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Findlen U, Richard C. Hearing and speech interactions in children with cerebral palsy, in the first 2 years : Focus on cerebral palsy. Pediatr Res 2024:10.1038/s41390-024-03403-0. [PMID: 39003333 DOI: 10.1038/s41390-024-03403-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 06/17/2024] [Accepted: 06/24/2024] [Indexed: 07/15/2024]
Abstract
Children with cerebral palsy (CP) face communication challenges stemming from neural lesions, hearing issues, and executive function impairments, which are further complicated by interactions between motor and hearing impairments. These challenges lead to limitations in daily activities and are compounded by delays in diagnosis and interventions, adversely affecting speech, language, and cognitive function. In infants with CP, impaired motor function disrupts both feedforward and feedback mechanisms crucial for speech sound production, exacerbating the overall impact on communication development. Understanding the interplay between hearing loss and speech production in children with CP, especially in the crucial early developmental stages, is essential for implementing timely interventions and guiding multidisciplinary care teams in both clinical and home settings. IMPACT QUESTIONS: Children with cerebral palsy (CP) face communication challenges due to neural, hearing, and motor issues, impacting speech and language development. Early and comprehensive testing, including auditory brainstem response, is crucial for timely diagnosis and intervention to mitigate adverse effects. The article emphasizes the need for advanced diagnostics and multidisciplinary interventions to improve communication skills and cognitive outcomes in children with CP.
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Affiliation(s)
- Ursula Findlen
- Nationwide Children's Hospital- Division of Clinical Therapies, Columbus, OH, USA
- The Ohio State Wexner Medical Center, College of Medicine, Department of Otolaryngology - Head & Neck Surgery, OSU Eye and Ear Institute, Columbus, OH, USA
| | - Celine Richard
- Department of Otolaryngology-Head & Neck Surgery, University of Tennessee Health Science Center, Memphis, TN, USA.
- Division of Otolaryngology-Head & Neck Surgery, Lebonheur Children's Hospital, Memphis, TN, USA.
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Abate BB, Tegegne KM, Zemariam AB, Wondmagegn Alamaw A, Kassa MA, Kitaw TA, Abebe GK, Azmeraw Bizuayehu M. Magnitude and clinical characteristics of cerebral palsy among children in Africa: A systematic review and meta-analysis. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003003. [PMID: 38905321 PMCID: PMC11192420 DOI: 10.1371/journal.pgph.0003003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/22/2024] [Indexed: 06/23/2024]
Abstract
Cerebral palsy (CP) is the most common motor disability in childhood which causes a child's behavioral, feeding, and sleep difficulties. It remains a poorly studied health problem in Africa. The main aim of this study was assessing the pooled prevalence of Cerebral Palsy (CP) and its clinical characteristics in Africa context. Systematic review and meta-analysis were conducted using Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines to search articles from electronic databases (Cochrane library, Ovid platform) (Medline, Embase, and Emcare), Google Scholar, CINAHL, PubMed, Maternity and Infant Care Database (MIDIRS). The last search date was on 12/05/ 2023 G. C. A weighted inverse variance random-effects model was used to estimate the pooled estimates of cerebral palsy and its types. The subgroup analysis, publication bias and sensitivity analysis were done. Studies on prevalence and clinical characteristics of cerebral palsy were included. The primary and secondary outcomes were prevalence and clinical characteristics of cerebral palsy respectively. A total of 15 articles with (n = 498406 patients) were included for the final analysis. The pooled prevalence of cerebral palsy in Africa was found to be 3·34 (2·70, 3·98). The most common type is spastic cerebral palsy accounting 69·30% (66·76, 71·83) of all cases. The second one is quadriplegic cerebral palsy which was found to be 41·49% (33·16, 49·81). Ataxic cerebral palsy accounted 5·36% (3·22, 7·50). On the other hand, dyskinetic cerebral palsy was found to be 10.88% (6·26, 15·49). About 32·10% (19·25, 44.95) of cases were bilateral while 25·17% (16·84, 33·50) were unilateral. The incidence of cerebral palsy in Africa surpasses the reported rates in developed nations. Spastic and quadriplegic subtypes emerge as the most frequently observed. It is recommended to channel initiatives toward the strategic focus on preventive measures, early detection strategies, and comprehensive management protocols.
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Affiliation(s)
- Biruk Beletew Abate
- Assistant Professor in Pediatrics and Child Health Nursing, College of Health Science, Woldia University, Weldiya, Ethiopia
| | | | - Alemu Birara Zemariam
- MSc in Pediatrics and Child Health Nursing, College of Health Science, Woldia University, Weldiya, Ethiopia
| | - Addis Wondmagegn Alamaw
- MSc in Emergency Medicine and Critical Care Nursing, College of Health Science, Woldia University, Weldiya, Ethiopia
| | - Mulat Awoke Kassa
- MSc in Psychiatry, College of Health Science, Woldia University, Weldiya, Ethiopia
| | - Tegene Atamenta Kitaw
- MSc in Adult Health Nursing, College of Health Science, Woldia University, Weldiya, Ethiopia
| | - Gebremeskel Kibret Abebe
- MSc in Emergency Medicine and Critical Care Nursing, College of Health Science, Woldia University, Weldiya, Ethiopia
| | - Molla Azmeraw Bizuayehu
- MSc in Pediatrics and Child Health Nursing, College of Health Science, Woldia University, Weldiya, Ethiopia
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García-Castro MI, Menor J, Alvarez-Carriles JC. Differential neuropsychological profiles in children and adolescents with motor disability in an inclusive educational setting. Child Neuropsychol 2024:1-25. [PMID: 38221861 DOI: 10.1080/09297049.2024.2304377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/29/2023] [Indexed: 01/16/2024]
Abstract
The aim of this study was to determine the potential cognitive impairment associated with motor disability in a group of children attending regular schools and to analyze whether there were different cognitive profiles according to the type of motor disability they presented. The study had 87 participants, 31 healthy and 56 with three types of motor disability: Neuromuscular Diseases (NMD Group), Cerebral Palsy-Hemiparesis (CP- HPx Group) and Cerebral Palsy-Diplegia (CP-DP). Ages ranged from 6 to 18 years and they had medium and medium-high socioeconomic and cultural levels. All participants attended regular state-funded and independent schools in an inclusive modality. The neuropsychological assessment included the following cognitive domains: processing speed, working memory, verbal and visual episodic memory, language, visuo-perception and constructive praxis and executive functioning. A second analysis was performed with the groups with CP: one based on the severity of gross motor impairment (GMFCS-E&R scale) and the other based on the levels of manual dexterity (MACS scale). ANCOVAs were performed controlling for age and processing speed in the three analyses. The group with CP-HPx was shown to be the most cognitively impaired of the three groups, with significant deficits in visuo-perception, verbal working memory, and visuo-spatial memory. Subjects with greater gross motor dysfunction (GMFCS-E&R) did not show the greatest cognitive impairment, while those with worse manual dexterity (MACS) exhibited greater cognitive impairment. Children and adolescents with motor disabilities, a priori cognitively normal, present different levels of cognitive impairment. This should be considered when planning educational adaptations for this infant-juvenile population.
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Affiliation(s)
- M Isabel García-Castro
- Physical Disability Unit, Regional Team of Attention to Students with Specific, Educational Support Needs, Regional Ministry of Education of the Principality of Asturias, Oviedo, Spain
| | - Julio Menor
- Department of Psychology, University of Oviedo, Spain
| | - Juan C Alvarez-Carriles
- Department of Psychology, University of Oviedo, Spain
- Clinical Neuropsychology Unit, Liaison Psychiatry Service, Central University Hospital of Asturias, Oviedo, Spain
- Institute of Health Research of the Principality of Asturias (ISPA), Oviedo, Spain
- Institute of Neurosciences of the Principality of Asturias (INEUROPA), Oviedo, Spain
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Vaillant E, Oostrom KJ, Beckerman H, Vermeulen RJ, Buizer AI, Geytenbeek JJM. Developmental trajectories of spoken language comprehension and functional communication in children with cerebral palsy: A prospective cohort study. Dev Med Child Neurol 2024; 66:95-105. [PMID: 37349942 DOI: 10.1111/dmcn.15673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 05/18/2023] [Accepted: 05/23/2023] [Indexed: 06/24/2023]
Abstract
AIM To investigate spoken language comprehension (SLC), single-word comprehension (SWC), functional communication development, and their determinants, in children with cerebral palsy. METHOD This was a prospective cohort study in the Netherlands spanning 2 years 6 months. The main outcomes were SLC and SWC, assessed by the Computer-Based instrument for Low motor Language Testing (C-BiLLT) and the Peabody Picture Vocabulary Test-III-NL (PPVT-III-NL) respectively; and functional communication, measured by a subscale of the Focus on the Outcomes of Communication Under Six-34 (FOCUS-34). Linear mixed models were used to determine developmental trajectories, which were compared with norm and reference data. Potential determinants, for example intellectual functions, speech production, functional communication level (classified with the Communication Function Classification System, CFCS), and functional mobility, were added to assess their effects. RESULTS Children with cerebral palsy (n = 188; mean age 59 months, range 17-110) were monitored for 2 years 6 months. Developmental trajectories for SLC (C-BiLLT) and SWC (PPVT-III-NL) were nonlinear; those for functional communication (FOCUS-34) were linear. Compared with norm and reference groups, significantly delayed SLC, SWC, and functional communication development were found. Determinants for SLC and SWC were intellectual functions and functional communication level (CFCS); and for functional communication development (FOCUS-34), speech production and arm-hand functioning. INTERPRETATION Children with cerebral palsy showed delayed SLC, SWC, and functional communication development compared with norm and reference groups. Remarkably, functional mobility was not associated with the development of SLC, SWC, or functional communication. WHAT THIS PAPER ADDS Children with cerebral palsy have delayed spoken language comprehension (SLC), single-word comprehension (SWC), and functional communication development, compared to norm and reference data. Determinants for SLC and SWC development are intellectual functions and functional communication level. Determinants for functional communication development are speech production and arm-hand functioning. Functional mobility is not associated with SLC, SWC, or functional communication.
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Affiliation(s)
- Emma Vaillant
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, the Netherlands
| | - Kim J Oostrom
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Maastricht UMC+, Department of Neurology, School of Mental Health and Neuro Science, Maastricht, the Netherlands
| | - Heleen Beckerman
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, the Netherlands
| | - R Jeroen Vermeulen
- Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Annemieke I Buizer
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, the Netherlands
- Emma Children's Hospital, Amsterdam UMC, Amsterdam, the Netherlands
| | - Johanna J M Geytenbeek
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Movement Sciences, Rehabilitation and Development, Amsterdam, the Netherlands
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Lillehaug HA, Klevberg GL, Stadskleiv K. Provision of augmentative and alternative communication interventions to Norwegian preschool children with cerebral palsy: are the right children receiving interventions? Augment Altern Commun 2023; 39:219-229. [PMID: 37212772 DOI: 10.1080/07434618.2023.2212068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 03/06/2023] [Indexed: 05/23/2023] Open
Abstract
Preschool children with cerebral palsy (CP) with no or unintelligible speech need augmentative and alternative communication (AAC), but not all children needing AAC have access to it. This study describes the use and perceived benefit of AAC and explores factors associated with receiving AAC interventions. Using a cross-sectional design, we combined parent-reported data with data from the Norwegian Quality and Surveillance Registry for Cerebral Palsy (NorCP). Communication, speech and hand function was classified according to the Communication Function Classification System (CFCS), Viking Speech Scale (VSS), and Manual Ability Classification System (MACS), accordingly. The need for AAC was defined as Levels III-V on the CFCS, without simultaneous classification at VSS Level I, and/or Levels III-IV on VSS. Parents reported on child- and family-directed AAC interventions using the Habilitation Services Questionnaire. Of the 95 children (42 females) with CP (M = 39.4 months, SD = 10.3), 14 had communication aids. Of the 35 children (31.4%) defined as needing AAC, 11 had been provided with communication aids. Parents of children with a communication aid reported satisfaction with and frequent use of the aid. Children at MACS Level III-V (OR = 3.4, p = .02) or with epilepsy (OR = 8.9, p < .01) were most likely to have received an AAC intervention. The low proportion of children receiving communication aids indicates an unmet need for AAC interventions among preschool children with CP.
