Cerebral Palsy

Marjun B. Temporosa Dr. Matilde Tonel

Student Course Facilitator

Objectives:
At the end of the lesson, students are expected to:
1. Described the different types, symptoms, warning signs and causes of learners with
cerebral palsy.
2. Determine the difficulties teachers and parents face in dealing with people with cerebral
palsy.
3. Analyzed the approaches utilized by teachers and parents in dealing with people with
cerebral palsy.

Definition:
- Cerebral Palsy is a group of permanent disorders of the development of movement and
posture, causing activity limitation (Hockenberry & Wilson).
- It is a motor disorder, the condition involves disturbances of sensation, perception,
communication, cognition and behavior, secondary musculoskeletal problems and
epilepsy (Hockenberry & Wilson).

Types of Cerebral Palsy:

1. Spastic Cerebral Palsy
The most common type of CP is spastic CP. Spastic CP affects about 80% of people
with CP.
People with spastic CP have increased muscle tone. This means their muscles are stiff
and, as a result, their movements can be awkward. Spastic CP usually is described by
what parts of the body are affected:
Spastic diplegia/diparesis―In this type of CP, muscle stiffness is mainly in the legs,
with the arms less affected or not affected at all. People with spastic diplegia might have
difficulty walking because tight hip and leg muscles cause their legs to pull together, turn
inward, and cross at the knees (also known as scissoring).
Spastic hemiplegia/hemiparesis―This type of CP affects only one side of a person’s
body; usually the arm is more affected than the leg.
Spastic quadriplegia/quadriparesis―Spastic quadriplegia is the most severe form of
spastic CP and affects all four limbs, the trunk, and the face. People with spastic
quadriparesis usually cannot walk and often have other developmental disabilities such as
intellectual disability; seizures; or problems with vision, hearing, or speech.

2. Ataxic Cerebral Palsy

People with ataxic CP have problems with balance and coordination. They might be
unsteady when they walk. They might have a hard time with quick movements or
 movements that need a lot of control, like writing. They might have a hard time
controlling their hands or arms when they reach for something.

3. Dyskinetic Cerebral Palsy

It includes athetoid and dystonic cerebral palsies.
People with dyskinetic CP have problems controlling the movement of their hands,
arms, feet, and legs, making it difficult to sit and walk. The movements are
uncontrollable and can be slow and writhing or rapid and jerky. Sometimes the face
and tongue are affected, and the person has a hard time sucking, swallowing, and
talking. A person with dyskinetic CP has muscle tone that can change (varying from
too tight to too loose) not only from day to day, but even during a single day.

4. Mixed Cerebral Palsy

Some people have symptoms of more than one type of CP. The most common type of
mixed CP is spastic-dyskinetic CP.

Figure 1.1
It shows the various types of cerebral palsy and areas of brain damage involved.

Signs and Symptoms:

 In early signs, the signs of CP vary greatly because there are many different types and
levels of disability. The main sign that a child might have CP is a delay reaching motor or
movement milestones (such as rolling over, sitting, standing, or

walking). The following are some other signs of possible CP. It is important to note that some
children without CP might also have some of these signs.

In a Baby Younger Than 6 Months of Age

 His head lags when you pick him up while he’s lying on his back.
 He feels stiff.
 He feels floppy.
 When held cradled in your arms, he seems to overextend his back and neck, constantly
acting as if he is pushing away from you.
 When you pick him up, his legs get stiff, and they cross or scissors.

In a Baby Older Than 6 Months of Age
 She doesn’t roll over in either direction.
 She cannot bring her hands together.
 She has difficulty bringing her hands to her mouth.
 She reaches out with only one hand while keeping the other fisted.

In a Baby Older Than 10 Months of Age

 He crawls in a lopsided manner, pushing off with one hand and leg while dragging the
opposite hand and leg.
 He scoots around on his buttocks or hops on his knees but does not crawl on all fours.

