Speech Therapy For Cerebral Palsy

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• Speech Therapy For Cerebral Palsy

Speech Therapy For Birth Injured Children

Most children diagnosed with cerebral palsy have difficulty controlling the muscles in their tongue, jaw, face, head, and neck. These difficulties usually cause limitations a child’s speech, swallowing, and chewing. Birth injury induced hearing impairments in children diagnosed with cerebral palsy may also lead to communication challenges and speech delays.

Speech and language therapy can help children with cerebral palsy strengthen the muscles involved in speech and oral motor skills, improving their ability to communicate, chew, and swallow. Specialized therapy can help child birth injury victims to express themselves more clearly, it enables them to have more enriching relationships with others, while giving them a greater sense of independence, confidence, and self-esteem.

At Miller Weisbrod Olesky, We Help You and Your Child Find Help NOW!

The ability to receive speech therapy is one of the goals of the birth injury attorneys at Miller Weisbrod Olesky. While settlements we have recovered provide long term resources that can be used for speech and language therapy, we know many families need help now. When a family hires our birth injury law firm, our nurses and nurse liaisons work immediately to help you find available specialists to provide a wide range of therapy and services.

Handling birth injury cases over the last 35 plus years, we know the benefits of early and continuous therapy for our young birth injury victims. Over the years, our team members have developed a system and network to provide birth injured children with immediate help and resources.

Staffed with a team of nurses and nurse attorneys, we begin the therapy process as soon as possible even if your child’s lawsuit has not been settled. Learn about our Miller Weisbrod Olesky nurses and our liaison program that ensures your child gets help NOW so they can begin the process of maximizing their physical therapy results.

What is Speech Pathology?

Birth injured children with speech deficits will almost always benefit from speech pathology – a specialized form of therapy to help a child develop the most appropriate and functional communication skills and improve their ability to feed competently.

A qualified Speech-Language Pathologist (SLP) will utilize a number of proven strategies to help a child learn to communicate effectively, while also working with them to prevent feeding and swallowing disorders. Apart from the SLP, trained nurses, nutritionists, lactation consultants, occupational therapists, physical therapists, and physicians will often be a part of the collaborative team focusing on speech pathology.

Feeding Problems and Speech Pathology

Speech pathology for a child diagnosed with feeding troubles may be started soon after birth. To determine an appropriate speech pathology treatment plan, the SLP team will perform a detailed assessment of the child’s oral motor skills, pre-feeding, and swallowing to understand the severity of feeding problems. Based on this assessment, the speech therapy plan may include the following steps:

• Practicing oral stimulation activities with babies who are unable to breastfeed or bottle-feed
• Individualized feeding interventions to help develop skills
• Therapy for feeding and dysphagia (difficult in swallowing)
• Tube weaning for babies that are being fed through a tube
• Oral motor activities and stimulation to promote early speech development
• Educating parents and caregivers

Unique Speech Challenges with Different Types of Cerebral Palsy

Spastic Cerebral Palsy

Children with this spastic (related to stiff muscles) Cerebral Palsy are more likely to struggle with poorly coordinated, imprecise, and slow oral movements which require extra effort. Their voice may sound hoarse or tight, while the speech may be slurred and unclear.

Dyskenetic Cerebral Palsy

Children with athetoid (related to poor muscle control) CP usually have difficulty controlling their tongue, jaw, and facial muscles. They may also find it hard to control their vocal cords and breathing as well as experience difficulties with chewing and swallowing.

Ataxic Cerebral Palsy

Children with ataxic (related to problems with balance) CP usually have a “scanning” speech. This means they will speak with breathy sounds in a monotone voice. The child’s speech may irregular, marked by accelerations and pauses. They may also have the problem of drooling.

Benefits of Speech Therapy for Birth Injured Children

Speech therapy and speech training helps most children with cerebral palsy related speech impairments articulate themselves more easily and effectively while communicating. In a few cases, speech improvements may not occur sufficiently despite professional speech therapy. In this situation, the child should continue working with a speech pathologist to learn to use alternative forms of communication and assistive devices.