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Affiliation(s)
- Hilde Aven Lillehaug
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
| | | | - Kristine Stadskleiv
- Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
- Department of Special Needs Education, University of Oslo, Oslo, Norway
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Gilbert LA, Gandham S, Ueda K, Chintalapati K, Pearson T, Aravamuthan BR. Upper Extremity Dystonia Features in People With Spastic Cerebral Palsy. Neurol Clin Pract 2023; 13:e200207. [PMID: 37780812 PMCID: PMC10540938 DOI: 10.1212/cpj.0000000000200207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/14/2023] [Indexed: 10/03/2023]
Abstract
Background and Objectives Dystonia in cerebral palsy (CP) is debilitating and common, but underdiagnosed, especially when coexistent with spasticity. With dedicated research-based assessment, dystonia is found in most people with spastic CP but is only clinically diagnosed in the minority. To begin addressing the high rates of dystonia underdiagnosis in this population, we determined the key feature experts use to assess upper extremity dystonia in people with spastic CP. Methods In this prospective cohort study, 3 pediatric movement disorder specialists assessed upper extremity dystonia in neurologic examination videos of people with spastic CP and isolated periventricular leukomalacia (PVL) on brain MRI (i.e., those with a brain injury pattern typical for spastic CP). Dystonia severity was rated using the 10-point Global Dystonia Severity Rating Scale, first by each expert independently and then again after consensus-building discussion. Conventional content analysis of these discussions revealed salient features ("codes") that experts used to assess upper extremity dystonia. Code frequency distributions were compared between dystonia severity categories using χ2 tests. Results We identified 96 people with spastic CP with isolated PVL on brain MRI seen in the St. Louis Children's Hospital CP Center between 2005 and 2018. Of them, 26 people were able and willing to be recorded while doing a standardized set of upper extremity examination maneuvers (age 4-25 years; 28% nonambulatory, 77% White). When assessing their videos, experts cited the "hand" less often and "shoulder" more often with increasing dystonia severity (p < 0.005, χ2 test). "Mirror movements" and the "hand open/close" examination maneuver were cited significantly more frequently in videos when experts were attempting to distinguish between no dystonia and mild dystonia (p < 0.005). Discussion Expert clinicians use distinct movement features to assess upper extremity dystonia in people with spastic CP and PVL. Attention to involuntary shoulder (vs hand) movements can help gauge dystonia severity. Differentiation between mirror movements and dystonia, particularly during the hand open/close examination maneuver, may help identify mild dystonia. These results can help guide upper extremity dystonia assessment in people with spastic CP, thus potentially helping mitigate dystonia underdiagnosis.
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Affiliation(s)
- Laura A Gilbert
- Division of Pediatric Neurology (LAG, SG, KU, KC, BRA), Department of Neurology, Washington University School of Medicine, St. Louis, MO; and Division of Neurology (TP), Nationwide Children's Hospital, Ohio State University, Columbus
| | - Sushma Gandham
- Division of Pediatric Neurology (LAG, SG, KU, KC, BRA), Department of Neurology, Washington University School of Medicine, St. Louis, MO; and Division of Neurology (TP), Nationwide Children's Hospital, Ohio State University, Columbus
| | - Keisuke Ueda
- Division of Pediatric Neurology (LAG, SG, KU, KC, BRA), Department of Neurology, Washington University School of Medicine, St. Louis, MO; and Division of Neurology (TP), Nationwide Children's Hospital, Ohio State University, Columbus
| | - Keerthana Chintalapati
- Division of Pediatric Neurology (LAG, SG, KU, KC, BRA), Department of Neurology, Washington University School of Medicine, St. Louis, MO; and Division of Neurology (TP), Nationwide Children's Hospital, Ohio State University, Columbus
| | - Toni Pearson
- Division of Pediatric Neurology (LAG, SG, KU, KC, BRA), Department of Neurology, Washington University School of Medicine, St. Louis, MO; and Division of Neurology (TP), Nationwide Children's Hospital, Ohio State University, Columbus
| | - Bhooma R Aravamuthan
- Division of Pediatric Neurology (LAG, SG, KU, KC, BRA), Department of Neurology, Washington University School of Medicine, St. Louis, MO; and Division of Neurology (TP), Nationwide Children's Hospital, Ohio State University, Columbus
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Seyhan-Biyik K, Esen-AydinlI F, Sel SA, Incebay Ö, Özcebe E, Kerem-Günel M, Anlar FB, Pennington L. Psychometric properties of the Viking Speech Scale-Turkish version for children with cerebral palsy aged 4-18 years based on live and video-based observation. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:687-703. [PMID: 36426770 DOI: 10.1111/1460-6984.12810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 09/27/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Speech is the most common method of communication. Video-based clinical communication evaluation is a requirement for children with speech-language impairments living in rural areas, and those who have limited mobility. AIMS To determine the validity and reliability of the Turkish version of the Viking Speech Scale (VSS-T) via live and video-based observation for children with cerebral palsy (CP) aged 4-18 years. METHODS & PROCEDURES A total of 142 children (mean age 8.18 ± 3.98 years; 68 female) with CP were included in this study. Their motor, communication, visual and eating-drinking function levels and comorbidities (dental, swallowing, cognitive impairments and epilepsy) were recorded. The Intelligibility in Context Scale (ICS), the Pediatric Evaluation of Disability Inventory-Social Function (PEDI-SF), and the Functional Independence Measure for Children-Communication (WeeFIM-C) were assessed to examine the concurrent validity of the VSS-T. The interrater reliability of the VSS-T was analysed between parents, physical therapists, and speech and language therapists from live and video-based observation. Intra-rater reliability was calculated from ratings made from live and video-based observations taken 3 weeks apart. OUTCOMES & RESULTS The VSS-T was strongly related to the ICS (r = -0.830), PEDI-SF (r = -0.819), WeeFIM-C (r = -0.643), other functional classifications (r > 0.432), and the comorbidities (Cramer's V > 0.284, p < 0.001). Good to excellent interrater reliability (κw ≥ 0.838) and intra-rater reliability (intraclass correlation coefficient (ICC) = 0.848-0.995) were found between parents and therapists. CONCLUSIONS & IMPLICATIONS Speech and language therapists, physical therapists, and parents can use the VSS-T as a valid and reliable classification system to describe speech intelligibility of 4-18-year-old children with CP. Both live and video-based observations can be used to administer the VSS-T. WHAT THIS PAPER ADDS What is already known on the subject The English version of the VSS has been shown to be a valid and reliable tool used to classify the speech of children with CP aged 4-13 years. The scale can be administered by means of live observation of the child or based on clinicians' notes on the case by parents, SLTs, physiotherapists and paediatricians. What this paper adds to existing knowledge The VSS-T is valid and reliable for children with CP aged 4-18 years. Video-based observation is a suitable method for evaluating the VSS-T levels. The VSS-T has a moderate association with the CFCS. What are the potential or actual clinical implications of this work? The VSS-T is a valid and reliable method of categorizing the severity of motor speech impairment for Turkish children with CP in clinical research studies, registry systems or epidemiological studies. Both experienced and inexperienced therapists can use either live or video-based observation methods to administer the VSS-T. This study extended the validity and reliability of the scale in children with CP aged up to 18 years. The VSS-T is also associated with the Visual Functional Classification System (VFCS), which has been recently developed for describing the visual abilities of children with CP in daily life. In addition, the VSS-T is associated with the presence of dental, swallowing, cognitive problems and epilepsy.
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Affiliation(s)
- Kübra Seyhan-Biyik
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Fatma Esen-AydinlI
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Sinem Asena Sel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Önal Incebay
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Esra Özcebe
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Mintaze Kerem-Günel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Fatma Banu Anlar
- Faculty of Medicine, Division of Neurology, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Lindsay Pennington
- Population Health Sciences, Institute Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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White matter microstructure and receptive vocabulary in children with cerebral palsy: The role of interhemispheric connectivity. PLoS One 2023; 18:e0280055. [PMID: 36649231 PMCID: PMC9844879 DOI: 10.1371/journal.pone.0280055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 12/20/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Communication and cognitive impairments are common impediments to participation and social functioning in children with cerebral palsy (CP). Bilateral language networks underlie the function of some high-level language-related cognitive functions. PURPOSE To explore the association between receptive vocabulary and white-matter microstructure in the temporal lobes and the central part of the temporo-temporal bundles in children with CP. MATERIALS AND METHODS 37 children with spastic motor type CP (mean age 9.6 years, 25 male) underwent a receptive vocabulary test (Peabody Picture Vocabulary Test, PPVT-IV) and 3T MRI. Mean fractional anisotropy (FA) and mean diffusivity (MD) were calculated for the temporal lobes and the interhemispheric bundles traversing the splenium of the corpus callosum and the anterior commissure. Associations between microstructure and receptive vocabulary function were explored using univariable linear regression. RESULTS PPVT-IV scores were significantly associated with mean white matter MD in the left temporal lobe, but not the right temporal lobe. There was no association between PPVT-IV and mean white matter FA in the temporal lobes. PPVT-IV scores were not significantly associated with the laterality of these diffusion tensor metrics. Within the corpus callosum, FA, but not MD of the temporo-temporal bundles was significantly associated with the PPVT-IV scores. Within the anterior commissure no equivalent relationship between diffusion metrics and PPVT-IV was found. CONCLUSION Our findings add further understanding to the pathophysiological basis underlying receptive vocabulary skills in children with CP that could extend to other patients with early brain damage. This study highlights the importance of interhemispheric connections for receptive vocabulary.
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Byiers BJ, Roberts CL, Burkitt CC, Merbler AM, Craig KD, Symons FJ. Parental Pain Catastrophizing, Communication Ability, and Post-surgical Pain Outcomes Following Intrathecal Baclofen Implant Surgery for Patients With Cerebral Palsy. FRONTIERS IN PAIN RESEARCH 2022; 2:809351. [PMID: 35295472 PMCID: PMC8915662 DOI: 10.3389/fpain.2021.809351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Abstract
There is strong evidence that psychosocial variables, including pain catastrophizing, influence parental and child ratings of pain, pain expression, and long-term outcomes among children with chronic pain. The role of these factors among children who have communication deficits due to cerebral palsy (CP) and other intellectual and developmental disabilities is currently unclear. In this study, parental pain catastrophizing was assessed before intrathecal baclofen (ITB) pump implantation for spasticity management in 40 children and adolescents with CP, aged 4 to 24 years. Pain was assessed before and after surgery with two methods: a parent-reported pain interference scale, and behavioral pain signs during a standardized range of motion exam. Linear mixed models with clinical/demographic factors and scores from the Pain Catastrophizing Scale for Parents (PCS-P), and child spoken language ability as predictors and the pain variables as the outcomes were implemented. On average, both pain outcomes improved after surgery. Only child spoken language ability predicted change in behavioral reactivity scores, with children with phrase speech showing an increase in reactivity at follow-up compared to pre-surgery levels, on average. A significant interaction between PCS-P scores and spoken language ability on change in pain interference scores over time showed that dyads with children with phrase speech whose parents reported high PCS-P scores reported the least improvement in pain interference at follow-up. Due to the preliminary nature of the study, future work is needed to investigate the parental behaviors that mediate the relationships between parental catastrophizing and pain outcomes in this population.
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Affiliation(s)
- Breanne J. Byiers
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
- *Correspondence: Breanne J. Byiers
| | - Caroline L. Roberts
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Chantel C. Burkitt
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
- Gillette Children's Specialty Healthcare, Saint Paul, MN, United States
| | - Alyssa M. Merbler
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Kenneth D. Craig
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Frank J. Symons
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
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Ward R, Hennessey N, Barty E, Elliott C, Valentine J, Cantle Moore R. Clinical utilisation of the Infant Monitor of vocal Production (IMP) for early identification of communication impairment in young infants at-risk of cerebral palsy: a prospective cohort study. Dev Neurorehabil 2022; 25:101-114. [PMID: 34241555 DOI: 10.1080/17518423.2021.1942280] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM To report prospective longitudinal data of early vocaliszations of infants identified "at-risk" of cerebral palsy (CP) for early identification of communication impairment. METHOD This case-control longitudinal prospective cohort study reports on the assessment of 36 infants, 18 identified as at-risk of CP at the time of enrolment and 18 typically developing (TD) children, at three time points: 6 months, 9 months and 12 months of age, Data were obtained through criterion and norm referenced assessments of vocaliszation behaviors. RESULTS Early vocal behaviors of infants identified as at-risk of CP did not differ from their age matched peers at 6 months of age, however, significant group differences emerged at 9 and 12 months when pre-canonical and canonical babble typically emerge. Generalized linear mixed models analysis showed that the rate of development of early language ability and more complex speech-related vocal behaviors was slower for infants at risk of CP when compared to TD infants, with over 75% of infants with CP showing below normal vocal production and impaired language by 12 months of age. INTERPRETATION Our data suggest characteristics of infant vocalizations associated with pre-canonical and canonical babbling provide a strong evidence base for predicting communication outcomes in infants at risk of CP.
