In terms of environmental and personal factors specific
to children with impaired communication, barriers included
the negative attitudes of others, the lack of speech pathology
services and being amongst unfamiliar people (due to increased
communication breakdowns). Key facilitators were a familiar
or quiet environment, being around familiar people or people with
a positive attitude and having access to AAC devices. These
factors are similar to those reported in adults with CP and
dysarthria [34]. However, some of these factors (i.e. the attitudes
of others) have also been reported in the whole population of
children with CP and not just those with communication deficits
[32,35]. Further research is required to delineate the relative
involvement of these factors in children with and without
communication disorders.