Cerebral palsy is a condition characterized by a range of signs and symptoms, including non-
movement symptoms such as head size differences, irritability, lack of interaction, hypotonia,
and delayed development in children. Movement symptoms include stiffness in arms and legs,
uncoordinated movements, slow, writhing, twisting, flinging, throwing, fidgeting, or dancing,
and spasms or contractions that cause discomfort or pain. Cerebral palsy can also lead to delayed
development, which can involve other abilities. In summary, cerebral palsy is a complex
condition that can impact various aspects of life, including movement, appearance, and behavior.
 Cerebral Palsy
Joanna Marie B. Batersal Dr. Matilde Tonel
Student Course Facilitator

Causes:
CP is caused by abnormal development of the brain or damage to the developing brain
that affects a child’s ability to control his or her muscles. There are several possible causes of the
abnormal development or damage. People used to think that CP was mainly caused by lack of
oxygen during the birth process. Now, scientists think that this causes only a small number of CP
cases.
The abnormal development of the brain or damage that leads to CP can happen before
birth, during birth, within a month after birth, or during the first years of a child’s life, while the
brain is still developing. CP related to abnormal development of the brain or damage that
occurred before or during birth is called congenital CP. The majority of CP (85%–90%) is
congenital. In many cases, the specific cause is not known. A small percentage of CP is caused
by abnormal development of the brain or damage that occurs more than 28 days after birth. This
is called acquired CP, and usually is associated with an infection (such as meningitis) or head
injury.

Treatment:
There is no cure for CP, but treatment can improve the lives of those who have the
condition. It is important to begin a treatment program as early as possible.
After a CP diagnosis is made, a team of health professionals works with the child and
family to develop a plan to help the child reach his or her full potential. Common treatments
include medicines; surgery; braces; and physical, occupational, speech, and recreation
therapy. No single treatment is the best one for all children with CP. Before deciding on a
treatment plan, it is important to talk with the child’s doctor to understand all the risks and
benefits.

Physical Therapy
• Physical therapy is directed toward good skeletal alignment for child with spasticity,
training, face involuntary motion and gait training. Physical therapy can help the child's
strength, flexibility, balance, motor development and mobility.
• Physical therapy uses orthotic devices, such as braces, casting, and splints to support and
improved walking.

Occupational Therapy
 • Using alternative strategies and adaptive equipment, occupational therapists work to
promote the 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.

Speech and Language Therapy

• Speech and language therapy can help improve communication, eating and swallowing. It
can also encourage confidence, learning and socialization.

Recreation Therapy
 This therapy can help improve your child's motor skills, speech, and emotional well-
being.

Intervention Services
Both early intervention and school-aged services are available through our nation’s
special education law—the Individuals with Disabilities Education Act (IDEA). Part C of IDEA
deals with early intervention services (birth through 36 months of age), while Part B applies to
services for school-aged children (3 through 21 years of age). Even if your child has not been
diagnosed with CP, he or she may be eligible for IDEA services.

Characteristics of Student with CP in a Classroom

Children with cerebral palsy may experience specific learning difficulties. These may
include a short attention span, motor planning difficulties (organization and sequencing),
perceptual difficulties and language difficulties. These can impact on literacy, numeracy, and
other skills. Learning may also be affected by difficulties in fine motor and gross motor
coordination and communication. Students with cerebral palsy need to put more effort into
concentrating on their movements and sequence of actions than others, so they may tire more
easily.
Students may therefore require the use of specialized equipment such as a wheelchair or
walking frame or assistance to walk.

Difficulties of Teachers and Parents in Dealing Children with Cerebral Palsy

Dealing with children who have cerebral palsy presents unique difficulties for both
teachers and parents. Some of the challenges they may face include:

1. Physical Limitations
Children with cerebral palsy may have physical limitations that affect their mobility,
dexterity, and ability to participate in activities. Teachers and parents may need to adapt learning
environments and activities to accommodate these limitations.
2. Communication Barriers
Some children with cerebral palsy may have difficulty with speech and communication,
making it challenging for teachers and parents to understand their needs and preferences.

