Early Childhood Intervention
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challenges pertaining to their child's development and
growth.
It is a place to find answers and practical
suggestions. That's what Early Intervention Support is all
about.
Whether a family has a child with a challenging behavior,
a disability or developmental issue, childhood is short - it
should be savored and enjoyed.
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Cerebral Palsy
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List of Diagnosis
Cerebral Palsy is the term used to describe any one of a number
of neurological disorders that appear in infancy or early childhood,
and permanently affect body movement and muscle coordination, but
don't worsen over time.
Even though cerebral palsy affects muscle movement, it isn't caused
by problems in the muscles or nerves. It is caused by abnormalities
in parts of the brain that control muscle movements. The majority of
children with cerebral palsy are born with it, although it may not
be detected until months or years later. Please read our article on
Selective Dorsal Rhizotomy.
Cerebral Palsy Symptoms
The early signs of Cerebral Palsy (CP) usually appear before a child
reaches 3 years of age. The most common are a lack of muscle coordination
when performing voluntary movements (ataxia); stiff or tight muscles and
exaggerated reflexes (spasticity); walking with one foot or leg dragging;
walking on the toes, a crouched gait, or a scissored gait; and muscle tone
that is either too stiff or too floppy.
A small number of children have Cerebral Palsy as the result of brain damage
in the first few months or years of life, brain infections such as bacterial
meningitis or viral encephalitis, or head injury from a motor vehicle
accident, a fall, or child abuse.
How is Cerebral Palsy Diagnosed?
Doctors test your baby's motor skills and closely evaluate the mothers
and baby's medical history. In addition to checking for the symptoms
mentioned above, the doctor will also test the baby's reflexes and look for
early development of hand preference. During the first twelve months of
life, babies usually do not show a hand preference. But infants with spastic
hemiplegia may develop a preference much earlier, since the hand on the
unaffected side of their body is stronger and more useful.
Doctors also rule out other disorders and determine if the condition is
getting worse. Cerebral Palsy is not progressive. So, if the child is
continuously losing additional motor skills, its another disease or
condition. Tests such as computed tomography (CT) scans, magnetic resonance
imaging (MRI), and ultrasonography can be ordered. Please read our article
on
Selective Dorsal Rhizotomy.
Causes of Cerebral Palsy
Cerebral Palsy is caused by an injury to the brain before, during, or
shortly after birth. In many cases, no one knows for sure what caused the
brain injury or what may have been done to prevent the injury.
Sometimes injuries to a baby's brain happen while the baby is still in the
mothers womb. The injury might be caused by an infection or by an accident
in which the mother is hurt. If a mother has a medical problem, such as high
blood pressure or diabetes, this can also cause problems in the baby. There
may be problems during birth, such as the baby not getting enough oxygen, or
a difficult delivery in which the baby's brain is injured. Problems after
birth may happen when a baby is born too soon (premature delivery) and his
body is not ready to live outside his mothers womb. Even babies born at the
right time can have infections, or bleeding in their brain which causes a
brain injury because the brain is still developing even after birth.
Cerebral Palsy Treatment
Cerebral Palsy cant be cured, but treatment will often improve a child's
capabilities. Many children go on to enjoy near-normal adult lives if their
disabilities are properly managed. In general, the earlier treatment begins,
the better chance children have of overcoming developmental disabilities or
learning new ways to accomplish the tasks that challenge them. Treatment may
include physical and occupational therapy, speech therapy, drugs to control
seizures, relax muscle spasms, and alleviate pain; surgery to correct
anatomical abnormalities or release tight muscles; braces and other orthotic
devices; wheelchairs and rolling walkers; and communication aids, such as
computers with attached voice synthesizers.
Read our article on
Selective Dorsal Rhizotomy.
Types of Cerebral Palsy?
