ABSTRACT
Objective To investigate the clinical characteristics of speech disorders in children with cerebral palsy (CP) and any relationship between those characteristics and cranial magnetic resonance images.Methods A sample of 138 children with CP were given the ＜ s-s ＞ language development test,a Chinese-language articulation test and oral motor scores to quantify their functional speech and articulation.The characteristics of their speech disorders,articulation and oral motor dysfunction were then related with abnormalities in their cranial magnetic resonance images (MRIs).Results Of the 138 MRIs,only 9 were normal.Three showed non-specific abnormalities (delayed myelination and/or broadening of the space outside the brain) and 122 (91％) showed specific abnormalities.Among the children with specific abnormalities,51.6％ had speech reception delay and 74.6％ had speech expression delays.The dysarthria rate was 71.3％,including 8.7％ with no speech ability at all.The main MRI abnormalities were lesions of the basal ganglia (23％),lesions of the cerebellum (11.5％),periventricular leukomalacia (PVL) (47.5％),extensive cortical or subcortical lesions (6.6％) and focal cerebral injury (11.5 ％).The corresponding oral motor scores increased successively.The children with lesions of the basal ganglia or cerebellum were most likely to manifest speech expression delay and dysarthria.The children with cortical or subcortical lesions or PVL also showed speech expression delay and dysarthria.However,the children who had a focal cerebral injury generally performed well on the speech ability assessment.Twelve children had no speaking ability at all,and in 7 of them the lesions were of the basal ganglia.Conclusions The probability and severity of speech disorders in children with cerebral palsy relate with specific abnormalities detectable with cranial MRI.Those with lesions of the basal ganglia or cerebellum will be more likely to show more severe speech disorders.
ABSTRACT
OBJECTIVE: This study was designed for evaluating the clinical usefulness of the Korean Denver Developmental Screening Test II (KDDST II) for screening of speech-language delays, for evaluating the co-morbidity of psychiatric disorders and examining the prevalence of hearing impairment in speech-language delays. METHOD: Fifty eight preschoolers whose chief complaints fell into 'late talker', 'dysarticulation' or 'stuttering' performed KDDST II, speech-language evaluation and hearing screening. Psychiatric consultation was performed if the child had any behavioral or emotional red flags. RESULTS: More than 50% were classified as 'language delay only', 25.9% as 'language delay with speech disorder', 22.4% as 'phonological disorder only'. Eleven children (34.4%) with language delay were classified as 'global developmental delay'. Sensitivity of KDDST II as a screening tool of language delay was only 84.4%. Two cases of hearing impairment and 3 cases of complicated otitis media were detected by hearing screening. Seventeen children (29.3%) also had psychiatric disorders such as attention deficit hyperactive disorder, anxiety disorder, and autism spectrum disorder. CONCLUSION: Evaluation of whole spectrums of development and hearing screening were recommended in the children with speech-language delays. Psychiatric consultation should be also considered in a case of any behavioral or emotional concerns.