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Students with neurological problems may need special education services, adaptation of physical facilities, knowledge of special equipment, use of technology, and modification of curricular activities. Conditions such as TBI, cerebral palsy, and the like, have neurological foundations that impact the students’ speech-language skills, and ultimately, academic performance. Communication deficits may be part of another condition in which the student has motor impairments, perceptual difficulties, cognitive deficits, behavioral problems, etc. Problems may be subtle or highly noticeable.

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CP – a disorder of voluntary movement and posture. No clear relationship (if any) between the degree of motor impairment and degree of intellectual impairment

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Cerebral palsy is often associated with other disabilities. It is not unusual to find children with cerebral palsy who also have hearing or vision problems or who have intellectual impairments. We know that all these conditions can adversely affect language.

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Children with cerebral palsy are at significant risk for speech and language difficulties. The speech difficulties of children with cerebral palsy are extremely heterogeneous and depend, to a great extent, on the specific nature of the physical disability. Individuals with cerebral palsy may have speech production difficulties in one or several areas, including respiration (e.g., rapid, shallow breathing), phonation (inadequate airflow), resonation (hypernasality), and articulation. Articulation is often affected because of difficulty controlling the tongue, lips, or mouth.

Differences in early development may have an impact on language. Studies of the interactions between children with cerebral palsy and their parents has shown a pattern of conversational dominance by parents and child passivity. Typically, parents have been reported to initiate most conversational exchanges, introduce topics, ask many closed questions, and issue many commands. Children tend to reply with limited information and fail to take a similar number of turns, to initiate an equal number of exchanges, or to use a full range of pragmatic functions. Children with cerebral palsy who have better speech intelligibility have been found to initiate more conversations and to use their communication for a wider range of functions compared with nonspeaking children.

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