Purpose: This study aimed to examine the contribution of speech motor impairment (SMI), language impairment, and communication modality to communicative and overall participation outcomes in school-age children with cerebral palsy (CP).
Method: Eighty-one caregivers of children with CP provided information about their child's speech and language skills, communication modality, and participation through a web-based survey. Caregiver responses to two validated scales were used to quantify children's communicative participation and overall participation. Children were classified into four speech-language profile groups and three communication modality groups for comparison, based on caregiver-reported information regarding their child's communication skills.
Results: Children with CP who had co-occurring SMI and language impairment had significantly lower levels of communicative participation and involvement in activities overall, compared to children with SMI alone. Among children with SMI, augmentative and alternative communication (AAC) use was associated with greater overall frequency of participation and involvement in life activities.
Conclusion: Children with CP who have both SMI and language impairment and those who are nonspeaking communicators should be prioritized early for communication interventions focused on maximizing participation, including consideration of AAC.