Motor Profile of Children With Developmental Speech and Language Disorders
Chris Visscher, PhDa,b, Suzanne Houwen, MSca,b, Erik J.A. Scherder, PhDa, Ben Moolenaar, BEdc, Esther Hartman, PhDa
a Center for Human Movement Sciences
b University Center for Sport, Movement, and Health, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
c Hanze Institute for Sports Studies, Hanze University Groningen, Groningen, Netherlands
OBJECTIVES. The purpose of this study was to investigate the motor profile of 125 children with developmental speech and language disorders and to test for differences, if any, in motor profile among subgroups of children with developmental speech and language disorders.
METHODS. The participants were 125 children with developmental speech and language disorders aged 6 to 9 years from 2 special schools for children with communication problems in the northern Netherlands. They were tested with the Movement Assessment Battery for Children. The children were classified by the schools’ speech and language therapists into 3 subgroups on the basis of language tests, oral motor tests, and clinical examinations: children with speech disorders (n = 14), language disorders (n = 46), or both (n = 65).
RESULTS. Compared with the norms of the Movement Assessment Battery for Children, children with developmental speech and language disorders performed significantly less well. Results showed that 51% of the children with developmental speech and language disorders had borderline or definite motor problems. Children with language disorders had significantly lower scores (ie, better performance) on the ball-skills subtest and the total test than children with speech disorders and children with both speech and language disorders. Furthermore, children with language disorders had significantly better performance on the balance subtest than children with both speech and language disorders.
CONCLUSIONS. The findings of this study support the idea that developmental speech and language disorders are frequently associated with motor problems and that the kind of developmental speech and language disorders affects motor performance differently. Speech and language disorders seem to have more impact on motor performance than only language disorders, and it seems that when speech production is affected, motor problems are more pronounced. The findings support the need to give early and more attention to the motor skills of children with developmental speech and language disorders in the educational and home setting, with special attention to children whose speech is affected.
Key Words: motor development • language development disorders • children
Abbreviations: DSLD—developmental speech and language disorder • ABC—Assessment Battery for Children • DCD—developmental coordination disorder
Developmental speech and language disorders (DSLDs) are characterized by delays in speech and language development in the absence of mental or physical handicap, hearing loss, emotional disorder, or environmental deprivation. The clinical picture is quite varied; many children have speech as well as language disorders, others may have pure speech disorders or pure language disorders. The prevalence of DSLDs varies from 1.3% to 7.4%, depending on the definition used.
Although most attention has been paid to the communication profile of children with DSLDs, it has been shown that motor problems are not uncommon in this population. The co-occurrence of motor problems and DSLDs may be explained by both factors within the child, such as a genetic risk or neurologic deficits, and environmental factors, such as communication difficulties negatively influencing social acceptance and participation in play and sports activities.
The majority of studies concerning motor problems in children with DSLDs mainly focused on fine motor tasks.Studies indicate that these children are significantly slower than regular children on tasks that mainly challenge eye-hand coordination (ie, pegboard, threading beads, fastening buttons, and tapping). Of note is that motor problems seem to not be restricted to tasks involving time constraints. For gross motor skills, it has been observed that skills like stepping, running, stair climbing, muscle tone, standing on 1 leg, hopping on 1 leg, toe gait, heel gait, and skills that involve object control or locomotor activity of children with language problems were poor relative to regular children. Moreover, balancing on 1 leg proved to be 1 of the most discriminating measures between children with specific language impairment and regular children. In contrast, results of an early study found no difference between children with specific language impairment and regular children in duration of balance.
Quite clearly there is strong evidence of clinically significant overlap between DSLDs and motor problems; however, 2 things are of note. First, hardly any attention has been paid to ball skills of children with DSLDs, although these skills explicitly may challenge eye-hand coordination, depend on balance control, and importantly contribute to the child’s social interaction with peers. Because children with DSLDs may already have problems with social acceptance,because of their communication difficulties, inadequate ball skills may further restrict the child’s capacity to interact socially and physically with peers. Within this scope, it is noteworthy that recent epidemiologic studies emphasize the value of a social and physical active lifestyle, particularly when started early in life. One of the major effects of such a lifestyle is reducing the risk for cognitive impairment later in life.
Second, research examining the motor performance of subgroups of children with DSLDs is limited. Hill suggested that subgroups of children with DSLDs differ in their performance on fine motor tasks. Bishop addressed the issue of subtype-specific differences in relation to motor performance and found some interesting results. In 2 twin studies where 1 or both twins had speech/language impairment along with a control group of unaffected children, she found that children with combined speech and language impairments obtained poorer scores on a pegboard and tapping task than unaffected children. Furthermore, she concluded that the link between speech/language impairments and motor problems was stronger for speech than for language impairments. It is important to gain insight in the performance profile of subgroups of children with DSLDs, because this information may provide clues for effective intervention.
Specifically, this study had 2 aims. The first aim was to investigate the motor profile of children with DSLDs with respect to manual dexterity, ball skills, and balance. The second aim was to test for differences, if any, in motor profile among 3 subgroups of children with DSLDs: children with speech disorders, children with language disorders, and children with both speech and language disorders. References
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