Spastic CP is caused by brain damage to the upper motor neurons within the pyramidal tract. The cardinal symptoms are stiff muscles that result in difficulty with muscle movement. These patients have both gross and fine motor deficits as well as communication impairments. Spastic dysarthria is seen in 35% of children with spastic CP (Hustad et al., 2010). Their speech and voice is characterized by hypernasality, breathy voice quality, monotonous speech, reduced loudness, and uncontrolled rate and rhythm of voice. Dependent on the severity of the spasticity, these children may experience extreme difficulty communicating with others. Language skills include lack of turn-taking, replying, answering or asking questions during conversations. Studies have shown that children with CP produce few utterances and use more monosyllabic utterances than multisyllabic utterances (Pirila et al, 2007). Feeding and swallowing problems are also seen in patients with CP. Studies have shown that 57% of children have sucking problems, and 38% have swallowing problems (Pakula et al, 2009). Up to 80% of these children have had non oral feeds on at least one …show more content…
Pennington and colleagues assessed the “It takes two to talk Hanen Program” and its effect on communication in caregivers and children with CP (2009). The goal of the Hanen program is to promote the child’s engagement and control during conversations. The study was completed with 11 mothers who had children with CP. Observations were completed prior to initiation of the program and then following the end of the Hanen program. The training included identifying the child’s style of communication and following the child’s lead in conversations. Results from the study showed that mothers initiated less conversations and increased their responses following treatment. The children initiated more conversation and requested more following the Hanen program. While the study found positive results they do not provide detailed information about treatment protocol. This makes therapy replication