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Cerebral palsy: improving the assessment of language understanding so children can receive the support they need

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Cerebral palsy is the most common serious physical disability in children, affecting around 2,000 babies born in the UK each year.[1-2] Children with cerebral palsy may experience lifelong difficulties with movement and coordination and can face a lifetime of challenges. Dr Lindsay Pennington of Newcastle University is creating a UK version of a new computerised assessment tool designed to assess how well children with severe problems with their movement and communication understand spoken language. The system will provide speech and language therapists with vital information that will enable accurate, individualised therapy and education – helping each child to achieve their full potential.

This project is funded together with Newcastle Upon Tyne Hospitals NHS Charity and the Great North Children's Hospital (GNCH) Foundation. It is also kindly supported by The Peter Sowerby Foundation.

How are children’s lives affected now?

As well as movement problems, estimates suggest that around half of all children with cerebral palsy also experience speech difficulties.3 While some children with the condition cannot talk at all, others can speak but their difficulties with controlling their movements makes their speech hard to understand.

“Children with cerebral palsy who have speech difficulties and who can’t move their hands effectively will experience difficulties communicating with others,” says Dr Pennington. “And some also find it hard to understand spoken language.”

It is very important to know how well a child understands spoken language so that they can receive appropriate treatment and education. But conventional comprehension tests are unsuitable for young children with severe movement and speech difficulties because they require them to speak, point to pictures and handle toys.

“Speech and language therapists often resort to using less accurate methods to estimate understanding in these children, which can lead to inappropriate interventions,” says Dr Pennington.

How could this research help?

“Our aim is to adapt a Dutch tool designed to assess language understanding in children with severe movement and speech difficulties for use in the UK, which will help to ensure that each child receives the best possible treatment and education,” says Dr Pennington.

A computerised assessment of spoken language understanding (called C-BiLLT) has recently been developed for young children with severe movement problems in the Netherlands. Children can operate the system using their usual method of controlling computers – such as touchscreen, mouse, switches or eye-gazing techniques.

With the developers of the original C-BiLLT, the team will now create an English language version that is suitable for use in the UK. They will initially test this in typically developing young children, followed by those with severe speech and movement issues.

“We hope to establish that this new tool is easy to use and can accurately assess language comprehension in children in the UK with cerebral palsy or other conditions that severely affect their speech and movement,” says Dr Pennington.


  1. Wimalasundera, N. & Stevenson, V.L., Cerebral palsy. BMJ Practical Neurology 2016; 16:184-194.
  2. Office for National Statistics, Vital statistics in the UK: births, deaths and marriages - 2018 [website accessed 04 Dec 2019]
  3. Norberg A. et al., Speech problems affect more than one in two children with cerebral palsy: Swedish population-based study 2013;102(2):161-166.

Research table

Project details

Project Leader Dr Lindsay Pennington, PhD MSc BSc (Hons) MRCSLT
Location Institute of Health and Society, Royal Victoria Infirmary, Newcastle University
Project Team Dr Mike Clarke, PhD MSc BSc (Hons)
Professor Janice Murray, PhD FRCSLT
Ms Kate Laws, BSc (Hons)
Dr John Swettenham, PhD
Dr Julie Lachkovic, PhD BSc
Dr Jenefer Sargent, MRCPCH
Professor Elaine McColl, PhD
Dr Joke Geytenbeek, PhD (funded by GNCH Foundation)
Other Locations Division of Psychology and Language Sciences, University College London
Faculty of Health, Psychology and Social Care, Manchester Metropolitan University
Regional Communication Aid Service, Northumberland Tyne and Wear NHS Foundation Trust
Neurodisability Service, Great Ormond Street Hospital for Children NHS Foundation Trust, London
Grant Awarded
Grant Amount £98,370
Start Date
End Date
Duration 24 months
Grant Code (GN number) GN2742


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