Spastic Cerebral Palsy
If muscle tone is too high or too tight, the term spastic is used to
describe the type of cerebral palsy. Children with spastic CP have stiff and
jerky movements because their muscles are too tight. They often have a hard
time moving from one position to another or letting go of something in their
hand. This is the most common type of Cerebral Palsy. About half of all
people with Cerebral Palsy have spastic Cerebral Palsy.
Ataxic Cerebral Palsy
Low muscle tone and poor coordination of movements is described as ataxic
(a-tax-ick) Cerebral Palsy. Children with ataxic CP look very unsteady and
shaky. They have a lot of shakiness, like a tremor you might have seen in a
very old person, especially when they are trying to do something like write,
turn a page, or cut with scissors. They also often have very poor balance
and may be very unsteady when they walk. Because of the shaky movements and
problems coordinating their muscles, kids with ataxic Cerebral Palsy may
take longer to finish writing or to complete art projects.
Athetoid Cerebral Palsy
The term athetoid is used to describe the type of Cerebral Palsy when
muscle tone is mixed sometimes too high and sometimes too low. Children with
athetoid Cerebral Palsy have trouble holding themselves in an upright,
steady position for sitting or walking, and often show lots of movements of
their face, arms and upper body that they don't mean to make (random,
involuntary movements). These movements are usually big. For some kids with
athetoid CP, it takes a lot of work and concentration to get their hand to a
certain spot (like to scratch their nose or reach for a cup). Because of
their mixed tone and trouble keeping a position, they may not be able to
hold onto things (like a toothbrush, fork, or pencil). About one-fourth of
all people with CP have athetoid Cerebral Palsy.
Mixed Cerebral Palsy
When muscle tone is too low in some muscles and too high in other
muscles, the type of cerebral palsy is called mixed. About one-fourth of all
people with Cerebral Palsy have mixed Cerebral Palsy.
Besides different kinds of muscle tone, kids with CP also show different
parts of their bodies that are affected by the CP. This is also due to what
part of their brain was hurt and how big the injury was. Please read our
article on
Selective Dorsal Rhizotomy.
Quadriplegia
When a child shows Cerebral Palsy in all four of their limbs both arms
and both legs, it is called quadriplegia. Quad means four. Usually, kids
with quadriplegia have trouble moving all the parts of their bodies, their
face and trunk, as well as their arms and legs, and may need a wheelchair to
get around. Because of the problems controlling the muscles in their face
and upper body, they also have trouble talking and eating.
Hemiplegia
Hemiplegia means that the CP affect one side of the child's body. Hemi
means half, so the right arm and leg or the left arm and leg are affected.
The other side of the child's body works just fine. Many children with
hemiplegia are able to walk and run, although they may look a little awkward
or have a limp.
Diplegia
Some children have Cerebral Palsy just in their legs, or much more severe
in their legs than in their arms. This is called diplegia. Di means two, so
in diplegia, only the two lower limbs are affected. As you probably can
guess, the difficulty for children with diplegia is using their legs, so
walking and running may be hard for them. Because their upper bodies are
usually not affected, they have a good ability to hold themselves upright
and a good use of their arms and hands. You may wonder whether anyone ever
has CP in their arms but not their legs. This happens sometimes, but it is
very, very rare.
Problems Associated with Cerebral Palsy?
In addition to problems controlling their muscle movement, children with
Cerebral Palsy may have some other problems too. Most of these are caused by
the same brain injury that caused the Cerebral Palsy.
Talking and Eating
Just as Cerebral Palsy can affect the way a person moves his or her arms
and legs, it can also affect the way he or she moves his or her mouth, face
and head. This can make it hard for the person to talk clearly and to bite,
chew and swallow food. If you meet a girl with CP, you may notice that her
speech is hard to understand or that she seems to work very hard just to get
out a few words. This is because she is not able to make her lips, jaw and
tongue move as quickly as you can. She may also have trouble controlling her
breathing flow to make her voice work. All of these parts of your body are
very important in talking.
