title: Spoken language comprehension of phrases, simple and compound-active sentences in non-speaking children with severe cerebral palsy.
abstract: BACKGROUND
  Children with severe cerebral palsy (CP) (i.e. 'non-speaking children with severely limited mobility') are restricted in many domains that are important to the acquisition of language.
  
  
  OBJECTIVE
  To investigate comprehension of spoken language on sentence type level in non-speaking children with severe CP.
  
  
  METHODS
  From an original sample of 87 non-speaking children with severe CP, 68 passed the pre-test (i.e. they matched at least five spoken words to the corresponding objects) of a specifically developed computer-based instrument for low motor language testing (C-BiLLT), admitting them to the actual C-BiLLT computer test. As a result, the present study included 68 children with severe CP (35 boys, 33 girls; mean age 6;11 years, SD 3;0 years; age range 1;9-11;11 years) who were investigated with the C-BiLLT for comprehension of different sentence types: phrases, simple active sentences (with one or two arguments) and compound sentences. The C-BiLLT provides norm data of typically developing (TD) children (1;6-6;6 years). Binomial logistic regression analyses were used to compare the percentage correct of each sentence type in children with severe CP with that in TD children (subdivided into age groups) and to compare percentage correct within the CP subtypes.
  
  
  RESULTS
  Sentence comprehension in non-speaking children with severe CP followed the developmental trajectory of TD children, but at a much slower rate; nevertheless, they were still developing up to at least age 12 years. Delays in sentence type comprehension increased with sentence complexity and showed a large variability between individual children and between subtypes of CP. Comprehension of simple and syntactically more complex sentences were significantly better in children with dyskinetic CP than in children with spastic CP. Of the children with dyskinetic CP, 10-13% showed comprehension of simple and compound sentences within the percentage correct of TD children, as opposed to none of the children with spastic CP.
  
  
  CONCLUSIONS
  In non-speaking children with severe CP sentence comprehension is delayed rather than deviant. Results indicate the importance of following comprehension skills across all age groups, even beyond age 12 years. Moreover, the subtype of CP should be considered when establishing an educational programme for sentence comprehension, and augmentative and alternative communication support. In addition, educational programmes for children with severe CP should take into account the linguistic hierarchy of sentence comprehension when focusing on the input and understanding of spoken language comprehension.
authors.affiliation: Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, the Netherlands.|The EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.|Neuroscience Campus Amsterdam, Amsterdam, the Netherlands.
authors.forename: Joke J M
authors.initials: JJ
authors.lastname: Geytenbeek
authors.affiliation: University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Margriet J M
authors.initials: MJ
authors.lastname: Heim
authors.affiliation: University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Dirk L
authors.initials: DL
authors.lastname: Knol
authors.affiliation: Department of Paediatric Neurology, VU University Medical Center, Amsterdam, the Netherlands.|Neuroscience Campus Amsterdam, Amsterdam, the Netherlands.
authors.forename: R Jeroen
authors.initials: RJ
authors.lastname: Vermeulen
authors.affiliation: Neuroscience Campus Amsterdam, Amsterdam, the Netherlands.|Department of Pediatric Psychology, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Kim J
authors.initials: KJ
authors.lastname: Oostrom
mesh_terms: D001308:Auditory Perceptual Disorders / Q000175:diagnosis* / Q000523:psychology*; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007805:Language Development Disorders / Q000175:diagnosis* / Q000523:psychology*; D007807:Language Tests; D008297:Male; D011578:Psycholinguistics; D012660:Semantics
keywords: cerebral palsy; language development; non-speaking; sentence comprehension; spoken language comprehension