Measuring language comprehension and learning in children with severe cerebral palsy with eye gaze approaches

University Of Wisconsin-Madison, Madison WI

Investigators

Abstract

Project Summary More than half of all children with cerebral palsy (CP) have communication challenges. A subset has impairments that are so severe that they lack functional speech. Many also have intellectual disability. Children with CP and severe speech impairment often have severe gross and fine motor limitations that restrict limb use. Augmentative and alternative communication (AAC) systems, particularly voice output devices that can be accessed with eye gaze, can provide crucial access to language for many children. However, our ability to match language features of AAC systems with language ability profiles of individual children is severely hindered by a lack of tools to accurately assess latent receptive language abilities in children with severe speech and motor impairment. AAC technologies currently require sustained eye-gaze for a specified dwell-time to activate word choices, which can be extremely challenging for children in this population. Innovations in other areas of language development research have led to the widespread use of eye-gaze techniques to measure receptive language and learning in other difficult-to-test populations, including infants and autistic toddlers. However, these techniques have yet to be leveraged to assess receptive language and learning ability in children with CP and severe speech and motor impairment. Data illuminating children's receptive vocabularies and their ability to learn new words would provide critical information for identification of an appropriate place to start when matching language features of AAC systems to underlying language abilities. Our long-term goal is to develop tools to better characterize receptive language and learning potential in children with CP and severe speech and motor impairments that can be used to match latent child language skills with language features of AAC systems. The objective of the proposed research is to begin this process by developing and testing eye gaze paradigms for use with children who have CP and severe speech and motor impairment. The planned studies will allow us to determine whether these methods provide more detailed and sensitive information than the usual behavioral tests. Aims are: 1.) To characterize lexical processing in children with CP and severe speech impairment using eye-gaze measures; 2.) To investigate novel word learning in children with CP and severe speech impairment using eye-gaze measures; and 3.) To characterize the relationships between familiar word processing (Aim 1), novel word learning (Aim 2), and traditional behavioral assessments of child language and cognitive attainment. This work will advance the development of tools for measuring latent language and cognitive skills in children with CP and severe speech and motor impairment. The ability to capture underlying skills at earlier chronological or developmental ages represents a critical advance in the current state of clinical assessment. Results will lead to a more accurate understanding of language development in children with CP and severe speech impairment, to the development of more precise AAC interventions, and to theoretical insights about the relationship between language production and comprehension in children who cannot talk.