Most children diagnosed with cerebral palsy can achieve some or all of the following benefits with speech therapy:

• Articulation
• Sound and word formation
• Pronunciation
• Listening
• Fluency
• Pitch
• Volume
• Vocabulary and language development
• Word-object association
• Word comprehension
• Improved vocal quality
• Breath control and support
• Speech muscle strength and coordination
• Swallowing
• Chewing

Indirect benefits of speech therapy include:

• Encouragement to learn and study
• Increased independence
• Improved literacy
• Increased problem-solving ability
• Improved expression of thoughts and ideas
• Reduction in shyness
• Increased self-esteem
• Improved socialization
• Improved physical health due to better chewing and swallowing
• Improved quality of life

Diagnosis of Speech Problems in Birth Injured Children

When speech issues are suspected in a birth injured child, the speech pathologist will first carry out an in-depth evaluation of the child’s cognitive and physical functioning. They will evaluate the nature of the child’s communication and speech challenges, identify the underlying causes, and determine an appropriate therapeutic approach.

A speech pathology diagnosis will be confirmed only after this detailed evaluation has been completed. The evaluation will usually include:

• Medical History: The SLP will examine the child’s case history and ask the caregivers a number of questions about the child’s general cognitive and physical functioning.


• Oral Cavity Exam: The speech pathologist will use special tools to identify any potential oral cavity or throat related irregularities that could be hindering speech. If they find obstructions, they will modify the treatment plan appropriately or may recommend surgery to correct the condition.


• Audiology Tests: Children diagnosed with cerebral palsy may also suffer from a hearing impairment, which has a correlation with speech. When the child is unable to completely hear or listen, they will incorrectly interpret sound, which impedes their language development. If the SLP determines that a hearing impairment is one of the underlying causes of the child’s speech issues, they may also refer the child to an otolaryngologist (head and neck surgeon) or an audiologist.
  
  These specialists can help in not only determining the extent of the hearing loss, but also fit the young child with hearing devices, including cochlear implants. We have seen tremendous speech and communication improvements for children we represent after they receive their first set of cochlear implants when hearing difficulties are a source of a child’s limitations.


• Articulation Assessments: The SLP will perform tests to detect if the child is dropping certain syllables or sounds from the spoken words. For instance, instead of saying “friend,” the child may be pronouncing it as “frien.” The speech therapist will specifically look for certain consonants that are generally hard to pronounce, such as “r” or “s”. To assess the child’s language and fluency, the therapist will perform specific tests that measure their ability to respond to unstructured communication.


• Cognitive Assessments: Children with birth injuries such as cerebral palsy may present with deficits in orientation, information processing, attention, memory, perception, problem solving, reasoning, and spatial cognition. The SLP will conduct an assessment of each of these cognitive aspects to determine which elements are affected to what degree, and make a comprehensive overall cognitive evaluation.

As a child reaches the age of 3, certain high-level testing like “neuropsychological testing” can be performed to identify the specific cognitive difficulties a young birth injury victim is suffering from. This testing many times is the key component of tailoring a long term treatment and therapy plan for a child with cerebral palsy or other hypoxic-ischemic encephalopathy birth injury.

Treatment Strategies Used in Speech Therapy

A certified speech language pathologist can help promote communication between a child and the parents or caregivers even when there is little or no verbal speech. This could include vocalizations (pre-language skills), gestures, manual sign language, communication boards, and voice output devices. Specific speech-language therapy exercises can be designed for toddlers and children to improve their ability to communicate and express themselves independently.

Language Intervention Activities

The speech language pathologist will interact with the child with one on one therapy, such as talking or playing using pictures, objects, books, or ongoing events with an aim to stimulate speech and language development.

The therapist will use repetition exercises and model correct pronunciation to help develop the child’s speech and linguistic skills. They will focus on developing the child’s language and word association with techniques such as flashcards with multiple sounds and words inscribed on them. They may also put together puzzle pieces with pairs of words, such as “bat and ball,” “shoes and socks,” and “toothpaste and toothbrush.”