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Affiliation(s)
- R Ward
- Kids Rehab, Perth Children's, Hospital, Perth, Australia.,School of Allied Health, Curtin University, Perth, Australia.,Institute of Health Research, University of Notre Dame Australia, Fremantle, Australia
| | - N Hennessey
- School of Allied Health, Curtin University, Perth, Australia
| | - E Barty
- Kids Rehab, Perth Children's, Hospital, Perth, Australia
| | - C Elliott
- Kids Rehab, Perth Children's, Hospital, Perth, Australia.,School of Allied Health, Curtin University, Perth, Australia.,Telethon Kids Institute, Perth, Australia
| | - J Valentine
- Kids Rehab, Perth Children's, Hospital, Perth, Australia
| | - R Cantle Moore
- NextSense Institute/Macquarie University, Sydney, New South Wales
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11
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Abdel Malek S, Mesterman R, Switzer L, DiRezze B, deVeber G, Fehlings D, Lunsky Y, Phoenix M, Gorter JW. Exploring demographic, medical, and developmental determinants of adaptive behaviour in children with hemiplegic cerebral palsy. Eur J Paediatr Neurol 2022; 36:19-25. [PMID: 34823070 DOI: 10.1016/j.ejpn.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 10/19/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022]
Abstract
Hemiplegic cerebral palsy (CP), the most common subtype, is characterized by high levels of mobility. Despite this, children with hemiplegic CP can face challenges functioning in and adapting to situations of everyday life. The purpose of this cross-sectional study (Hemi-NET database) was to identify factors associated with adaptive behaviour in 59 children with hemiplegic CP (ages 4-18; GMFCS I-IV). Using multivariate regression analyses, the relationship between demographic, medical, and developmental factors and adaptive behaviour (measured by the Adaptive Skills Composite score of the BASC-2) was explored. Results indicate that 34% of children had impaired adaptive skills. An autism diagnosis and lower communication functioning were significantly associated with poorer adaptive skills (R2 = 0.42, F(4, 43) = 7.87, p < 0.001), while factors such as IQ scores and GMFCS level were not. The results contribute to the growing literature that suggests that clinicians and researchers need to look beyond motor functioning when working with individuals with CP.
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Affiliation(s)
- Sandra Abdel Malek
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 403, Hamilton, Ontario, L8S 1C7, Canada; CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 408, Hamilton, Ontario, L8S 1C7, Canada.
| | - Ronit Mesterman
- Department of Paediatrics, McMaster University, 1280 Main Street West, Health Sciences Centre, 3A, Hamilton, Ontario, L8S 4K1, Canada
| | - Lauren Switzer
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada
| | - Briano DiRezze
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 403, Hamilton, Ontario, L8S 1C7, Canada; CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 408, Hamilton, Ontario, L8S 1C7, Canada
| | - Gabrielle deVeber
- Division of Neurology, Hospital for Sick Children, 555 University Avenue, Neurology Clinic, 6C Atrium, Toronto, Ontario, M5G 1X8, Canada
| | - Darcy Fehlings
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada; Department of Pediatrics, University of Toronto, 555 University Avenue, Black Wing Room 1436, Toronto, Ontario, M5G 1X8, Canada; Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Suite 160, Toronto, Ontario, M5G 1V7, Canada
| | - Yona Lunsky
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario, M5T 1R8, Canada; Azrieli Centre for Adult Neurodevelopmental Disabilities, CAMH, McCain Complex Care & Recovery Building, 1025 Queen Street West, Toronto, Ontario, M6K 1H4, Canada
| | - Michelle Phoenix
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 403, Hamilton, Ontario, L8S 1C7, Canada; CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 408, Hamilton, Ontario, L8S 1C7, Canada; Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario, M4G 1R8, Canada
| | - Jan Willem Gorter
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 403, Hamilton, Ontario, L8S 1C7, Canada; CanChild Centre for Childhood Disability Research, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences, Room 408, Hamilton, Ontario, L8S 1C7, Canada; Department of Paediatrics, McMaster University, 1280 Main Street West, Health Sciences Centre, 3A, Hamilton, Ontario, L8S 4K1, Canada
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12
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Koopmans C, Sakash A, Soriano J, Long HL, Hustad KC. Functional Communication Abilities in Youth With Cerebral Palsy: Association With Impairment Profiles and School-Based Therapy Goals. Lang Speech Hear Serv Sch 2021; 53:88-103. [PMID: 34767477 DOI: 10.1044/2021_lshss-21-00064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
PURPOSE The aim of this study was to examine the relationship between functional communication skills, underlying speech, language, and cognitive impairments and school-based speech pathology services in students with cerebral palsy (CP). METHOD Thirty-five participants with CP who had Individualized Education Programs (IEPs) were classified according to the Communication Function Classification System (CFCS). Participants completed laboratory assessments of speech, receptive language, executive functioning, and nonverbal cognition. Each participant's speech and language IEP goals were coded into treatment units and then categorized into seven, mutually exclusive target goal areas. Nonparametric analyses were employed to examine differences among CFCS groups in the number of deficit areas and the number of goal areas from the IEP. Descriptive analyses were used to evaluate the extent to which deficit and goal areas in the IEP co-occurred by CFCS level. RESULTS Those in more involved CFCS levels demonstrated more severe speech, receptive language, and cognitive impairments. However, there were no significant differences in the number of deficit areas across CFCS groups. Regardless of CFCS level, there were no differences in the number of treatment goals specified in the IEP. Literacy was the only goal area addressed across all CFCS levels. Those in the most involved CFCS levels had augmentative and alternative communication (AAC) goals, but those with more moderate restrictions in functional communication who also had markedly reduced speech intelligibility did not typically have speech or AAC goals. INTERPRETATION Individuals with CP across CFCS levels demonstrate variability in underlying deficit profiles, suggesting that measures of both functional communication and of underlying deficits are necessary to provide a complete picture of communication needs. Literacy goals were common across all CFCS levels, but AAC goals were limited to the most severely involved individuals, suggesting that continuing education may be necessary to support speech-language pathologists in developing treatments involving the integration of AAC and speech to foster functional communication at school. Supplemental Material https://doi.org/10.23641/asha.16968073.
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Affiliation(s)
| | | | - Jennifer Soriano
- Waisman Center, University of Wisconsin-Madison.,Department of Communication Sciences and Disorders, University of Wisconsin-Madison
| | | | - Katherine C Hustad
- Waisman Center, University of Wisconsin-Madison.,Department of Communication Sciences and Disorders, University of Wisconsin-Madison
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13
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Caynes K, Rose TA, Burmester D, Ware RS, Johnston LM. Reproducibility and validity of the Functional Communication Classification System for young children with cerebral palsy. Dev Med Child Neurol 2021; 63:866-873. [PMID: 33638178 DOI: 10.1111/dmcn.14844] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 11/30/2022]
Abstract
AIM To examine interrater agreement and validity of the Functional Communication Classification System (FCCS) for young children with cerebral palsy (CP) aged 2 or 3 years. METHOD Speech-language pathologist (SLP) and parent FCCS ratings for 31 children with CP (aged 2y, n=16; aged 3y, n=15; 18 males, 13 females) were examined for interrater agreement using a weighted Cohen's kappa statistic. Relationships between FCCS (SLP) ratings and: (1) concurrent validity with the Language Use Inventory, a standardized pragmatic assessment for children aged 18 to 47 months, (2) gross motor and fine motor function, (3) associated impairments (visual and intellectual), and (4) primary expressive communication mode were examined using Spearman's correlation coefficients. RESULTS Almost perfect interrater agreement between SLP and parent FCCS ratings were found (kw =0.94). Correlations with FCCS (SLP) were excellent for pragmatic function (rs =-0.83, p<0.001), intellectual function (rs =0.89, p<0.001), and primary expressive communication mode (rs =0.92, p<0.001). Correlations were good for gross motor function (rs =0.72, p<0.001) and visual impairment (rs =0.70, p<0.001) and fair for fine motor function (rs =0.53, p<0.002). Analysis was unwarranted for epilepsy (n=1 out of 31) and hearing-associated impairments (n=0 out of 31). INTERPRETATION The FCCS has excellent interrater agreement and validity for communication classification of children with CP aged 2 or 3 years and is highly suitable for surveillance and research purposes. What this paper adds The Functional Communication Classification System (FCCS) is a valid instrument for children with cerebral palsy (CP) aged 2 or 3 years. Excellent agreement exists between speech-language pathologist and parent FCCS ratings. The FCCS has excellent correlation with intelligence, pragmatic function, and primary expressive mode. Stronger correlations with the Gross Motor Function Classification System and vision exist for children aged 2 or 3 years. Weaker correlations with manual ability exist when compared to older children with CP.
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Affiliation(s)
- Katy Caynes
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
| | | | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Qld, Australia
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14
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Martinec S, Cesarec G, Tomečak Krilić AM, Radošević T, Bakran Ž, Mejaški Bošnjak V. FUNCTIONAL CLASSIFICATION OF CHILDREN WITH CEREBRAL PALSY IN KRAPINA-ZAGORJE COUNTY. Acta Clin Croat 2021; 60:282-289. [PMID: 34744279 PMCID: PMC8564855 DOI: 10.20471/acc.2021.60.02.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 10/03/2019] [Indexed: 11/30/2022] Open
Abstract
The aim was to study functional abilities and to create functional classification of children with cerebral palsy (CP) in Krapina-Zagorje County, based on the classification of gross and fine motor skills and associated impairments. Classification was performed according to the SCPE (Surveillance of Cerebral Palsy in Europe) criteria. We used standardized and complementary functional classification systems for cerebral palsy to create a functional profile. Research included 44 children with CP in the age range of 4 to 18 years. The results showed that the majority of children had bilateral spastic CP (63.6%), followed by unilateral spastic (22.7%) while the representation of dyskinetic CP was 9.09% and ataxic CP 4.55%. Based on the classification of gross and fine motor skills, 43.2% of children had the ability to walk, 11% of children could walk with assistive mobility devices, while 45.4% of children had a low functional level. The study also analyzed the associated impairments where higher classification score of motor impairment correlated with the severity of impairment. The results showed that children with dyskinetic CP and severe motor impairment could have mild cognitive impairment. We systematically present the neuropsychological and functional profile according to the CP type.
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Affiliation(s)
| | - Gordana Cesarec
- 1Krapinske Toplice Special Hospital for Medical Rehabilitation, Department of Physical and Rehabilitation Medicine, Krapinske Toplice, Croatia; 2Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia; 3Department of Neuropediatrics, Zagreb Children's Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Marija Tomečak Krilić
- 1Krapinske Toplice Special Hospital for Medical Rehabilitation, Department of Physical and Rehabilitation Medicine, Krapinske Toplice, Croatia; 2Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia; 3Department of Neuropediatrics, Zagreb Children's Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Tomislav Radošević
- 1Krapinske Toplice Special Hospital for Medical Rehabilitation, Department of Physical and Rehabilitation Medicine, Krapinske Toplice, Croatia; 2Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia; 3Department of Neuropediatrics, Zagreb Children's Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Žarko Bakran
- 1Krapinske Toplice Special Hospital for Medical Rehabilitation, Department of Physical and Rehabilitation Medicine, Krapinske Toplice, Croatia; 2Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia; 3Department of Neuropediatrics, Zagreb Children's Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Vlatka Mejaški Bošnjak
- 1Krapinske Toplice Special Hospital for Medical Rehabilitation, Department of Physical and Rehabilitation Medicine, Krapinske Toplice, Croatia; 2Josip Juraj Strossmayer University of Osijek, School of Medicine, Osijek, Croatia; 3Department of Neuropediatrics, Zagreb Children's Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia
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15
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Stability of the Communication Function Classification System among Children with Cerebral Palsy in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041881. [PMID: 33671982 PMCID: PMC7919265 DOI: 10.3390/ijerph18041881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022]
Abstract
Interest in the prognosis of skill levels has been an important issue among children with cerebral palsy (CP). This study aimed to verify the stability of the Communication Function Classification System (CFCS) in 2- to 18-year-old children with CP. Data collected from 171 children with CP who received rehabilitation therapy in hospitals or attended special elementary schools in South Korea were reviewed. They were divided into two groups, children <4 years and children ≥4 years. Participants were evaluated over 1-year and 2-year intervals from the first rating. Agreement between the three measurements and the weighted kappa were analyzed. At the 1-year interval, results demonstrated a high agreement rate of the CFCS in children ≥4 years old, and during the 2-year interval the study revealed a low agreement rate in children aged 2–4 years. The results indicated the stability of the CFCS in children ≥4 years old but some change of the CFCS in 2- to 4-year-old children. Moreover, the findings suggested that the change of the CFCS varied with time and age. Based on these results, it is recommended that the CFCS assessments be performed periodically, especially among 2- to 4-year-old children with CP.
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16
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Himmelmann K, Horber V, Sellier E, De la Cruz J, Papavasiliou A, Krägeloh-Mann I. Neuroimaging Patterns and Function in Cerebral Palsy-Application of an MRI Classification. Front Neurol 2021; 11:617740. [PMID: 33613420 PMCID: PMC7887285 DOI: 10.3389/fneur.2020.617740] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/17/2020] [Indexed: 01/02/2023] Open
Abstract
Background: Cerebral palsy (CP) is a disorder of movement and posture and every child with CP has a unique composition of neurological symptoms, motor severity, and associated impairments, constituting the functional profile. Although not part of the CP definition, magnetic resonance imaging (MRI) sheds light on the localization, nature, and severity of brain compromise. The MRI classification system (MRICS), developed by the Surveillance of Cerebral Palsy in Europe (SCPE), describes typical MRI patterns associated with specific timing of vulnerability in different areas of the brain. The classification has proven to be reliable and easy to use. Aims: The aim of this study is to apply the MRICS on a large dataset and describe the functional profile associated with the different MRI patterns of the MRICS. Materials and Methods: Data on children with CP born in 1999-2009 with a post-neonatal MRI from 20 European registers in the JRC-SCPE Central Registry was included. The CP classification and the MRICS was applied, and The Gross Motor Function Classification (GMFCS) and the Bimanual Fine Motor Function (BFMF) classification were used. The following associated impairments were documented: intellectual impairment, active epilepsy, visual impairment, and hearing impairment. An impairment index was used to characterize severity of impairment load. Results: The study included 3,818 children with post-neonatal MRI. Distribution of CP type, motor, and associated impairments differed by neuroimaging patterns. Functional profiles associated with neuroimaging patterns were described, and the impairment index showed that bilateral findings were associated with a more severe outcome both regarding motor impairment and associated impairments than unilateral compromise. The results from this study, particularly the differences in functional severity regarding uni- and bilateral brain compromise, may support counseling and service planning of support of children with CP.
