Clinical utilisation of the Infant Monitor of vocal Production (IMP) for early identification of communication impairment in young infants at-risk of cerebral palsy: a prospective cohort study

Abstract

Aim: To report prospective longitudinal data of early vocaliszations of infants identified "at-risk" of cerebral palsy (CP) for early identification of communication impairment. Method: This case-control longitudinal prospective cohort study reports on the assessment of 36 infants, 18 identified as at-risk of CP at the time of enrolment and 18 typically developing (TD) children, at three time points: 6 months, 9 months and 12 months of age, Data were obtained through criterion and norm referenced assessments of vocaliszation behaviors. Results: Early vocal behaviors of infants identified as at-risk of CP did not differ from their age matched peers at 6 months of age, however, significant group differences emerged at 9 and 12 months when precanonical and canonical babble typically emerge. Generalized linear mixed models analysis showed that the rate of development of early language ability and more complex speech-related vocal behaviors was slower for infants at risk of CP when compared to TD infants, with over 75% of infants with CP showing below normal vocal production and impaired language by 12 months of age. Interpretation: Our data suggest characteristics of infant vocalizations associated with pre-canonical and canonical babbling provide a strong evidence base for predicting communication outcomes in infants at risk of CP.

Profiling the Longitudinal Development of Babbling in Infants with Cerebral Palsy: Validation of the Infant Monitor of Vocal Production (IMP) Using the Stark Assessment of Early Vocal Development-Revised (SAEVD-R)

“…The IMP was found to be sensitive to departure from typical development in children identified as at risk of communication impairment secondary to CP [21]. Specifically, the rate of development of more complex and speech-like vocal behaviours in the infants at risk of CP was slower compared to typically developing infants, with group differences emerging at 9 months and 12 months of age, when pre-canonical and canonical babble typically emerge.…”

“…Nathani and Oller [9] suggest the pre-canonical stages may "yield predictive power comparable to that which has been found with the onset of canonical babble" (p. 322), which has relevance to early identification of communication impairment in the CP population. To this end, Ward et al [21] reported on the assessment of infant vocalisations using the Infant Monitor of vocal Production (IMP, [28,35,36]) as a potentially predictive tool for use within the clinical environment.…”

“…Research suggests early departure from typical development in the use of early protophones may be a valid predictor of expressive language skills not only in neurotypically developing children but also in children with neurodevelopmental conditions [12][13][14]. Marked differences in the vocalisations of infants with neurodevelopmental disorders have been reported, including autism spectrum disorder [15], Down syndrome [16], fragile X [17], and CP [18][19][20][21]. Of interest to this paper, children with CP have been shown to differ in their ability to use different sounds together and babble fluently and rhythmically [19,21].…”

“…Marked differences in the vocalisations of infants with neurodevelopmental disorders have been reported, including autism spectrum disorder [15], Down syndrome [16], fragile X [17], and CP [18][19][20][21]. Of interest to this paper, children with CP have been shown to differ in their ability to use different sounds together and babble fluently and rhythmically [19,21]. These findings suggest identification of communication impairment secondary to CP is possible before 2 years of age and indicate the need for clinically feasible and valid assessment tools.…”

The Effectiveness of Sensory Integration Interventions on Motor and Sensory Functions in Infants with Cortical Vision Impairment and Cerebral Palsy: A Single Blind Randomized Controlled Trial

“…Sensory processing problems are experienced in children with CVI [ 14 ]; however, to our knowledge, there is no sensory integration intervention study in children with CVI. When studies with infants and children with CP were examined, it was observed that the literature has mainly included physical, cognitive, and language-speech assessment studies and intervention studies [ 15 , 16 , 17 ]. There are also sensory integration assessment and intervention studies [ 6 , 18 , 19 , 20 ].…”