Alignment of classification paradigms for communication abilities in children with cerebral palsy

Abstract

Aim We examined three communication ability classification paradigms for children with cerebral palsy (CP): the Communication Function Classification System (CFCS), the Viking Speech Scale (VSS), and the Speech Language Profile Groups (SLPG). Questions addressed inter-judge reliability, whether the VSS and the CFCS captured impairments in speech and language, and whether there were differences in speech intelligibility among levels within each classification paradigm. Method 80 children (42 males) with a range of types and severity levels of CP participated (mean age, 60 months; SD 4.8 months). Two speech-language pathologists classified each child via parent-child interaction samples and previous experience with the children for the CFCS and VSS, and uisng quantitative speech and language assessment data for the SLPG. Intelligibility scores were obtained using standard clinical intelligibility measurement. Results Kappa values were .67 (95% CI [.55, .79]) for the CFCS, .82 (95% CI [.72, .92]), for the VSS, .95 (95% CI [.72, .92]) for the SLPG. Descriptively, reliability within levels of each paradigm varied, with the lowest agreement occurring within the CFCS at levels II (42%), III (40%), and IV (61%). Neither the CFCS nor the VSS were sensitive to language impairments captured by the SLPG. Significant differences in speech intelligibility were found among levels for all classification paradigms. Interpretation Multiple tools are necessary to understand speech, language, and communication profiles in children with CP. Characterization of abilities at all levels of the ICF will advance our understanding of the ways that speech, language, and communication abilities present in children with CP.

Longitudinal growth of receptive language in children with cerebral palsy between 18 months and 54 months of age

“…At 48 to 54 months, children were classified into one of three speech‐language profile groups following our earlier work . We used a retrospective classification approach where we looked backwards in time at early behavior, given knowledge of later outcomes because our studies suggest that children with CP cannot be readily classified using the speech‐language profile group paradigm before 4 years of age .…”

Longitudinal development of communication in children with cerebral palsy between 24 and 53 months: Predicting speech outcomes

“…At 48–53 months, children were classified into one of four speech language profile groups (SLPG) [5, 12] based on prospective clinical measurement of speech motor and language abilities. Children with no speech motor involvement (NSMI) had no clinical evidence of speech or language comprehension impairment.…”

“…In earlier work, we developed a model for classifying speech and language profiles in 4-year old children with CP [5, 12]. Using prospective behavioral speech and language data from 4-year old children, this research employed a four profile group model based on the presence or absence of speech motor involvement and the presence or absence of receptive language involvement.…”

Speech, language, communication, and cerebral palsy

“…Hustad et al. 's paper introduces a new classification system that incorporates both speech and language function and is a welcome addition to the field.…”

“…Schemes have been developed to classify both speech 1 and communication, 2 and are now being applied in epidemiological research. 3,4 Hustad et al's paper 5 introduces a new classification system that incorporates both speech and language function and is a welcome addition to the field.…”