Assessment of CP PDF

Assessment of CP M O H A M M E D A LQ A H TA N I  Tests for sensory abilities point discrimination: Two simultaneous stimulation on 2 both sides of the body or different areas of the same part with suitable stimuli. Inability to perceive the two points of stimulation is called a...

Assessment of CP M O H A M M E D A LQ A H TA N I  Tests for sensory abilities point discrimination: Two simultaneous stimulation on 2 both sides of the body or different areas of the same part with suitable stimuli. Inability to perceive the two points of stimulation is called as loss of 2 point discrimination. Suggests cortical lesion (parietal) Pain: A sharp edged stimuli placed on the organ/ area to be tested Reduced sensation of pain: hypoalgesia Increased sensation of pain: hyperalgesia Loss of pain sensation: analgesia Temperature: test for ability to sense hot or cold Loss of ability to recognize limb position (when eyes are closed) eg. agnosia Astereognosis: loss of recognition of form, shape etc. with eyes closed Loss of vibration sense: tested with a vibrating stimulus, E.g. use of tuning fork  Associated issues with CP Visual difficulties. Auditory difficulties. Cognitive disfunctions: MR more in spastic than dyskinetic. Seizure disorders. Emotional and behavioural disorders; e.g.: hyperactivity. Pseudo degeneration: due to reduced use of a structure which has neuromotor impairment, there is functional overlay. Orthopedic difficulties. Perceptual difficulties; e.g.: agnosia. Speech, language & communication difficulties.  Role of professionals GP: identification of early signs, referral, counselling. Paediatrician: diagnosis, monitoring growth and development. Neurologist: assess neurological status, prescribe medications. Neurosurgeon Orthopaedic surgeon; prescribe orthotic aids. SLPs, PTs, OTs. Special educator; reading & writing skills. Social worker When speech is impaired, since it is caused due to neurological injury, the speech disorder is called as dysarthria. Since it happens in the developmental period, it is called developmental dysarthria.  Motor speech disorders in children - dysarthria Dysarthria- all speech systems involved or unitary systems involved Assessment: 1] perceptual 2] objective – a] acoustic b] aerodynamic c] kinematic d] muscular Dysfunction in the neuromuscular control may be in the form of weakness of structures, slowness of movement, reduced or lack of coordination of structures because of  Dysarthria; Specific features 1] Immature speech system; changing picture with age (repeated assessments necessary). 2] Primitive and pathological reflexes specifically in CP. 3] Specific clusters of symptoms in syndromic and metabolic conditions. 4] Implications on language development delay.  Dysarthria; Specific features 5] Nonprogressive lesions in CP, but physiological effects due to neural maturation may be changing. 6] Presence of associated problems; requiring intensive therapeutic intervention and more likely for language to be delayed. 7] Reduced prelinguistic experiences and abilities. 8] Idiosyncratic influences; i.e. family, environment, needs etc.  Specific errors of speech system Respiratory; dynamic, rhythm. Laryngeal; pitch, loudness, quality. Resonance; hypernasality. Articulation; DDK. Prosodic; intonation, rhythm, etc. Language; receptive & expressive.  SLPs assessment models: 1] Process / physiological model: Articulation & Motor Speech: Goldman-Fristoe Test of Articulation - Frenchay Dysarthria Assessment. Language: CELF, Preschool Language Scale (PLS)- Receptive- Expressive Emergent Language Test (REEL). AAC: Communication Matrix - Dynamic AAC Goals Grid (DAGG). Swallowing: VFSS or FEES. Respiratory: manometers, spirometers, measures of lung volumes and capacities.  :SLPs assessment models 2] Point place model: Points (valves) in speech production mechanism determine quality of speech production. Errors in specific valves needs to be assessed either subjectively (rating scale) or objectively to get a global picture of the type of involvement. 0: Normal; 6: Severe ?Questions