Longitudinal development of communication in children with cerebral palsy between 24 and 53 months: Predicting speech outcomes.

OBJECTIVE To determine whether communication at 2 years predicted communication at 4 years in children with cerebral palsy (CP); and whether the age a child first produces words imitatively predicts change in speech production. METHOD 30 children (15 males) with CP participated and were seen 5 times at 6-month intervals between 24 and 53 months (mean age at time 1 = 26.9 months (SD 1.9)). Variables were communication classification at 24 and 53 months, age that children were first able to produce words imitatively, single-word intelligibility, and longest utterance produced. RESULTS Communication at 24 months was highly predictive of abilities at 53 months. Speaking earlier led to faster gains in intelligibility and length of utterance and better outcomes at 53 months than speaking later. CONCLUSION Inability to speak at 24 months indicates greater speech and language difficulty at 53 months and a strong need for early communication intervention.