Speech problems affect half of all children with cerebral palsy

By Joanna Lyford, Senior medwireNews Reporter

Speech disorders are highly prevalent among children with cerebral palsy and vary according to the nature and timing of the brain injury, an investigation by Swedish researchers has found.

In the study, children with speech disorders typically had cerebellar maldevelopment and lesions, whereas nonverbal individuals tended to have cortical/subcortical and basal ganglia lesions. Overall, one in two children with cerebral palsy had some form of speech problem, report Ann Nordberg (University of Gothenburg) and co-authors writing in Acta Paediatrica.

For the study, Nordberg et al retrospectively reviewed medical charts of 129 children (66 girls) with cerebral palsy born between 1999 and 2002 in a region of western Sweden.

In all, 27 children (21%) had been diagnosed with a speech disorder and a further 41 (32%) were nonverbal. Interestingly, the nature of speech abnormality varied by cerebral palsy subtype, such that speech disorders were most common in ataxic children and those with bilateral palsy, whereas the majority of children with dyskinetic cerebral palsy were nonverbal.

Speech abnormalities were also associated with gross motor function and cognitive ability, both of which were significantly more likely to be impaired among nonverbal children than in those without any speech abnormality.

Finally, speech ability differed with the nature of brain damage, as revealed by neuroimaging. The proportion of children with cortical/subcortical lesions was equally distributed approximately among the three speech ability groups, while cortical/subcortical and basal ganglia lesions were most common in the nonverbal children, and periventricular white matter lesions of immaturity were most common in children without speech disorders.

Of note, cerebellar lesions were found only in children with speech disorders, and the authors hypothesize that severe speech deficits may only occur in the presence of bilateral lesions.

"The timing of the brain insult seems important for speech ability," the researchers add. "Lesions acquired late in gestation, around or after birth, were most common in the nonverbal group, while periventricular white matter lesions, acquired late in the second and early in the third trimester, were most common in children without speech disorders."

The team concludes: "Speech ability is related to the type of cerebral palsy, gross motor function, the presence of mental retardation and the localization of brain maldevelopment and lesions in children with cerebral palsy. Further data are now being collected on the language, cognition and communication skills of the 27 children with speech disorders identified by this study."

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