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Affiliation(s)
- Kate Himmelmann
- Department of Pediatrics, Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Veronka Horber
- Department of Paediatric Neurology, University Children's Hospital, Tübingen, Germany
| | - Elodie Sellier
- Univ. Grenoble Alpes, CNRS, Grenoble INP, CHU Grenoble Alpes, TIMC-IMAG, Grenoble, France.,RHEOP, Grenoble, France
| | - Javier De la Cruz
- Research Institute (i+12), SAMID, University Hospital "12 Octubre", Madrid, Spain
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17
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Soriano JU, Hustad KC. Speech-Language Profile Groups in School Aged Children with Cerebral Palsy: Nonverbal Cognition, Receptive Language, Speech Intelligibility, and Motor Function. Dev Neurorehabil 2021; 24:118-129. [PMID: 33356732 PMCID: PMC7856067 DOI: 10.1080/17518423.2020.1858360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Purpose: To explore the relationship of intelligibility, receptive language, executive functioning, and motor skills to nonverbal cognitive skills among children with cerebral palsy (CP) in different speech-language profile groups. Method: Twenty-seven children with CP aged 10-12 years old participated in the study. They completed a battery of standard clinical assessments. The relationship of various skillsets with nonverbal cognitive ability was explored using correlational procedures. Additionally, we examined pairwise differences in nonverbal cognitive skills among profile groups. Cohen's Kappa and Chi-square tests were used to study the consistency of receptive language and nonverbal cognitive performance. Results: Children who showed better nonverbal cognitive abilities demonstrated better motor, receptive language, and intelligibility skills. Nonverbal cognition was generally consistent with receptive language. Conclusion: Nonverbal cognitive impairment often co-occurs with language and speech motor impairment among children with CP. Speech-language profile groups are a useful framework for describing both communication and cognitive abilities.
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Affiliation(s)
- Jennifer U. Soriano
- Wisconsin Intelligibility, Speech, and Communication Laboratory, Waisman Center, University of Wisconsin – Madison, Madison, WI, USA,Department of Communication Sciences & Disorders, University of Wisconsin – Madison, Madison, WI, USA
| | - Katherine C. Hustad
- Wisconsin Intelligibility, Speech, and Communication Laboratory, Waisman Center, University of Wisconsin – Madison, Madison, WI, USA,Department of Communication Sciences & Disorders, University of Wisconsin – Madison, Madison, WI, USA
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18
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Pennington L, Dave M, Rudd J, Hidecker MJC, Caynes K, Pearce MS. Communication disorders in young children with cerebral palsy. Dev Med Child Neurol 2020; 62:1161-1169. [PMID: 32729634 DOI: 10.1111/dmcn.14635] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 06/13/2020] [Accepted: 06/13/2020] [Indexed: 01/04/2023]
Abstract
AIM To test the prediction of communication disorder severity at 5 years of age from characteristics at 2 years for children with cerebral palsy (CP) whose communication is giving cause for concern. METHOD In this cohort study, 77 children (52 males; 25 females) with communication difficulties and CP were visited at home at 2 (mean 2y 4mo; SD 3mo) and 5 (mean 5y 5mo; SD 4mo) years of age. Information on the type and distribution of motor disorder, seizures, gross and fine motor function, hearing, and vision were collected from medical notes. Non-verbal cognition, language comprehension, language expression, spoken vocabulary, and methods of communication were assessed directly at age 2 years. At 5 years, communication and speech function were rated using the Communication Function Classification System (CFCS), Functional Communication Classification System (FCCS), and Viking Speech Scale (VSS). RESULTS In multivariable regression models, CP type, Gross Motor Function Classification System level, vision, the amount of speech understood by strangers, non-verbal cognition, and number of consonants produced at age 2 years predicted the CFCS level at age 5 years (R2 =0.54). CP type, Manual Ability Classification System level, amount of speech understood, vision, and number of consonants predicted the FCCS level (R2 =0.49). CP type, amount of speech understood by strangers, and number of consonants predicted the VSS level (R2 =0.50). INTERPRETATION Characteristics at 2 years of age predict communication and speech performance at 5 years, and should inform referral to speech and language therapy.
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Affiliation(s)
- Lindsay Pennington
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Mona Dave
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Jennifer Rudd
- Child and Adolescent Mental Health Services, Tees, Esk and Wear Valleys, NHS Foundation Trust, Durham, UK
| | | | - Katy Caynes
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Mark S Pearce
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
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19
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Mei C, Fern B, Reilly S, Hodgson M, Reddihough D, Mensah F, Morgan A. Communication behaviours of children with cerebral palsy who are minimally verbal. Child Care Health Dev 2020; 46:617-626. [PMID: 32557737 DOI: 10.1111/cch.12792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 06/01/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is a lack of population-based studies exploring the communicative behaviours of minimally verbal children with cerebral palsy (CP), with factors associated with superior and poorer communication outcomes unknown. This study aimed to examine the communication behaviours of minimally verbal children with CP recruited from a representative community sample and to identify factors associated with communication outcomes. METHODS Twenty minimally verbal children aged 5-6 years, recruited through the Victorian Cerebral Palsy Register, completed the Communication and Symbolic Behaviour Scales-Developmental Profile (CSBS-DP). Linear regressions examined child-related and environmental factors associated with communication outcomes. RESULTS CSBS-DP total raw scores ranged from 0 to 113. Strengths were the use of conventional gestures and understanding of language. Challenges were noted in using sequential action schemes during play. Communication typically served to regulate the behaviour of others. All participants demonstrated reduced functional communication (Communication Function Classification System levels III-IV). In the multivariable regression model adjusted for cognition, poorer communication skills were associated with Manual Ability Classification System levels IV-V (P = 0.004). CONCLUSIONS Although some children with CP who are minimally verbal use a variety of communication functions, significant functional limitations may be apparent. Severe upper limb impairment may provide an early indication of greater communication difficulties.
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Affiliation(s)
- Cristina Mei
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,Orygen, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Bethany Fern
- University of Melbourne, Melbourne, Victoria, Australia
| | - Sheena Reilly
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | | | - Dinah Reddihough
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,University of Melbourne, Melbourne, Victoria, Australia.,Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Fiona Mensah
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,University of Melbourne, Melbourne, Victoria, Australia.,Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Angela Morgan
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia.,University of Melbourne, Melbourne, Victoria, Australia
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20
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Mei C, Hodgson M, Reilly S, Fern B, Reddihough D, Mensah F, Pennington L, Losche A, Morgan A. Oromotor dysfunction in minimally verbal children with cerebral palsy: characteristics and associated factors. Disabil Rehabil 2020; 44:974-982. [PMID: 32744922 DOI: 10.1080/09638288.2020.1788179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM To explore the characteristics and associated factors of oromotor dysfunction in minimally verbal children with cerebral palsy (CP) aged five to six years, recruited from a population-based registry. Methods: Twenty children with CP who were minimally verbal completed a standardised, observational oromotor assessment. Linear regression analyses examined the relationship between oromotor dysfunction and potential associated factors (e.g., fine and gross motor function, communication, and feeding). Results: Oromotor dysfunction affected every participant and was identified in all structures examined (i.e., face, jaw, lips, and tongue). Oromotor movements showed little dissociation among jaw, lip, and tongue movements. Oromotor dysfunction was univariately associated with the Manual Ability Classification System levels IV-V (p = 0.001), reduced communication skills (p = 0.002), and a prolonged eating duration (>45 min) (p = 0.006), even when non-verbal cognition served as a covariate. Interpretation: Oromotor dysfunction was highly prevalent in our sample of minimally verbal children with CP, having significant functional impacts on feeding and communication. Findings suggest that fine motor function (i.e., Manual Ability Classification System levels IV-V) is a stronger predictor than gross motor function for identifying children with CP who are minimally verbal and at risk of oromotor dysfunction.IMPLICATIONS FOR REHABILITATIONOromotor dysfunction was highly prevalent in our sample of minimally verbal children with cerebral palsy.Severe fine motor impairment strongly predicted oromotor dysfunction, indicating that fine motor function may provide an early indicator of impaired oromotor function for this clinical population.Robust, standardised measures of motor speech-related oromotor development suitable for children with cerebral palsy who are minimally verbal are lacking.Until such a measure is developed, formal evaluation may be achieved via oral motor assessments standardised for typically developing children, with the caveat one must interpret the results with caution.
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Affiliation(s)
- Cristina Mei
- Murdoch Children's Research Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
| | | | - Sheena Reilly
- Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | | | - Dinah Reddihough
- Murdoch Children's Research Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia
| | - Fiona Mensah
- Murdoch Children's Research Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia
| | - Lindsay Pennington
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Annabel Losche
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Angela Morgan
- Murdoch Children's Research Institute, Melbourne, Australia.,University of Melbourne, Melbourne, Australia
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21
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Kristoffersson E, Dahlgren Sandberg A, Holck P. Communication ability and communication methods in children with cerebral palsy. Dev Med Child Neurol 2020; 62:933-938. [PMID: 32281100 DOI: 10.1111/dmcn.14546] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/16/2020] [Indexed: 11/28/2022]
Abstract
AIM To investigate if communication ability and method were related to each other and to age, sex, gross motor function, or manual ability in children with cerebral palsy. METHOD This cross-sectional study used data registered in the Swedish Cerebral Palsy Surveillance Program registry, involving 3000 children aged 0 to 18 years. Pearson's χ2 test and Spearman's correlation were used to test associations between variables. RESULTS Communication ability and method were related to each other and to age, gross motor function, and manual ability. Aided communication methods were more frequently used among older children. The more functional the communication was, the less use of unaided communication occurred. Different communication methods were used across all Communication Function Classification System (CFCS) levels. Speech was most common in more functional levels, used by 72% of the children. Forty-five per cent were considered effective communicators in all environments. For classification of communication level and method, some recurring registration errors were made by the raters. INTERPRETATION Some raters may need clarification on interpretations of CFCS instructions. Results indicate that children should be presented to aided augmentative and alternative communication and manual signs earlier and to a greater extent.
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Affiliation(s)
| | - Annika Dahlgren Sandberg
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden.,Division of Logopedics, Phoniatrics and Audiology, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Pernille Holck
- Department of Research and Development, Psychiatry and Habilitation, Pernille Holck, Region Scania, Sweden
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Fiske SI, Haddeland AL, Skipar I, Bootsma JN, Geytenbeek JJ, Stadskleiv K. Assessing language comprehension in motor impaired children needing AAC: validity and reliability of the Norwegian version of the receptive language test C-BiLLT. Augment Altern Commun 2020; 36:95-106. [PMID: 32706281 DOI: 10.1080/07434618.2020.1786857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Children with severe motor impairments who need augmentative and alternative communication (AAC) comprise a heterogeneous group with wide variability in cognitive functioning. Assessment of language comprehension will help find the best possible communication solution for each child, but there is a lack of appropriate instruments. This study investigates the reliability and validity of the Norwegian version of the spoken language comprehension test C-BiLLT (computer-based instrument for low motor language testing) - the C-BiLLT-Nor - and whether response modality influences test results. The participants were 238 children with typical development aged 1;2 to 7;10 (years/months) who were assessed with the C-BiLLT-Nor and tests of language comprehension and non-verbal reasoning. There was excellent internal consistency and good test-retest reliability. Tests of language comprehension and non-verbal reasoning correlated significantly with the C-BiLLT-Nor, indicating good construct validity. Factor analysis yielded a two-factor solution, suggesting it as a measure of receptive vocabulary, grammar, and overall language comprehension. No difference in results could be related to response mode, implying that gaze pointing is a viable option for children who cannot point with a finger. The C-BiLLT-Nor, with norms from 1;6-7;6 is a reliable measure of language comprehension.
