Price, Katherine; (2017) Early social communication skills of children with cerebral palsy. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

The clinical motivation for this study arose from repeated observations that some children with cerebral palsy (CP), despite provision of equipment and support, were still failing to reach their expected communication potential. In the clinical field, this failure has been commonly viewed to be the result of physical dependence on adult partners, or linked directly to the children’s physical or learning disabilities, arising from the neurological and developmental deficits associated with CP. Social responsiveness and shared attention underpin language and communication development. Children with cerebral palsy (CP) may be vulnerable to disruption in the development of these foundation skills (Nordin & Gillberg, 1996). However, there are few guidelines for assessment of these skills in this group of children (Watson & Pennington, 2015). This current study aimed to: 1. develop an assessment protocol to support the identification of autism spectrum disorder (ASD) in children with CP at GMFCS levels IV and V; 2. compare the assessment tool (Gaze-NoTe) profiles of performance of children with CP with those seen in children with ASD and with children with Down syndrome (DS); 3. investigate any links, for the children with CP, between social communication deficits skills/deficits and performance on other measures of motor, language, visual and cognitive skills. The study included 57 children in these three groups, matched for age, language and non-verbal abilities. The children with CP (n=32) were screened for their ability to use looking behaviours to give responses (Clarke et al., 2016). A measure of social responsiveness/joint attention, (Gaze-NoTe), accessible by all three groups was derived from established assessments. Children with CP gave reliable responses to the tasks offered, and a range of skills was seen. Many children showed social responsiveness/joint attention skills at a level of development significantly below their language age/performance age, and the performance on the target measure Gaze-NoTe was significantly different across the three groups.

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