Oromotor dysfunction and communication impairments in children with cerebral palsy: a register study
Jackie Parkes1, Nan Hill, Mary Jane Platt
1School of Nursing and Midwifery, Queen's University of Belfast, UK. j.parkes@qub.ac.uk
Insights
Oromotor dysfunction and communication impairments are common in children with cerebral palsy (CP), affecting over 40% of those with early-onset CP. These conditions correlate with reduced gross motor function and intellectual abilities.
Area of Science:
- Pediatric Neurology
- Developmental Disabilities
- Speech-Language Pathology
Background:
- Cerebral palsy (CP) is a group of disorders affecting movement and posture, often accompanied by other impairments.
- Oromotor dysfunction and communication difficulties are frequently observed in children with CP, impacting their quality of life and development.
Purpose of the Study:
- To determine the prevalence of oromotor dysfunction and communication impairments in children with CP.
- To investigate the clinical associations of these impairments with other conditions.
- To analyze trends in these impairments over time.
Main Methods:
- A cohort of 1357 children born between 1980 and 2001 with CP were assessed at age 5.
- Standardized assessments included motor speech, swallowing/chewing difficulties, excessive drooling, and communication impairments.
- Data were analyzed for associations with clinical subtype, Gross Motor Function Classification System (GMFCS) level, intellectual impairment, and mortality.
Main Results:
- Among children with early-onset CP, 36% had motor speech problems, 21% swallowing/chewing difficulties, 22% excessive drooling, and 42% communication impairments.
- All impairments were significantly linked to poorer gross motor function and intellectual impairment.
- Motor speech problems varied by CP subtype; swallowing/chewing and communication issues were associated with early mortality; communication impairments were linked to seizures. A decline in motor speech and drooling rates was observed in severe CP (GMFCS IV-V) over time.
Conclusions:
- Oromotor dysfunction and communication impairments are highly prevalent in children with cerebral palsy.
- These impairments are significantly associated with poorer gross motor function and intellectual impairment.
- Understanding these associations is crucial for comprehensive care and intervention strategies for children with CP.
Aim:
to report the prevalence, clinical associations, and trends over time of oromotor dysfunction and communication impairments in children with cerebral palsy (CP).
Method:
multiple sources of ascertainment were used and children followed up with a standardized assessment including motor speech problems, swallowing/chewing difficulties, excessive drooling, and communication impairments at age 5 years.
Results:
a total of 1357 children born between 1980 and 2001 were studied (781 males, 576 females; median age 5y 11mo, interquartile range 3-9y; unilateral spastic CP, n=447; bilateral spastic CP, n=496; other, n=112; Gross Motor Function Classification System [GMFCS] level: I, 181; II, 563; III, 123; IV, 82; IV, 276). Of those with 'early-onset' CP (n=1268), 36% had motor speech problems, 21% had swallowing/chewing difficulties, 22% had excessive drooling, and 42% had communication impairments (excluding articulation defects). All impairments were significantly related to poorer gross motor function and intellectual impairment. In addition, motor speech problems were related to clinical subtype; swallowing/chewing problems and communication impairments to early mortality; and communication impairments to the presence of seizures. Of those with CP in GMFCS levels IV to V, a significant proportion showed a decline in the rate of motor speech impairment (p=0.008) and excessive drooling (p=0.009) over time.
Interpretation:
these impairments are common in children with CP and are associated with poorer gross motor function and intellectual impairment.
