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

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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.

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About the authors

Olga E. Agranovich

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: olga_agranovich@yahoo.com
ORCID iD: 0000-0002-6655-4108
SPIN-code: 4393-3694
Scopus Author ID: 56913386600
ResearcherId: B-3334-2019
http://www.rosturner.ru/kl10.htm

MD, PhD, Dr. Sci. (Med.)

Russian Federation, Saint Petersburg

Zoya E. Agranovich

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery; Center for Restorative Treatment “Child Psychiatry” named after S.S. Mnukhin

Email: barsik1966@mail.ru
ORCID iD: 0000-0003-1622-7114
Russian Federation, Saint Petersburg; Saint Petersburg

Evgenia I. Ermolovich

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery; “XXI century”

Email: dr.lazareva@bk.ru
ORCID iD: 0000-0001-6716-1034
SPIN-code: 6598-5653

MD, neurologist

Russian Federation, Saint Petersburg; Saint Petersburg

Ekaterina V. Petrova

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: pet_kitten@mail.ru
ORCID iD: 0000-0002-1596-3358
SPIN-code: 2492-1260
Scopus Author ID: 57194563255

MD, PhD, Cand. Sci. (Med.)

Russian Federation, Saint Petersburg

Anna N. Shestakova

National Research University “Higher School of Economics”

Email: a.shestakova@hse.ru
ORCID iD: 0000-0001-9374-9878
SPIN-code: 6010-6538
Scopus Author ID: 6701794973
ResearcherId: H-3329-2013
Russian Federation, Moscow

Evgeny D. Blagovechtchenski

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery; National Research University “Higher School of Economics”

Author for correspondence.
Email: eblagovechensky@hse.ru
ORCID iD: 0000-0002-0955-6633
SPIN-code: 2811-5723
Scopus Author ID: 6506349269
ResearcherId: B-5037-2014

PhD, Cand. Sci. (Biol.)

Russian Federation, Saint Petersburg; Moscow

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Supplementary files

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2. Fig. 1. Box plots for “hand dysfunction” according to the diagnosis. AMC, arthrogryposis multiplex congenita; OP, obstetric palsy

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3. Fig. 2. Box plots for “functional disorders” according to the diagnosis. AMC, arthrogryposis multiplex congenita; OP, obstetric palsy

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4. Fig. 3. Box plots for “number of surgeries” according to the diagnosis. AMC, arthrogryposis multiplex congenita; OP, obstetric palsy

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5. Fig. 4. Speech disorders in patients of different age groups. GUS, general underdevelopment of speech; LGUS, lexical and grammatical underdevelopment of speech; PPU, phonetic–phonemic underdevelopment

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