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Children with cerebral palsy face wide-ranging challenges, but a cerebral palsy diagnosis does not guarantee limitations. With the help of assistive technology, CP patients not only overcome movement problems, but they also confront speech and hearing difficulties.
Communication boards and hearing devices, for example, give children the tools they need to express their needs, interact with others and engage in routine daily activities.
Alternative and augmentative communication (AAC) technology has direct benefits for children with CP, helping them overcome challenges and successfully interact in diverse social settings.
Special equipment and adaptive devices are frequently used to enhance mobility, but technology also plays a vital role assisting CP patients facing communication, hearing and vision impairment.
Speech and communication difficulties are common among cerebral palsy patients. When muscle groups in the face, mouth, neck and throat are affected by the disorder, forming words and sentences can be challenging. Children with CP may also experience hearing problems and other issues interfering with communication.
When CP impairment impacts communication, speech pathologists and other specialists utilize assistive and adaptive technology to facilitate development and inspire confidence. Communication devices are particularly useful outside the doctor’s office, where they empower patients to ask questions, participate socially and form personal relationships.
Communication boards are an effective tool for developing language skills. The time-tested devices depict images, words and phrases, which children identify and use to express themselves. To show emotions and share thoughts, cerebral palsy patients simply touch or point to the images, effectively bridging the communication gap between educators, patients, parents and peers.
Once fully manual, the assistive aids were limited by the number of pictures on each board. Technology has changed the way communication boards are used, making the devices more portable and expanding their effectiveness. Modern, electronic versions are capable of displaying countless image variations, on small, lightweight screens.
In practice, a child’s communication board can be customized to reflect daily life. Each electronic board is assigned categories, which a child uses to identify and select familiar concepts and words like “home” and “school”. Much like choosing from a computer menu, the user then selects particulars, such as family, friends and food, to communicate about these subjects.
Each of these subcategories, in turn, is broken-down further, pointing to individual meals and foods, for example. At school, board images can be tailored for classroom subjects, preparing children to participate and ask questions.
Assistive devices turn abilities into advantages, so CP patients with movement problems can use their eyes to communicate. When the disorder makes it hard to move and manipulate arms, wrists, hands and fingers, cerebral palsy patients use their gaze, rather than gestures, to communicate and control computer functions.
Eye tracking technology follows a user’s gaze on his or her computer screen, enabling the patient to select, scroll, zoom and perform other mouse functions, using only visual cues. Communication boards equipped with eye tracking technology require users to briefly focus their gaze on particular images, selecting them to communicate words and sentences. In combination with other programs, eye tracking can be used for dictation, phones calls, text and email, social media and playing games.
Eye tracking and voice generating devices improve quality of life for some, so the technology is used alongside speech therapy to boost communication and understanding. Positioning and other physical concerns, as well as cognitive and visual abilities are important considerations, when evaluating eye tracking candidates.
Tracking equipment is expensive and subject to some environmental limitations. Sunlight and personal visual variations, for example, can interfere with performance. Eye tracking software and hardware malfunctions leave users without reliable access to their computers, so back-ups are suggested for those dependent on the technology.
It is thought 10-20% of children affected by cerebral palsy experience some level of hearing loss or limitation. Partial loss is common, ranging from widespread to slight. Hearing difficulties may be present, if a child with cerebral palsy:
Hearing loss slows personal development, particularly occurring alongside other symptoms associated with cerebral palsy. The complication also stands between patients, peers and caregivers, limiting a patient’s ability to interact with others. Hearing aids are effective solutions, in some cases, as well as other devices used to assist hearing and communication.
Deafness is a permanent condition, so it cannot be corrected with therapy. A game-changing assistive hearing device, cochlear implant, can restore sound for some CP patients, using a complex array of mics, speech processors and transmitters to stimulate the auditory nerve and help users hear sounds.
Depending upon the nature and scope of deafness, cochlear implants may enable users to hear loud sounds or to perceive speech at conversational volume. Each case is unique, so specialists consider the risks and benefits for each patient, before recommending the procedure.
Cochlear implants are two-piece devices. One part is surgically implanted under the skin and the other piece of the device sits behind the ear. It is not a hearing aid, which only amplifies input, but an assistive tool capable of sorting out sounds for the user.
Typically recommended for cerebral palsy patients with moderate to complete hearing loss, cochlear implants bypass damaged parts of the auditory system, stimulating sounds. Surgery for cochlear implants takes about two hours, under general anesthetic. Although a child may be ready to return home one day after cochlear implant surgery, recovery time is 3-6 weeks, before the patient is fitted for the second piece of the device.
How Does a Cochlear Implant Work?
Cochlear implants “organize” sounds, using pitch, frequency, volume and other inputs to filter and extract what is heard by the user. The sounds heard by the patient may be different than traditional sounds processed by the brain. Hearing improvement depends upon a number of factors, which must be considered before moving ahead with the procedure:
More than 70,000 patients in the U.S. have received cochlear implants – more than 200,000 worldwide. Most have a single implant, but double implants are becoming more common as the benefits become clear. There are some limitations associated with cochlear implant surgery:
Manipulating eating utensils, pens and pencils, and other small objects can be difficult for cerebral palsy patients commonly struggling with fine motor control. Adaptive equipment rethinks writing tools and utensils, modifying traditional designs for greater ease of use.
Writing and typing aids reinforce independence, giving children the tools they need to communicate and excel at school.
Pen and pencil grips – These add-ons make pens and pencils easier to hold, creating surfaces for CP patients to grab and grip. The devices can be customized to the size and shape most beneficial for each user.
Weighted pen or pencil – Transferrable weights can be used with regular pens and pencils, adding heft and leverage.
Slanted writing board – Positioning is an important aspect of cerebral palsy management. Slanted writing boards keep muscles relaxed and aligned as children write and draw.
Typing aids help with communication and performance with keyboard functions. The assistive tool is strapped to the user’s hand, extending a “pointer”, which can be manipulated to press keyboard keys and use communication boards. Special keyless keyboards are also being refined for use by those with motor difficulties.
Cerebral palsy patients face challenges completing everyday tasks. From dressing and eating to personal care, daily activities can pose difficulties. Various adaptive devices make routine tasks easier, empowering CP patients to enjoy independent lives. Assistive devices and equipment contribute in diverse settings:
Assistive and adaptive technologies are used together with a full range of treatment and therapy solutions. The specialized equipment is helpful for some individuals with CP, ranging from mobility aids to adaptive learning tools and everyday items, modified for ease of use. Assistive devices enabling communication are particularly valuable, boosting social confidence and reinforcing educational goals.
When a team of medical specialists recommends augmentative and adaptive devices, outside help is available for those needing equipment. Online listings maintained by advocacy and support organizations help connect patients in need with available equipment. Local chapters of national cerebral palsy organizations may also administer programs, as well as churches and educators committed to improving CP outcomes.