Communication and Speech
Speech and Language
It is not clear why some children talk and others do not. The absence of speech, or the development of only minimal speech, has been well documented, even in the more mildly affected. For a small percentage of individuals with CdLS, speech develops normally. For most, however, the ability to communicate is influenced by the developmental factors related to the syndrome, as well as access to early intervention programs and speech therapy. The decision to begin speech therapy should not be delayed.
Most children with CdLS exhibit errors in articulation, with sound substitutions and distorted or missing consonants. These errors are the result of a number of factors, including overall developmental delay, a smaller oral cavity, a retruded lower jaw, a tendency toward lower muscle tone, and hearing impairment.
In addition, most children with CdLS exhibit childhood apraxia of speech (CAS), a neurological disorder in which the precision and consistency of movements underlying speech are impaired. CAS may occur as a result of known neurological impairment, in association with complex neurobehavioral disorders of known or unknown origin, or as an idiopathic neurogenic speech sound disorder.
Augmentative and Alternative Communication (AAC)
One of the most challenging issues for people with CdLS is finding the best communication tool. It could be speech, signing, communication boards, computer programs, or some other means.
Examples of more formalized available AAC strategies include communication boards; Sign Language; Hand Talk or gestural code; Blissymbolics; Total Communication; Pantomime; a manual alphabet; eye-blinking encoding; or electronic communication aids. For children with severe upper-limb malformations there are gestural-assisted and neuro-assisted strategies available. Unfortunately, almost all augmentative communication strategies are difficult to learn for children who have difficulty understanding nonverbal or gestural communication.
Before considering the use of augmentative or alternative communication, a number of factors need to be considered. These include the level of cognition, motor abilities, receptive language abilities, and the motivation to communicate. Your child’s speech-language pathologist can guide you.