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Affiliation(s)
- Sara Ida Fiske
- Department of Special Needs Education, University of Oslo, Oslo, Norway
| | | | - Ingvild Skipar
- Department of Educational Science, University of South-Eastern Norway, Borre, Norway
| | - Jael N Bootsma
- CanChild Centre for Childhood Disability Research and School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Johanna J Geytenbeek
- Rehabilitation Department, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
| | - Kristine Stadskleiv
- Department of Special Needs Education, University of Oslo, Oslo, Norway.,Department of Clinical Neurosciences for Children, Oslo University Hospital, Oslo, Norway
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Molinaro M, Broman AT, Rathouz PJ, Hustad KC. Longitudinal Development of Receptive Vocabulary in Children with Cerebral Palsy and Anarthria: Use of the MacArthur-Bates CDI. Dev Neurorehabil 2020; 23:285-293. [PMID: 31352864 PMCID: PMC6986977 DOI: 10.1080/17518423.2019.1646829] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To examine receptive language growth in children with cerebral palsy (CP) and anarthria using a parent-reported measure of vocabulary. METHOD Scores from 47 children (29 males) with CP and anarthria were obtained from the vocabulary checklists on the MacArthur-Bates Communication Development Inventories (MCDI) and analyzed to examine the distribution of receptive language growth. Linear trajectories of word composite scores were created using a linear-mixed model, incorporating between two and ten data points per child. RESULTS Three different growth trajectories emerged: approximately 23% grew by 100 or more words per year, 13% grew by 50-100 words per year, and 64% grew by 50 words per year or less. Age-four vocabulary was strongly correlated with rate of increase in vocabulary. CONCLUSION Receptive vocabulary scores from the MCDI are increasing at a reduced pace for most children with CP and anarthria. More sensitive measures of language assessment are necessary to gain a complete picture of their language ability levels.
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Affiliation(s)
- Michael Molinaro
- Department of Communication Sciences and Disorders, University of Wisconsin, Madison, USA,Waisman Centre, University of Wisconsin, Madison, USA
| | - Aimee Teo Broman
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health. Madison, USA
| | - Paul J. Rathouz
- Department of Population Health, University of Texas, Austin, USA
| | - Katherine C. Hustad
- Department of Communication Sciences and Disorders, University of Wisconsin, Madison, USA,Waisman Centre, University of Wisconsin, Madison, USA
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24
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Andrews C, Kakooza-Mwesige A, Almeida R, Swartling Peterson S, Wabwire-Mangen F, Eliasson AC, Forssberg H. Impairments, functional limitations, and access to services and education for children with cerebral palsy in Uganda: a population-based study. Dev Med Child Neurol 2020; 62:454-462. [PMID: 31762018 DOI: 10.1111/dmcn.14401] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2019] [Indexed: 12/25/2022]
Abstract
AIM To describe the functional limitations and associated impairments of children with cerebral palsy (CP) in rural Uganda, and care-seeking behaviour and access to assistive devices and education. METHOD Ninety-seven children with CP (42 females, 55 males; age range 2-17y) were identified in a three-stage population-based screening with subsequent medical examinations and functional assessments. Information on school and access to care was collected using questionnaires. The data were compared with Swedish and Australian cohorts of children with CP. We used the χ2 test and linear regression models to analyse differences between groups. RESULTS Younger children were more severely impaired than older children. Two-fifths of the children had severe impairments in communication, about half had intellectual disability, and one third had seizures. Of 37 non-walking children, three had wheelchairs and none had walkers. No children had assistive devices for hearing, seeing, or communication. Care-seeking was low relating to lack of knowledge, insufficient finances, and 'lost hope'. One-third of the children attended school. Ugandan children exhibited lower developmental trajectories of mobility and self-care than a Swedish cohort. INTERPRETATION The needs for children with CP in rural Uganda are not met, illustrated by low care-seeking, low access to assistive devices, and low school attendance. A lack of rehabilitation and stimulation probably contribute to the poor development of mobility and self-care skills. There is a need to develop and enhance locally available and affordable interventions for children with CP in Uganda. WHAT THIS PAPER ADDS Development of mobility and self-care skills is lower in Ugandan than Swedish children with cerebral palsy (CP). Older children in Uganda with CP are less impaired than younger children. Untreated seizures and impairments of communication and intellect are common. Access to health services, assistive devices, and education is low. Caregivers lack knowledge and finances to seek care and often lose hope of their child improving.
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Affiliation(s)
- Carin Andrews
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Angelina Kakooza-Mwesige
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Department of Pediatrics and Child Health, Makerere University, Kampala, Uganda
| | - Rita Almeida
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Swartling Peterson
- Department of Public Health, Karolinska Institutet, Stockholm, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,UNICEF, New York, NY, USA
| | - Fred Wabwire-Mangen
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ann-Christin Eliasson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Stockholm, Sweden
| | - Hans Forssberg
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Astrid Lindgren Children's Hospital, Stockholm, Sweden
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25
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Caynes K, Rose TA, Theodoros D, Burmester D, Ware RS, Johnston LM. The Functional Communication Classification System: extended reliability and concurrent validity for children with cerebral palsy aged 5 to 18 years. Dev Med Child Neurol 2019; 61:805-812. [PMID: 30613944 DOI: 10.1111/dmcn.14135] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/02/2018] [Indexed: 11/30/2022]
Abstract
AIM To examine psychometric properties and clinical utility of the Functional Communication Classification System (FCCS) for classifying observable communication function in children with cerebral palsy (CP) aged 5 to 18 years. METHOD Eighty-two children (38 males, 44 females) with CP in six age groups (5y [n=15], 8y [n=14], 10y [n=14], 12y [n=14], 15y [n=11], and 17y [n=14]) were assessed by a speech-language pathologist (SLP) and parent for FCCS ratings. Data were compared with: (1) everyday communication function, assessed using the Clinical Evaluation of Language Fundamentals - Fourth Edition Pragmatics Profile (CELF-4 PP) for familiar and unfamiliar partners; (2) motor speech, gross and fine motor function; and (3) associated impairments, including epilepsy, intelligence, hearing, and vision. Interrater agreement was calculated for FCCS ratings using kappa (κ) statistics. Relationships between FCCS ratings and other measures were examined using Spearman's correlation coefficient. RESULTS Almost perfect interrater agreement was demonstrated between SLP and parent FCCS ratings (κw =0.96). Correlations were excellent between FCCS ratings with CELF-4 PP ratings, motor speech, and intellect; moderate with gross and fine motor function; and fair with other associated impairments (hearing, visual, and epilepsy). There was no correlation between age and FCCS. INTERPRETATION The FCCS is a reliable and valid communication classification system for children with CP aged 5 to 18 years, and highly suitable for surveillance, research, and clinical purposes. WHAT THIS PAPER ADDS The Functional Communication Classification System (FCCS) is valid and reliable for communication classification in children with cerebral palsy. Excellent agreement is present between speech language pathologists and parents. The FCCS shows excellent correlation with pragmatics, motor speech, and intelligence. The FCCS is moderately correlated with gross and fine motor function. The FCCS has fair correlation with epilepsy, hearing, and vision.
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Affiliation(s)
- Katy Caynes
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Tanya A Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Deborah Theodoros
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | | | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Leanne M Johnston
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
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Kavlak E, Tekin F. Examining various factors affecting communication skills in children with cerebral palsy. NeuroRehabilitation 2019; 44:161-173. [PMID: 30856125 DOI: 10.3233/nre-182580] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Cerebral palsied children may have difficulties in acting as senders and/or receivers in the communication process. The aim of this study is examining that which maternal and child-related factors affect the communication skills of cerebral palsied children. METHODS 188 cerebral palsy diagnosed children ages between 2-18 years were assessed by Communication Function Classification System for communication skills. Maternal factors such as occupation, and educational status, and child-related factors such as gender, time of birth, clinical type of cerebral palsy, origin period of cerebral palsy; also daily living activities and gross motor functions of children were included in the assessment for examining how they affect the communication skills of cerebral palsied children. RESULTS Lower maternal age, higher gross motor function level, ataxic type and hemiparetic involvement (p < 0,05); educational status, maternal unemployment, female gender, and premature birth (p > 0,05) affected positively on the communication skills. There were no effects of delivery method (p > 0,05). CONCLUSIONS Communication skills of cerebral palsied children are affected by maternal age, educational status, occupation, and child's gender, birth term, origin period of cerebral palsy, clinical type of cerebral palsy, extremity involvement, motor development level and gross motor function. But the method of delivery has no effect on the communication functions of cerebral palsied children.
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Affiliation(s)
- Erdoğan Kavlak
- Pamukkale University School of Physical Therapy and Rehabilitation, Denizli, Turkey
| | - Fatih Tekin
- Pamukkale University School of Physical Therapy and Rehabilitation, Denizli, Turkey
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27
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Sakash A, Broman AT, Rathouz PJ, Hustad KC. Executive function in school-aged children with cerebral palsy: Relationship with speech and language. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 78:136-144. [PMID: 29853333 PMCID: PMC6033269 DOI: 10.1016/j.ridd.2018.05.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 04/03/2018] [Accepted: 05/22/2018] [Indexed: 05/29/2023]
Abstract
BACKGROUND AND AIMS Although children with cerebral palsy (CP) are at an increased risk for developing speech, language, and executive function (EF) impairments, little is known regarding the relationship among these risk factors. The current study examined how different profiles of speech and language impairment might be associated with impairments in EF skills in school-aged children with CP. METHODS AND PROCEDURES Forty-seven school-aged children with CP were included. Each child contributed between one and four data points for a total of 87 data points. Children were classified into speech and language profile groups at each data point. EF skills were examined using the Behavior Rating Inventory of Executive Function questionnaire. OUTCOMES AND RESULTS Compared to a mean of 50 from a normative population of children, mean scores on all measures of EF were significantly elevated for all groups (p<.05). The proportion of children with CP with elevated EF scores was significantly higher for all groups compared to the expected proportion in a normal population of children (p<.05). CONCLUSIONS AND IMPLICATIONS Children with CP who do not have impairments in speech or language may be at risk for EF difficulties which may negatively affect social communication, academic performance, and functional independence.
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Affiliation(s)
- Ashley Sakash
- Waisman Center, University of Wisconsin-Madison, United States.
| | - Aimee Teo Broman
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, United States
| | - Paul J Rathouz
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, United States
| | - Katherine C Hustad
- Waisman Center, University of Wisconsin-Madison, United States; Department of Communication Sciences and Disorders, University of Wisconsin-Madison, United States
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28
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Choi JY, Park J, Choi YS, Goh YR, Park ES. Functional Communication Profiles in Children with Cerebral Palsy in Relation to Gross Motor Function and Manual and Intellectual Ability. Yonsei Med J 2018; 59:677-685. [PMID: 29869466 PMCID: PMC5990683 DOI: 10.3349/ymj.2018.59.5.677] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 04/10/2018] [Accepted: 05/03/2018] [Indexed: 12/03/2022] Open
Abstract
PURPOSE The aim of the present study was to investigate communication function using classification systems and its association with other functional profiles, including gross motor function, manual ability, intellectual functioning, and brain magnetic resonance imaging (MRI) characteristics in children with cerebral palsy (CP). MATERIALS AND METHODS This study recruited 117 individuals with CP aged from 4 to 16 years. The Communication Function Classification System (CFCS), Viking Speech Scale (VSS), Speech Language Profile Groups (SLPG), Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and intellectual functioning were assessed in the children along with brain MRI categorization. RESULTS Very strong relationships were noted among the VSS, CFCS, and SLPG, although these three communication systems provide complementary information, especially for children with mid-range communication impairment. These three communication classification systems were strongly related with the MACS, but moderately related with the GMFCS. Multiple logistic regression analysis indicated that manual ability and intellectual functioning were significantly related with VSS and CFCS function, whereas only intellectual functioning was significantly related with SLPG functioning in children with CP. Communication function in children with a periventricular white matter lesion (PVWL) varied widely. In the cases with a PVWL, poor functioning was more common on the SLPG, compared to the VSS and CFCS. CONCLUSION Very strong relationships were noted among three communication classification systems that are closely related with intellectual ability. Compared to gross motor function, manual ability seemed more closely related with communication function in these children.
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Affiliation(s)
- Ja Young Choi
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jieun Park
- Department of Rehabilitation Speech-Language Therapy, Severance Rehabilitation Hospital, Seoul, Korea
| | - Yoon Seong Choi
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yu Ra Goh
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Sook Park
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
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29
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Mutlu A, Kara ÖK, Livanelioğlu A, Karahan S, Alkan H, Yardımcı BN, Hidecker MJC. Agreement between parents and clinicians on the communication function levels and relationship of classification systems of children with cerebral palsy. Disabil Health J 2018; 11:281-286. [DOI: 10.1016/j.dhjo.2017.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 10/12/2017] [Accepted: 11/11/2017] [Indexed: 12/01/2022]
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30
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Hidecker MJC, Slaughter J, Abeysekara P, Ho NT, Dodge N, Hurvitz EA, Workinger MS, Kent RD, Rosenbaum P, Lenski M, Vanderbeek SB, DeRoos S, Paneth N. Early Predictors and Correlates of Communication Function in Children With Cerebral Palsy. J Child Neurol 2018; 33:275-285. [PMID: 29366365 PMCID: PMC8583866 DOI: 10.1177/0883073817754006] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Birth characteristics and developmental milestones were evaluated as early predictors/correlates of communication in children with cerebral palsy. The hypothesis was that maternal report of child's age for vocal play and first words would predict current functional communication. A case series of 215 children, 2 to 17 years (mean age = 8.2 years, SD = 3.9) with cerebral palsy was recruited from medical practices in 3 Michigan cities. Early developmental data were collected by maternal interview. The child's Communication Function Classification System (CFCS) level was obtained from parent. Predictors of less functional communication included gestational age >32 weeks, number of comorbidities, age of first words after age 24 months, and use of communication methods other than speech. Several birth characteristics and developmental language milestones were predictive of later communication performance for children with cerebral palsy. These characteristics and milestones should trigger referrals for communication evaluations, including speech, language, hearing, and/or augmentative and alternative communication.
