Driving Forces: Mobility and Environmental Language in Children with Cerebral Palsy

Abstract

Independent mobility is an important milestone in early childhood that typically emerges alongside communication milestones. Early provision of powered mobility devices for children with physical disabilities has been documented to promote gains in cognitive, motor, and communication domains. Language Environmental Analysis (LENA) has not yet been validated for children with cerebral palsy with physical and/or communication impairments. This study sought to apply LENA to this population while participating in a mobility intervention using adapted ride-on cars. Methods: Audio recordings were independently transcribed and coded according to LENA definitions of adult word counts (AWC), conversational turns (CT), and child vocalizations (CV) for a subset of participants (n=6) in Communication Functioning Classification System (CFCS) levels I –IV. Accuracy was assessed with inter-rater reliability and Wilcoxon signed-ranks test. Intervention outcomes were assessed using a repeated measures ANOVA for all participants (n=12) across the duration of ride-on car use. Results: Hand codings and LENA codings achieved high agreement. No statistically significant differences were observed in AWC and CT counts across CFCS levels, and a minimal difference in CV counts was detected between CFCS levels. No significant differences were observed in intervention outcomes. Discussion: Results support feasibility of mobility intervention with LENA technology. Further validation of LENA for the CP population is needed. Clinical implications and future directions are discussed.