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M.N. Butt1, I. Khan1, S. Farooq1
1Muzaffarabad Physical Rehabilitation Centre, Physical Therapy, Muzaffarabad, Pakistan
Background: Cerebral palsy (CP) is a neuromuscular disorder caused by non-progressive brain damage[1]. Physical disability is the hallmark of cerebral palsy and associated impairments include visual problems, hearing loss, speech problems and many others [2-9]. Our focus is to highlight speech and hearing problems for improving management of children with cerebral palsy.
Purpose:
- To determine the prevalence of speech and hearing impairment among children with cerebral palsy.
- To identify the associated factors with management of speech and hearing impairment.
- To improve referral linkages for promoting multidisciplinary approach in the management of cerebral palsy
Methods: A cross-sectional survey was conducted in Muzaffarabad Physical Rehabilitation Centre, Azad Jammu and Kashmir, Pakistan. Both male and female children with cerebral palsy aged at least 2 years were included in the study. Children with cerebral palsy who have co-morbidities like epilepsy and mental retardation were excluded. Data was collected from patients who visited the centre from March 2019 to March 2020 via file records and phone calls because of Pandemic COVID-19. Consecutive sampling was done. Data was analysed using SPSS-21.
Results: A total of 225 children with cerebral palsy met the inclusion criteria. Of which 158 children had speech impairment (83.5% speech impairment only and 16.5% speech and hearing impairment). Mean age was 5.03±3.31 years. 59.5% children were spastic quadriplegic and 34.8% were spastic diaplegic. 98.1% children with cerebral palsy have family income less than 300 US$ per month. These children were assessed using gross motor function classification scale, 57.6% children with cerebral palsy fall in grade IV, 19.6% in grade II and 19.6% in grade III. None of the children with cerebral palsy and hearing impairment in the study has ever visited specialist for hearing assessment due to lack of resources. Only 4.4% children with cerebral palsy consulted speech therapist outside their province but did not take speech therapy session. 94% Children with cerebral palsy and speech impairment never consulted any speech therapist for evaluation. The main reasons for not consulting a speech therapist were lack of awareness about speech therapy 23.4%, both lack of awareness and lack of resources 46.8% and unavailability of speech therapist in local hospitals 21.5%.
Conclusion(s): It has been concluded that speech impairment is more prevalent than hearing impairment among children with cerebral palsy. Paucity of resources, lack of awareness about speech therapy and unavailability of speech therapist in local hospitals are the main reasons for not consulting the speech therapist. Lack of communication can lead to poor rehabilitation outcomes as over half of patients fall in grade IV on GFMCS. Communication (hearing and speech) is crucial for children with cerebral palsy to better understand the functional exercises for the activities of daily life and for conveying their concerns both to parents/care givers and health care provider.
Implications:
- To educate patient about speech therapy and its importance.
- To arrange hearing assessment for the patients by improving referral linkage with local specialist.
- To make strategy to provide speech therapy in our centre in coming future to facilitate children with cerebral palsy and speech impairment.
Funding, acknowledgements: I want to pay my regards to International Committee of Red Cross for funding this research project.
Keywords: Cerebral palsy, Communication, speech
Topic: Paediatrics
Did this work require ethics approval? Yes
Institution: Muzaffarabad Physical Rehabilitation Centre, Muzaffarabad Azad Jammu & Kashmir, Pakistan
Committee: Research Ethical Committee
Ethics number: 1326/Admin/2020
All authors, affiliations and abstracts have been published as submitted.
