Cerebral palsy and communication

Cerebral palsy (CP) is not a specific medical condition, it is a general term that describes a disorder of movement caused by damage to the brain.  Every person with cerebral palsy is different in their abilities and needs. If a person has severe physical and mobility difficulties, so much attention may get paid to transport, wheelchair access and suchlike that communication issues may be overlooked.

Communication difficulties are very common in people with CP (though not everyone experiences these) and they can range from mild to very severe. Cerebral palsy mainly affects the person’s ability to physically speak. People with cerebral palsy usually understand other people’s language better than they themselves can speak. Their own speech may be very slow and laboured, or be very slurred and hard to understand, which may make others underestimate their abilities. Speech may be so severely affected that they have to use some form of Augmentative and Alternative Communication (see below) to replace or supplement oral speech.

People with cerebral palsy may have poor head control or may not turn their heads easily. Some may also have difficulties with vision, visual perception and/or hearing. Any of these could affect a person’s ability to follow what’s being said in a group situation. They may not be able to handle materials or turn pages without help.

Other difficulties might include:

• Unable to use a pen to take notes, so may need notes provided and/or someone to scribe for them
• Difficulties with literacy, so print material is not accessible without help
• Lack of control of facial expressions (or lack of facial expressions) due to neuromuscular causes, may give a misleading impression or make the person’s mood difficult to ‘read’
• Easily distracted, so need information in quite shortish ‘chunks’
• Easily fatigued

Audio quote: Barry

Audio quote: Nigel

Augmentative and Alternative Communication (AAC)

People with cerebral palsy who cannot make themselves understood through oral speech will often use some form of augmentative communication, such as pointing to a letter or word board, to spell out their message.  They may point to pictures or symbols to transmit ideas. They may use a portable voice output communication aid or computer to ‘speak’ for them.

Augmentative and alternative communication (AAC): Practical advice

 AAC: further information 

Key actions

To enable a person with cerebral palsy to engage more fully, make sure they have: 

• meetings in a place that is fully accessible and spacious enough to accommodate wheelchairs, with disabled parking spaces.
• reasonably short meetings.
• assistance if they need it – for example, an individual may choose to be accompanied by a familiar person who can understand their speech or sign or symbol board, and  act as an ‘interpreter’ if necessary.
• if requested, an adjustable height table for communication equipment to rest on, nearby power point (or extension lead) to plug in equipment with weak batteries
• plenty of advance notice of the topic(s) under discussion and any key vocabulary that will be involved. 
• lots of time both to prepare and to deliver their responses
• any presentations or materials in text backed up with spoken output (computer speech or presenter reads out what is written on the screen) and picture /symbol support
• materials sent in electronic format, so they can be accessed via their own computer with switches if necessary, to read back text in synthetic speech.

 Cerebral palsy: further information 

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