Longitudinal change in speech classification between 4 and 10 years in children with cerebral palsy.
Helen L Long, Tristan J Mahr, Phoebe Natzke and 2 others
PMID 35262181WHAT IT FOUND
Children with cerebral palsy were more likely to move to less severe speech levels between ages 4 and 10.
Speech level at age 4 predicted level at age 10. Children rated most severe at age 4 most likely remained most severe at age 10.
Key findings
01Speech severity ratings were more likely to decrease or remain the same than increase across age visits: among 227 possible age-to-age changes, there were 65 decreases, 10 increases, and 152 unchanged ratings.
02Expected VSS levels decreased with age: 3.3 at age 4, 3.0 at age 6, 2.8 at age 8, and 2.5 at age 10.
03Children rated VSS level IV at age 4 had a model-estimated probability of 0.62 for remaining VSS level IV at age 10.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 5% of children started in VSS level I and 60% started in VSS level IV, so the sample was heavily weighted toward severe speech impairment. The sample came from a longitudinal project focused on speech and language development, and the authors note possible self-selection bias, with families of children who have significant speech concerns overrepresented. The model did not account for CP subtype, speech therapy dosage, spasticity treatments, seizure activity, or epilepsy. About 43% of children were receiving speech therapy at some point, but the nature, intensity, and progress of treatment were not available. The study observed speech development only between ages 4 and 10, and the authors do not know how far the findings extend to earlier or later ages. VSS ratings reflect perceived severity and may combine impairment from CP with typical speech developmental immaturity.
Declared interests
The study was supported by the National Institute on Deafness and Other Communication Disorders, the National Institute of Child Health and Human Development, and the National Institutes of Health. The supplied text does not state commercial sponsorship or additional author conflict-of-interest details.
The easy way to misread this
Do not conclude that speech therapy caused the improvement. About 43% of children received some speech therapy, but treatment type, intensity, and progress were not available, and children rated VSS level IV at age 4 had a model-estimated probability of 0.62 for remaining level IV at age 10.