Literacy development in children with cerebral palsy

摘要

This thesis concerns the literacy difficulties of fifteen children with cerebral palsy (CP). The children were an opportunistic sample from two schools, and were initially selected on the basis that they had typical abilities in other school subjects. A review of the literature pertaining to the development of literacy and related aspects of cognitive development in typically-developing children and children with CP informed the development of the research strategy. The children's literacy, their general non-verbal and communication abilities, as well as a set of cognitive abilities that could be related to literacy impairments, were assessed. The findings revealed that most, but not all, of the children with CP had literacy difficulties with low scores in reading and spelling, and all the children had problems with handwriting. Standardised assessments showed that while the children had good verbal abilities, they had very low scores on a non-verbal test. The children with the most severe literacy difficulties also had the most problems with phonological processing. Almost all of the children had difficulties with visual and spatial perception; however the better readers had typical results in an assessment of visual sequential memory. Tests of working memory (WM) revealed a clear division between typical levels of performance on verbal recall measures, and very poor performance on the visual components of working memory tests. There were mixed results for the assessment of the central executive, but generally those children who were the more able in literacy had higher scores. Correlations suggested that visual sequential memory; phonological segmentation; verbal recall; and aspects of the central executive of working memory were most closely associated with the children's literacy abilities. Thus, the findings indicate that children with CP ha,ve specific cognitive impairments, including a new suggestion that poor visual sequential memory abilities could delay the development of reading and spelling skills.