SPECIAL POPULATIONS

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SPECIAL POPULATIONS

• Cerebral Palsy

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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.

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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
• Childs behaviour influences how parents interact
• Less chance of normal imitation, expansion of
  utterances by communication partners
• No opportunities for practise and feedback

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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

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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

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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

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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.

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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)

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What type of system?

• Will depend on cognitive level, motor skills and
  communication partners
• Look at all factors before deciding on a system,
  dont think of a system first.
• Trialling essential
• Be forward thinking

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Hi-tech and Low-tech Systems

• Low tech- communication charts, communication
  books, symbols
• Hi-tech - dedicated communication devices,
  computers

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Low Tech Examples
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Hi Tech Examples

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System Considerations

• Access
• Portability/Size
• Durability
• Message Representation
• Ease of Use
• Support
• Ability to add/change messages

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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

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