Try this: Make a g sound (say guh). To do that, you must pull your tongue
back and touch the back of your tongue to the back part of the roof of your
mouth (your palate). Then, you must breathe out a little but not let the
breath through until you are ready to make the sound. When you say guh, you
let your tongue drop while letting the breath out and turning on your voice.
Whew! That's a lot of stuff to do just to make one sound. Just think of all
the movements you must put together to say a whole word, or a sentence. Now
imagine what it would be like to make sounds and words if you had trouble
controlling your tongue, lips, and breathing!
The speech problem most children with Cerebral Palsy have is called
dysarthria (dis-are-three-a). That means it is hard for them to control and
coordinate the muscles needed to talk. Their speech may sound very slow and
slurred, and their faces may look a little funny when they are trying to
talk. Some kids voices may sound different, too. If too much air comes
through your nose when you talk, you sound hypernasal (hyper means too
much), like Erkel from the old TV show Family Matters. If not enough air
comes through your nose, you sound hyponasal (hypo means not enough), like
when you have a bad cold and cant breathe through your nose. If you meet
someone with CP who has speech problems, try hard to listen carefully when
they are talking, and don't be afraid to tell them when you cant understand
something they've said. Most people would rather say it again or find a
different way to communicate (maybe writing or pointing), than have you
pretend you understood them when you did not.
Many of the same muscles involved in talking are also used when you eat.
Some kids with CP might not be able to bite and chew foods like a hotdog or
a peanut butter sandwich. They may also have trouble sucking through a straw
or licking an ice cream cone.
Learning Problems
About one-fourth to one-half of children with Cerebral Palsy also have
some type of learning problem. It may be a learning disability, so that they
have trouble with one or two subjects in school but learn other things
pretty well, or may be a more severe learning problem like mental
retardation, in which they learn everything at a slower rate. There are many
different levels of mental retardation, so that people with mild mental
retardation may learn to read and write and do math, but people with more
severe mental retardation probably will not. This does not mean that
children with severe mental retardation cant learn. It means that they learn
at a slower pace than most other kids, and that they will need some special
learning help in school.
Seizures
About half of all children with Cerebral Palsy have seizures. This means
that they have times when there is some abnormal activity in their brains
that interrupts what they are doing. Often, the abnormal brain activity
happens in the same place as the brain injury which caused the CP. Your
brain is constantly sending messages out to your body to breathe, to move,
to keep your heart pumping. A seizure is a series of abnormal messages being
sent out very close together. These abnormal messages may cause someone to
stare and stop moving during a seizure, or may cause them to loose control
of their body and fall down. Some people show shaking movements all over
when they are having a seizure. Seizures usually last a few seconds to a few
minutes, and in most case are not dangerous. Many children take special
medicine to help prevent seizures or reduce the number of seizures they
have.
You may already know that seizures also occur in many people who do not have
Cerebral Palsy.
Therapy for Cerebral Palsy
Children with Cerebral Palsy often go to different kinds of therapy to
help them improve their motor skills for things like walking, talking and
using their hands. Some kids get therapy at school and some kids go to a
special clinic to see their therapists. Therapists are special teachers who
are trained to work with people on learning better or easier ways to do
things. Just like a coach who helps you learn and practice new skills to
make you a better soccer or basketball player, therapists coach people to
help them learn and practice new skills.
Physical Therapy
Physical therapists help children with CP learn better ways to move and
balance. They may help children with Cerebral Palsy learn to walk, use their
wheelchair, stand by themselves, or go up and down stairs safely. Kids may
also work on fun skills in physical therapy like running, kicking and
throwing a ball, or learning to ride a bike. Physical therapy is usually
called PT for short.
Speech and Language Therapy
Speech therapists work with children on communication skills.
