Dysarthria syndromes in children with cerebral palsy

Abstract

BoDyS Bogenhausen Dysarthria Scales AIM To investigate whether dysarthria syndromes acquired in adulthood can also be observed in children with cerebral palsy (CP) and, if so, whether they align with children's CP subtypes. METHOD Twenty-six children with CP participated (mean age 7y 8mo [SD 1y 2mo], 5y 1mo-9y 10mo; 16 males and 10 females). Speech samples were elicited in a computer-based game and were analysed using the auditory perceptual criteria of the Bogenhausen Dysarthria Scales (BoDyS). For statistical classification, three comparison groups of adults with standard dysarthria syndromes (i.e. spastic, hyperkinetic, and ataxic) were used. Their BoDyS data were entered into a mixture discriminant analysis, with data from the comparison groups as the training sample and those from the children with CP as the test sample. Results were related to findings in a group of adults with CP. RESULTS Among the children with CP, most had spastic (n=14), while fewer had ataxic (n=9) or hyperkinetic (n=3), dysarthria. However, syndrome allocations were significantly more ambiguous than in adults with CP. For 11 children, their dysarthria syndromes did not align with their CP subtype.

Recent developments in classifying and assessing dysarthria in children

“…This is not surprising, given the complexities that come with describing and classifying atypical speech in a group whose motor system is yet to fully develop and mature. More recently though, research in this field has gained momentum and the papers by Sch€ olderle et al 1 and Veenhuis et al 2 augment our growing knowledge of the classification and assessment of dysarthria in children.…”

“…However, dysarthria syndrome allocation is significantly more ambiguous in children than in adults. 1 Classifying dysarthria in children on the basis of syndromes established for adults may be of limited clinical utility. In line with the goal of personalized medicine, a needs-based approach to therapy appears warranted to best support the children's speech development.…”

“…Definitions of specific neurodevelopmental disorders generally focus on key functional deficits. Developmental coordination disorder (DCD), for example, is defined by the acquisition and execution of coordinated motor skills being substantially below that expected, given the individual's chronological age 1 and specific learning disorder (impairments in reading, spelling, writing, or mathematics). These definitions do not account for the complexity of neurodevelopmental and neurocognitive deficits that may be associated with or may even contribute to aetiology in these conditions.…”

“…First, it can provide a broad description of features one may expect to see in a group, and second, it may direct speech and language therapists to relevant treatment targets. However, dysarthria syndrome allocation is significantly more ambiguous in children than in adults 1 . Classifying dysarthria in children on the basis of syndromes established for adults may be of limited clinical utility.…”

DMCN 2021 highlights: expanding our lifelong commitment to disabled people worldwide

“…My personal highlights also include documented phenomenology of dysarthria in CP, 4 evidence‐based, consumer‐informed consensus to optimize respiratory health disease in CP, 5 and one on physical activity in this condition. I wonder what yours are, and would welcome any suggestion to further improve DMCN .

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