Speech therapy has long been used in cerebral palsy to develop communication skills. Many are not aware of what cerebral palsy is and how it affects children and adults. Learning about cerebral palsy is often the first step in understanding speech therapy’s role in improving a child’s life.
In the mid 1800’s, William Little was the first person to record cerebral palsy and it’s affects on infants, toddlers and children. Mr. Little noticed that this condition occurred in the child’s first year of life. It caused stiff and spastic muscles. The muscles affected most severely were in the legs. A child’s arms were affected, but often not as severely as the legs. Children had difficulty grabbing objects of any size or weight. The children were unable to crawl or had delayed abilities to learn to crawl. A large number of the children were not able to walk without assistance or at all. Mr. Little noticed that the symptoms did not appear to get worse or to improve. The condition was called Little’s Disease. William little believed that the condition was a result of difficulty at birth.
In 1897, Sigmund Freud disagreed with William Little’s work. Freud believed that the condition began while the child was still in the womb and was a result of damage to the brain in development. Sigmund Freud noticed mental retardation, visual disturbances and seizures in these patients. These additional diagnoses reinforced Freud’s claim that the root cause was in the brain development.
Little’s disease was changed to Cerebral Palsy as the name indicates what has happened to the infant. The brain (cerebral) and the muscles and motor control (palsy) are both affected. Future research showed that both of the men were correct. There is a percentage of infants that are afflicted with cerebral palsy while still in the womb and a percentage during delivery and after delivery. Congenital cerebral palsy occurs 70 percent of the time prior to birth, 20 percent of the time during birth and 10 percent of the time after birth. Premature infants have a higher rate of cerebral palsy than full term infants.
Cerebral Palsy affects both the brain and muscles of an infant; at times this can cause the inability or difficulty of an infant to breath, swallow or as they grow speak. This difficulty can be caused by the damage to the area of the brain in which these functions are located or by the muscles controlling these functions being affected. Speech therapy can teach the child, his family members and care givers what they can do to work with the child at home, at school and in the community to increase communication and decrease frustration. The earlier the speech therapy intervention that greater the opportunity for improvement not only in communication but the quality of life.
Speech therapy is to correct speech disorders, restore speech abilities, introduce communication aids, teach sign language, and improve listening skills. Muscle training is included as often the child needs to be taught how to use his tongue muscle in order to begin to communicate.
Speech therapy includes not only working on the verbal communication, but also the non-verbal communication skills. Those skills include looking directly at the person speaking and listening. They are taught to speak slowly and to lip read. Slow speaking and lip reading will assist the child in learning how to use their mouth properly to make sounds and mouth the words. Pictures are used in two ways: introduce the word with visual and audio connections and to assist the child in non-verbal communication. Objects are also used in the same manner; the speaker may hold an apple and an orange to ask the child which he prefers. The child is able to ask for the one that he wants, hear the word and see the object, connecting word to object to verbally and physically receiving what he desires. This reinforces the need to the child to communicate either verbally or with an object. Reading books to the child slowly, pointing out words, objects and demonstrating changing tones of voice is also a great way to demonstrate communication.
Speech therapies begin with a hearing test for the child regardless of the age. A child that has a hearing deficit will be examined for medical causes for the hearing loss such as fluid in the ear. If the hearing loss is able to be corrected by antibiotics or simple surgical procedures, speech therapy will begin quickly. If the hearing loss is due to a physical deformity or damage to the area of the brain that controls the hearing function other forms of speech and communication will be pursued.
Speech therapy begins simply with the child developing their ability to articulate sounds. A therapist may begin with the letter (s). The sound (SSSSS) will be taught to the child until the child is able to repeat that sound with no consonants. Once the single sound is mastered the child moves on to using the sound in the beginning of a word for a week. With the letter (S) the child will hear it spoken in the following words: Sun, Sorry, Soup, Sick, Sandwich, Skate, Slip, Sock, Shoe, Shovel. The next week the child will hear the sound in the middle of words: beSide, bloSSom, baSSon, baSketball, baSeball. The following week the sound will be in the end of the word: meSS, bleSS, dreSS, impreSS, beSt, reSt.
Once the sounds have been mastered the child is then taught to say 10 to 20 words that are essential in his life. The words may include: drink, milk, sleep, dress, more, please, tired, play. This will allow the parent, child and care giver to begin communicating about the child’s needs and wants.
Once articulation is mastered or well on its way to mastered; the speech therapist will being working on more of the language skills by teaching the child how to read a book and do activities related to the book. This enables the child to understand the cause and effect of language. You read a book, Give a Mouse a Cookie and then work with the child to make a cookie, serve a cookie or simply eat a cookie so the child the story come to life. Once the child is able to see and understand how communication works and develops the simplest of communication skills the child will be encouraged to continue to develop communication skills.
In the event the child is unable to speak due to the severity of his cerebral palsy diagnosis; the speech therapist may teach the child to master forms of non-verbal communication. This may include communication boards with pictures, words and letters depending on his mental capabilities. Gesturing may be introduced or may advance to sign language. Computers have enabled non-verbal children and adults to communicate with programs that will speak for them or simply writing what they want to communicate.
Speech therapy has helped in large and small ways the over 764,000 children and adults communicate to the best of their abilities. Each year 8,000 infants are diagnosed with cerebral palsy and 1,200 to 1,500 preschool children are diagnosed with cerebral palsy. That is one in every 400 children and adults that have been diagnosed with some degree of cerebral palsy. The early these children are introduce to speech therapy, the higher the quality of life they can obtain.
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