Communication skills may mean talking, using sign language, or using a
communication aid. Children with CP who are able to talk may work with a
speech therapist on making their speech clearer, (easier to understand) or
on building their language skills by learning new words, learning to speak
in sentences, or improving their listening skills. Children who are not able
to talk because of their difficulty controlling the muscles needed for
speech may learn sign language or use some kind of communication aid. A
communication aid might be a book or poster with pictures that show things
the person might want, or an alphabet board that the person can use to spell
out their message. There are also computers that are used as communication
aids that actually talk for the person!
Occupational Therapy
Occupational therapists usually work with children on better ways to use
their arms, hands, and upper body. They may teach children better or easier
ways to write, draw, cut with scissors, brush their teeth, dress and feed
themselves, or control their wheelchair. Occupational therapists also help
children with CP find the right special equipment to make some everyday jobs
a little easier.
Recreational Therapy
Recreational therapists help kids with Cerebral Palsy have fun! They work
with children on sports skills or other leisure activities. In recreational
therapy, kids may work on dance, swimming, or horseback riding. They may
also work on art or horticulture (growing and taking care of plants), or
almost any other hobby they are interested in.
Selective Dorsal Rhizotomy
Selective dorsal rhizotomy is a neurosurgical procedure which can
permanently reduce spasticity and improve motor functions in children with
cerebral palsy. If preformed at an early age it can reduce the number of
orthopedic surgeries a child might need in the future. Learn more in our
article on
Selective Dorsal Rhizotomy.
Where Can I Get More Information?
United Cerebral Palsy (UCerebral Palsy)
1660 L Street, NW
Suite 700
Washington, DC 20036
Tel: 202-776-0406 800-USA-5UCerebral Palsy (872-5827)
Fax: 202-776-0414
E-mail national@uCerebral Palsy.org
Website: www.uCerebral Palsy.org
Pathways Awareness Foundation [For Children With Movement
Difficulties]
150 N. Michigan Avenue
Suite 2100
Chicago, IL 60601
Tel: 312-893-6620 800-955-CHILD (2445)
Fax: 312-893-6621
E-mail
friends@pathwaysawareness.org
Website:
www.pathwaysawareness.org
March of Dimes Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
Tel: 914-428-7100 888-MODIMES (663-4637)
Fax: 914-428-8203
E-mail askus@marchofdimes.com
Website: www.marchofdimes.com
Easter Seals
230 West Monroe Street
Suite 1800
Chicago, IL 60606-4802
Tel: 312-726-6200 800-221-6827
Fax: 312-726-1494
E-mail info@easterseals.com
Website: www.easterseals.com
Children's Neurobiological Solutions (CNS) Foundation
1826 State Street
Santa Barbara, CA 93101
Tel: 866-CNS-5580 (267-5580) 805-898-4442
E-mail info@cnsfoundation.org
Website: www.cnsfoundation.org
Childrens Hemiplegia and Stroke Assoc. (CHASA)
4101 West Green Oaks Blvd., Ste. 305
PMB 149
Arlington, TX 76016
Tel: 817-492-4325
E-mail info437@chasa.org
Website: www.hemi-kids.org
United Cerebral Palsy (UCerebral Palsy) Research & Educational
Foundation
1025 Connecticut Avenue
Suite 701
Washington, DC 20036 Tel: 202-496-5060 800-USA-5UCerebral Palsy (872-5827)
Fax: 202-776-0414
E-mail national@uCerebral Palsy.org
Website: www.uCerebral
Palsyresearch.org
Pedal with Pete [For Research on Cerebral Palsy]
P.O. Box 274
Kent, OH 44240
Tel: 800-304-PETE (7383)
Fax: 330-673-1240
E-mail petezeid@aol.com
Website: www.pedalwithpete.com
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Diagnosis
Learn More About Early Intervention
Therapy Options
Thankfully, there are many ways to deal with childhood developmental
delays and behaviors. These include in-home services, outpatient (you take
your child to a clinic), inpatient (following injury or surgery) and school
based services. Which type of therapy should you choose?
Visit our Therapy Options
area to learn more.
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