Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Amsterdam, Netherlands.
Department of Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam Reproduction and Development, Amsterdam UMC, University of Amsterdam and Vrije Universiteit Amsterdam, Emma Children's Hospital, Amsterdam, Netherlands.
Disabil Rehabil. 2023 May;45(10):1667-1679. doi: 10.1080/09638288.2022.2072960. Epub 2022 May 15.
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 ( = 0.637); in preschool children: functional communication, speech function and language activities ( = 0.820), and in schoolchildren: functional communication, intellectual functioning and arm-hand functioning ( = 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.
确定脑瘫（CP）儿童口语理解（SLC）的决定因素。
纳入 207 名 CP 儿童的横断面数据：82 名幼儿（18 个月至 3 岁；11 岁），59 名学龄前儿童（4 岁；0-5 岁；11 岁）和 66 名学龄儿童（6 岁；0-8 岁；11 岁），涵盖所有粗大运动功能分类系统（GMFCS）水平。使用基于计算机的低运动语言测试工具（C-BiLLT）评估 SLC。从病历和家长问卷中检索潜在决定因素。按发育阶段，使用多变量回归分析评估 SLC 的决定因素。
59%的儿童表现出低于平均水平的 SLC。不同发育阶段 SLC 的决定因素不同。在幼儿中：年龄、运动类型、功能性交流和言语功能（ = 0.637）；在学龄前儿童中：功能性交流、言语功能和语言活动（ = 0.820），在学龄儿童中：功能性交流、智力功能和手臂-手功能（ = 0.807）。对于所有发育阶段，功能性移动性不是一个重要的决定因素。
所有 GMFCS 水平的 CP 儿童中，有相当大比例的儿童存在 SLC 损伤。研究结果表明，SLC 主要由 CFCS 分类的功能性交流决定。我们建议对所有 CP 儿童进行 SLC 的标准化评估和监测。
所有 GMFCS 水平的儿童都可能在口语理解方面存在困难。在所有发育阶段，功能性交流（CFCS 分类）是口语理解的重要决定因素。强烈建议对所有 CP 儿童进行口语理解、语言产生、言语和交流的标准化评估和监测。当儿童表现出低于平均水平的表现时，特别是在口语理解方面，建议进行言语和语言治疗以及家长指导。
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