# Differential Diagnosis of Functional Speech Deficits in Children with Cerebral Palsy

> **NIH NIH R01** · UNIVERSITY OF WISCONSIN-MADISON · 2020 · $473,130

## Abstract

Speech is the primary means through which most people express themselves. However, speech must be
sufficiently intelligible to enable successful communication. The estimated 2.5 per 1000 children who have
cerebral palsy (CP) are at significant risk for communication disorders. Different speech, language, and
communication disorder profiles have been documented in children with CP. However, a common theme
across profiles is reduced speech intelligibility relative to typical age expectations. For about half of children
with CP, intelligibility deficits can be clearly associated with clinical manifestation of the speech motor disorder
dysarthria. Recent work from our laboratory also indicates that many additional children with CP may have
sub-clinical speech motor deficits resulting in subtle intelligibility reductions. Reduced intelligibility has
significant negative consequences for functional communication, social participation, and quality of life.
Enhancing intelligibility is a primary goal of intervention. One critical challenge in children with CP is early
diagnosis of speech disorders. A key problem is differentiating those with borderline or mild speech motor
deficits from those who are within an age appropriate range of variability. A significant barrier is that systematic
age-based performance standards establishing benchmarks and cut-points for typical versus atypical
development on variables that reflect functional speech motor performance and are valued outcome measures
in dysarthria do not exist. Thus, empirical differentiation of typical from atypical speech motor ability is
extremely difficult, especially for children with more subtle deficits (i.e. those with mild dysarthria and those with
CP who may have sub-clinical speech motor issues). As a result many children with CP may miss an important
window of opportunity for intervention. This research will address the problem of early diagnosis of speech
motor disorders in children with CP by 1.) creating growth curves based on empirical data that establish age-
specific expectations and quantify the range of typical variability for children between the ages of 3-7 years on
measures of functional speech capacity (intelligibility, speech rate, intelligible words per minute) that are known
to be problematic in dysarthria but that have never been comprehensively quantified from a developmental
perspective in typical children. 2.) establishing standards (via directly measured and statistically validated age-based cut-points) for the identification of typical and atypical functional speech performance. Results will
enable early empirical identification of speech motor deficits in children who are at-risk based on their CP
diagnosis. The ability to confirm speech motor deficits in the early years and to differentiate the mildest cases
from typical developmental variability will ensure that children are identified for treatment, capitalizing on the
benefits of neuroplasticity and growth. Furt...

## Key facts

- **NIH application ID:** 9966943
- **Project number:** 5R01DC015653-05
- **Recipient organization:** UNIVERSITY OF WISCONSIN-MADISON
- **Principal Investigator:** Katherine C Hustad
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $473,130
- **Award type:** 5
- **Project period:** 2016-07-08 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9966943

## Citation

> US National Institutes of Health, RePORTER application 9966943, Differential Diagnosis of Functional Speech Deficits in Children with Cerebral Palsy (5R01DC015653-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9966943. Licensed CC0.

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