Development curves of communication and social interaction in individuals with cerebral palsy
Siok Swan Tan1,2, Marloes van Gorp1,3, Jeanine M Voorman4
1Department of Rehabilitation Medicine, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
Insights
Individuals with cerebral palsy (CP) without intellectual disability show typical communication and social development. Those with CP and intellectual disability have less favorable development with significant individual variation.
Area of Science:
- Pediatric Rehabilitation
- Neurodevelopmental Disorders
- Communication Sciences
Background:
- Cerebral palsy (CP) affects motor function and can impact communication and social interaction development.
- Longitudinal data on the developmental trajectories of communication and social skills in individuals with CP across the lifespan are limited.
- Understanding these trajectories is crucial for targeted interventions and support.
Purpose of the Study:
- To determine the developmental curves of communication and social interaction from childhood into adulthood for individuals with cerebral palsy (CP).
- To compare these developmental trajectories between individuals with and without intellectual disability.
Main Methods:
- Longitudinal assessment of 421 individuals with CP (aged 1-20 years at baseline) over 13 years.
- Utilized the Vineland Adaptive Behavior Scales to assess communication and social interactions.
- Employed nonlinear mixed-effects modeling to estimate performance limits and age of 90% limit attainment (age90).
Main Results:
- Individuals with CP and without intellectual disability demonstrated developmental curves for communication and social interaction comparable to typically developing individuals, irrespective of Gross Motor Function Classification System (GMFCS) level.
- Age90 for various communication and social skills ranged from 3 to 16 years in individuals without intellectual disability.
- Individuals with CP and intellectual disability exhibited lower performance levels and significant variability in development, with GMFCS level V showing the least favorable outcomes.
Conclusions:
- Communication and social interaction development in individuals with CP without intellectual disability follows typical patterns.
- Individuals with CP and intellectual disability experience more challenging developmental pathways with considerable individual differences.
- These findings highlight the need for tailored support strategies considering cognitive status in individuals with CP.
Aim:
To determine development curves of communication and social interaction from childhood into adulthood for individuals with cerebral palsy (CP).
Method:
This Pediatric Rehabilitation Research in the Netherlands (PERRIN)-DECADE study longitudinally assessed 421 individuals with CP, aged from 1 to 20 years at baseline, after 13 years (n=121 at follow-up). Communication and social interactions were assessed using the Vineland Adaptive Behavior Scales. We estimated the average maximum performance limit (level) and age at which 90% of the limit was reached (age90 ) using nonlinear mixed-effects modeling.
Results:
One-hundred individuals without intellectual disability were aged 21 to 34 years at follow-up (39 females, 61 males) (mean age [SD] 28y 5mo [3y 11mo]). Limits of individuals without intellectual disability, regardless of Gross Motor Function Classification System (GMFCS) level, approached the maximum score and were significantly higher than those of individuals with intellectual disability. Ages90 ranged between 3 and 4 years for receptive communication, 6 and 7 years for expressive communication and interrelationships, 12 and 16 years for written communication, 13 and 16 years for play and leisure, and 14 and 16 years for coping. Twenty-one individuals with intellectual disability were between 21 and 27 years at follow-up (8 females, 13 males) (mean age [SD] 24y 7mo [1y 8mo]). Individuals with intellectual disability in GMFCS level V showed the least favourable development, but variation between individuals with intellectual disability was large.
Interpretation:
Individuals with CP and without intellectual disability show developmental curves of communication and social interactions similar to typically developing individuals, regardless of their level of motor function. Those with intellectual disability reach lower performance levels and vary largely in individual development.
What This Paper Adds:
Communication and social interactions in individuals with cerebral palsy without intellectual disability develop similarly to typically developing individuals. Communication and social interactions of individuals with intellectual disability develop less favourably and show large variation.
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