Sara Rinaldi

Background: Individuals with complex communication needs (CCNs) require comprehensive communication profiles to guide effective interventions, yet the clinical literature offers limited tools to support this process. To address this gap, the “Italian CP & Language Network”—a multidisciplinary group of speech–language pathologists, psychologists, and child neuropsychiatrists—developed a novel, comprehensive clinical instrument specifically designed to evaluate the communication skills of children and adolescents with CCNs. Methods: The development process was informed by an initial preliminary survey conducted across participating clinical centres to map out the observation tools routinely used in daily practice. Results: Based on these insights, the network designed a structured clinical interview named the Italian IVCAA (Intervista sulla Valutazione delle Competenze e delle Abilità Comunicative). The instrument was structured to systematically assess four core areas: core communication abilities, communicative behaviours, communicative functions, and communicative modalities (vocal, gestural, graphic/symbolic, and written). The Italian IVCAA provides a structured framework that successfully describes an individual’s unique communication profile. It maps out specific strengths and weaknesses across diverse modalities, establishing a standardized baseline for clinical use. Conclusions: The Italian IVCAA serves as a valuable clinical tool for identifying communication profiles in individuals with CCNs. It offers a practical starting point for setting tailored goals in augmentative and alternative communication (AAC) interventions and establishes a reliable framework for monitoring changes in communicative competence over time.

Background: Communication, language, and speech disorders are highly prevalent in children with cerebral palsy (CP) and substantially impact social, educational, and community participation. However, few studies have systematically characterized communicative and linguistic profiles using standardized assessments. This paper outlines the work of the ‘Italian CP & Language Network’ over the last two years, focusing on identifying research priorities, developing specialized assessment protocols, and proposing a shared classification system for speech and language disorders in children with CP. Methods: A survey was sent to 11 specialized centers to investigate clinical practices and assessment tools. Based on the results and an extensive literature review, the group developed three age- and complexity-based diagnostic protocols and a shared classification system. Results: The survey highlighted high variability in test selection, especially for speech and pragmatic assessment, and a significant need for ad hoc tools for augmentative and alternative communication (AAC). Three standardized protocols were defined: (1) early language (<48 months), (2) school-age language and pragmatics (4–12 years), and (3) minimally verbal children (6–12 years). A multi-level classification system for language and speech disorders was proposed to improve diagnostic consistency. Conclusions: Standardizing assessment is a critical step toward early identification of communicative vulnerabilities to guide tailored interventions and promote participation and quality of life across developmental stages. The group provides a framework for prospective multicenter data collection to correlate linguistic and speech phenotypes with neuroradiological features and motor outcomes.

Background. Language disorder is the most frequent developmental disorder in childhood and it has a significant negative impact on children’s development. The goal of the present review was to systematically analyze the effectiveness of interventions in children with developmental language disorder (DLD) from an evidence-based perspective. Methods. We considered systematic reviews, meta-analyses of randomized controlled trials (RCTs), control group cohort studies on any type of intervention aimed at improving children’s skills in the phono-articulatory, phonological, semantic-lexical, and morpho-syntactic fields in preschool and primary school children (up to eight years of age) that were diagnosed with DLD. We identified 27 full-length studies, 26 RCT and one review. Results. Early intensive intervention in three- and four-year-old children has a positive effect on phonological expressive and receptive skills and acquisitions are maintained in the medium term. Less evidence is available on the treatment of expressive vocabulary (and no evidence on receptive vocabulary). Intervention on morphological and syntactic skills has effective results on expressive (but not receptive) skills; however, a number of inconsistent results have also been reported. Only one study reports a positive effect of treatment on inferential narrative skills. Limited evidence is also available on the treatment of meta-phonological skills. More studies investigated the effectiveness of interventions on general language skills, which now appears as a promising area of investigation, even though results are not all consistent. Conclusions. The effectiveness of interventions over expressive and receptive phonological skills, morpho-syntactic skills, as well as inferential skills in narrative context underscores the importance that these trainings be implemented in children with DLD.