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Affiliation(s)
- Mary Jo Cooley Hidecker
- Division of Communication Disorders, University of Wyoming, Laramie, WY, USA.,Department of Epidemiology& Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Jaime Slaughter
- Department of Health Systems & Sciences Research and Department of Epidemiology & Biostatistics, Drexel University, PA, USA
| | - Purni Abeysekara
- Department of Community Health & Prevention, Drexel University, PA, USA
| | - Nhan T Ho
- Sergievesky Center, Columbia University Medical Center, New York, NY, USA
| | - Nancy Dodge
- Department of Pediatrics, Helen DeVos Children’s Hospital, Grand Rapids, MI, USA
| | - Edward A Hurvitz
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | | | - Ray D Kent
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON, Canada
| | - Madeleine Lenski
- Department of Epidemiology& Biostatistics, Michigan State University, East Lansing, MI, USA
| | | | - Steven DeRoos
- Division of Pediatric Neurology, Helen DeVos Children’s Hospital, Grand Rapids, MI, USA
| | - Nigel Paneth
- Departments of Epidemiology& Biostatistics and Pediatrics & Human Development, Michigan State University, East Lansing, MI, USA
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Choi JY, Hwang EH, Rha D, Park ES. Reliability and validity of the Korean-language version of the Communication Function Classification System in children with cerebral palsy. Child Care Health Dev 2018; 44:140-146. [PMID: 28929518 DOI: 10.1111/cch.12507] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 07/05/2017] [Accepted: 08/07/2017] [Indexed: 12/01/2022]
Abstract
PURPOSE The Communication Function Classification System (CFCS) and Viking Speech Scale (VSS) are useful systems for describing the broad communication function and speech intelligibility, respectively, of children with cerebral palsy (CP). The aims of this study were to determine the reliability and validity of the Korean version of the CFCS and also to investigate the association between the CFCS and the VSS and other functional classifications for children with CP. MATERIALS AND METHODS Participants were 50 children with CP (33 males, 17 females; mean age 7.2 years, range 4-16 years) recruited from a rehabilitation hospital. We analysed the interrater and intrarater reliabilities of the Korean version of the CFCS and VSS between parents, a physiatrist, and a speech-language pathologist (SLP). The social function domain of the Paediatric Evaluation of Disability Inventory was assessed to examine the concurrent validity of the CFCS and VSS. RESULTS The intrarater reliabilities of the CFCS and VSS were excellent in a physiatrist (ƙ = 0.92, ƙ = 0.94, respectively) and an SLP (ƙ = 0.98, ƙ = 0.98) and very good in parents (ƙ = 0.87, ƙ = 0.89). The interrater reliability of the CFCS and VSS was very good between the physiatrist and SLP (ƙ = 0.87, ƙ = 0.89) and good between parents and the SLP (ƙ = 0.63, ƙ = 0.78) and between parents and the physiatrist (ƙ = 0.61, ƙ = 0.76). The CFCS and VSS were strongly related with the social function domain of Paediatric Evaluation of Disability Inventory. In addition, we found very strong associations between the VSS and CFCS. CONCLUSIONS The Korean version of the CFCS is a valid and reliable tool to classify communication ability and is strongly associated with the VSS, a reliable tool to classify speech intelligibility.
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Affiliation(s)
- J Y Choi
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - E H Hwang
- Department of Rehabilitation Speech-Language Therapy, Severance Rehabilitation Hospital, Seoul, Korea
| | - D Rha
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - E S Park
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea
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32
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Goh YR, Choi JY, Kim SA, Park J, Park ES. Comparisons of severity classification systems for oropharyngeal dysfunction in children with cerebral palsy: Relations with other functional profiles. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 72:248-256. [PMID: 29223113 DOI: 10.1016/j.ridd.2017.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Revised: 10/02/2017] [Accepted: 12/01/2017] [Indexed: 05/28/2023]
Abstract
This study aimed to investigate the relationships between various classification systems assessing the severity of oropharyngeal dysphagia and communication function and other functional profiles in children with cerebral palsy (CP). This is a prospective, cross-sectional, study in a university-affiliated, tertiary-care hospital. We recruited 151 children with CP (mean age 6.11 years, SD 3.42, range 3-18yr). The Eating and Drinking Ability Classification System (EDACS) and the dysphagia scales of Functional Oral Intake Scale (FOIS), Swallow Function Scales (SFS), and Food Intake Level Scale (FILS) were used. The Communication Function Classification System (CFCS) and Viking Speech Scale (VSS) were employed to classify communication function and speech intelligibility, respectively. The Pediatric Evaluation of Disability Inventory (PEDI) with the Gross Motor Function Classification System (GFMCS) and the Manual Ability Classification System (MACS) level were also assessed. Spearman correlation analysis to investigate the associations between measures and univariate and multivariate logistic regression models to identify significant factors were used. Median GMFCS level of participants was III (interquartile range II-IV). Significant dysphagia based on EDACS level III-V was noted in 23 children (15.2%). There were strong to very strong relationships between the EDACS level with the dysphagia scales. The EDACS presented strong associations with MACS, CFCS, and VSS, a moderate association with GMFCS level, and a moderate to strong association with each domain of the PEDI. In multivariate analysis, poor functioning in EDACS were associated with poor functioning in gross motor and communication functions.
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Affiliation(s)
- Yu-Ra Goh
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ja Young Choi
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seon Ah Kim
- Department of Pediatric Occupational Therapy, Severance Rehabilitation Hospital, Seoul, Republic of Korea
| | - Jieun Park
- Department of Rehabilitation Speech-Language Therapy, Severance Rehabilitation Hospital, Seoul, Republic of Korea
| | - Eun Sook Park
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Cognitive functioning in dyskinetic cerebral palsy: Its relation to motor function, communication and epilepsy. Eur J Paediatr Neurol 2018; 22:102-112. [PMID: 29108712 DOI: 10.1016/j.ejpn.2017.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/25/2017] [Accepted: 10/15/2017] [Indexed: 12/23/2022]
Abstract
BACKGROUND Cerebral palsy (CP) is a disorder of motor function often accompanied by cognitive impairment. There is a paucity of research focused on cognition in dyskinetic CP and on the potential effect of related factors. AIM To describe the cognitive profile in dyskinetic CP and to assess its relationship with motor function and associated impairments. METHOD Fifty-two subjects with dyskinetic CP (28 males, mean age 24 y 10 mo, SD 13 y) and 52 typically-developing controls (age- and gender-matched) completed a comprehensive neuropsychological assessment. Gross Motor Function Classification System (GMFCS), Communication Function Classification System (CFCS) and epilepsy were recorded. Cognitive performance was compared between control and CP groups, also according different levels of GMFCS. The relationship between cognition, CFCS and epilepsy was examined through partial correlation coefficients, controlling for GMFCS. RESULTS Dyskinetic CP participants performed worse than controls on all cognitive functions except for verbal memory. Milder cases (GMFCS I) only showed impairment in attention, visuoperception and visual memory. Participants with GMFCS II-III also showed impairment in language-related functions. Severe cases (GMFCS IV-V) showed impairment in intelligence and all specific cognitive functions but verbal memory. CFCS was associated with performance in receptive language functions. Epilepsy was related to performance in intelligence, visuospatial abilities, visual memory, grammar comprehension and learning. CONCLUSION Cognitive performance in dyskinetic CP varies with the different levels of motor impairment, with more cognitive functions impaired as motor severity increases. This study also demonstrates the relationship between communication and epilepsy and cognitive functioning, even controlling for the effect of motor severity.
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Hustad KC, Allison KM, Sakash A, McFadd E, Broman AT, Rathouz PJ. Longitudinal development of communication in children with cerebral palsy between 24 and 53 months: Predicting speech outcomes. Dev Neurorehabil 2017; 20:323-330. [PMID: 27792399 PMCID: PMC5409890 DOI: 10.1080/17518423.2016.1239135] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine whether communication at 2 years predicted communication at 4 years in children with cerebral palsy (CP); and whether the age a child first produces words imitatively predicts change in speech production. METHOD 30 children (15 males) with CP participated and were seen 5 times at 6-month intervals between 24 and 53 months (mean age at time 1 = 26.9 months (SD 1.9)). Variables were communication classification at 24 and 53 months, age that children were first able to produce words imitatively, single-word intelligibility, and longest utterance produced. RESULTS Communication at 24 months was highly predictive of abilities at 53 months. Speaking earlier led to faster gains in intelligibility and length of utterance and better outcomes at 53 months than speaking later. CONCLUSION Inability to speak at 24 months indicates greater speech and language difficulty at 53 months and a strong need for early communication intervention.
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Affiliation(s)
- Katherine C. Hustad
- Department of Communication Sciences and Disorders, University of Wisconsin – Madison,Waisman Center, University of Wisconsin – Madison
| | - Kristen M. Allison
- Department of Communication Sciences and Disorders, University of Wisconsin – Madison,Waisman Center, University of Wisconsin – Madison
| | | | - Emily McFadd
- Department of Communication Sciences and Disorders, University of Wisconsin – Madison,Waisman Center, University of Wisconsin – Madison
| | - Aimee Teo Broman
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health
| | - Paul J. Rathouz
- Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health
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Borgestig M, Rytterström P, Hemmingsson H. Gaze-based assistive technology used in daily life by children with severe physical impairments - parents' experiences. Dev Neurorehabil 2017; 20:301-308. [PMID: 27537982 DOI: 10.1080/17518423.2016.1211769] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To describe and explore parents' experiences when their children with severe physical impairments receive gaze-based assistive technology (gaze-based assistive technology (AT)) for use in daily life. METHODS Semi-structured interviews were conducted twice, with one year in between, with parents of eight children with cerebral palsy that used gaze-based AT in their daily activities. To understand the parents' experiences, hermeneutical interpretations were used during data analysis. RESULTS The findings demonstrate that for parents, children's gaze-based AT usage meant that children demonstrated agency, provided them with opportunities to show personality and competencies, and gave children possibilities to develop. Overall, children's gaze-based AT provides hope for a better future for their children with severe physical impairments; a future in which the children can develop and gain influence in life. CONCLUSION Gaze-based AT provides children with new opportunities to perform activities and take initiatives to communicate, giving parents hope about the children's future.
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Affiliation(s)
- Maria Borgestig
- a Department of Social and Welfare Studies , Linköping University , Linköping , Sweden.,b Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health , Uppsala University , Uppsala , Sweden
| | - Patrik Rytterström
- a Department of Social and Welfare Studies , Linköping University , Linköping , Sweden
| | - Helena Hemmingsson
- a Department of Social and Welfare Studies , Linköping University , Linköping , Sweden
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Choi JY, Choi YS, Park ES. Language Development and Brain Magnetic Resonance Imaging Characteristics in Preschool Children With Cerebral Palsy. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:1330-1338. [PMID: 28492849 DOI: 10.1044/2016_jslhr-l-16-0281] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 11/21/2016] [Indexed: 06/07/2023]
Abstract
PURPOSE The purpose of this study was to investigate characteristics of language development in relation to brain magnetic resonance imaging (MRI) characteristics and the other contributing factors to language development in children with cerebral palsy (CP). METHOD The study included 172 children with CP who underwent brain MRI and language assessments between 3 and 7 years of age. The MRI characteristics were categorized as normal, malformation, periventricular white matter lesion (PVWL), deep gray matter lesion, focal infarct, cortical/subcortical lesion, and others. Neurodevelopmental outcomes such as ambulatory status, manual ability, cognitive function, and accompanying impairments were assessed. RESULTS Both receptive and expressive language development quotients (DQs) were significantly related to PVWL or deep gray matter lesion severity. In multivariable analysis, only cognitive function was significantly related to receptive language development, whereas ambulatory status and cognitive function were significantly associated with expressive language development. More than one third of the children had a language developmental discrepancy between receptive and expressive DQs. Children with cortical/subcortical lesions were at high risk for this discrepancy. CONCLUSIONS Cognitive function is a key factor for both receptive and expressive language development. In children with PVWL or deep gray matter lesion, lesion severity seems to be useful to predict language development.
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Affiliation(s)
- Ja Young Choi
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoon Seong Choi
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Sook Park
- Department of Rehabilitation Medicine, Severance Hospital, Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Borgestig M, Sandqvist J, Ahlsten G, Falkmer T, Hemmingsson H. Gaze-based assistive technology in daily activities in children with severe physical impairments-An intervention study. Dev Neurorehabil 2017; 20:129-141. [PMID: 26930111 DOI: 10.3109/17518423.2015.1132281] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To establish the impact of a gaze-based assistive technology (AT) intervention on activity repertoire, autonomous use, and goal attainment in children with severe physical impairments, and to examine parents' satisfaction with the gaze-based AT and with services related to the gaze-based AT intervention. METHODS Non-experimental multiple case study with before, after, and follow-up design. Ten children with severe physical impairments without speaking ability (aged 1-15 years) participated in gaze-based AT intervention for 9-10 months, during which period the gaze-based AT was implemented in daily activities. RESULTS Repertoire of computer activities increased for seven children. All children had sustained usage of gaze-based AT in daily activities at follow-up, all had attained goals, and parents' satisfaction with the AT and with services was high. DISCUSSION The gaze-based AT intervention was effective in guiding parents and teachers to continue supporting the children to perform activities with the AT after the intervention program.
