Cerebral Palsy

Cerebral palsy is a neurological condition that can impact upon a child’s speech skills. Cerebral palsy can affect movement and muscles (e.g. tongue, lips and jaw) needed to produce speech. It can make a child’s speech difficult to understand.

Speech and language therapy can help reduce the level of difficulty that your child is experiencing. Our speech and language therapists can work on creating a programme that will increase your child’s ability to communicate clearly.

Cerebral palsy affects a child’s muscle tone, movement, coordination and control. It is the result of brain damage during pregnancy, birth or up to two years after the child is born. Cerebral palsy affects gross motor skills such as standing, walking as well as fine motor skills such as holding a cup or writing. Cerebral palsy can affect functions within our body such as breathing, eating, learning and bowel movements. Cerebral palsy is not a progressive condition. There are different types of cerebral palsy:

Spastic cerebral palsy

Is the most common form of cerebral palsy, muscles seem to be stiff and tight causing stiff and exaggerated movement.

Ataxic cerebral palsy

Impacts balance and causes shaky movements as a result of impaired voluntary muscle coordination.

Dyskinetic cerebral palsy

Is separated into two areas:

• Athetoid - Involuntary movements of limbs such as hands, arms and legs.
• Dystonic - Impacts trunk muscle more than limbs and therefore causes a fixed, twisted posture.

Mixed cerebral palsy

A combination of symptoms from spastic, ataxic and dyskinetic cerebral palsy.

Cerebral palsy is caused by brain damage or impaired development of the brain specific to the areas controlling movement. The damage to the brain or abnormal development can occur during pregnancy, at the birth or in the first few years of childhood. It can be caused by several factors including:

• Periventricular leukomalacia.
• Abnormal development of the brain.
• Intracranial haemorrhage.
• Stroke
• Brain damage during or after birth.
• Infection caught by mother during the pregnancy.
• Mutations in the baby’s genes that can affect development of the brain.
• A premature birth.

Research shows that in the United Kingdom approximately 1 in 400 people are affected by cerebral palsy. Children who are born with an average birth weight, it is estimated 1 in a 1,000 will have cerebral palsy, compared to those who are born with a lower than average birth weight, 2 in a 1,000 will have cerebral palsy.

The symptoms and severity of symptoms of cerebral palsy differ according to the type of cerebral palsy. Some children may only appear to have mild problems while others may be severely disabled. Cerebral palsy can also vary in where it affects a child some children may only be affected on one side of their body whereas others may be affected on both. Some children are only affected in their legs whereas others are affected in their legs and arms.

Symptoms include:

Spastic cerebral palsy

• Hypertonia - weak and stiff muscles.

Dyskinetic cerebral palsy 

• Variance between stiffness (hypertonia) and floppiness (hypotonia) due to unconscious ability to contract and relax muscles.
• Uncontrollable body movements.
• Involuntary spasms and body posture.

Ataxic cerebral palsy 

• Difficulties with balance.
• Difficulties with coordination.
• Involuntary shaking (tremors).

Mixed cerebral palsy 

• One or more features of spastic, dyskinetic and ataxic cerebral palsy.

Speech language and communication difficulties include:

• Speech sound difficulties - due to abnormal muscle tone, muscle coordination and delay / disorder.
• Difficulties with rhythm, intonation, pitch and resonance.
• Difficulties with expressive language.
• Difficulties with swallowing, eating and drinking.

• Difficulties with gross and fine motor skills, such as walking and writing.

Often the speech, language and communication skills of a child who cerebral palsy can be affected. This can affect their daily living, depending on the severity of their difficulties, being independent can often become difficult as they are dependent on another person to help them be understood by others. Some daily difficulties a child with cerebral palsy experiences include:

• Difficulties being understood by others.
• Difficulties expressing thoughts, feelings and ideas in accurate manner.
• Difficulties expressing emotion through change in intonation pattern.
• Difficulties taking part in activities at school and home.
• Difficulties socialising with others and making meaningful friendships.
• Difficulty accessing the curriculum.
• Developing interests further due to mobility and communication difficulties.

Speech and language therapy can benefit a child with cerebral palsy by increasing their interaction with those around them through developing their already existing skills.

Our speech and language therapists can deliver assessments that show your child’s levels of ability and need. Assessments would vary according to your child’s area of difficulties. Our speech and language therapists carry out a variety of formal and informal assessments including:

• Expressive language assessments.
• Speech sound assessments.

• Assessment of intonation, rhythm and rate of speech, tone and volume of voice.

• Oro-motor examination- assessing muscles used in speech (jaw, tongue, lips).
• Assessment of resonance.

There are many benefits of speech and language therapy for children with cerebral palsy. Through learning new skills and enhancing their skills set, speech and language therapy aims to enable children to express themselves in a manner which they are understood.

Our speech and language therapists will assess your child’s needs and work with your child, you and their school to create a unique therapy programme that is individual to you child’s needs, strengths, motivators and aims.

A child with cerebral palsy may have speech difficulties that makes their speech difficult to understand. This can affect their confidence in school, they can choose to reduce their levels of participation in class activities, such as reading, which may affect their learning. Our speech and language therapists can work with your child to create a therapy programme that works specifically on each sound your child finds difficult.

Therapy we offer include:

• Expressive language programmes.
• Speech sound development.
• Oro-motor development exercises.
• Eating, drinking and swallowing guidance.
• Group therapy.
• Individual therapy.
• Advice, training and guidance for parents, carers, teachers and other professionals involved.

Speech and language therapy can help increase your child’s level of interaction, socialisation and confidence through developing skills to enhance their communication. Our speech and language therapists will work with you to create a tailor made programme that is based on increasing your child’s skills as well as yours and your child’s priorities.