NEURODEVELOPMENTAL DISORDERS

Cerebral Palsy

What is it?

Cerebral palsy refers to a collection of permanent neurological disorders affecting muscle tone, movement, and posture.

It can implicate other bodily functions such as sight, hearing, breathing, eating, talking, and could also lead to intellectual disability and learning problems.

It is usually first detected through developmental delays in the child which prevents them from attaining certain motor milestones (e.g., sitting, crawling, and walking).

Causes

Cerebral palsy usually results from brain damage.

This includes brain trauma or developmental abnormalities before a child’s birth, during the birth process, or before the age of 5, when the brain is still developing. Some children may be born with the condition while others could develop it later.

Unfortunately, causes of cerebral palsy can only be identified in about half of the cases. Some of the most important risk factors increasing chances of occurrence are premature birth, low birth weight, multiple births (e.g., twins or triplets), and complications during labour and delivery.

How does Cerebral Palsy Look Like?

Unlike other disorders that you may find on our website, cerebral palsy is an extremely expansive condition encompassing a slew of symptoms across different domains of functioning.

It affects each person differently. Each case of cerebral palsy is a unique combination of symptoms at varying levels of severity. This combination is partly determined by the nature and timing of brain injury. Here is a non-exhaustive list of the possible symptoms in cerebral palsy:

Ψ Spasticity: a state of constant muscle tightness
Ψ Involuntary movements and tremors
Ψ Intellectual disabilities
Ψ Speech abnormalities

Cerebral palsy is commonly classified into 4 types:

Ψ Spastic: The most common type, accounting for around 70 to 80% of children with cerebral palsy. It is characterised by muscle stiffness and awkward movements.

Ψ Dyskinetic: People with dyskinetic cerebral palsy have problems controlling the movement of their limbs, and any attempt to initiate movements in these areas can lead to abnormal and uncontrolled movements.

Ψ Ataxic: This form of cerebral palsy involves disturbances in balance, coordination, depth perception, and fine motor control.

Ψ Mixed Cerebral: A person with mixed cerebral palsy possess symptoms from more than one of the above categories. Spastic-dyskinetic is the most common combination found in mixed cerebral palsy.

Cerebral Palsy in Children

3 types of motor problems can be observed in children with cerebral palsy:

Ψ Brain damage causes primary impairments such as abnormal muscle tone — being overly stiff or floppy, lack of balance and coordination, and muscle weakness
Ψ Secondary impairments like muscle contractures and joint deformities may set in over time as limbs are forcefully contorted into painful and awkward positions
Ψ The child may eventually develop tertiary impairments in response to the earlier impairments. This includes hyperextension of the knee.

The type and extent of impairment vary across cases and may manifest in areas such as the arms, legs, and face. Due to the various impairments, children with cerebral palsy may face difficulties in everyday motor tasks such as walking, chewing, swallowing of food and drink, and holding on to objects.

Additionally, they may suffer from other associated problems such as epileptic seizures, vision or hearing impairment, communication and speech problems, and moderate to profound intellectual disability.

While cerebral palsy may sound like a scary condition, it is non-progressive. That is, the condition will not cause the brain to degenerate over time.

Addressing Cerebral Palsy

Unfortunately brain damage is irreversible, and so cerebral palsy is a permanent condition and incurable. However, its impact can be minimised, and therapy and treatment can improve the lives of children with cerebral palsy. Some of the common methods to address it include:

Ψ Medication: Medicine relieving muscle tightness can be prescribed to boost physical functions, alleviate pain, and manage secondary impairments

Ψ Surgery: Some children with cerebral palsy are more likely to benefit from surgical procedures than others, especially in cases where the symptoms are severe. Such operations may involve the correction of bone abnormalities, snipping of specific nerves, and lengthening of tendons. They can also reduce the child's need for medications and even prevent the need for future surgery.

Ψ Physical therapy: Therapy exercises may be used to strengthen muscles and improve mobility, posture, and balance.

Ψ Speech therapy: Through speech therapy, a child can learn to speak with more clarity or to communicate through alternative means (e.g., sign language or communication devices). It can also lead to improvements in swallowing and breathing problems.

As with most other disorders, there is no best method for all, and not all methods are suitable for every child. It is crucial for parents to work closely with healthcare professionals to develop the optimal management plan for their child.

Supporting your child with Cerebral Palsy

Caring for a child with cerebral palsy can feel overwhelming. Here are some ways you can better attend to your child's medical and emotional needs while taking care of your own mental wellbeing — remember that you need to take care of yourself before you can take care of someone else.

Ψ Get involved in your child’s management plan

Due to their unique condition, your child may need to see several health care professionals (e.g., paediatricians, surgeons, psychologists, and social workers) and undergo multiple treatments or therapies as part of their management plan. It is thus important to keep track of the different treatments and therapies that your child is receiving, as well as the various appointments they have to attend. Being more involved in your child's medical care enables you to make more informed health decisions for them and ensure that they are getting the most appropriate help.

Ψ Help your child stay positive

Oftentimes, children with cerebral palsy may be upset that their condition prevents them from engaging in activities enjoyed by their peers. You should constantly remind your child of their strengths and the things that they are able to accomplish (with or without assistance). It is advisable to help your child realise the similarities they share with other children — this can be something as simple as a common interest in a certain topic or a favourite dish that they share. All this will help your child feel a greater sense of belonging and see themselves in a more positive light.

Ψ Get in touch with other parents

Consider getting to know other parents of children with cerebral palsy, as they may be able to provide valuable advice to help you better manage your child's condition. Being able to empathise with your challenges in caring for a child with cerebral palsy, they may also render emotional support to you and even your child.