CONGENITAL MUSCULAR TORTICOLLIS AND SPEECH DEVELOPMENT: A RETROSPECTIVE STUDY WITH FOLLOW-UP

Purpose/Hypothesis: To describe the prevalence of speech-language delay in children with a history of congenital muscular torticollis (CMT) from January 1, 2017 to December 31st, 2020 at the researcher’s institution. This will be compared to the prevalence of speech delay in the general population. It is hypothesized that children with a current or past medical history of CMT are associated with a higher prevalence of delayed speech milestones as compared to the prevalence of delayed speech milestones in the general population.

Number of Subjects: 358 patients met inclusion criteria and were identified from the EMR data retrieval. Of the 358 patients from the PT caseload, 21 patients had been seen at this institution for a speech-language evaluation. The remaining 337 patients were contacted via phone for completion of a questionnaire regarding participant’s speech-language development to determine the presence of speech-language delay. 55 participants completed the questionnaire, resulting in a total study population of 76 participants.

Materials/Methods: Subjects identified after a review of EMR of patients seen at Hospital for Special Surgery from January 1st, 2017-December 31st, 2020 with a diagnosis of Torticollis and/or Plagiocephaly. Potential subject’s parents/guardians were contacted via phone for participation should the EMR not contain target speech milestone variables. Should a request be made for participation via email, questionnaire was sent via email. 9-item questionnaire was used to obtain information regarding participant’s speech- language development to determine the presence of a speech- language delay within this population sample.

Results: Out of the 76 participants, 47 experienced delays in speech-language development. Suggesting that 62% exhibited delayed speech-language milestones and/or required intervention from SLPs. The prevalence of speech delay in this study population was summarized using a rate calculation. Previous estimates of the baseline rate of children with delayed speech patterns vary from 8-9% ((NIDCD), 2016) to 20% (JAMA Pediatr., 2015). Utilizing a One-Sample Proportion Test, the proportion of children with speech-language delays within the study population significantly deviated from previous proportions observed in the general population. This data is based on ongoing data collection with projected data collection to be complete in June 2024.

Conclusions: While current studies research the relationship between gross motor development and speech development, no study directly addresses the impact of CMT on the development of the motor speech system and language acquisition. The results of this preliminary study indicate that patients with CMT may be at an increased risk of delayed speech and language acquisition as compared to the general population.

Clinical Relevance: Physical therapists have a unique opportunity to flag delayed milestones with their regular contact with the patient over time and engagement with a caregiver. Consistent inquiry and documentation of early speech milestones in the record could facilitate a timely referral for SLP services in the population with a history of CMT.