Functional Communication Profiles in Children with Cerebral Palsy in Relation to Gross Motor Function and Manual and Intellectual Ability

PURPOSE

The aim of the present study was to investigate communication function using classification systems and its association with other functional profiles, including gross motor function, manual ability, intellectual functioning, and brain magnetic resonance imaging (MRI) characteristics in children with cerebral palsy (CP).

MATERIALS AND METHODS

This study recruited 117 individuals with CP aged from 4 to 16 years. The Communication Function Classification System (CFCS), Viking Speech Scale (VSS), Speech Language Profile Groups (SLPG), Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and intellectual functioning were assessed in the children along with brain MRI categorization.

RESULTS

Very strong relationships were noted among the VSS, CFCS, and SLPG, although these three communication systems provide complementary information, especially for children with mid-range communication impairment. These three communication classification systems were strongly related with the MACS, but moderately related with the GMFCS. Multiple logistic regression analysis indicated that manual ability and intellectual functioning were significantly related with VSS and CFCS function, whereas only intellectual functioning was significantly related with SLPG functioning in children with CP. Communication function in children with a periventricular white matter lesion (PVWL) varied widely. In the cases with a PVWL, poor functioning was more common on the SLPG, compared to the VSS and CFCS.

CONCLUSION

Very strong relationships were noted among three communication classification systems that are closely related with intellectual ability. Compared to gross motor function, manual ability seemed more closely related with communication function in these children.

Mathematical modelling of MSW incineration on a travelling bed

The rising popularity of incineration of municipal solid waste (MSW) calls for detailed mathematical modelling and understanding of the incineration process. In this paper, governing equations for mass, momentum and heat transfer for both solid and gaseous phases in a moving bed in a solid-waste incineration furnace are described and relevant sub-models are presented. The burning rates of volatile hydrocarbons in the moving bed of solids are limited not only by the reaction kinetics but also the mixing of the volatile fuels with the under-fire air. The mixing rate is averaged across a computation cell and correlated to a number of parameters including local void fraction of the bed, gas velocity and a length scale comparable to the particle size in the bed. A correlation equation is also included to calculate the mixing in the freeboard area immediately next to the bed surface. A small-scale fixed bed waste incinerator was built and test runs were made in which total mass loss from the bed, temperature and gas composition at different locations along the bed height were measured. A 2-D bed-modelling program (FLIC) was developed which incorporates the various sub-process models and solves the governing equations for both gases and solids. Thermal and chemical processes are mainly confined within a layer about 5-9 times in thickness of the averaged particle size in the burning bed. For a large part of the burning process, the total mass loss rate was constant until the solid waste was totally dried out and a period of highly rising CO emission followed. The maximum bed temperature was around 1200 K. The whole burning process ended within 60 min. Big fluctuations in species concentration were observed due to channelling and subsequent 'catastrophic' changes in the local bed conditions. Reasonably good agreement between modelling and measurements has been achieved. Yet the modelling work is complicated by the channelling phenomenon in the bed. Numerical simulations without consideration of the channelling effect produced very good agreement with experiments concerning the total mass loss, but significant discrepancy exists for temperature and gas composition profiles. Transient phenomena such as the breaking of waste particles and the "catastrophic" creation of new burning channels occurring during waste incineration is a vital area requiring further investigation at the fundamental level. The underlying theory of bed behaviour must be extended to include these transient events.