OCCUPATIONAL THERAPY FOR CEREBRAL PALSY

For children with cerebral palsy, occupational therapy can help with muscle and
joint coordination issues — issues that can make everyday tasks difficult. Some of
these tasks include eating, brushing teeth and bathing. Occupational therapy can
help to improve physical, cognitive and social abilities, as well as fine motor skills
and posture.

Each type of cerebral palsy presents different symptoms that may hinder a child’s
ability to live independently and complete daily activities.

Occupational therapy can help with the following issues related to each type
of CP:
 Spastic - Muscle stiffness in the upper and/or lower limbs and jerky
movements characterize spastic cerebral palsy. Among other things, this can
lead to difficulty getting dressed, bathing, using the bathroom, eating,
drinking, writing and holding objects.
 Athetoid - Children with athetoid cerebral palsy are unable to regulate muscle
tone, which makes it difficult to control their movements. Trouble with
grasping objects, posture, drooling, swallowing, and speaking are common
among children with athetoid CP.
 Ataxic - Problems with balance and coordination are common among children
with ataxic cerebral palsy. These children often struggle with precise
movements and have tremors or shakiness. This makes it difficult to perform
tasks like writing or eating that require precise finger movements, or repetitive
movements like clapping.
 Flaccid
Common difficulties often (but not always) experienced by those with low
muscle tone:
 Fatigues quickly.
 Poor posture.
 Increased flexibility, increasing susceptibility to injuries.
 Poor persistence to gross motor tasks.
 Lack appropriate body awareness feedback.
 Avoids chewy foods.
 Preference to engage in sedentary activities.
Management strategies that support the child with low muscle tone (at
preschool, school and/or home):
 Reward system.
 Appropriate set up for school desk.
 Encouragement.
 Provide opportunities to succeed by simplifying activities.
 Extra time to complete tasks.
 Recognise and reinforce the child’s strengths.


Occupational therapy involves using functional activities to progressively improve

functional performance.

Occupational therapy exercises focus on the following skill areas:

 Fine Motor Control - Improves hand dexterity by working on hand muscle
strength, finger isolations, in-hand manipulations, arching the palm of the
 hand, thumb opposition and pincer grasp. Activities include squeezing a
clothespin, playing with water squirt toys and pushing coins into the slot of a
piggy bank.
 Bilateral Coordination - Play/movements teach the child to control both
sides of the body at the same time, like drumming, pushing a rolling pin and
pulling apart construction toys (Legos).
 Upper Body Strength and Stability - Play focuses on strengthening and
stabilizing the trunk (core), shoulder and wrist muscles through exercises,
such as crawling, lying on the tummy while reading, playing catch in a
kneeling position and pouring water from a pitcher into a cup.
 Crossing the Midline - These activities, like making figure eights with
streamers and throwing balls at a target to the right or left of center, teach the
child to reach across the middle of their body with their arms and legs to the
opposite side.
 Visual Motor Skills - Improves hand-eye coordination through activities, like
drawing, stringing beads or macaroni and catching and throwing a ball.
 Visual Perception - These activities improve the ability to understand,
evaluate and interpret what’s being seen. Activities include alphabet puzzles,
playing with different shapes and matching games.
Self-Care - Improves the ability to perform activities of daily living and prepare
the child to be more independent at home, at school and in the community.
Exercises can be as simple as practicing these ADLs, like brushing their teeth,
getting dressed and self-feeding. Occupational therapy involves using functional
activities to progressively improve functional performance.

Occupational Therapy Techniques and Devices

Occupational therapy includes repetitive exercises, games and other techniques
that help develop and reinforce new skills. For example, an occupational therapist
may help a child practice drawing, writing or grasping by repeating the activity on
a regular basis.

Many parents are surprised to learn that occupational therapy is fun for their
children, as they play with a variety of toys, make crafts and play games their
therapist. Of course, each of these activities seeks to improve specific skills that
will help children overcome challenges in their lives.

Alternatively, adaptive equipment may be used, including splints, braces, or

specialized equipment or devices, to help achieve a goal that otherwise isn’t
possible. Occupational therapy sessions may be dedicated to learning how to use
this equipment effectively.

Adaptive Equipment

Adaptive equipment and technology are rapidly evolving as inventors find new
ways to solve cerebral palsy limitations.

A few examples of adaptive equipment that may be used in occupational therapy

include:
 Braces, walkers or canes

 Writing or typing tools

 Specialized eating utensils

 Voice-to-text technology
  Electronic braille systems

 Communication boards

 Bath chairs

 Sports equipment

Sensory Therapy

Sensory integration therapy is used to improve a child’s ability to understand and

interpret signals being sent to their brain. Sensory therapy exposes children to
different physical experiences, textures and sensations. Play-Doh, slime, silly
putty, liquids, sand and finger paints are all common tools in sensory therapy.

Constraint-Induced Movement Therapy

Children with cerebral palsy may participate in constraint-induced movement

therapy (CIMT). CIMT attempts to strengthen the weaker part of the body by
restraining its stronger counterpart.

It’s very common for children with cerebral palsy to focus their movements on the
strong part of their body, which weakens the parts that are already harder to use.
CIMT helps reverse the impacts of this unintentional neglect.

Occupational Therapy at Home

Families can support their child’s occupational therapy by helping practice new
skills at home. Occupational therapists will make recommendations on how to
continue therapy in the home to help guide parents.
Parents may also be able to make changes around the home to support their child’s
development. For example, a therapist may recommend switching bedrooms,
installing specialized equipment or using adaptive technology at home. Following
the advice of a therapist can help increase a child’s success and improve their
quality of life.