PHONIATRICS Brain damage motor handicap BDMH CORRECTED

- Executive Summary

1- Assessment of the child with BDMH (CP):

A. Elementary diagnostic procedures:

Through history taking and clinical examination (including vocal tract and neurological examination):

◽ Exclude progressive neurological disorders such as neurodegenerative diseases.

◽ Exclude non-specific motoric insults causing diffuse brain damage (global developmental delay/intellectual disability).

◽ Establish the presence of specific motoric insult.

◽ Determine the type of BDMH (CP) whether spastic, ataxic, dyskinetic, or atonic. (Strong recommendation)

B. Clinical diagnostic aids: including

◽ Psychometric evaluation to determine IQ, mental age, and social age.

◽ Language assessment by standardized Arabic language test to determine receptive, expressive, and total language ages.

◽ Speech assessment for associated dysarthria.

◽ Swallowing assessment for associated feeding and swallowing disorders including instrumental evaluation if needed. (Strong recommendation)

C. Additional instrumental measures: including

◽ Magnetic resonance imaging (MRI): to investigate etiology in a child or young person with suspected or known BDMH if this is not clear from history or clinical examination.

◽ Audiometry: Initial baseline and regular ongoing hearing assessment are necessary.

◽ Electroencephalogram (EEG): Since epilepsy occurs in around 1 in 3 children with BDMH (CP).

◽ Ophthalmological examination: Initial baseline and regular ongoing visual assessment are necessary. (Strong recommendation)

2- Management of the child with BDMH (CP) through multidisciplinary team approach:

◽ Phoniatric role:

1- Management of language, speech, and communication difficulties: through language and speech therapies that are tailored according to the child’s deficits.

2- Management of feeding and swallowing problems and saliva control: after selection of the appropriate therapy option.

◽ Management of co-morbidities by other team members e.g. neurologist, audiologist, physical therapist, etc. (Strong recommendation)