3. Educational Support
Children with cerebral palsy may require specialized educational support and
accommodations to help them succeed in school. Teachers may need to develop individualized
education plans (IEPs) and work closely with support staff to meet the child's unique needs.

4. Emotional and Behavioral Challenges

Children with cerebral palsy may experience frustration, anxiety, or depression related to
their condition, which can impact their behavior and emotional well-being. Teachers and parents
may need to provide emotional support and help the child develop coping strategies.

5. Social Integration
Children with cerebral palsy may face challenges in social situations due to their physical
limitations or communication difficulties. Teachers and parents can play a crucial role in
facilitating social interactions and fostering inclusive environments.

6. Access to Healthcare Services

Access to healthcare services, including physical therapy, occupational therapy, and
assistive devices, is essential for children with cerebral palsy. However, navigating the healthcare
system and securing appropriate services can be challenging for both teachers and parents.

7. Financial Strain
The cost of medical care, therapy, and assistive devices for children with cerebral palsy
can place a significant financial strain on families. Teachers and parents may need to advocate
for resources and support to ensure the child's needs are met.

Approaches of Teachers and Parents in Dealing People with Cerebral Palsy

Educators, therapists, parents, and students with CP can work together to create an
educational plan. This may include setting up an individualized education program (IEP) or 504
plan to help kids reach their full potential. Plans may include therapy, a classroom aide, and
more. As a child grows, this plan will change.
To support students in your classroom:
 Keep walkways open. Make your classroom easy to move through and free of obstacles.
Students may need extra help moving around or reaching things.
  Be aware of seating arrangements and adjust if they aren’t working. Kids with CP who
are self-conscious of uncontrolled movements or other differences may want to sit in the
back or away from others. Try to put kids near other students who encourage them to be
involved in activities.
 Give extra time, if needed. Some kids may need more time to travel between classes,
complete assignments, or activities, and take tests. They might need extra bathroom
breaks too. Talk to the students and parents to find out what’s best.

 Have a plan for missed instruction, assignments, and testing. Students with CP may miss
class time to go to doctor visits or to see the school nurse to take medicine. Know how
the student will make up for missed time.
 Talk about and celebrate differences. Students with CP want to be accepted like everyone
else. But sometimes they’re targeted by others who see them as “different.” Talk about
and celebrate differences and focus on the interests that kids share. Be mindful of
bullying and keep a zero-tolerance policy for that behavior.
 Be prepared for medical emergencies by planning ahead with parents. Know what to do
and who to call if a student with CP has a medical emergency or event, like a seizure.

References:
What is cerebral palsy? (2022, May 2). Centers for Disease Control and Prevention.
https://www.cdc.gov/ncbddd/cp/facts.html
Cerebral Palsy Alliance Research Foundation. (n.d.). How cerebral palsy affects people.
https://cparf.org/what-is-cerebral-palsy/how-does-cerebral-palsy-affect-people/?
fbclid=IwAR3hZr9nM6aC64Zng6y4AoL4UNvc2quNXjbT

Classroom adjustments: Cerebral Palsy

https://www.nccd.edu.au/professional-learning/classroom-adjustments-cerebral-palsy?
fbclid=IwAR2b68vehi2rFIaa2ElsUqoAlembviw6P4fQFHh7MtLPfxnY75D187UZ1YY

Cerebral Palsy Factsheet (for Schools)

https://l.facebook.com/l.php?u=https%3A%2F%2Fkidshealth.org%2Fen%2Fparents
%2Fcp-factsheet.html&h=AT0HEXqnPLCXWzYV-i6BGBO7OKDvmY5hj-
ccu0izYysCDzm4aoBfYZUgOimBCVXfv3aeOYlCgo8AqkJ_NgaX6UMyJZpsr76kZ5yDV_
SPusNjMl2Y4OF9HU9sMPENpwrzajXjBb5mPVi0j-g