CommDis2 SLP405
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| Cerebral Palsy bkgd | -Onset before age 3-5 (TBI after).
-Non-progressive, but changes throughout lifetime.
-Brain damage, not cranial/spinal nerves.
-Dysarthria (30-80%), sometimes apraxia.
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| CP prevalence | -Most common childhood handicap.
-2 to 3 per 1,000 live births. (400k)
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| CP etiologies | PRENATAL- Intrauterine infection, stroke, toxemia, placental abruption.
PERINATAL- Hypoxia, kernicterus, trauma
POSTNATAL- Infection, trauma, hydrocephalus.
Pre and perinatal problems signaled by neonatal encephalopathy
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| CP types (3) | Spastic, ataxic, dyskinetic (athetoid & choreic – basal ganglia)
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| Spastic CP characteristics (5) | -Increased tone. -Hyperactivity of stretch reflexes (clasp-knife). -Difficult passive movement. -Rigidity. -Clonus: rapid muscular contraction and relaxation. -Babinski’s sign: big toe up.
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| Spastic CP evolution | -low tone at first (or normal). -first noticed at 3-6 mos. .-spasticity develops later
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| Spastic CP outlook (3) | -Hemiplegia (L or R): most learn to walk, 1/2 employed. -Diplegia (upper or lower): 1/3 employed. -Quadriplegic: 1/4 need total care.
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| Ataxic CP characteristics | Low birth tone. Later wide stance, ataxic gait. -Possible perceptual deficits. -Poor orientation of body in space. Incoordination, action tremor, dysmetria.
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| Athetoid CP (Dyskinetic) | -Hypotonic at first then hyperkinetic, choreic, or athetoid symptoms appear (choreoathetosis). -Tonic neck reflexes & snakey movements. -Swallowing and dysarthria probs common. -Often ave. IQ.
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| CP associated problems (6) | -Reduced cognition. -Behavior problems. -Seizures. -Vision. -Speech and language. -Hearing.
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| Speech subsystems affected by CP | Respiration, phonation, resonance, articulation
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| CP-Respiration | -Normal resting tidal volume. -Higher residual volume. -Reduced abdominal strength. -poor valve coordination 1.less available insp. vol. that, 2. is used up too quickly for phonation.
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| CP-Phonation | Insufficient driving pressure. Low air volume requires greater effort for speech.
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| CP-Articulation/Resonance | Extended non-speech postures interfere.
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