Language and Children with Neuromotor Impairment

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Language and Children with Neuromotor Impairment

• Children with Cerebral Palsy
• have the most common neuromotor impairment.

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The Common Elements of CP

• It is caused by an injury to the brain
• It appears very early in life, either at birth or
  during the preschool years.
• The damage to the brain does not become worse
  over time, though an individuals capability for
  functional movement may deteriorate.
• Etiology
• The cause of cerebral palsy are classified by
  when they occur.
• During pregnancy (prenatal)
• During Birth (perinatal)
• During first few years of life ( postnatal)

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Language Characteristics of Children with
Cerebral Palsy

• There is no pattern of communication deficits
  identified with cerebral palsy.
• The key to predicting the language deficits and
  potential of children with cerebral palsy is to
  assess their ability to compensate.
• Associated Problems in Children with Cerebral
  Palsy
• Intellectual disability difficult with test and
  their inability to produce reliable verbal or
  other motor responses.
• Orthopedic problems- an imbalance in muscles
• Feeding problems - abnormal development of oral
  reflexes and damage to the cranial nerve.
• Hearing loss - Both conductive and sensorineural
  losses are found
• Seizures - are very common
• Visual impairment- has been found in 9 of
  children

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Implications for Intervention

• In all cases, language intervention has 3
  purposes.
• To compensate for impaired motor and sensory
  functions
• To facilitate the development of motor speech
  skills and cognitive- linguistic abilities
• To modify the environment so that the child is
  able to communicate more independently
• A central component of all intervention for
  children with cerebral palsy is the development
  of a program for proper handling and positioning.

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Other Communication with Neuromotor Impairment

• Muscular Dystrophy
  
• Spina Bifida
• Spinal Cord Injury

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Muscular Dystrophy

• Is the progressive disorder that produces
  weakness and wasting of the muscles .
• The early signs of this condition are problems of
  balance and motor coordination
• Over time it affects the arms, legs and face, so
  that eventually the child is unable to walk or
  talk
• There are 20 types of muscular dystrophy

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Spina Bifida

• Refers to a range of defects caused by a cleft in
  the spinal column.
• It is the most common central nervous system
  malformation.
• Milder forms do not affect the spinal cord itself
  and can, if necessary, be corrected by surgery.
• Spina bifida myelomeningocele is the most severe
  form that is caused by a large opening in the
  vertebral column through which the spinal cord
  and nerve roots protrude.
• As with children with cerebral palsy the motor
  impairment severely reduces the opportunities for
  physical exploration and may therefore also
  contribute to cognitive delay.

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Spinal Cord Injury

• The most common cause of spinal cord injury is
  trauma from motor vehicle and sports accidents.
• Typically results in fractures and dislocation of
  the cervical vertebra.
• There are typically no direct effects on speech
  and language from spinal cord injury.

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Language and Children with Cleft Palate
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Cleft Palate

• Cleft lip, cleft palate, and related disorders
  are malformations of the midface and oral cavity.
• A variety of forms can occur, from small notch of
  the lip to a total cleavage affecting the lip,
  bony palate, and other facial structures.
• In 2002 March of Dimes Birth Defect Foundation
  estimates that one child in every 1,000 is born
  with cleft lip, cleft palate, or both.
• The frequency of clefting is lowest for African
  Americans and grows progressively higher for
  white Americans, Asian Americans, and certain
  Native Americans.
• The occurrence of combined cleft lip and palate
  is nearly twice as great for males, but females
  have a higher incidence of isolated cleft palate.

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Language Characteristics of Children with Cleft
Palate

• Children with cleft palate who are just beginning
  to talk tend to use words that begin with
  different sounds.
• As children grow older, the gap in language
  abilities between those with clefts and those
  without gradually close.
• The problems that remain often appear related to
  interpersonal factors, such as concerns about
  appearance and peer acceptance.

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Variable Potentially Disrupting Language
Acquisition in Children with Cleft Palate

• Intellectual disability high among children
  with cleft
• Hearing Loss- Risk of developing middle ear
  likely to lead to fluctuating conductive hearing
  loss
• Surgery and recuperation surgery for cleft lip
  usually done 10 weeks of age repair of palate
  commonly postponed until later but in most cases
  is completed before 12 months.
• During the first 2 years of life children with
  clefts show relative delays in cognitive and
  psychomotor development
• Disruption in speech production- palatal surgery
  performed most often during the period when
  children are babbling or beginning to use their
  first words
• Unintelligible speech- nearly all children with
  cleft palate will have reduced speech
  intelligibility, especially until the cleft has
  been surgically corrected and they have had time
  to adjust to the changes in speech mechanism.