The project is being implemented with the support of UNICEF Ukraine and with financial support from the Government of Norway.
Implemented by: Partner:
Area Clinica di Neuroscienze
Neuroriabilitazione Santa Marinella
Luigi Marotta
luigi.marotta@opbg.net
Topic 1 (30 minutes)
Verbal and non-verbal communication. Language and communication deficits after other injuries.
Topic 2 (30 minutes)
Evaluation procedures and assestment tools. Receptive abilities.
Topic 3 (30 minutes)
Evaluation procedures and assestment tools. Expressive abilities.
Topic 4 (30 minutes)
Guidelines and care needs. Augmentative Alternative Communication strategies.
Topic 1 (30 minutes)
Verbal and non-verbal communication. Language and communication deficits after other injuries.
Topic 2 (30 minutes)
Evaluation procedures and assestment tools. Receptive abilities.
Topic 3 (30 minutes)
Evaluation procedures and assestment tools. Expressive abilities.
Topic 4 (30 minutes)
Guidelines and care needs. Augmentative Alternative Communication strategies.
This unit aims to equip speech therapists, as well as other therapists and caregivers, working with children with severe acquired brain injuries….
Introduction ...or spinal cord injuries and other conditions affecting language and communication skills, with the necessary knowledge and practical skills.
These disabilities have a strong impact during early care and reintegration into daily activities.
Our focus will therefore be on re-establishing sufficient communication skills in young patients from the time of initial admission.
https://www.investoinfo.com/ blog/what-is-communication/
IC consists of the set of phenomena that convey the exchange of information between two or more persons, whether through verbal language or body language
in the absence of cognitive, sensory, motor, affective problems and major socio-environmental problems.
In the presence of congenital and/or acquired brain damage, genetic syndromes or other pathologies
Communication disorders represent the most frequent developmental disorders between 2 and 6 years of age. They represent a set of syndromic pictures characterised by different quality and severity difficulties in the comprehension, production and use of language.
Language disorder
Phonetic-phonological disorder
Fluency disorder with onset in childhood
Social Communication Disorder
Communication Disorder without Specification
1. Language disorder (expressive, receptive and mixed) is part of the neurodevelopmental disorders and is characterised by a delay in one or more areas of language development
This in the absence of cognitive, sensory, motor, affective problems and socio-environmental problems.
Phonetic-phonological disorder (speech and sound disorders)
They specifically describe difficulties in phono-articulatory and phonological organisational levels.
They functionally include disorders that fall under the definition of Childhood Apraxia of Speech (CAS).
Fluency
onset in childhood is commonly known as stuttering, is a speech disorder that disrupts the smooth flow of speech. It's characterized by repetitions, prolongations, or blocks of sounds, syllables, or words, and can cause anxiety and impact social interactions and academic performance.
is a neurodevelopmental condition characterized by persistent difficulties with using verbal and nonverbal communication for social purposes.
Individuals with SCD struggle to adapt their communication to different social situations, understand social cues, and engage in reciprocal social interactions.
SCD is distinct from Autism Spectrum Disorder (ASD) though some symptoms can overlap.
The key differentiator is the presence of restricted, repetitive patterns of behavior, interests, or activities (RRBs). If these RRBs are present, the diagnosis leans towards ASD; if absent, SCD is considered.
This category is used when there's a communication impairment causing significant distress or impairment in social, occupational, or other areas of functioning, but the specific type or cause isn't clear or can't be determined.
Traumatic Brain Injury (TBI) in children leads to complex, evolving conditions.
Rehabilitation is crucial after acute medical care.
Goal: Restore function and improve quality of life.
While acute care focuses on medical needs, rehabilitation becomes paramount afterward.
Neuropsychological and linguistic-communicative deficits are assessed using clinical observation and standardized tests that allow for age-based comparison, correlation with brain areas, and verification of processing strategies.
Multidisciplinary Evaluation
: Complete clinical balance of patient deficits.
Outlines primary rehabilitation objectives. Followed by detailed rehabilitation programs for each treatment area.
Brief, repeated Sessions throughout the day are more effective.
