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SPECIAL POPULATIONS. Cerebral Palsy. Cerebral Palsy. A group of disabling conditions affecting movement and posture Caused by a defect or lesion to one or more specific areas of the brain
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SPECIAL POPULATIONS Cerebral Palsy
Cerebral Palsy • A group of disabling conditions affecting movement and posture • Caused by a defect or lesion to one or more specific areas of the brain • Damage may occur during fetal development, during delivery, shortly after birth or in early infancy. Usually before 2 years of age. • The effects of CP can range from isolated articulation problems to severe sensorimotor involvement.
CP and Language Disorders • Damage may not be focal but diffuse, resulting in not only motor speech problems but cognitive and receptive problems • Changes in interaction with parents and communication partners • Child’s behaviour influences how parents interact • Less chance of normal imitation, expansion of utterances by communication partners • No opportunities for practise and feedback
Assessment • Follow same process as for all children but: • Feeding and swallowing issues likely • Motor skills can make some assessment difficult e.g. comprehension ‘point to….., verbal expression tasks
Adapting Assessment Methods • Be creative! • Could adapt standardised assessment tasks but obviously no longer standardised • Make up own assessments e.g. use CR procedures • Some checklists/rating scales exist for this population
Intervention • Follow same process as for all children but: • Swallowing and feeding intervention likely • Need to adapt tasks to allow for lack of motor skills • May need to work on motor speech specifically • Consideration of augmentative or alternative communication
Augmentative and Alternative Communication (AAC) • Speech is always the best option • Most universal form of communication • Most efficient • Access to greatest no. of comm. partners • Children not ‘lazy’ But for some speech just not an option….
When to consider AAC – R. Paul • Can be too quick to go to alternative modalities • Decision tree for choosing non speech modes Fig 3-4 • Developmental level of 18mths before introducing any AAC • Impt for child to be showing some communication intent (if not work on this)
What type of system? • Will depend on cognitive level, motor skills and communication partners • Look at all factors before deciding on a system, don’t think of a system first. • Trialling essential • Be forward thinking
Hi-tech and Low-tech Systems • Low tech- communication charts, communication books, symbols • Hi-tech - dedicated communication devices, computers
System Considerations • Access • Portability/Size • Durability • Message Representation • Ease of Use • Support • Ability to add/change messages
Ongoing Role of SLT • As for all children with speech and language problems but also… • remember previous points about reduced interaction, production, imitation and feedback • Ensure vocabulary meeting needs • Allow for language development • Adapt therapy tasks to accommodate physical skills • Develop literacy skills