Speech and language therapy for mutism after brain tumour surgery

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Find in-depth information on the speech and language problems that can occur as a result of brain tumour treatment, and the ways that speech and language therapy can help.

Key points

  • Mutism is a potential complication of brain surgery that will improve over time.
  • Do not force your child to speak as they may be unable to and it may frustrate or upset them
  • A speech and language test will be conducted after the operation to assess for changes in talking and listening.

What is a speech-language pathologist (SLP)?

An SLP is a trained professional in the assessment and treatment of communication.

Areas of communication that are often looked at include:

  • oral motor functioning and articulation (coordination of speech muscles for talking)
  • language comprehension and production (ability to understand or express ideas)
  • reading and writing
  • thinking skills (memory, problem solving and reasoning)
  • social interaction skills
  • voice, fluency (smooth versus bumpy speech), and resonance (oral and nasal airflow during speech)

Both speech and language may be impacted by various cancers and cancer treatments and may require SLP intervention.

Mutism after brain tumour surgery

Transient cerebellar mutism is a potential complication for children who undergo surgery for a posterior fossa tumour. This type of tumour is located in the back part of the brain. Mutism occurs in about 1 out of every 5 to 10 cases of an operation to a tumour in this part of the brain. It results in the child being unable to speak. In severe cases, language is also affected and can result in your child having difficulties understanding questions or instructions.

This mutism will improve over time. However, it will often be frustrating and difficult for your child and for you.

Mutism is part of a larger set of problems. This is called a syndrome. Some of the other symptoms you may notice in your child are:

  • changes in their behaviour
  • emotional difficulties
  • cortical blindness: their eyes may work fine, but their brain isn’t seeing images
  • ataxia: they may not be able to balance while walking
  • extreme irritability: they may kick and scream for hours, even though you try hard to calm them down

How long will the mutism last?

While the other symptoms described above may improve, mutism can last much longer, possibly many months.

Will my child recover completely?

All children will be able to speak again, but they may not speak in the same way as they did before the operation. There may be some problems such as slurred speech, slowness or stuttering. Difficulty recalling words when speech returns is also common.

A speech-language pathologist will work with your child to help them improve.

How do I communicate with my child?

It is best not to try to force your child to speak. They may not be physically able to say any words. Forcing speech will only frustrate them. You can find other ways to communicate. A speech-language pathologist or other experts may be available to help you.

Often, you can begin by finding a signal that your child can use to mean "yes" and "no." For example, one thumb up could mean "yes" and a thumb down could mean "no." Another example is getting them to squeeze your hands: one time for "yes", two times for "no". It is also helpful to speak to your child in simple sentences that ask for a "yes" or "no" answer, for example, "Are you cold?" or "Do you want a blanket?"

Your child’s treatment team may provide a picture or letter board so that your child can communicate by pointing to pictures or spell out words by pointing to letters. These picture boards can be created and changed to meet the needs of your child.

How will an SLP help?

The SLP will assess your child’s communication through a number of activities, tests, and observations. These will be tailored to meet the needs of your child. For example, for younger children all assessment will be done through play. The goal is to help improve your child’s communication and work to their strengths.

Once your child is discharged, the SLP will make any appropriate referrals for ongoing therapy in the community.
Last updated: January 10th 2022