Q&A: Speech Therapy for a Child with PVL (Periventricular Leukomalacia)

What types of therapy could the speech therapist do with my child who has PVL (Periventricular leukomalacia)? He is 14 months old and doesn’t have an interest in toys.

Periventricular leukomalacia is often seen in premature infants when there is decreased blood flow to the brain before, during or after birth.  Due to the decrease in blood flow to the periventricular area of the brain, nerve fibers are damaged and can effect muscle control throughout the body.  PVL can cause cerebral palsy and other brain functions can be affected such as behavioral problems and developmental delays.

The speech language pathologist will be able to evaluate your child to determine if there are expressive language delays, receptive language delays, oral motor delays and/or feeding delays. They can also observe play skills and social skills to determine if they are within normal limits. If your child is showing delays in an area a plan will be developed to determine what goals should be addressed to advance his/her skills.

To examine expressive language the therapist will observe how the child communicates his wants/needs (pointing, sounds, words etc.) If a delay is found the therapist could focus on improving oral communication, gestures/sign language, simple communication devices or other methods of communication depending on the child’s needs.

Receptive language is what the child understands is being communicated to him/her. Examples of this are (following simple directions, identifying specific people/objects, identifying simple body parts etc.) The speech therapist should identify if the child is delayed and work on improving comprehension through play and various activities.

Oral motor skills are needed for sound production and feeding skills. There are many techniques to improve these skills such as increasing tongue mobility, lip closure, chewing, moving through textures etc. depending on the problem areas.

You noted your child is not playing with toys. I would focus on increasing his/her interactions with you. Have him make sounds with you, play patty cake, peek-a-boo etc. If he participates in these games incorporate a ball or car into the play. You lead play with the toy and see if he will imitate. If his motor skills are effected you can help move his/her hands/feet so your child is able to experience the action for play.

We recommend talking with your child’s doctor and a pediatric speech language pathologist (SLP) regarding your concerns and having a speech language evaluation. If speech therapy is recommended the SLP should be able to provide suggestions regarding what toys/activities would be appropriate for your child to improve development in areas of delay.