Cerebral Palsy is a neurological condition associated with brain damage before or during birth, or in the early part of life. Damage can happen to different parts of the brain, responsible for or involved in different functions.It is usually considered a motor disorder, so a disorder of movement, but it may be associated with learning and/or sensory difficulties too. Equally, the issues may be purely of a movement nature with little impact on cognition or communication.
Cerebral Palsy is further classified by which part(s) of the body are affected (hemiplegia, diplegia or quadriplegia) and by the impact on a person’s muscle tone (ataxia, spastic, athetoid or mixed types).
The impact of Cerebral Palsy on communication will depend on where brain damage has occurred, the impact of this on motor skills that impact on communication, as well as specific damage to areas of the brain important for direct control of oral muscles. So for example, if a child struggles with controlling their head or posture generally, there is likely to be an impact on their oral skills, because oral skill development for talking and chewing relies on underlying postural skills. Breath control for talking is equally important, and can be compromised by postural difficulties.
Generally speaking, the wider the impact of gross motor difficulties associated with Cerebral Palsy, the more complex the impact on speech is likely to be. People with complex and extensive physical disability associated with Cerebral Palsy may require Augmentative and Alternative Communication (AAC) to supplement or replace speech.
A person with Cerebral Palsy may also have a much more specific difficulty with the muscles in the mouth, depending on where damage has occurred. Speech may be slower to co-ordinate, more effortful, and sound slurred and harder to understand. Some people whose speech is slurred may choose to use AAC too.
Some people with Cerebral Palsy may have few or no speech issues. For example, I have worked with young people who have only needed to come and see me as a Speech Therapist because their chewing has been slightly slower and making their mealtimes longer than they would like.They have had no speech impact at all. Diplegia will only impact on the lower limbs for example, and we wouldn’t typically expect any communication difficulties.
The level of impact of Cerebral Palsy on spoken language is not necessarily associated with a person’s intellectual ability, and it is important never to make assumptions about this.
The brain damage underlying cerebral palsy equally may lead to difficulties with language comprehension and learning.
So what does this mean for you if you meet or will be supporting a child with Cerebral Palsy? As you can see, Cerebral Palsy is a very broad term and doesn’t imply anything about a child’s communication or learning.The absolute best way to support the communication of a child or young person with Cerebral Palsy is to ask them what works for them, and/or talk to their families and the people who know them to understand the impact of Cerebral Palsy for them, and what helps. Supporting a child or young person with Cerebral Palsy to develop their communication skill will need the involvement of a Speech and Language Therapist, but may well also need the expertise of a Physiotherapist and Occupational Therapist to unpick the complex relationships between postural skill and oral control/function.
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