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Neurological Conditions

Cerebral Palsy

What is it?

Cerebral Palsy is the most common physical disability in childhood. It is a general term for a group of conditions caused by non-progressive disturbances to the developing brain during pregnancy or infancy. There is no cure for cerebral palsy (CP) and for most people living with CP the cause is unknown.

Cerebral palsy is caused by abnormal development of part of the brain or by damage to parts of the brain that control movement. This damage can occur before, during, or shortly after birth. The majority of children have congenital cerebral palsy CP (that is, they were born with it), although it may not be detected until months or years later. A small number of children have acquired cerebral palsy, which means the disorder begins after birth. Some causes of acquired cerebral palsy include brain damage in the first few months or years of life, brain infections such as bacterial meningitis or viral encephalitis, problems with blood flow to the brain, or head injury from a motor vehicle accident, a fall, or child abuse.

Cerebral palsy presents as a life-long disorder of posture and movement and may be accompanied by other impairments such as disturbances of sensation, communication issues, epilepsy, visual, hearing and behavioural issues.

How Cerebral Palsy affects children?

Whilst cerebral palsy is not a progressive condition, changes may occur over time. As the child grows and uses their muscles more, their muscles may become tighter. Cerebral palsy varies greatly in how it affects the individual due to varying types of CP, severity of movement disorder, and related functional abilities and limitations. Some effects of CP include:

  • Inactivity due to impairment of motor centers in the brain
  • Intellectual disability
  • Growth and developmental delay
  • Deformities of the spine
  • Strabismus (cross eyes)
  • Impaired hearing
  • Speech and language disorders
  • Incontinence
  • Contractures
  • Poor dental health
  • Early intervention is important in supporting children with CP and their families.

Childhood inactivity is magnified in children with CP due to impairment of the motor centers of the brain that produce and control voluntary movement. While children with CP may exhibit increased energy expenditure during activities of daily living, movement impairments make it difficult for them to participate in sports and other activities at a level of intensity sufficient to develop and maintain strength and fitness.

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Prenatal screening and diagnosis

Most children with cerebral palsy are diagnosed during the first 2 years of life.  But if a child’s symptoms are mild, it can be difficult for a doctor to make a reliable diagnosis before the age of 4 or 5.

Doctors will order a series of tests to evaluate the child’s motor skills. During regular visits, the doctor will monitor the child’s development, growth, muscle tone, age-appropriate motor control, hearing and vision, posture, and coordination, in order to rule out other disorders that could cause similar symptoms. Although symptoms may change over time, CP is not progressive. If a child is continuously losing motor skills, the problem more likely is a condition other than CP such as a genetic or muscle disease, metabolism disorder, or tumours in the nervous system.

Lab tests can identify other conditions that may cause symptoms similar to those associated with CP.

Getting help with Cerebral Palsy

It is recommended that early occupational therapy is implemented for babies and young children with any type or severity of cerebral palsy.  The first two years of life is a critical period for neuroplasticity and so the brain is most likely to be more responsive to intensive practice of activities during this time.

Cerebral palsy can’t 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.

There is no standard therapy that works for every individual with cerebral palsy. Once the diagnosis is made, and the type of CP is determined, a team of health care professionals will work with a child and his or her parents to identify specific impairments and needs, and then develop an appropriate plan to tackle the core disabilities that affect the child’s quality of life.

Physical therapy, usually begun in the first few years of life or soon after the diagnosis is made, is a cornerstone of CP treatment. Specific sets of exercises (such as resistive, or strength training programs) and activities can maintain or improve muscle strength, balance, and motor skills, and prevent contractures. Special braces (called orthotic devices) may be used to improve mobility and stretch spastic muscles.

Occupational therapy focuses on optimising upper body function, improving posture, and making the most of a child’s mobility. Occupational therapists help individuals address new ways to meet everyday activities such as dressing, going to school, and participating in day-to-day activities.

Recreation therapy encourages participation in art and cultural programs, sports, and other events that help an individual expand physical and cognitive skills and abilities. Parents of children who participate in recreational therapies usually notice an improvement in their child’s speech, self-esteem, and emotional well-being.

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