Are Children with Congenital Amputations More Susceptible to Speech/Language Problems?

JEAN L. McMAHON, MD**, AND THOMAS E. BALAZY, MDDenver, Colorado


It has been suggested, but never confirmed by systematic examination, that a relationship between congenital limb amputation and speech/language problems exists. From 1980 to 1984, 142 pediatric amputees were assessed by tests such as the Oral Peripheral Examination, Standard Speech Analysis, Goldman/Fristo Test of Articulation, Peabody Picture Vocabulary Test, and the Test of Oral/ Language Development; tests were selected according to the age of the child. Amputees included 28 children with traumatic single limb loss, 18 with malignant single limb loss, 52 congenital upper-limb amputees, 24 congenital lower-limb amputees, and 20 congenital multiple-limb amputees. Speech/language problems occurred in 10.7 percent of the traumatic, none of the malignant, 59 percent of the congenital upper-limb, 16 percent of the congenital lower-limb, and 76 percent of the congenital multiple-limb amputees. Congenital multiple-limb and congenital upper-limb amputees had a significantly greater proportion of speech/ language problems (P>0.001) than traumatic amputees. No significant difference existed between congenital lower-limb and traumatic amputees. This study confirms the relationship between congenital limb amputation and accompanying speech/language deficits.

**Children's Hospital, 1056 East 19th Avenue, Denver, CO 80218