Cerebral palsy

 

What is cerebral palsy?

Cerebral palsy is a physical disability that is caused by damage to the developing brain. It usually appears before the age of 3 and is assessed through delays in developmental milestones such as sitting up or reaching for toys. Although cerebral palsy is predominantly a motor disability, it often co-occurs with other difficulties such as sleep disturbance, learning disabilities, hearing loss, swallowing difficulties, depression, anxiety and epilepsy. The brain damage associated with cerebral palsy is usually non-progressive meaning that it does not get worse over time. With appropriate interventions, most difficulties with cerebral palsy can be appropriately managed.

What causes cerebral palsy?  

In a vast majority of cases, the brain damage associated with cerebral palsy occurs in utero (i.e. before birth) or in the first year of life. The exact cause of the impairment is unknown, but is thought arise from a range of causes such as complications during birth (e.g. lack of oxygen) or stroke. There are a range of other risk factors such as premature birth, low birth weight, blood clotting issues or prolonged bacterial infection. Studies suggest that there isn’t a strong genetic basis for cerebral palsy.

Types of cerebral palsy

Types of cerebral palsy are primarily classified by the type of motor difficulty that they result in.
  • Spastic Cerebral Palsy: is the most common type of cerebral palsy (around 80% of people) and is characterized by stiff muscles.
  • Athetoid CP: is characterized by involuntary movement.
  • Ataxic CP: is the least common type of cerebral palsy and is characterized by difficulty in the coordination of movement.
These categories are further divided into subcategories based on the limbs that they involve.
  • Diplegia: affects the legs
  • Hemiplegia: affects one side of the body (both arm and leg).
  • Monoplegia: affects one limb
  • Triplegia: affects three limbs
  • Quadriplegia: affects four limbs.

Tips for parents

  • It is important to keep in mind that children with cerebral palsy may also have comorbid learning difficulties. Learning situations may need to be restructured in order to minimise the impact of these disabilities. It is recommended that if learning issues are suspected that your child undergoes a comprehensive cognitive assessment with a neuropsychologist at SCDC.
  • Often children with motor difficulties understand the activity but have difficulty planning the sequence of steps to achieve their goal. Thus, complex motor tasks may need to be broken into smaller achievable steps. Some children may need some initial physical prompts or demonstration of the activity. However, as your child becomes more familiar with the sequence of movements, this assistance should be gradually withdrawn.
  • Where possible, establish regular routines for each day to assist with motor planning.
  • Children with cerebral palsy may also have perceptual difficulties, such as judging distance/size and understanding how to move around obstacles. These skills can be improved through practice, and games such as navigating obstacle courses can provide a fun and engaging way for the child to rehearse these skills. Other games such as lego, spot the difference, clapping to rhythms and dot-to-dot may also be useful in improving perceptual awareness. Intervention by a behavioural optometrist may be warranted.
  • Children with cerebral palsy may also have difficulty in producing and understanding language. Where possible, break down instructions into smaller steps and use simple language to facilitate understanding. The sequence may also be illustrated through a series of pictures to help your child comprehend the order of activities. For non-verbal children, strategies such as sign language or using pictograms may also be considered to help them communicate. If your child is having some language issues our speech therapist would be happy to assess and treatment them as required.
  • Do not anticipate your child’s every need, and give appropriate opportunities for them to communicate what they want and wait for the child to initiate communication.
  • Where possible, provide your child with a choice between items as this will facilitate their sense of independence and control over their surroundings. If your child has difficulty expressing or understanding language, objects, pictures and photos can help them to understand what choices are available.
  • Some children with communication difficulties will take longer to respond than other children their age, so ensure that adequate time is allowed for responses.