Avoid standardized 60-minute sessions.
Patient Capacity:
Short attention spans. Process limited information simultaneously.
Extraverbal Communication Training (AAC; for anarthric patients).
Reading, Writing, and Independent Communication
Methodology: Clinical Observation.
Standardized Tests:
Allow performance comparison across different ages.
Verify processing strategies.
Integration:
Combine test results with informal assessments (interviews with family, teachers, therapists).
1. Identify Cognitive-Linguistic Profile: Strengths and weaknesses (for training and compensation).
2. Impact on Daily Activities: Determine which areas most interfere with daily life.
3. Define & Monitor Goals: Set cognitive rehabilitation goals and update based on progress.
4. Baseline & Progress: Obtain baseline indicators and measure improvements.
5. Treatment Efficacy: Demonstrate which treatments promote cognitive-linguistic improvement.
6. Personalized Learning: Identify personal thinking/learning style for customized training.
Environmental
Identify variables impacting adaptive cognitive function and learning.
Definition: Speech articulation disorders due to neurological lesions.
Types: Flaccid, spastic, ataxic, hypotonic/hyperkinetic (depending on lesion site).
• Acquired Stuttering: Possible after TBI (brainstem/basal ganglia damage).
• Common Presentation: Dysphonia often associated with mixed dysarthria after severe TBI.
• Rehabilitation: Challenging; simultaneous treatment of dysphonia and dysarthria.
Speech therapy for articulation often shows unsatisfactory results.
Definition: Impaired language performance (requires baseline development, usually >2 years old).
Leading Cause: TBI is now the primary cause of aphasia in children.
Types: Children can exhibit all adult forms (e.g., Wernicke's, Broca's, anomic, conduction, transcortical).
Recovery vs. Persistence: While recovery is often high, persistent (even subclinical) language disorders are common after severe TBI.
Long-Term Impact: Significantly influence academic performance and overall prognosis.
Learning Disabilities: Can lead to marked learning disabilities, reading, and writing disorders.
Monitoring: Systematic, long-term monitoring is crucial for early detection and intervention.
Recovery Expectation: Complete recovery from aphasic syndrome is rarely achieved.
Definition: Difficulties with social use of language.
Understanding/developing conversation topics.
Interpreting stories, metaphors, humor.
Understanding/producing gestures and facial expressions.
Prosodic difficulties.
Social Interaction: Significant difficulties in turn-taking and inhibiting inappropriate behaviors/thoughts.
Child vs. Adult Impact: More profound impact on children, affecting social interaction during personality development.
Rehabilitation Focus: Essential to include pragmatic aspects of communication in treatment.
Systematic Evaluation: Crucial for diagnosis, prognosis, and appropriate rehabilitation of language and verbal communication disorders after severe TBI.
Ongoing Monitoring: Most children do not achieve full linguistic development, so neuro-linguistic skills need continuous monitoring.
Castelli, E., Marotta, L., Gazzellini, S., & Tarter, G. (2020). Manuale di logopedia in et‡ evolutiva. Erikson Ed.
McCabe, P., Beiting, M., Hitchcock, E. R., Maas, E., Meredith, A., Morgan, A. T., ... & Grigos, M. I. (2024). Research Priorities for Childhood Apraxia of Speech: A Long View. Journal of speech, language, and hearing research, 67(9S), 3255-3268.
Novak, I. (2014). Evidence-based diagnosis, health care, and rehabilitation for children with cerebral palsy. Journal of child neurology, 29(8), 1141-1156.
On, Z. X., Ryan, N. P., Konjarski, M., Catroppa, C., & Stargatt, R. (2022). Social cognition in paediatric traumatic brain injury: A systematic review and meta-analysis. Neuropsychology review, 1-22.
Il presente documento Ë stato elaborato in n.xx slide da Ospedale Pediatrico Bambino Ges˘ il xxxxxx.
I contenuti sono strettamente riservati; Ë vietata la riproduzione e la divulgazione, anche solo parziale, senza il benestare scritto di Ospedale Pediatrico Bambino Ges˘.