Although cerebral palsy is a lifelong disability, there are many interventions that can help reduce its impact on the body and the individual’s quality of life. Therapy aims to improve the condition of cerebral palsy and people’s day-to-day lives.
A variety of nondrug therapies can help a person with cerebral palsy enhance functional abilities:
- Occupational therapy. For the first 1 to 2 years after birth, both physical and occupational therapists provide support with issues such as head and trunk control, rolling, and grasping. Later, both types of therapists are involved in wheelchair assessments if needed. Using alternative strategies and adaptive equipment, occupational therapists work to promote your child’s independent participation in daily activities and routines in the home, the school and the community. Adaptive equipment may include walkers, quadrupedal canes, seating systems or electric wheelchairs.
- Braces or splints may be recommended for your child. Some of these supports help with function, such as improved walking. Others may stretch stiff muscles to help prevent rigid muscles (contractures).
- Speech and language therapy. Speech-language pathologists can help improve your child’s ability to speak clearly or to communicate using sign language. Speech-language pathologists can also teach your child to use communication devices, such as a computer and voice synthesizer, if communication is difficult. Another communication device may be a board covered with pictures of items and activities your child may see in daily life. Sentences can be constructed by pointing to the pictures. Speech therapists may also address difficulties with muscles used in eating and swallowing.
- Physiotherapy. Muscle training and exercises may help your child’s strength, flexibility, balance, motor development and mobility. You’ll also learn how to safely care for your child’s everyday needs at home, such as bathing and feeding your child.
- Psychologists. Psychologists can help improve your child’s ability to manage and communicate their thoughts and feelings. They can also support
inthe development of IEPs within the school system and act as a case manager and advocate.
- Therapist Aid. Some children may benefit from recreational therapies, such as therapeutic horseback riding, gardening clubs, and modified sports groups. This type of therapy can help improve your child’s motor skills, speech and emotional well-being. The Therapist Aid can support your child during these sessions to ensure inclusion.
Coping and support
When a child is diagnosed with a disabling condition, the whole family faces new challenges. Here are a few tips for caring for your child and yourself:
- Foster your child’s independence. Encourage any effort at independence, no matter how small. Just because you can do something faster or more easily than your child doesn’t mean you should.
- Be an advocate for your child. You are an important part of your child’s health care team. Don’t be afraid to speak out on your child’s behalf or to ask tough questions of your physicians, therapists and teachers.
- Find support. A circle of support can make a big difference in helping you cope with cerebral palsy and its effects. As a parent, you may feel grief and guilt over your child’s disability.
Preparing for your appointment
If your child has cerebral palsy, how you learn about your child’s condition may depend on the severity of the disabilities, when problems first appeared, and whether there were any risk factors during pregnancy or delivery.
What you can do
- Write down current symptoms, even if some may seem unrelated to your child’s cerebral palsy concerns.
- Make a list of all your or your child’s medications, vitamins and supplements.
- Bring any clinical notes, scans, laboratory test results or other information from your Doctors (Paediatrician/GP).
- Write down your or your child’s key medical information, including other conditions.
- Write down key personal information, including any recent changes or stressors in your child’s life.
- Write down questions to ask your therapist.
- Ask a relative or friend to accompany you, to help you remember what your therapist says.
About Cerebral Palsey
Cerebral palsy is a disorder of movement, muscle tone or posture that is caused by damage that occurs to the immature, developing brain, most often before birth.
Signs and symptoms appear during infancy or preschool years. In general, cerebral palsy causes impaired movement associated with abnormal reflexes, floppiness or rigidity of the limbs and trunk, abnormal posture, involuntary movements, unsteady walking, or some combination of these.
People with cerebral palsy may have problems swallowing and commonly have eye muscle imbalance, in which the eyes don’t focus on the same object. People with cerebral palsy also may suffer reduced range of motion at various joints of their bodies due to muscle stiffness.
Cerebral palsy’s effect on functional abilities varies greatly. Some affected people can walk while others can’t. Some people show normal or near-normal intellectual capacity, but others may have intellectual disabilities. Epilepsy, blindness or deafness also may be present.
There are some signs that may indicate a child has Cerebral Palsy. Not all signs are visible at birth and may become more obvious as babies develop.
- Low muscle tone (baby feels ‘floppy’ when picked up)
- Unable to hold up his/her own head while lying on their stomach or in a supported sitting position
- Muscle spasms or feeling stiff
- Poor muscle control, reflexes and posture
- Delayed development (can’t sit up or independently roll over by 6 months)
- Feeding or swallowing difficulties
- Prefers to use one side of their body
Depending on the level of severity of Cerebral Palsy, toddlers and children may experience difficulties with physical development such as:
- not walking by 18 months
- not speaking simple sentences by 24 months
If your child is not reaching these milestones or they display some of the signs of cerebral palsy, you may need to speak to general practitioner or paediatrician.
Signs and symptoms can vary greatly. Movement and coordination problems associated with cerebral palsy may include:
- Variations in muscle tone, such as being either too stiff or too floppy
- Stiff muscles and exaggerated reflexes (spasticity)
- Stiff muscles with normal reflexes (rigidity)
- Lack of muscle coordination (ataxia)
- Tremors or involuntary movements
- Slow, writhing movements (athetosis)
- Delays in reaching motor skills milestones, such as pushing up on arms, sitting up alone or crawling
- Favouring one side of the body, such as reaching with only one hand or dragging a leg while crawling
- Difficulty walking, such as walking on toes, a crouched gait, a scissors-like gait with knees crossing, a wide gait or an asymmetrical gait
- Excessive drooling or problems with swallowing
- Difficulty with sucking or eating
- Delays in speech development or difficulty speaking
- Difficulty with precise motions, such as picking up a crayon or spoon
The disability associated with cerebral palsy may be limited primarily to one limb or one side of the body, or it may affect the whole body. The brain disorder causing cerebral palsy doesn’t change with time, so the symptoms usually don’t worsen with age. However, muscle shortening and muscle rigidity may worsen if not treated aggressively.
Brain abnormalities associated with cerebral palsy also may contribute to other neurological problems. People with cerebral palsy may also have:
- Difficulty with vision and hearing
- Intellectual disabilities
- Abnormal touch or pain perceptions
- Oral diseases
- Mental health (psychiatric) conditions
- Urinary incontinence
At your appointment, your therapist will ask you questions about the following:
- Muscle tone
- Muscle strength
- Age-appropriate motor skills
- Sensory abilities, such as vision, hearing and touch