Determinants of spoken language comprehension in children with cerebral palsy

To identify determinants of spoken language comprehension (SLC) in children with cerebral palsy (CP). Cross-sectional data of 207 children with CP were included: 82 toddlers (18 months–3;11 years), 59 preschool children (4;0–5;11 years), and 66 schoolchildren (6;0–8;11 years), across all Gross Motor Function Classification System (GMFCS) levels. SLC was assessed using the Computer-Based instrument for Low motor Language Testing (C-BiLLT). Potential determinants were retrieved from medical files and through parental questionnaires. Per developmental stage, multivariable regression analyses were used to assess determinants of SLC. Fifty-nine percent of the children showed below average SLC. Significant determinants for SLC differed per developmental stage. In toddlers: age, motor type, functional communication and speech function (R2 = 0.637); in preschool children: functional communication, speech function and language activities (R2 = 0.820), and in schoolchildren: functional communication, intellectual functioning and arm-hand functioning (R2 = 0.807). For all developmental stages, functional mobility was not a significant determinant. A large proportion of children with CP across all GMFCS levels have SLC impairments. Findings indicate that SLC is strongly determined by functional communication classified with CFCS. We recommend standardized assessment and monitoring of SLC in all children with CP.
IMPLICATIONS FOR REHABILITATIONChildren across all GMFCS levels can experience difficulties in spoken language comprehension.At all developmental stages, functional communication (classified with CFCS) is an important determinant of spoken language comprehension.Standardized assessment and monitoring of spoken language comprehension, language production, speech, and communication of all children with CP, is strongly recommended.When children show below average performances, especially in spoken language comprehension, intervening with speech and language therapy and guidance for parents, is advised. Children across all GMFCS levels can experience difficulties in spoken language comprehension. At all developmental stages, functional communication (classified with CFCS) is an important determinant of spoken language comprehension. Standardized assessment and monitoring of spoken language comprehension, language production, speech, and communication of all children with CP, is strongly recommended. When children show below average performances, especially in spoken language comprehension, intervening with speech and language therapy and guidance for parents, is advised.

本研究旨在识别脑瘫儿童（CP）言语理解能力（SLC）的决定因素。纳入了207名脑瘫儿童的横断面数据：82名幼儿（18个月至3岁11个月）、59名学龄前儿童（4岁至5岁11个月）和66名学龄儿童（6岁至8岁11个月），涵盖所有粗大运动功能分级系统（GMFCS）级别。言语理解能力通过计算机辅助的低运动语言测试工具（C-BiLLT）进行评估。潜在的决定因素从医疗记录和家长问卷中获取。针对每个发展阶段，采用多变量回归分析评估了SLC的决定因素。59%的儿童表现出低于平均水平的言语理解能力。SLC的决定因素随发展阶段而异。在幼儿阶段：年龄、运动类型、功能性沟通和言语功能（R² = 0.637）；在学龄前儿童阶段：功能性沟通、言语功能和语言活动（R² = 0.820），以及在学校儿童阶段：功能性沟通、智力功能和手部功能（R² = 0.807）。在所有发展阶段，功能性运动能力并非显著的决定因素。在所有GMFCS级别中，大量脑瘫儿童存在SLC障碍。研究结果指出，SLC的强烈决定因素为功能性沟通，其分类为CFCS。我们建议对所有脑瘫儿童进行标准化的SLC评估和监测。