Provision of speech therapy assistance and organization of education for children with obstetric palsy and arthrogryposis multiplex congenita with impaired upper limb function

Abstract

BACKGROUND: The pathology of upper limb deformities often leads not only to impaired self-ability but may be one of the factors that lead to the development of specific difficulties in a child at various stages of learning. Deficiency of visual-motor integration and/or its subcomponents (visual perception and motor coordination) are the risk factors for academic failure. Children aged <3 years with arthrogryposis multiplex congenita and obstetric palsy are have delayed speech development and behavioral disorders, which require correction, including speech therapy at an early age.

AIM: To examine the features of the organization of correctional and developmental education of children with arthrogryposis multiplex congenita and obstetric palsy, depending on their speech development and motor disorders, and assess the features of speech development of children with obstetric palsy.

MATERIAL AND METHODS: From 2020 to 2022, we examined 46 children aged 6–15 (average age, 9.57 ± 2.91) years with upper limb deformities caused by arthrogryposis multiplex congenita and obstetric palsy. Speech therapy and orthopedic and statistical methods were used.

RESULTS: The study included 25 children (54.3%) with arthrogryposis multiplex congenita and 21 (45.7%) with obstetric palsy. In addition, 5.09 ± 4.34 procedures were performed for the correction of orthopedic pathology. Most of the patients had mild (n = 17, 36.9%) and moderate (n = 20, 43.5%) functional disorders of the upper extremities, and 30 (65.2%) had problems with hand function. Moreover, 11 (23.9%) children had delayed speech development at an early age. Speech pathology was detected in 41 (89.1%) children (general speech underdevelopment, n = 20, 43.9%; lexical-grammatical underdevelopment, n = 12, 26.1%; and phonetic-phonemic underdevelopment, n = 9, 19.8%. Dysarthria was the main speech pathology in 25 patients of different age groups (54.3%). Moreover, 18 (52.9%) schoolchildren had impaired writing ability. The speech pathology in patients with arthrogryposis multiplex congenita and obstetric palsy were the same. These groups differed from each other by the form of learning (p < 0.05).

CONCLUSIONS: Children and adolescents with arthrogryposis multiplex congenita and obstetric palsy have special educational needs and often need speech therapy assistance taking into account the specific orthopedic pathology.

Keywords

arthrogryposis multiplex congenita / obstetric palsy / children / speech and motor disorders / upper limbs / education

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Funding

ФБГУ «НМИЦ детской травматологии и ортопедии имени Г.И. Турнера» Минздрава России(№ 20-65-47016)