Development curves of communication and social interaction in individuals with cerebral palsy.
Siok Swan Tan, Marloes van Gorp, Jeanine M Voorman and 5 others
PMID 31541474WHAT IT FOUND
Children and adults with cerebral palsy without intellectual disability reached communication and social skill levels comparable to typical development.
Written communication lagged in childhood. With intellectual disability, final levels were lower and varied widely, especially at GMFCS level V.
Key findings
01For individuals without intellectual disability, estimated limits for communication and social interaction were comparable to those of typically developing individuals.
02Written communication showed the greatest lag compared with typically developing individuals during childhood; 9-year-old children with CP scored 6 VABS points lower, meaning three fewer VABS activities.
03For individuals with intellectual disability, estimated limits were lower in GMFCS level V than in GMFCS levels I to IV for all subdomains except written communication, and scores varied much more from person to person.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The Vineland Adaptive Behavior Scales lists activities up to age 19, so a plateau may not mean development has stopped. The most difficult interrelationships items were discarded, so that domain reflects development between 0 and 15 years. The VABS records whether activities are usually performed, not the quality of communication, difficulty of participation, satisfaction, or preferences. No Dutch reference data were available, so comparisons with typically developing individuals were descriptive rather than statistically tested. Observations for individuals without intellectual disability in GMFCS level V were discarded because there were too few. Only 121 adults participated at 13-year follow-up, and scores were self-reported or caregiver-reported rather than measured by direct speech or language testing.
Declared interests
The article reports funding by Fonds NutsOhra. It does not report other conflicts of interest, and it does not say the funder designed the study.
The easy way to misread this
Do not read GMFCS level as a communication or social prognosis. The curves for GMFCS levels I to IV were not significantly different, and GMFCS addresses gross motor function.