Longitudinal development of communication in children with cerebral palsy between 24 and 53 months: Predicting speech outcomes.
Katherine C Hustad, Kristen M Allison, Ashley Sakash and 3 others
PMID 27792399WHAT IT FOUND
Children with cerebral palsy who were not yet talking at age 2 were highly likely to remain unable to speak at age 4.
For those who did begin speaking, earlier onset predicted faster gains in intelligibility and sentence length. Later starters showed persistent speech difficulties through preschool.
Key findings
0173% of children who were not yet talking at 2 years of age remained unable to speak (anarthric) at 4 years of age, while none developed typical speech and language abilities.
02The age at which a child first produced single words in imitation significantly predicted the rate of gain in speech intelligibility and utterance length, with earlier onset associated with faster progress.
03Even children who began imitating single words by 24 months had reduced speech intelligibility relative to typically developing 4-year-olds, indicating persistent needs for intervention.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was small (30 children) and not fully representative of the broader population. All participants had spastic cerebral palsy; children with dyskinetic or ataxic CP were not included, so findings may not generalize to other CP types. The measure for speech onset (imitative single-word production) may underestimate the onset of naturalistic speech, as some children may produce words spontaneously before succeeding on the imitation task. Data only extended to 53 months, so the study does not capture speech development beyond early childhood.
Declared interests
The authors have no conflicts of interest to disclose.
The easy way to misread this
Do not assume that children with cerebral palsy who are not talking at 2 years will never speak, as 27% did develop speech by age 4. However, note that none of these children developed typical speech and language abilities; all had speech motor involvement. Conversely, do not assume that children who start speaking early will catch up to typical peers, as even early talkers showed reduced intelligibility at 4 years.