Cerebral Palsy

Cerebral Palsy General Information

Cerebral Palsy (CP) is an umbrella term that describes loss or impaired motor function that resulted from damage to the brain. Motor function refers to the ability to coordinate and control muscles and movements, maintain posture, have normal reflex reactions, and balance. Brain damage that results in CP occurs while the brain is still developing:  before, during, or after birth up to 3 years of age. CP is permanent but non-contagious and non-progressive. Keep in mind, the brain damage itself is “non-progressive” but the conditions that accompany it can worsen or get better. These conditions include permanent muscle contractions, incontinence, and problems chewing. Though many factors can lead to cerebral palsy, a major risk is premature birth. Genetics, trauma, and infections during pregnancy also contribute to the.

There are various classifications of CP based on motor control, area of body affected, when brain damage occurred, and degree of severity. The different classifications are all important for different purposes. Different people working with someone which has CP will need to focus on different aspects of their disability and use one classification system over another. Which classification system used may also change as a child develops. As CP is an umbrella term, there are many different forms of CP. An individual with CP may have muscles permanently contracted (spastic paralysis) while another individual has no tone in some muscles (flaccid paralysis).

From: Cerebral Palsy by Miller Freeman, and http://en.wikipedia.org/wiki/Cerebral_palsy

Warning signs and symptoms that your child may have cerebral palsy:

•           Doctors will screen and do tests during pregnancy to identify early signs of CP

•           Problem with their movements in hands and legs

•           Not being able to crawl, sit up, or walk when they are expected to (developmental delay)

•           Difficulty chewing and swallowing

•           Problems with vocalization

•           Seizures

•           Choking

•           Difficulty grasping objects

•           Fatigue

•           Inability to focus on objects

•           Inability to hear

•           Pain

From http://www.nhs.uk/conditions/cerebral-palsy/Pages/Introduction.aspx, Cerebral Palsy by Miller 

Freeman, and A Classification of Cerebral Palsy by W. L. Minear

How Can Cerebral Palsy Affect a Child?

Early intervention is important because it allows for immediate help before critical periods of development are passed that may cause permanent problems if identified too late. This includes walking, speech, muscle control for various body parts, and may result in learning disabilities. It is also important to consider if other conditions might be causing the symptoms described above since a child may have more than one condition affecting them.

From Cerebral Palsy by Miller Freeman

Support for Children with Cerebral Palsy

The overarching goal for all levels of support is to allow an individual with CP to reach their maximum potential. There are a number of support systems that help children with disabilities including family, the community, and the government. Two predominant support teams that are of particular interest to children with CP are:

Physician:

The specialist that a child with CP will usually be introduced to is a neuro-orthopaedist. These doctors deal with disorders of the skeletal system and further specialize in studying neurological disorders. They have a an exceptional understanding of the condition of CP and are able to diagnose, assess, and plan further actions for the family.

Many people overlook the involvement of the primary care physician (or general practitioner). It is important to continue routine check-ups even if a child is under the care of a specialist because the specialist usually does not provide the general medical care needed to assure the child stays healthy.

Therapists:

Most children with CP work with a therapist. Therapists help with increasing and maintaining the normal functions of the child. A child may be seeing one therapist or a number of therapists depending on the child’s needs and it should be noted that the care provided by therapists do overlap.

Physiotherapists (also called physical therapists) mainly focus on gross motor skills—the large muscle groups that are important for walking, sitting, lifting, throwing, etc.

Occupational therapists concern themselves with fine motor skills—writing, getting dressed, and other daily tasks that require intricate control.

Speech therapists are not limited to just helping children with speaking but oral motor activities in general (such as chewing and swallowing).

From: Cerebral Palsy by Miller Freeman

Cerebral Palsy in the Classroom

Because of the huge range of severities and types of CP’s, teachers, parents, and other people involved in the education system have to be particularly mindful of choosing which education system is best for each child on a case by case basis. By assigning a child to a special education program, it may limit their potential capabilities. Special education programs usually encompass a variety of special needs from physical impairments to emotional disorder. Taking a student away from their peers in a typical classroom setting may limit their social interactions and thus social development. On the other hand, a child with CP may not be able to follow a regular education class. In this case, putting them in a typical classroom setting would actually limit their potential.

Most children with CP will attend public schools. Depending on the severity that CP has affected them, they may be in a special education class, a typical classroom setting, or follow the mainstream schooling model.  Mainstreaming is where a child will participate in both regular education classes and special education classes depending on which suits their needs better for a specific class. This is perhaps the best practice for most students with CP and it then is a matter of which classes they require special needs. It is important to remember that some children may not be suited to be taught in a public school and require home-based instruction, home schooling, or private schooling. Still others can participate in public education but require supplementary tutoring. The collective team of educators, parents, and the children themselves need to determine which schooling practice is best suited for them.

From Cerebral Palsy by Miller Freeman, http://learningdisabilities.about.com/od/gi/p/grossmotorskill.htm, and http://en.wikipedia.org/wiki/Mainstreaming_(education)

Cerebral Palsy Resources

Cerebral Palsy by Freeman Miller MD

Available online at: http://link.springer.com/book/10.1007/b138647/page/1  and hard copy

National Health Service (England)

http://www.nhs.uk/conditions/cerebral-palsy/Pages/Introduction.aspx

MyChild™

http://cerebralpalsy.org/