Articulation Therapy

Sound production or articulation exercises are important to speech language pathology. The speech therapist will typically utilize play activities to model correct syllables and sounds for the child. The level of activities will be determined according to the child’s age and their unique needs.

The therapist will physically demonstrate before the child how to produce certain sounds, such as the “r” or “s” sound. They may use a mirror or language cards to show the child how to move the tongue to make a particular sound.

Oral Exercises

To help strengthen a child’s jaw muscles when tone and strength are limiting factors, the SLP may encourage the child and their caregivers to focus more on serving foods that demand extra chewing (such as carrots, celery, and apples). The child may also practice opening and closing the mouth while the therapist holds their chin (so that only the jaw muscles are used).

Tongue strengthening exercises to improve enunciation may involve sticking out the tongue and pushing it gently against a spoon or tongue depressor for a few seconds at one time. The therapist may also train the child and their caregivers in performing lip exercises to help form words. These may involve squeezing the lips around a candy or lollipop to improve muscle strength, and pursing the lips to enhance lip extension.

Swallowing Exercises

In addition to using oral exercises and facial massage to relieve spasms in the muscles of the child’s mouth, the speech therapist will also work with various food temperatures and textures to help develop the child’s oral awareness while they eat, chew, and swallow.

Swallowing therapy may include performing an “effortful swallow.” This involves collecting the saliva or another liquid in the mouth and swallowing it down the throat in a single gulp. This ensures that fluids and food fragments do not fall into the airway.

Another swallowing exercise is called the “masako maneuver,” which will help strengthen the muscles located at the back of the throat. In this exercise, the therapist will ask the child to stick out their tongue, and put mild pressure on it with their teeth so that it stays in place – and then attempt swallowing.

Augmentative and Alternative Communication Devices

Augmentative and Alternative Communication (AAC) refers to the use of any form or technique other than talking to express yourself. Picture charts, communication boards, and sign language are typically used as early AAC strategies to support communication in birth injured children diagnosed with speech problems. As the child grows, more advanced AAC devices can be added to increase the child’s communication ability.

Common AAC tools and devices include:

• Oral sensory chewing objects
• Placement tools (to position the tongue correctly for certain sounds)
• Tongue depressors
• Straws
• Word cards
• Picture boards
• Erasable boards
• Books
• Flip charts to relay more detailed messages
• Paper and pencil
• Communication boards
• Digital tablets
• Laptops and desktops
• Vocal synthesizers
• Speech generating devices
• Speech therapy mobile apps
• Custom software programs

Qualifications of a Speech Therapist and Speech Therapy Assistant

A speech language pathologist (SLP), commonly known as a speech therapist is a trained and certified professional specializing in the assessment and treatment of disorders related to speech, language, and swallowing. When selecting an SLP, it’s vital to check whether they have experience working with children diagnosed with cerebral palsy.

The SLPs may have to collaborate with other professionals, such as the child’s physician, psychologist, occupational therapist, physical therapist, and social workers in order to develop a comprehensive treatment plan. Speech pathologists are expected to have in-depth knowledge of the anatomical aspects of the mouth, throat & esophagus. In addition, they should be familiar with the cognitive and developmental problems that may impede communication.

SLPs are required to complete an accredited master’s degree program in speech and language pathology. In order to obtain a license to practice in most states, SLPs should have a certification from the American Speech-Language-Hearing Association (ASHA). To maintain this certification, speech therapists must update their training on new techniques and add at least 30 hours of professional development every three years.

Speech therapists may receive assistance from a qualified speech pathology assistant during their practice. The assistant is usually required to hold a license to practice and must have completed a bachelor’s degree program in speech & language pathology. The assistant’s role is to support the speech therapist in the implementation of the treatment plan designed for a child.

Since speech disorders may sometimes be related to hearing impairment, the speech therapist may also complete a course in audiology and receive a dual certification from ASHA.

