Communication performance of children with Cerebral Palsy: relation with spoken language comprehension and contextual factors

Abstract

Aim: The aim of the present study was to investigate the relationship between everyday communication performance and the level of spoken language comprehension in children with cerebral palsy (CP). Beside spoken language comprehension, the role of contextual factors is also examined. Participants: 59 children with CP (35 males, 24 females; mean age 6y 10m; SD 2y 4m; range 2y 9m-11y 10m) participated in the present study. Distribution of type of CP was 49.2% with bilateral spastic CP, 13.6% with unilateral spastic CP, 18.6% with dyskinetic CP, 1.7% with ataxic CP and 13.6% with mixed CP. The percentage of children classified as GMFCS levels I to V was 15.3%, 13.6%, 8.5%, 22.0% and 39.0% respectively (1.7% unknown). Method: Parents, teachers and speech and language therapists (SLT) of the child with CP were sent a survey to classify the communication performance of the child with the Communication Function Classification System (CFCS). In addition, information was collected about contextual factors such as type of CP, level of Gross Motor Function Classification System (GMFCS), the method of communication (verbal, non verbal and/or using augmentative and alternative communication) and associated impairments. SLT reported the level of spoken language comprehension. Depending on age and motor abilities of the child, different language tests were used to the measure level of spoken language comprehension. Results: The communication performance of children with CP classified by SLT was strongly correlated with the level of spoken language comprehension (r=.62, p ≤ .01) and the methods of communication (r=.69, p ≤ .01). A moderate correlation was demonstrated in the classification of parents (level of spoken language comprehension: r=.49, p ≤ .01 and methods of communication: r=.43, p ≤ .01). Communication performance (classified by SLT) and GMFCS level was moderately correlated (r=.58, p ≤ .01), just as the sum of associated impairments (r= .48, p ≤ .01). Interpretation: The method of communication and the level of spoken language of a child with CP seem most strongly related to their everyday communication performance.