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Speech in children with cerebral palsy: Characteristics, associated factors, and the importance of a differential diagnosis

Lookup NU author(s): Professor Lindsay Pennington



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Mac Keith Press, 2020.

For re-use rights please refer to the publisher's terms and conditions.


AIM To examine the frequency, characteristics and factors associated with speech delay and disorder in a community sample of children with cerebral palsy (CP) aged 5 and 6 years. METHOD Participants were 84 children with CP identified through a population-based registry. Speech and oromotor function were systematically evaluated to provide a differential diagnosis of articulation, phonological and motor speech disorders. RESULTS 82% (69/84) of participants had delayed or disordered speech production, including minimally verbal presentations (n=20). Verbal participants (n=64) presented with dysarthria (78%), articulation delay or disorder (54%), phonological delay or disorder (43%), features of childhood apraxia of speech (CAS) (17%), or mixed presentations across these conditions. Speech intelligibility was poorest in those with dysarthria and features of CAS. Speech delay and disorder in verbal participants was associated with language impairment (p=0.002) and reduced health-related quality of life (p=0.04) (Fisher’s exact test). Poorer speech accuracy (i.e., lower percent consonants correct) correlated with greater impairments in both language (p=<0.001) and oromotor function (p=<0.001) (Spearman’s test). INTERPRETATION The speech profile of children with CP is characterized by impairment at multiple levels of speech production (phonetic, cognitive-linguistic, neuromuscular execution, and high-level planning/programming), highlighting the importance of a personalized differential diagnosis informing targeted treatment.

Publication metadata

Author(s): Mei C, Reilly S, Bickerton M, Mensah F, Turner S, Kumaranayagam D, Pennington L, Reddihough D, Morgan A

Publication type: Article

Publication status: Published

Journal: Developmental Medicine and Child Neurology

Year: 2020

Volume: 62

Issue: 12

Pages: 1374-1382

Print publication date: 01/12/2020

Online publication date: 26/06/2020

Acceptance date: 29/04/2020

Date deposited: 30/04/2020

ISSN (electronic): 1469-8749

Publisher: Mac Keith Press


DOI: 10.1111/dmcn.14592


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