Cerebral Palsy David Beasley, Carolyn Dennis, Donna Smith, AnnMarie Zillmann,

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Cerebral PalsyDavid Beasley, Carolyn Dennis,
Donna Smith, Ann-Marie Zillmann,

• What is it?
• CP is an impairment of muscle control which
  results from some interference with the
  developing brain.
• Children can have problems such as weakness,
  stiffness, awkwardness, slowness, shakiness and
  difficulty with balance
• This may result in difficulties in posture,
  mobility, fine motor skills, speech and/or
  eating.
• These problems can range from mild to severe. In
  mild CP, the child may be slightly clumsy in one
  arm or leg. In severe cases, the whole body may
  be affected.

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Causes Incidence

• Radiation exposure, infection, or use of certain
  drugs during 1st 3 months of pregnancy, or
  chromosome abnormalities.
• Damage in later stages of pregnancy.
• Birth complications.
• Neo-natal complications
• Incidence is approximately 1 in 500 with the
  incidence of boys being affected 30 higher than
  girls

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Types of CP

• CP can be described in terms of
• Severity mild, moderate, severe or profound
• Location monoplegia (1 limb), hemiplegia (2
  limbs on the same side of the body), paraplegia
  (both legs), triplegia (3 limbs), or quadriplegia
  (all 4 limbs and sometimes face and mouth),
  diplegia (all 4 limbs but more so the legs)
• Symptom type (spasticity, athetosis, rigidity,
  ataxia or tremor)

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Symptom Types

• Spasticity-characterized by excessively
  contracted or tight muscles, interfering with
  normal movement activity, often resulting in
  shortening and atrophy of the muscles and muscle
  deformities.
• Athetosis- characterised by involuntary movement
  of the muscles, usually appearing as a twisting,
  writhing series of movement.
• Rigidity-characterised by a slow, laboured
  movements of the muscles around the joint.

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• Symptom Types Cont
• Ataxia-characterised by a stumbling gait and poor
  sense of movement or muscular effort. The muscles
  are often flaccid and there are often problems
  with the sense of touch, depth perception and
  balance
• Tremor- trembling or shaking movements occurring
  either only when the person moves intentionally
  or only when they are at rest

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Implications

• Developmental Problems
• motor development
• Sensory development (impaired hearing, vision,
  tactile and kinaesthetic)
• Perceptual disturbances impairment of Neuro
  linguistic processing skills such as attending,
  decoding, storing, retrieving and encoding
  information

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Medical Implications (Treatment)

• Use of sedatives or nerve-blocking chemicals
• Orthopaedic surgery or neurosurgery
• Use of braces for walking, special seating,
  wheelchairs

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Social Behavioural

• Approximately 60 of people with CP also have
  some degree of cognitive impairment, leading to
  perceptual emotional deficits.
• Perceptual problems include distractibility,
  resistance to change, dissociation,
  disinhibition, difficulties in figure-ground
  organization, taking a long time to respond to
  requests or questions
• Emotional problems include emotional instability
  characterized by flushing, inappropriate
  laughing, gagging, etc. when excited, and
  emotional upsets stemming from the environment.

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Educational Implications

• With the high reliance of the eyes, ears, arms,
  hands and voice for communication, children with
  CP are at a considerable disadvantage.
• 30-40 of chn with CP have defective vision,
  13.3 have impaired hearing, 78.5 have arm /or
  hand involvement on the right side, 70-80
  have moderate to profound vocal communication
  problems.

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• Educational Implications
• Printing may be preferred over writing.
• The use of a keyboard may be easier and allow the
  student to keep up.
• This can be achieved by having a matrix of the
  worksheets on the computer.
• A tape recorder could be used to record students
  responses. (Assessment)
• Sit the children close to the blackboard if they
  have a visual impairment or short attention span.
• Introduce appropriate individual classroom
  strategies
• E.g. Thick pencil or pencil grip will help with
  grasping, soft pencil for the student who presses
  hard when writing.

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• Educational Implications cont
• Communication Aids can be used for students with
  little or no speech. A child who is slow to
  answer does not imply that they do not
  understand. Ensure adequate time is given.
• Levels of activity must be considered for
  successful outcome. Time limits that are
  achievable.
• Ask the student to do part of the activity.
• One on one assistance with a buddy or teacher
  aide is achievable when the teacher is unable to
  assist.

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• Cont
• Because of this and the other implications
  mentioned large proportions of children with CP
  are classified as severely handicapped
  educationally and in need of a multidisciplinary
  and very special educational curriculum.

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Resources Books Cerebral Palsy. BrisDept. Of
Education, Queensland, 1995. Cerebral Palsy a
Practical Guide. Marion Stanton. Cerebral Palsy
An Information Guide for Teachers. Produced by
Kids First. Call 362.196836 Cer CerebralPalsy
Basic abilities A Plan for Training the
Preschool Child. Author- Brereton, Beatrice Le
Gay call 371.916 Bre Cerebral Palsy In Childhood.
Call 618.92836 Woo Cerebral Palsy Interaction
Games for Severely Handicapped Children without
Speech. Call 618.92836 Bre
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Resources cont Video Who Is to
Blame? Publication - Adelaide, (South Australia).
Foundation Studios, Womens Childrens Hospital.
1996. Call 616-836 Cer - reserve collection. My
Left Foot. Available to borrow from Video Ezy etc.
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Websites www.birth-injury-malpractice-law.com/cer
ebral-palsy.shtm Discussion Board www.healthboards
.com/cerebral-palsy/ www/sjromers/cp,/patientedu/c
erebralpalsy.html www.newhorizons.org/spreeds_intr
.html www.conductive-edu.org.uk/conductive.html ww
w.cerebralpalsytoday.com/cerebral-palsy-hb.htm www
.ucpsouthflorida.org/ //neuro-www.mgh.harvard.edu/
neurowebforum/GeneralFeedback www.myzone.co.za/zzm
yZone/zlteal/gel_cerebral.cfm