Article

AIM: To assess spoken language comprehension in non-speaking children with severe
cerebral palsy (CP) and to explore possible associations with motor type and
disability. METHOD: Eighty-seven non-speaking children (44 males, 43 females,
mean age 6y 8mo, SD 2y 1mo) with spastic (54%) or dyskinetic (46%) CP (Gross
Motor Function Classification System [GMFCS] levels IV [39%] and V [61%])
underwent spoken language comprehension assessment with the computer-based
instrument for low motor language testing (C-BiLLT), a new and validated
diagnostic instrument. A multiple linear regression model was used to investigate
which variables explained the variation in C-BiLLT scores. Associations between
spoken language comprehension abilities (expressed in z-score or age-equivalent
score) and motor type of CP, GMFCS and Manual Ability Classification System
(MACS) levels, gestational age, and epilepsy were analysed with Fisher's exact
test. A p-value <0.05 was considered statistically significant. RESULTS:
Chronological age, motor type, and GMFCS classification explained 33% (R=0.577,
R(2) =0.33) of the variance in spoken language comprehension. Of the children
aged younger than 6 years 6 months, 52.4% of the children with dyskinetic CP
attained comprehension scores within the average range (z-score >/=-1.6) as
opposed to none of the children with spastic CP. Of the children aged older than
6 years 6 months, 32% of the children with dyskinetic CP reached the highest
achievable age-equivalent score compared to 4% of the children with spastic CP.
No significant difference in disability was found between CP-related variables
(MACS levels, gestational age, epilepsy), with the exception of GMFCS which
showed a significant difference in children aged younger than 6 years 6 months
(p=0.043). INTERPRETATION: Despite communication disabilities in children with
severe CP, particularly in dyskinetic CP, spoken language comprehension may show
no or only moderate delay. These findings emphasize the importance of introducing
alternative and/or augmentative communication devices from early childhood.
CI - (c) 2014 Mac Keith Press.

Langue : ANGLAIS