The Phonological Awareness Abilities of Children with Cerebral Palsy who do not Speak (summary)


It is sometimes assumed that people who cannot speak are also unable to understand what is said to them, possibly because they haven't had the opportunity to develop an 'articulatory code' or a mental representation of words that are said to them because they have not been able to learn the motor patterns needed to use typical speech.

However most children with cerebral palsy who do not speak have intact or only mildly delayed understanding of language but research indicates that they might be disadvantaged in processing spoken and written language.

What was the aim of the study?
The study aimed to investigate 'whether a congenital inability to speak invariably affects performance on phonological awareness tasks'. The authors aimed to look at the importance of the connection between being able to speak and the development of phonological awareness; that is the ability to detect, identify and manipulate the sound structure of language.

What did the authors do?
They compared 11 children with cerebral palsy, 5 of whom could speak and 6 who were non-verbal, with 10 children without disabilities on several phonological awareness tasks: judgement of written rhyme, syllable segmentation and phoneme manipulation. The groups of children were matched for non-verbal intelligence but the children without disabilities were slightly younger. The children with cerebral palsy had little experience of literacy.

The research used a standardised assessment of phonological awareness skills which was adapted to enable non-verbal responses to be given. The tasks the participants carried out were:

  • Non-word reading – the children had to recognise the word spoken to them from a choice of 4 possible written forms.
  • Syllable Identification – to identify whether 2 spoken words had the same syllable at the beginning or end, or if there was no matching syllable.
  • Syllable segmentation – identifying how many syllables, from 1 to 4, there were in a word.
  • Visual and spoken rhyme – saying whether 2 words, presented either in spoken or written form, rhymed.
  • Phoneme segmentation – using spoken words and non-words the children were asked to identify how many sounds there were in each.
  • Phoneme manipulation – participants were asked to take away one sound from a spoken word and make a new word which they identified from a choice of 4 pictures e.g. 'spin' minus /s/ makes 'pin'.

What did they find?
The research found speaking children with cerebral palsy performed better on phoneme manipulation and visual rhyming tasks than those who were non-speaking, but no other significant differences were found between those groups.

There were no significant differences found between the children with cerebral palsy and the children without disabilities overall.

The children with cerebral palsy were older than the non-disabled group and therefore might have had more literacy experience and reading ability which could account for some of the differences.

The results indicated that the ability to speak is not essential for the development of phonological awareness, but it might have an influence on some tasks. It might, therefore, be that speaking children with cerebral palsy have an advantage over non-speakers in the acquisition of literacy skills.

Things you may want to look into:

Reading and spelling, phonological awareness, and working memory in children with severe speech impairments: A longitudinal study

Words in puddles of sound: modelling psycholinguistic effects in speech segmentation

Initial insights into phoneme awareness intervention for children with complex communication needs

Added to site July 2014