Assessment of Cerebral Palsy

Assessment of CP

• Assessing sensory abilities involves testing point discrimination, pain, temperature, stereognosis, and vibration sense.
• Point discrimination: Two simultaneous stimuli on different parts of the body; inability to perceive the two points signifies loss of two-point discrimination, suggesting a parietal cortical lesion.
• Pain: Sharp stimuli applied to an area to assess pain response; reduced pain sensation is hypoalgesia; increased pain sensation is hyperalgesia; loss of pain sensation is analgesia.
• Temperature: Testing ability to sense hot and cold; loss of ability to recognize limb position (eyes closed) is agnosia.
• Astereognosis: Inability to recognize form, shape, etc. with eyes closed.
• Loss of vibration sense: Tested with a vibrating stimulus (e.g., tuning fork).

Associated Issues with CP

• Visual and auditory difficulties are common.
• Cognitive dysfunction is more prevalent in spastic CP than in dyskinetic CP.
• Seizures are also possible.
• Emotional and behavioral issues like hyperactivity may occur.
• Pseudo-degeneration can occur due to reduced use of structures affected by neuromotor impairment.
• Orthopedic difficulties are present, and perceptual problems like agnosia can affect the patient's ability to recognize objects, shapes, and spatial relationships.
• Difficulty with speech, language, and communication also could present.

Role of Professionals

• General practitioners (GPs) identify early signs, refer to specialists, and provide counseling.
• Paediatricians diagnose and monitor growth and development.
• Neurologists assess neurological status and prescribe medications.
• Neurosurgeons might be involved.
• Orthopaedic surgeons prescribe orthotic aids.
• Speech-language pathologists (SLPs), physical therapists (PTs), and occupational therapists (OTs) are important.
• Special educators help with reading and writing skills.
• Social workers provide support to the patient and family.

Developmental Dysarthria

• Dysarthria is a speech disorder due to neurological injury.
• If the onset occurs during the developmental period, it's termed developmental dysarthria.

Motor Speech Disorders in Children (Dysarthria)

• Dysarthria affects all speech systems or unitary systems.
• Assessment involves perceptual and objective measures (acoustic, aerodynamic, kinematic, muscular).
• Neuromuscular control dysfunction can manifest as weakness, slowness, or lack of coordination, often due to spasticity, flaccidity, or involuntary movements.

Dysarthria: Specific Features

• Speech may be immature, needing repeated assessments to capture changing features with age.
• Reflexes may be primitive or pathologic, especially in CP.
• Specific symptom clusters might exist in syndromic or metabolic conditions.
• Language development delay can result.
• Non-progressive lesions in CP may have evolving physiological effects due to neural maturation.
• Associated problems necessitate intensive therapeutic interventions, potentially delaying language development.
• Reduced prelinguistic experiences and abilities.
• Idiosyncratic factors (family, environment, needs) influence outcomes.

Specific Errors of Speech System

• Respiratory, laryngeal, resonance, articulation, prosodic, and language errors are outlined by speech system, and examples for each. Specific examples of disorders like athetoid, spastic, and ataxic are given with pitch, loudness, quality, prosody, along with examples of abnormal prosody.

SLPs Assessment Models

• Process/physiological model
• Articulation & Motor Speech: Goldman-Fristoe Test of Articulation, Frenchay Dysarthria Assessment
• Language: CELF, PLS (receptive and expressive), REEL
• AAC: Communication Matrix (Dynamic AAC Goals Grid)
• Swallowing: VFSS or FEES
• Respiratory: Manometers, spirometers, measures of lung volumes and capacities.

SLPs Assessment Models (Point Place)

• Speech production quality is evaluated through specific points of assessment, or valves.
• Each system's valves is assessed and categorized as Normal (0) or Severe (6)
• Respiratory system, Phonatory valve, Resonatory valve, and Articulatory valves are the main assessment for detailed evaluation and treatment.

This quiz covers the assessment of sensory abilities in individuals with cerebral palsy, including point discrimination, pain sensitivity, temperature recognition, and vibration sense. Additionally, it discusses associated issues such as visual, auditory difficulties, and cognitive dysfunction prevalent in different types of CP.