Where can a Child Receive Speech & Language Therapy?

Depending on factors such as the child’s age, health condition, and accessibility of services in the local area, speech and language therapy may be received one-on-one or in a group setting. In many cases, the speech pathologist and their assistant may provide treatment at the child’s home.

In any case, for children with cerebral palsy who have communication difficulties, the ideal scenario would be to provide professional therapy to the child as well as train the parents or caregivers in exercises and activities, so that the child can practice at home to build their skills.

Some of the locations where birth injured children usually receive speech therapy include:

• The child’s home
• Clinical practice
• Hospital
• Nursing home
• Rehabilitation center
• Community health center
• Public or private school through programs such as Early Childhood Intervention (ECI)
• State health department

Is Your Child’s Cerebral Palsy or other Birth Injury Related Complication the Result of Medical Malpractice?

Parents whose children suffer from cerebral palsy or other birth injury related complications want and deserve answers as to cause of their child’s injury and whether mistakes by the doctors and nurses contributed to the injury.

Were there signs during the pregnancy, labor, and delivery process that birth related complications like preeclampsia, pregnancy-induced diabetes or a maternal infection were present, but not either recognized or properly treated. During the labor and delivery, were there clear indications that their baby was suffering from fetal distress, but appropriate actions were not taken by the obstetrician or nurses? Did the neonatal resuscitation team delay in providing important breathing support after birth? Were serious neonatal conditions like hypoglycemia or jaundice missed or treated incorrectly?

The experienced birth injury lawyers at Miller Weisbrod Olesky will help you determine if mistakes of the medical providers caused a birth injury to your child. Our experienced birth injury attorneys have represented families all over the United States in their time of need after a birth injury. We use our experience and expertise to obtain you and your child a medical malpractice settlement that will help provide specialized medical therapy like speech in order to maximize the quality of life and independence of your child throughout their life.

Sometimes families are reluctant to contact a medical malpractice lawyer. It’s also not uncommon for parents to feel overwhelmed by the responsibilities they encounter in caring for their injured child and worried that they will not be able to help out in a lawsuit involving their child’s birth injury. Our birth injury attorneys and nursing staff will address these hesitations and concerns, so you can focus on your child and maximizing their care.

Why Should You Talk with the Knowledgeable Attorneys at Miller Weisbrod Olesky?

The only way to find out if you have a birth injury case is to talk to a lawyer experienced in birth injury lawsuits. It’s not uncommon that a birth related complication results in a preventable birth injury, including cerebral palsy, but it takes a detailed expert review by a birth injury attorney of the medical records from your child’s birth to determine if the birth injury was the result of medical malpractice.

At Miller Weisbrod Olesky, a team of committed lawyers, nurses and paralegals uses our detailed medical negligence case review process to assess your child’s potential birth injury case. We start by learning more about you and your child and the status of meeting/missing developmental milestones. Then we gather medical records to determine what happened before, during, and after your delivery. We call in skilled medical experts who review your records and let us know if they think medical errors could have caused your child’s injuries.

If we feel medical negligence caused or contributed to your child’s injuries, we meet with you to discuss how you can receive compensation from the medical professionals who made the errors. Our birth injury attorneys have covered millions of dollars in settlements for families of children that have suffered a birth injury.

At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do.

Registered Nurses and Nurse-Attorneys Are a Vital Part of Our Birth Injury Team…and Yours

Most national birth injury law firms will employ one or two nurses to assist the review of cases and medical research. But Miller Weisbrod Olesky offers an unmatched number of nurses and nurse-attorney employees support to both the birth injury attorneys and our clients.

Our team of registered nursing staff and nurse-attorneys bring a deep level of medical and personal insight to every client’s case. Our nursing team includes both an experienced labor and delivery nurse as well as an ICU nurse. Working closely with the rest of the team, they investigate the reasons behind a birth injury and how medical professionals breached their standard of care.

Contact Our National Birth Injury Lawyers