Effectiveness of augmentative alternative communication therapy in children with cerebral palsy with expressive speech delay
DOI:
https://doi.org/10.18203/2349-3291.ijcp20252960Keywords:
Cerebral palsy, Perisylvian syndrome, Augmentative alternative communication therapyAbstract
Background: The objectives of the study were to determine the effectiveness of augmentative alternative communication therapy (AAC) in children with cerebral palsy (CP) and to correlate the outcome of AAC therapy with the communication function classification system (CFCS) and gross motor function system classification (GMFCS) levels.
Methods: This is a prospective interventional study. Among the children satisfying the inclusion criteria, CFCS and GMFCS scoring, and the family impact of assistive technology scale AAC scoring (FIATS AAC) were taken. AAC therapy was administered based on the patient's baseline communication skills, utilizing both aided and unaided techniques on a weekly follow-up basis. The outcome was assessed at 6 months following therapy by both the investigator and the speech therapist using the FIATS-AAC questionnaire.
Results: All cohorts (n=101) had a predominant expressive language delay. Among 101 cohorts, 43.5% belonged to level 3 GMFCS, and 42.5% belonged to level 3 CFCS classification. 93.06% (n=94) used low-tech AAC, and 6.94% (n=7) used high-tech AAC. The correlation between baseline and follow-up FIATS AAC scores showed a significant improvement in the score, with a p<0.01.
Conclusion: Children with expressive speech delay could benefit from AAC as it aids in communication with family and social interaction. Additionally, this study correlates the association between GMFCS and CFCS with AAC therapy.
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References
Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. The Definition and Classification of Cerebral Palsy. Dev Med Child Neurol. 2007;49(s109):1-44.
Patel DR, Neelakantan M, Pandher K, Merrick J. Cerebral palsy in children: a clinical overview. Transl Pediatr. 2020;9(Suppl 1):S125-35. DOI: https://doi.org/10.21037/tp.2020.01.01
Pennington L, Roelant E, Thompson V, Robson S, Steen N, Miller N. Intensive dysarthria therapy for younger children with cerebral palsy. Dev Med Child Neurol. 2013;55(5):464-71. DOI: https://doi.org/10.1111/dmcn.12098
Hidecker MJC, Paneth N, Rosenbaum PL, Kent RD, Lillie J, Eulenberg JB, et al. Developing and validating the Communication Function Classification System (CFCS) for individuals with cerebral palsy. Dev Med Child Neurol. 2011;53(8):704-10. DOI: https://doi.org/10.1111/j.1469-8749.2011.03996.x
Mei C, Reilly S, Reddihough D, Mensah F, Morgan A. Motor speech impairment, activity, and participation in children with cerebral palsy. Int J Speech-Lang Pathol. 2014;16(4):427-35. DOI: https://doi.org/10.3109/17549507.2014.917439
Smith AL, Hustad KC. AAC and Early Intervention for Children with Cerebral Palsy: Parent Perceptions and Child Risk Factors. Augment Altern Commun. 2015;31(4):336-50. DOI: https://doi.org/10.3109/07434618.2015.1084373
Ryan S, Shepherd T, Renzoni A, Servais M, Kingsnorth S, Laskey C, et al. Responsiveness of a parent-reported outcome measure to evaluate AAC interventions for children and youth with complex communication needs. Augment Altern Commun. 2018;34(4):348-58. DOI: https://doi.org/10.1080/07434618.2018.1520296
Patil A, Gowda VK, Shivappa, SK, Benakappa N. Profile of Worster Drought Syndrome (WDS): Unrecognized Subtype of Cerebral Palsy From Tertiary Care Center in South India. J Pediatr Neurosci. 2021;17(1):17-22. DOI: https://doi.org/10.4103/jpn.JPN_122_20
Hustad KC, Miles LK. Alignment between Augmentative and Alternative Communication Needs and School-Based Speech-Language Services Provided to Young Children with Cerebral Palsy. Early Child Serv (San Diego). 2010;4(3):129-40.
Sharma T, Chauhan G, Duggal T, Bhardwaj AK. Congenital bilateral perisylvian syndrome: a rare cause of epilepsy. Int J Contemp Pediatr. 2016;3:659-61. DOI: https://doi.org/10.18203/2349-3291.ijcp20161059
Krägeloh-Mann I, Hagberg G, Meisner C, Haas G, Eeg-Olofsson KE, Selbmann HK, et al. Bilateral spastic cerebral palsy--a collaborative study between southwest Germany and western Sweden. III: Aetiology. Dev Med Child Neurol. 1995;37(3):191-203. DOI: https://doi.org/10.1111/j.1469-8749.1995.tb11992.x
Hemsley B, Kuek M, Bastock K, Scarinci N, Davidson B. Parents and children with cerebral palsy discuss communication needs in hospital. Dev Neurorehabil. 2013;16(6):363-74. DOI: https://doi.org/10.3109/17518423.2012.758187
Coan-Brill J, Costigan FA, Kay J, Stadskleiv K, Batorowicz B, Chau T, et al. Developing a Profile of Canadian Children with Cerebral Palsy Who Require Augmentative and Alternative Communication. Am J Speech-Lang Pathol. 2025;34(2):605-16. DOI: https://doi.org/10.1044/2024_AJSLP-24-00284
Andersen G, Mjøen T, Vik T. Prevalence of Speech Problems and the Use of Augmentative and Alternative Communication in Children with Cerebral Palsy: A Registry-Based Study in Norway. Augment Altern Commun. 2010;19(1):12-20. DOI: https://doi.org/10.1044/aac19.1.12
Watson RM, Pennington L. Assessment and management of the communication difficulties of children with cerebral palsy: a UK survey of SLT practice. Int J Lang Commun Disord. 2015;50(2):241-59. DOI: https://doi.org/10.1111/1460-6984.12138
Fox CM, Boliek CA. Intensive voice treatment (LSVT LOUD) for children with spastic cerebral palsy and dysarthria. J Speech Lang Hear Res. 2012;55(3):930-45. DOI: https://doi.org/10.1044/1092-4388(2011/10-0235)
Binger C, Light J. The effect of aided AAC modeling on the expression of multi-symbol messages by preschoolers who use AAC. Augment Altern Commun. 2007;23(1):30-43. DOI: https://doi.org/10.1080/07434610600807470