Communication and Children with Cerebral Palsy

Original Editor - Roelie Wolting - The information on this page has developed for you from the expert work of Roelie Wolting alongside the Enablement Cerebral Palsy Project and Humanity and Inclusion.
Top Contributors - Michelle Lee, Naomi O'Reilly, Kim Jackson, Laura Ritchie, Tarina van der Stockt, Admin, Simisola Ajeyalemi, Evan Thomas, Lauren Lopez and Olajumoke Ogunleye

Communication Introduction

Communication occurs when a sender transmits a message and a receiver understands the message. An effective communicator independently alternates as a sender and a receiver regardless of the demands of a conversation including settings (e.g. community, school, work, home), conversational partners and topics. All methods of communication performance are considered in determining the CFCS level. To find out more about the GFCS have a look at this page.

Methods and Challenges of Communication

Here is a list of methods of communication and what challenges a child with Cerebral Palsy may come across:

Method	Challenge
Speaking	Coordination of mouth and tongue muscles People do not listen to them
Listening	Concentration
Writing	Fine Motor Skills
Showing / Pointing at Pictures	Fine Motor Skills Hand - Eye Co-ordination
Making Gestures / Sign Language	Fine Motor Skills Motor Planning
Body Language / Facial Expression	Muscle Control of Body / Face

Here are some examples of specific problems that some children with Cerebral Palsy can have when communicating:

• Floppy Children (Hyoptonia):
  • These children can have problems speaking with a clear voice because the muscles of the trunk are weak and this also influences the loudness of the speech.

• Children with Complex Disabilities (CP and Intellectual disability):
  • They will have problems with understanding as well

If children who have problems with speaking are not given an alternative to speech, they may have difficulty sending a response and the communication cycle will break down.

Developing Communication Skills

There are many different ways to influence and develop communication skills in children with Cerebral Palsy. Here are some ideas of games to help improve mouth control:

• Imitate a chicken by keeping a "worm" between the lips (not between the teeth!). How long can you hold it (make a game - who is the champion?!)
• Making Funny Noises e.g. the noise of a starting car or motor bike
• Blow a Kiss
• Imitate the wailing siren of a police care: i-u-i-u-i
• Clicking the tongue, fast and slow, like the sound of a horse on the road
• Make the tip of the tongue like a tower and stick it out of the mouth as far as possible
• Try to touch the nose, cheek, and chin with the tongue. Who is doing best?
• Inflate a balloon (or imitate it)
• Make funny faces, using all parts of the face (you can also use a mirror)
• Try to blow a ping-pong ball or a piece of cotton wool away: who is the best? Can you blow further than last week?

Speech and Language Therapists or Occupational Therapists will ideally be involved in the treatment and development of speech with the child with Cerebral Palsy. In this video an Occupational Therapist talks about the problems and treatments for communication difficulties in children with Cerebral Palsy. 

Additional Resources

Hambisela_Module_4 In: Getting to Know Cerebral Palsy: A learning resource for facilitators, parents, caregivers, and persons with cerebral palsy