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Affiliation(s)
- Maria Borgestig
- a Department of Social and Welfare Studies , Linköping University , Linköping , Sweden.,b Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health , Uppsala University , Uppsala , Sweden
| | - Jan Sandqvist
- a Department of Social and Welfare Studies , Linköping University , Linköping , Sweden
| | - Gunnar Ahlsten
- b Folke Bernadotte Regional Habilitation Centre and Department of Women´s and Children´s Health , Uppsala University , Uppsala , Sweden
| | - Torbjörn Falkmer
- c School of Occupational Therapy & Social Work, Curtin University , Perth , WA , Australia.,d School of Occupational Therapy, La Trobe University , Melbourne , Victoria , Australia.,e Rehabilitation Medicine, Department of Medicine and Health Sciences (IMH), Faculty of Health Sciences , Linköping University & Pain and Rehabilitation Centre, UHL, County Council , Linköping , Sweden
| | - Helena Hemmingsson
- a Department of Social and Welfare Studies , Linköping University , Linköping , Sweden
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Coleman A, Fiori S, Weir KA, Ware RS, Boyd RN. Relationship between brain lesion characteristics and communication in preschool children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 58:55-64. [PMID: 27591975 DOI: 10.1016/j.ridd.2016.08.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 08/28/2016] [Accepted: 08/29/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND MRI shows promise as a prognostic tool for clinical findings such as gross motor function in children with cerebral palsy(CP), however the relationship with communication skills requires exploration. AIMS To examine the relationship between the type and severity of brain lesion on MRI and communication skills in children with CP. METHODS AND PROCEDURES 131 children with CP (73 males(56%)), mean corrected age(SD) 28(5) months, Gross Motor Functional Classification System distribution: I=57(44%), II=14(11%), III=19(14%), IV=17(13%), V=24(18%). Children were assessed on the Communication and Symbolic Behavioral Scales Developmental Profile (CSBS-DP) Infant-Toddler Checklist. Structural MRI was analysed with reference to type and semi-quantitative assessment of the severity of brain lesion. Children were classified for motor type, distribution and GMFCS. The relationships between type/severity of brain lesion and communication ability were analysed using multivariable tobit regression. OUTCOMES AND RESULTS Children with periventricular white matter lesions had better speech than children with cortical/deep grey matter lesions (β=-2.6, 95%CI=-5.0, -0.2, p=0.04). Brain lesion severity on the semi-quantitative scale was related to overall communication skills (β=-0.9, 95%CI=-1.4, -0.5, p<0.001). Motor impairment better accounted for impairment in overall communication skills than brain lesion severity. IMPLICATIONS Structural MRI has potential prognostic value for communication impairment in children with CP. WHAT THIS PAPER ADDS?: This is the first paper to explore important aspects of communication in relation to the type and severity of brain lesion on MRI in a representative cohort of preschool-aged children with CP. We found a relationship between the type of brain lesion and communication skills, children who had cortical and deep grey matter lesions had overall communication skills>1 SD below children with periventricular white matter lesions. Children with more severe brain lesions on MRI had poorer overall communication skills. Children with CP born at term had poorer communication than those born prematurely and were more likely to have cortical and deep grey matter lesions. Gross motor function better accounted for overall communication skills than the type of brain lesion or brain lesion severity.
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Affiliation(s)
- Andrea Coleman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Centre for Children's Health Research, The University of Queensland, Australia.
| | - Simona Fiori
- Department of Developmental Neuroscience, IRCCS Stella Maris, Pisa, Italy
| | - Kelly A Weir
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Centre for Children's Health Research, The University of Queensland, Australia; Speech Pathology Department, Lady Cilento Children's Hospital, Brisbane, Australia; Queensland Children's Medical Research Institute, Children's Health Queensland, Australia
| | - Robert S Ware
- UQ Child Health Research Centre, School of Medicine, The University of Queensland, Australia; School of Public Health, The University of Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Centre for Children's Health Research, The University of Queensland, Australia
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Barty E, Caynes K, Johnston LM. Development and reliability of the Functional Communication Classification System for children with cerebral palsy. Dev Med Child Neurol 2016; 58:1036-41. [PMID: 27087436 DOI: 10.1111/dmcn.13124] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/20/2016] [Indexed: 11/28/2022]
Abstract
AIM This paper describes the development, validation, and reliability of the Functional Communication Classification System (FCCS), designed to classify expressive communication skills of children with cerebral palsy (CP) aged 4 years and 5 years (between their fourth and sixth birthdays). METHOD The Functional Communication Classification System (FCCS) was developed in 2006 using a literature review, client file audit, and expert consultative committee process in order to devise scale content, structure, and check clinical validity and utility. Interrater reliability was examined between speech-language pathologists (SLPs), other allied health professionals (AHPs), and parents of 48 children with CP. The scale was revised and a clinical reasoning prompt sheet added, then trialled again for 42 children. The result was a five-level system with descriptors and decision-making guides for classification of functional expressive communication for children with CP. RESULTS Overall interrater reliability was excellent for the final FCCS, intraclass correlation coefficient=0.97 (95% confidence interval 0.95 to 0.98). Kappa values were 0.94 between SLPs and AHPs, 0.59 between SLPs and parents, and 0.60 between AHPs and parents. INTERPRETATION The FCCS is a reliable tool for describing functional communication in young children with CP, appropriate for use by SLPs, other AHPs, and parents of children with CP.
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Affiliation(s)
| | - Katy Caynes
- The University of Queensland, Brisbane, Qld, Australia
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Trabacca A, Vespino T, Di Liddo A, Russo L. Multidisciplinary rehabilitation for patients with cerebral palsy: improving long-term care. J Multidiscip Healthc 2016; 9:455-462. [PMID: 27703369 PMCID: PMC5036581 DOI: 10.2147/jmdh.s88782] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Cerebral palsy (CP) is one of the most frequent causes of child disability in developed countries. Children with CP need lifelong assistance and care. The current prevalence of CP in industrialized countries ranges from 1.5 to 2.5 per 1,000 live births, with one new case every 500 live births. Children with CP have an almost normal life expectancy and mortality is very low. Despite the low mortality rate, 5%-10% of them die during childhood, especially when the severe motor disability is comorbid with epilepsy and severe intellectual disability. Given this life expectancy, children with CP present with a lifelong disability of varying severity and complexity, which requires individualized pathways of care. There are no specific treatments that can remediate the brain damage responsible for the complex clinical-functional dysfunctions typical of CP. There are, however, a number of interventions (eg, neurorehabilitation, functional orthopedic surgery, medication, etc) aimed at limiting the damage secondary to the brain insult and improving these patients' activity level and participation and, therefore, their quality of life. The extreme variability of clinical aspects and the complexity of affected functions determine a multifaceted skill development in children with CP. There is a need to provide them with long-term care, taking into account medical and social aspects as well as rehabilitation, education, and assistance. This long-term care must be suited according to children's developmental stage and their physical, psychological, and social development within their life contexts. This impacts heavily on the national health systems which must set up a network of services for children with CP, and it also impacts heavily on the family as a whole, due to the resulting distress, adjustment efforts, and changes in quality of life. This contribution is a narrative review of the current literature on long-term care for children with CP, aiming at suggesting reflections to improve these children's care.
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Affiliation(s)
- Antonio Trabacca
- Scientific Institute I.R.C.C.S. "Eugenio Medea" - "La Nostra Famiglia" - Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Teresa Vespino
- Scientific Institute I.R.C.C.S. "Eugenio Medea" - "La Nostra Famiglia" - Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Antonella Di Liddo
- Scientific Institute I.R.C.C.S. "Eugenio Medea" - "La Nostra Famiglia" - Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Luigi Russo
- Scientific Institute I.R.C.C.S. "Eugenio Medea" - "La Nostra Famiglia" - Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi Research Centre, Brindisi, Italy
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Guedes-Granzotti RB, Andrade LA, Silva KD, Bicalho ICS, Fukuda MTH, Domenis DR. Adaptação transcultural do Communication Function Classification System para indivíduos com paralisia cerebral. REVISTA CEFAC 2016. [DOI: 10.1590/1982-021620161840716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: realizar a adaptação transcultural do Communication Function Classification System para a população brasileira e verificar a aplicabilidade da versão traduzida. Métodos: o estudo foi constituído de duas etapas, a primeira relacionada com o processo de tradução e adaptação transcultural por meio da tradução, análise semântica dos itens, e retrotradução do instrumento. A segunda, à testagem do instrumento, foi realizada em 40 pacientes com diagnóstico de paralisia cerebral. Resultados: a versão final recebeu a chancela da autora do instrumento original e foi publicada pela mesma, juntamente com a versão original e todas as demais traduções, no site http://cfcs.us. 60% (24) dos pacientes eram do sexo masculino e 40% (16) do feminino, as idades variaram entre dois anos e quatro meses à 28 anos e dois meses, e a idade média de 7,7 (±4,6). O instrumento foi de fácil e rápida aplicação, e todos os níveis de comunicação foram observados. Sendo que oito pacientes estavam no Nível I, nove no Nível II, dois no Nível III, treze no Nível IV e oito no Nível V. Conclusões: a versão traduzida e adaptada para o Português Brasileiro do CFCS possibilitou a classificação do desempenho da comunicação diária de indivíduos com Paralisia Cerebral em um dos cinco Níveis de Comunicação. Entretanto, para que seja amplamente utilizado em ambientes clínicos e de pesquisa, ainda há necessidade de trabalhos futuros que verifiquem a sensibilidade e a especificidade do mesmo, além da validação das propriedades psicométricas da versão brasileira do instrumento.
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Hustad KC, Oakes A, McFadd E, Allison KM. Alignment of classification paradigms for communication abilities in children with cerebral palsy. Dev Med Child Neurol 2016; 58:597-604. [PMID: 26521844 PMCID: PMC4853292 DOI: 10.1111/dmcn.12944] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2015] [Indexed: 11/29/2022]
Abstract
AIM We examined three communication ability classification paradigms for children with cerebral palsy (CP): the Communication Function Classification System (CFCS), the Viking Speech Scale (VSS), and the Speech Language Profile Groups (SLPG). Questions addressed interjudge reliability, whether the VSS and the CFCS captured impairments in speech and language, and whether there were differences in speech intelligibility among levels within each classification paradigm. METHOD Eighty children (42 males, 38 females) with a range of types and severity levels of CP participated (mean age 60mo, range 50-72mo [SD 5mo]). Two speech-language pathologists classified each child via parent-child interaction samples and previous experience with the children for the CFCS and VSS, and using quantitative speech and language assessment data for the SLPG. Intelligibility scores were obtained using standard clinical intelligibility measurement. RESULTS Kappa values were 0.67 (95% confidence interval [CI] 0.55-0.79) for the CFCS, 0.82 (95% CI 0.72-0.92) for the VSS, and 0.95 (95% CI 0.72-0.92) for the SLPG. Descriptively, reliability within levels of each paradigm varied, with the lowest agreement occurring within the CFCS at levels II (42%), III (40%), and IV (61%). Neither the CFCS nor the VSS were sensitive to language impairments captured by the SLPG. Significant differences in speech intelligibility were found among levels for all classification paradigms. INTERPRETATION Multiple tools are necessary to understand speech, language, and communication profiles in children with CP. Characterization of abilities at all levels of the International Classification of Functioning, Disability and Health will advance our understanding of the ways that speech, language, and communication abilities present in children with CP.
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Affiliation(s)
- Katherine C. Hustad
- Department of Communication Sciences and Disorders University of Wisconsin – Madison
- Waisman Center University of Wisconsin – Madison
| | - Ashley Oakes
- Waisman Center University of Wisconsin – Madison
| | - Emily McFadd
- Department of Communication Sciences and Disorders University of Wisconsin – Madison
- Waisman Center University of Wisconsin – Madison
| | - Kristen M. Allison
- Department of Communication Sciences and Disorders University of Wisconsin – Madison
- Waisman Center University of Wisconsin – Madison
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Affiliation(s)
- Lindsay Pennington
- Institute of Health and Society, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle University, Newcastle upon Tyne, UK
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Schölderle T, Staiger A, Lampe R, Strecker K, Ziegler W. Dysarthria in Adults With Cerebral Palsy: Clinical Presentation and Impacts on Communication. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2016; 59:216-229. [PMID: 27057824 DOI: 10.1044/2015_jslhr-s-15-0086] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 08/26/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE Although dysarthria affects the large majority of individuals with cerebral palsy (CP) and can substantially complicate everyday communication, previous research has provided an incomplete picture of its clinical features. We aimed to comprehensively describe characteristics of dysarthria in adults with CP and to elucidate the impact of dysarthric symptoms on parameters relevant for communication. METHOD Forty-two adults with CP underwent speech assessment by means of standardized auditory rating scales. Listening experiments were conducted to obtain communication-related parameters-that is, intelligibility and naturalness-as well as age and gender estimates. RESULTS The majority of adults with CP showed moderate to severe dysarthria with symptoms on all dimensions of speech, most prominently voice quality, respiration, and prosody. Regression analyses revealed that articulatory, respiratory, and prosodic features were the strongest predictors of intelligibility and naturalness of speech. Listeners' estimates of the speakers' age and gender were predominantly determined by voice parameters. CONCLUSION This study provides an overview on the clinical presentation of dysarthria in a convenience sample of adults with CP. The complexity of the functional impairment described and the consequences on the individuals' communication call for a stronger consideration of dysarthria in CP both in clinical care and in research.
