title: Oromotor dysfunction and communication impairments in children with cerebral palsy: a register study.
abstract: OBJECTIVE
  to report the prevalence, clinical associations, and trends over time of oromotor dysfunction and communication impairments in children with cerebral palsy (CP).
  
  
  METHODS
  multiple sources of ascertainment were used and children followed up with a standardized assessment including motor speech problems, swallowing/chewing difficulties, excessive drooling, and communication impairments at age 5 years.
  
  
  RESULTS
  a total of 1357 children born between 1980 and 2001 were studied (781 males, 576 females; median age 5y 11mo, interquartile range 3-9y; unilateral spastic CP, n=447; bilateral spastic CP, n=496; other, n=112; Gross Motor Function Classification System [GMFCS] level: I, 181; II, 563; III, 123; IV, 82; IV, 276). Of those with 'early-onset' CP (n=1268), 36% had motor speech problems, 21% had swallowing/chewing difficulties, 22% had excessive drooling, and 42% had communication impairments (excluding articulation defects). All impairments were significantly related to poorer gross motor function and intellectual impairment. In addition, motor speech problems were related to clinical subtype; swallowing/chewing problems and communication impairments to early mortality; and communication impairments to the presence of seizures. Of those with CP in GMFCS levels IV to V, a significant proportion showed a decline in the rate of motor speech impairment (p=0.008) and excessive drooling (p=0.009) over time.
  
  
  CONCLUSIONS
  these impairments are common in children with CP and are associated with poorer gross motor function and intellectual impairment.
authors.affiliation: School of Nursing and Midwifery, Queen's University of Belfast, UK. j.parkes@qub.ac.uk
authors.forename: Jackie
authors.initials: J
authors.lastname: Parkes
authors.forename: Nan
authors.initials: N
authors.lastname: Hill
authors.forename: Mary Jane
authors.initials: MJ
authors.lastname: Platt
authors.forename: Caroline
authors.initials: C
authors.lastname: Donnelly
mesh_terms: D017668:Age of Onset; D002547:Cerebral Palsy / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003147:Communication Disorders / Q000453:epidemiology* / Q000209:etiology; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007494:Ireland; D008297:Male; D009059:Mouth Diseases / Q000453:epidemiology* / Q000209:etiology; D009068:Movement / Q000502:physiology*; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies