Developmental trajectories of spoken language comprehension and functional communication in children with cerebral palsy: A prospective cohort study

Abstract

AimTo investigate spoken language comprehension (SLC), single‐word comprehension (SWC), functional communication development, and their determinants, in children with cerebral palsy.MethodThis was a prospective cohort study in the Netherlands spanning 2 years 6 months. The main outcomes were SLC and SWC, assessed by the Computer‐Based instrument for Low motor Language Testing (C‐BiLLT) and the Peabody Picture Vocabulary Test‐III‐NL (PPVT‐III‐NL) respectively; and functional communication, measured by a subscale of the Focus on the Outcomes of Communication Under Six‐34 (FOCUS‐34). Linear mixed models were used to determine developmental trajectories, which were compared with norm and reference data. Potential determinants, for example intellectual functions, speech production, functional communication level (classified with the Communication Function Classification System, CFCS), and functional mobility, were added to assess their effects.ResultsChildren with cerebral palsy (n = 188; mean age 59 months, range 17–110) were monitored for 2 years 6 months. Developmental trajectories for SLC (C‐BiLLT) and SWC (PPVT‐III‐NL) were nonlinear; those for functional communication (FOCUS‐34) were linear. Compared with norm and reference groups, significantly delayed SLC, SWC, and functional communication development were found. Determinants for SLC and SWC were intellectual functions and functional communication level (CFCS); and for functional communication development (FOCUS‐34), speech production and arm–hand functioning.InterpretationChildren with cerebral palsy showed delayed SLC, SWC, and functional communication development compared with norm and reference groups. Remarkably, functional mobility was not associated with the development of SLC, SWC, or functional communication.

Bringing the Computer-Based instrument for Low motor Language Testing to Canada: A survey of caregiver and clinician perspectives

“…Both caregivers and clinicians viewed the C-BiLLT-CAN with considerable optimism, with caregivers anticipating a variety of positive effects of results across a breadth of environments and clinicians anticipating consequent improvements in service provision. These results capture the latent clinical usefulness of the C-BiLLT-CAN and also foreshadow a role in research endeavours aimed at understanding the promotion of positive outcomes for children withCP and LFS (48,49). A recent scoping review by Chagas and colleagues(50) found that few longitudinal studies on the development of children with CP systematically tracked changes in levels of or factors in uencing communication, Visual and auditory access modi cations may also improve feasibility of the C-BiLLT-CAN for the considerable proportion of children with CP and LFS who informed survey responses that also had a visual impairment such as CVI (e.g., 55) until a specially designed version of the test, currently under consideration, is available to meet the particular needs of these children.Caregivers and clinicians assigned moderate to high ratings of importance to several additional response methods not currently supported by the C-BiLLT-CAN.…”