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Vander Zwart KE, Geytenbeek JJ, de Kleijn M, Oostrom KJ, Gorter JW, Hidecker MJC, Vermeulen RJ. Reliability of the Dutch-language version of the Communication Function Classification System and its association with language comprehension and method of communication. Dev Med Child Neurol 2016; 58:180-8. [PMID: 26136153 DOI: 10.1111/dmcn.12839] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/27/2015] [Indexed: 11/28/2022]
Abstract
AIM The aims of this study were to determine the intra- and interrater reliability of the Dutch-language version of the Communication Function Classification System (CFCS-NL) and to investigate the association between the CFCS level and (1) spoken language comprehension and (2) preferred method of communication in children with cerebral palsy (CP). METHOD Participants were 93 children with CP (50 males, 43 females; mean age 7y, SD 2y 6mo, range 2y 9mo-12y 10mo; unilateral spastic [n=22], bilateral spastic [n=51], dyskinetic [n=15], ataxic [n=3], not specified [n=2]; Gross Motor Function Classification System level I [n=16], II [n=14], III, [n=7], IV [n=24], V [n=31], unknown [n=1]), recruited from rehabilitation centres throughout the Netherlands. Because some centres only contributed to part of the study, different numbers of participants are presented for different aspects of the study. Parents and speech and language therapists (SLTs) classified the communication level using the CFCS. Kappa was used to determine the intra- and interrater reliability. Spearman's correlation coefficient was used to determine the association between CFCS level and spoken language comprehension, and Fisher's exact test was used to examine the association between the CFCS level and method of communication. RESULTS Interrater reliability of the CFCS-NL between parents and SLTs was fair (r=0.54), between SLTs good (r=0.78), and the intrarater (SLT) reliability very good (r=0.85). The association between the CFCS and spoken language comprehension was strong for SLTs (r=0.63) and moderate for parents (r=0.51). There was a statistically significant difference between the CFCS level and the preferred method of communication of the child (p<0.01). Also, CFCS level classification showed a statistically significant difference between parents and SLTs (p<0.01). INTERPRETATION These data suggest that the CFCS-NL is a valid and reliable clinical tool to classify everyday communication in children with CP. Preferably, professionals should classify the child's CFCS level in collaboration with the parents to acquire the most comprehensive information about the everyday communication of the child in various situations both with familiar and with unfamiliar partners.
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Affiliation(s)
- Karlijn E Vander Zwart
- Department of Rehabilitation, Via Reva Rehabilitation Center, Apeldoorn, the Netherlands
| | - Joke J Geytenbeek
- Department of Paediatric Rehabilitation Medicine, VU Medical Center, Amsterdam, the Netherlands
| | | | - Kim J Oostrom
- Department of Paediatric Psychology, VU Medical Center, Amsterdam, the Netherlands
| | - Jan Willem Gorter
- CanChild Centre for Childhood Disability Research, Department of Paediatrics, McMaster University, Hamilton, ON, Canada
| | | | - R Jeroen Vermeulen
- Department of Paediatric Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
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Hurley DS, Sukal-Moulton T, Gaebler-Spira D, Krosschell KJ, Pavone L, Mutlu A, Dewald JPA, Msall ME. Systematic Review of Cerebral Palsy Registries/Surveillance Groups: Relationships between Registry Characteristics and Knowledge Dissemination. INTERNATIONAL JOURNAL OF PHYSICAL MEDICINE & REHABILITATION 2015; 3:266. [PMID: 27790626 PMCID: PMC5079705 DOI: 10.4172/2329-9096.1000266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The aims of this study were to provide a comprehensive summary of the body of research disseminated by Cerebral Palsy (CP) registries and surveillance programs from January 2009 through May 2014 in order to describe the influence their results have on our overall understanding of CP. Secondly, registries/surveillance programs and the work they produced were evaluated and grouped using standardized definitions and classification systems. METHOD A systematic review search in PubMed, CINAH and Embase for original articles published from 1 January 2009 to 20 May 2014 originating from or supported by population based CP registries and surveillance programs or population based national registries including CP were included. Articles were grouped by 2009 World CP Registry Congress aim, registry/surveillance program classification, geographical region, and the International Classification of Function, Disability and Health (ICF) domain. Registry variables were assessed using the ICF-CY classification. RESULTS Literature searches returned 177 articles meeting inclusion criteria. The majority (69%) of registry/surveillance program productivity was related to contributions as a Resource for CP Research. Prevention (23%) and Surveillance (22%) articles were other areas of achievement, but fewer articles were published in the areas of Planning (17%) and Raising the Profile of CP (2%). There was a range of registry/surveillance program classifications contributing to this productivity, and representation from multiple areas of the globe, although most of the articles originated in Europe, Australia, and Canada. The domains of the ICF that were primarily covered included body structures and function at the early stages of life. Encouragingly, a variety of CP registry/surveillance program initiatives included additional ICF domains of participation and environmental and personal factors. INTERPRETATION CP registries and surveillance programs, including novel non-traditional ones, have significantly contributed to the understanding of how CP affects individuals, families and society. Moving forward, the global CP registry/surveillance program community should continue to strive for uniformity in CP definitions, variables collected and consistency with international initiatives like the ICF so that databases can be consolidated for research use. Adaptation to new technologies can improve access, reduce cost and facilitate information transfer between registrants, researchers and registries/surveillance programs. Finally, increased efforts in documenting variables of individuals with CP into adulthood should be made in order to expand our understanding of CP across the lifespan.
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Affiliation(s)
- Donna S Hurley
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Theresa Sukal-Moulton
- Functional and Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | | | - Kristin J Krosschell
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | | | - Akmer Mutlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Julius PA Dewald
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Michael E Msall
- University of Chicago Comer Children’s Hospital and Kennedy Research Center on Intellectual and Neurodevelopmental Disabilities, Chicago, IL, USA
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Morgan AT. Innovative assessment reveals speech production and language comprehension are dissociable skills in severe cerebral palsy. Dev Med Child Neurol 2015; 57:215-6. [PMID: 25349055 DOI: 10.1111/dmcn.12615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Angela T Morgan
- Murdoch Childrens Research Institute, Melbourne, Vic., Australia; The University of Melbourne, Melbourne, Vic., Australia
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Abstract
To explore factors associated with communication impairments in children with cerebral palsy. Data were obtained on children born between 1999 and 2008 from the Quebec Cerebral Palsy Registry (REPACQ). Out of 535 children with cerebral palsy, 297 were identified to have communication impairments (55.5%). Of these, 96 were unable to communicate verbally (32.3%), 195 had some verbal communication (65.7%), and 6 were unspecified (2.0%). These children were significantly more likely to have a more severe motor deficit (Gross Motor Function Classification System levels IV and V and Manual Ability Classification System levels IV and V), to have spastic quadriplegia or dyskinetic subtypes of cerebral palsy, and gray matter injury on neuroimaging. Communication impairment is a common comorbidity in cerebral palsy and is associated with a more severe motor deficit, spastic quadriplegic or dyskinetic subtype of cerebral palsy, and gray matter injury on neuroimaging. This information allows clinicians to better predict and manage communication impairment in children with cerebral palsy.
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Affiliation(s)
- James Yue Zhang
- Faculty of Medicine, Division of Pediatric Neurology, McGill University, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada
| | - Maryam Oskoui
- Departments of Neurology/Neurosurgery & Pediatrics, Division of Pediatric Neurology, McGill University, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada
| | - Michael Shevell
- Departments of Neurology/Neurosurgery & Pediatrics, Division of Pediatric Neurology, McGill University, Montreal Children's Hospital-McGill University Health Centre, Montreal, Quebec, Canada
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49
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Coleman A, Weir K, Ware RS, Boyd R. Predicting functional communication ability in children with cerebral palsy at school entry. Dev Med Child Neurol 2015; 57:279-85. [PMID: 25387764 DOI: 10.1111/dmcn.12631] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/29/2014] [Indexed: 11/27/2022]
Abstract
AIM To explore the value of demographic, environmental, and early clinical characteristics in predicting functional communication in children with cerebral palsy (CP) at school entry. METHOD Data are from an Australian prospective longitudinal study of children with CP. Children assessed at 18 to 24 and 48 to 60 months corrected age were included in the study. Functional communication was classified at 48 to 60 months using the Communication Function Classification System (CFCS). Predictive variables included communication skills at 18 to 24 months, evaluated using the Communication and Symbolic Behavioural Scales Developmental Profile (CSBS-DP) Infant-Toddler Checklist. Early Gross Motor Function Classification System (GMFCS), Manual Ability Classification System, and motor type and distribution were evaluated by two physiotherapists. Demographic and comorbid variables were obtained through parent interview with a paediatrician or rehabilitation specialist. RESULTS A total of 114 children (76 males, 38 females) were included in the study. At 18 to 24 months the mean CSBS-DP was 84.9 (SD 19.0). The CFCS distribution at 48 to 60 months was I=36(32%), II=25(22%), III=20(18%), IV=19(17%), and V=14(12%). In multivariable regression analysis, only CSBS-DP (p<0.01) and GMFCS (p<0.01) at 18 to 24 months were predictors of functional communication at school entry. INTERPRETATION Body structure and function and not environmental factors impact functional communication at school entry in children with CP. This provides valuable guidance for early screening, parent education, and future planning of intervention programs to improve functional communication.
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Affiliation(s)
- Andrea Coleman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, The University of Queensland, Herston, Qld, Australia
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50
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Compagnone E, Maniglio J, Camposeo S, Vespino T, Losito L, De Rinaldis M, Gennaro L, Trabacca A. Functional classifications for cerebral palsy: correlations between the gross motor function classification system (GMFCS), the manual ability classification system (MACS) and the communication function classification system (CFCS). RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:2651-2657. [PMID: 25062096 DOI: 10.1016/j.ridd.2014.07.005] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 07/02/2014] [Indexed: 06/03/2023]
Abstract
This study aimed to investigate a possible correlation between the gross motor function classification system-expanded and revised (GMFCS-E&R), the manual abilities classification system (MACS) and the communication function classification system (CFCS) functional levels in children with cerebral palsy (CP) by CP subtype. It was also geared to verify whether there is a correlation between these classification systems and intellectual functioning (IF) and parental socio-economic status (SES). A total of 87 children (47 males and 40 females, age range 4-18 years, mean age 8.9±4.2) were included in the study. A strong correlation was found between the three classifications: Level V of the GMFCS-E&R corresponds to Level V of the MACS (rs=0.67, p=0.001); the same relationship was found for the CFCS and the MACS (rs=0.73, p<0.001) and for the GMFCS-E&R and the CFCS (rs=0.61, p=0.001). The correlations between the IQ and the global functional disability profile were strong or moderate (GMFCS and IQ: rs=0.66, p=0.001; MACS and IQ: rs=0.58, p=0.001; CFCS and MACS: rs=0.65, p=0.001). The Kruskal-Wallis test was used to determine if there were differences between the GMFCS-E&R, the CFCS and the MACS by CP type. CP types showed different scores for the IQ level (Chi-square=8.59, df=2, p=0.014), the GMFCS-E&R (Chi-square=36.46, df=2, p<0.001), the CFCS (Chi-square=12.87, df=2, p=0.002), and the MACS Level (Chi-square=13.96, df=2, p<0.001) but no significant differences emerged for the SES (Chi-square=1.19, df=2, p=0.554). This study shows how the three functional classifications (GMFCS-E&R, CFCS and MACS) complement each other to provide a better description of the functional profile of CP. The systematic evaluation of the IQ can provide useful information about a possible future outcome for every functional level. The SES does not appear to affect functional profiles.
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Affiliation(s)
- Eliana Compagnone
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Jlenia Maniglio
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Serena Camposeo
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 2 (Developmental Psychopathology), Brindisi Research Centre, Brindisi, Italy
| | - Teresa Vespino
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Luciana Losito
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Marta De Rinaldis
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Leonarda Gennaro
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy
| | - Antonio Trabacca
- Scientific Institute I.R.C.C.S. "Eugenio Medea", "La Nostra Famiglia", Neurorehabilitation Unit 1 (Developmental Neurology and Functional Rehabilitation), Brindisi Research Centre, Brindisi, Italy.
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