Analysis and enhancement of communication behaviour in children with cerebral palsy

The research reported in this thesis examined the idiosyncratic and subtle behaviours of children with cerebral palsy by combining the theoretical areas of prelinguistic communication and functional behaviour. It examined how mothers interpret the behaviour of their children as communicative and how this information may be used to enhance the child's communication skills.

The research consisted of three studies. Study One used an interview protocol known as the Inventory of Potential Communicative Acts (IPCA) to assess the communicative potential of the behaviours used by 6 children with cerebral palsy aged 18 months to 36 months. The findings suggested that the mothers interpreted many of the subtle and idiosyncratic behaviours exhibited by these children as forms of communication.

In Study Two, specific structured situations were designed to verify the information given by mothers on the IPCA. Findings from this study suggested that some of the behaviours reported by mothers on the IPCA could be reliably verified as forms of communication through these structured situations. After the children's current communicative behaviours were verified, desired replacement communicative behaviours were determined for each child involved in the study.

This information was then used in Study Three, which described an intervention to replace and enhance the child's prelinguistic forms with more conventional and symbolic behaviours that served the same communicative function. Results from the intervention demonstrated that as children acquired the replacement form, and the frequency of the prelinguistic form decreased. Overall, the results from these three studies raise important issues about the similarities and differences in the conceptual and practical links between prelinguistic communication and functional behaviour. It provided a model of decision making in relation to choice of intervention and in particular, the way in which existing communicative forms may be identified and treated within an intervention. This thesis has also highlighted the need to refine the techniques used in the current research to enable children with cerebral palsy access to more effective communication interventions.