Effects of Augmentative and Alternative Communication in Children With Cerebral Palsy Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Paralysis; Cerebral Palsy
Study type: Interventional

Summary: 
      Cerebral Palsy is a neuromuscular disorder that causes multiple disabilities in an
      individual.

      Children's ability to rely on speech as a primary mode of communication can be compromised by
      cerebral palsy. Children with communication difficulties face many barriers to participating
      in everyday life and have a heightened risk of social isolation and mental health problems.

      So, augmentative, and alternative communication (AAC) strategies and tools are helpful for
      children with CP. AAC is classified into manual signs and symbols, and low, mid, and high-
      tech communication aids form part of a total communication approach whereby all potential
      modalities of communication are explored and supported. The World Health Organization
      International Classification of Function, Disability, and Health for Children and Youth is
      increasingly being used to support decision-making. The study will be carried out at Rising
      Sun Institute for Special Children. The study design for this study is Randomized Control
      Trials. The convenience Sampling Technique will be used to collect data and 16 children with
      cerebral palsy will be included in this study. Both males and females with the age range of
      3-15 years will be included in this study. The children will be randomly assigned into
      groups, group A will be allocated 8 children as the control group, and in group B, 8 as the
      treatment/ interventional group. Dysarthric Profile will be used for assessment purposes and
      aided Augmentative and Alternative communication system for the intervention. The
      pre-assessment of the child's Early Functional development will be done. Then, the low- tech
      (PECS) will be used for 6 weeks for the intervention. We will take 3 sessions per week for 40
      minutes for the treatment group while the control group will remain the same. After the end
      of 6 weeks, the post-assessment of the child's Early Functional development will also be
      done. This indicates the effectiveness of AAC devices in the communication of children with
      Cerebral Palsy. The use of AAC methods could help to reduce aggressiveness among children
      with cerebral palsy. Moreover, AAC-based information and tools enable them to create
      environments that will support or enhance the ability of people with complex communication
      needs to interact with family members, peers, teachers, and others.
    

Detailed description: 
      Communication abilities are basic developmental skills within the adaptive development of a
      person, particularly during childhood. Therefore, children and teenagers with receptive and
      expressive communication impairment face challenges over numerous life spans. Several kinds
      of literature have detailed that they appear to have higher rates of psychosocial
      disabilities, lower scholarly performance, more peer rejection, and troubles in their social
      intelligence, compared to normal developing peers. Roughly 8% of children between the ages of
      3 and 17 a long time within the United States face language and communication problems, and
      thus may need extra support for normal communication skills. (1) Individual with complex
      communication needs is likely to come from several different conditions (e.g., cerebral
      palsy).

      Even though some individuals with these challenges will be effectively supported by
      assistance from other people, such as teachers, caregivers, community workers, and family
      friends, there will be some who are underserved due to the lack of rehabilitation specialists
      in low-income countries. (2) Cerebral Palsy has a neurogenic origin leading to physical
      impairment in children or may be caused by maternal (perinatal, natal, and postnatal
      injuries). The common types of cerebral palsy are spastic, flaccid, ataxic, or mixed types,
      determined by the site of the lesion in the brain. It adversely affects gross and fine motor
      development, receptive-expressive language skills, speech (articulation), voice (intensity,
      pitch, and quality), and fluency, depending on etiology. (3) The prevalence of CP in the
      United States ranges from 3-4 per 1000 live births.

      Within the 2009-16 period, the prevalence of CP in children matured 3-17 a long time was 3.2
      per 1000. The prevalence of low birth weight (LBW) and preterm in live births are altogether
      higher (40-100/1000). According to a study in Swabi, Pakistan, the prevalence of CP is 1.22
      per 1000 live births. However, country-wide statistics are not found but 6.9% incidence of CP
      children admission in a Lahore hospital out of the 6.7% pediatric neurological admissions.

      Research suggests evidence of the impact of the use of AAC-implemented intervention on 9
      children in rural Kenya who have complex communication needs. The intervention used mainly
      low- tech materials that were specifically designed to strengthen the child's communication
      while remembering the caregiver's natural expertise. A pretest-posttest design was used in
      this study. Data were gathered using an adapted version of the Communication Profile, which
      was based on the International Classification of Functioning, Disability, and Health (ICF)
      framework. Qualitative analysis was conducted in the final section of the study. The data
      provided evidence of statistically significant positive changes in the communication of
      children with cerebral palsy at the levels of Body Structure Function and Activities. Also,
      the analysis revealed the positive perception of parents regarding AAC. (2) OBJECTIVE

      To investigate the effects of Augmentative and Alternative Communication in Children with
      Cerebral Palsy. HYPOTHESES NULL HYPOTHESIS Ho= Augmentative and alternative communication is
      not an effective intervention for children with cerebral palsy.

      ALTERNATE HYPOTHESIS H A =Augmentative and alternative communication is an effective
      intervention for children with cerebral palsy. STUDY DESIGN Randomized Control trials

      SETTING Rising Sun Institute for Special Children

      DURATION OF THE STUDY 6 months after the approval of the synopsis

      SAMPLE SIZE This sample is 16 according to the literature review. STUDY GROUPS Group A:
      Treatment Group will consist of 8 children with cerebral palsy. Group B: Control Group will
      consist of 8 children with cerebral palsy.

      SAMPLING TECHNIQUE Simple Random Sampling Technique

      DATA COLLECTION TOOL Dysarthric Profile will be used for assessment purposes and a low-tech
      Picture Exchange Communication System (PECS) for the intervention.

      DATA COLLECTION PROCEDURE:

      According to the inclusion criteria, 16 children will be recruited. The children will be
      assigned into groups. The randomly selected groups will be allocated 8 children as the
      control group and 8 as the treatment/ interventional group. A pre-assessment of the child's
      Early Functional development will be done. After that, the low-tech intervention will be
      applied for 6 weeks (3 sessions per week for 40 minutes) to the treatment group while the
      control group will remain the same. After the end of 6 weeks, the post-assessment of the
      child's Early Functional development will be done. This indicates the effectiveness of AAC in
      the communication of children with Cerebral Palsy.
    

Intervention name(s): Augmentative Alternative Communication; Augmentative Alternative Communication Device
Intervention type(s): Behavioral; Other
Intervention description(s): Traditional Method; Augmentative Alternative Communication Device 3 session for 40 minutes
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: Cerebral Palsy; Augmentative and Alternative Communication Devices; Speech and Language Therapy; Assisted Communication