Language and Learning Implications

Cerebrovascular Accident (CVA)

CVA affect on language development and language performance

The development of language in children who have experienced a CVA is highly varied and depends greatly on the location and extent of the brain damage. When children experience a CVA, language development may be delayed. Because language is imperative for the process of learning, it is crucial that any language impairments that do occur are targeted in therapy (das Dores Rodrigues, Ciasca, Elcione Guimarães, Ibraim da Freiria Elias, Camargo Oliveira, & Valeriana Leme de Moura-Ribeiro, 2011). Positive improvement is possible due to the highly plastic nature of children's' brains resulting in reorganization of language skills. Language and cognitive deficits have been shown to persist throughout these children's life, although functional gains with little regression have been shown to be positive (Hurvitz, Beale, Ried, & Nelson, 1999). Research has shown that children who experience CVAs earlier in their development experience a more maladaptive reorganization of the brain than children who have strokes later in their development (das Dores Rodrigues, et. al., 2011).

Some specific disorders in speech and language that may be seen in this population could include:

Dysarthria- a motor disorder that involves poor coordination, limited range of motion, and decreased strength of muscles used for speech (Morgan & Vogel, 2008). Children may have spastic or flaccid muscular tone.
Apraxia of speech- difficulty with motor planning of the muscles required for speech that is not due to a specific motor disorder or weakness. Children may have difficulty coordinating the necessary muscles to produce speech
Aphasia- a disorder of at least one type of communication modality (production, comprehension, reading, and/or writing). Children may have difficulty with expressive or receptive language abilities requiring therapy.
Auditory Processing Disorder- a disorder in the ability of the central nervous system to accurately and quickly process auditory information. Children may have difficulty understanding speech in noise.
Dysphagia- difficulty in swallowing function that may be experienced after an acute CVA event (Lefton-Greif & Arvedson, 2008). Children may require modified diets for brief or longer time periods.
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Learning Difficulties

Learning difficulties are very common in children who have experienced CVA (das Dores Rodrigues, et. al., 2011). As with speech and language characteristics, learning difficulties may vary widely between any two children with prior CVAs. Children who have experienced a CVA are more likely to develop:

  • Sensory processing disorders
  • Specific learning impairments
  • Attention problems
  • Behavioral problems
  • Cognitive impairments

These learning difficulties may be lasting, and may require special education and classroom modifications and accommodations depending on the extent of the difficulty. Medication may be able to alleviate some issues, as with attention problems (Pediatric Stroke, 2015). Unfortunately, a child does not typically experience only one of the language, learning, or physical limitations but often experiences multiple difficulties, requiring a variety of different types of rehabilitation, therapeutic, and medical services.

Possible Physical Limitations

Physical limitations to students may hinder mobility in classrooms, participation in physical activities, and may require medication to alleviate certain symptoms (such as seizure disorders). Some physical limitations that children who have experienced a CVA may exhibit include:

  • Cerebral Palsy
  • Seizure disorders
  • Hemiparesis
  • Vision problems
  • Hearing problems

Due to the often lasting effects of these physical issues that may be experienced by children, physical and occupational therapy are often provided for many years to increase a child's functional abilities (Pediatric Stroke, 2015).