Growing up can be tough with even the easiest of circumstances. As children get older, they play and interact with other children, making friends along the way. Children do not, however, all have the same experiences with growing up in their school or home environment. Some children have a tougher time than others to interact or make friends. Children with disabilities have characteristically been in this category. It is not their fault, however, that people look at them in this way. Children with cerebral palsy are in this special group of people. Each child should have the same opportunities as their so-called “normal” agemates such as to going to school, playing sports, and making friends.

Cerebral palsy (CP) is a “non-progressive, non-contagious condition that causes physical disability in human development” (1). This means that the disease does not get worse as the child gets older, and that the disease cannot be spread to other people by means of coughing, sneezing, breathing on them, or even with direct contact. This disorder is usually discovered at the time of birth or shortly thereafter, usually up to age three. Cerebral palsy affects the area of the brain called the cerebellum, which is characterized for its important role in sensory perception and motor control. Many children who are diagnosed as having CP have either had brain damage to the motor control centers of the brain (the cerebellum) during pregnancy, which account for about 75% of all cases, or from brain trauma after birth, such as an early car accident, which accounts for about 15% of the other cases (1).

There is no cure for cerebral palsy as of yet, but researchers are working on finding out if there is a specific genetic component responsible for this disease. If a gene is determined to be partly responsible, geneticists can then try to isolate it, and figure out what can be done to stop this from happening to more children in the future. Researchers, however, have a long way to go before any significant data can be determined from their findings so far.

There are four major classifications of cerebral palsy: spastic, athetoid/dyskinetic, ataxic, and mixed. Each classification represents a different area of the brain that was damaged. Spastic cerebral palsy is the most common out of the four types. It occurs in about 70% to 80% of all cases. This type is characterized by the muscles being hypertonic, meaning that they are oversensitive to stimuli and react more quickly. This type of CP usually has damage in the motor cortex of the brain. There are three main types of spastic CP as well: spastic hemiplegia, meaning that only one side of the body is affected; diplegia, only the lower extremities are affected; and quadriplegia, all four limbs are affected equally. Most people with spastic diplegia, even though only their legs are affected, do eventually walk. Spastic quadriplegia is the most severe form out of these three subtypes because it is characterized with more secondary symptoms such as high blood pressure, urinary infections, heart attacks, and strokes (1).

Ataxia is the second type of cerebral palsy. This is usually caused by damage to the cerebellum, which is responsible for most motor functions. Ataxia is much less common than spastic CP, only occurring in about 10% of all cases. People with this type of CP have motor problems such as with writing, typing, and especially with balance and walking activities. It is also common for them to have “difficulty with visual and/or auditory processing of objects” (1).

Athetoid, or dyskinetic, CP is when a person has mixed muscle tone, meaning that some people have hypertonia (too much muscle tone) and other have hypotonia (not enough muscle tone). This type of CP is characterized by damage to the extrapyramidal motor system and the basal ganglia, occurring in about 25% of all cases. These people typically have problems with sitting in an upright position, holding steady, and walking. Many also have involuntary motions. Mixed cerebral palsy is just a combination of these types already mentioned, and can be any combination (1).

Cerebral palsy is a fairly common disease in children, occurring in about two out of 1000 births, and has a higher rate in males than females. Approximately 10,000 infants and babies are diagnosed with CP each year, many of them being diagnosed by the time they enter preschool (1). Not a lot of information is known about the direct causes of how children develop cerebral palsy, but researchers can hypothesize what they think are contributing factors in many of the cases. They have found that “premature, very small babies who don’t cry in the first five minutes after delivery, who need to be on a ventilator for over four weeks, and who has bleeding in the brain” are the most at risk for developing the disease (2). This is a particularly narrow description in that most small premature babies born have over a 90% chance of NOT having cerebral palsy (2).

CP can also become an issue after birth, even if the birthing process was completely normal. There are many factors that may contribute to the disease presenting itself in early childhood. Other causes that may come up later are: toxins such as lead poisoning, shaken baby syndrome, near drowning, encephalitis, meningitis, and asphyxia. The three most common forms of asphyxia that may contribute to children developing CP are choking on a foreign object, poisoning, and near drowning. Asphyxia causes less oxygen to be transported to the brain, depriving it of its essential nutrients to function properly, therefore damage to the brain may be permanent (1).

Cerebral palsy may be difficult to diagnose because each child develops differently. However, children do follow a common, general pattern in their development, so this has been used to help with some of the debate. The most common
way of diagnosing CP is through the normal developmental milestones, such as reaching for toys, sitting, and walking. Each of these is based on certain motor functions, which is the most prevalent problem with people with cerebral palsy. When a physician is looking for a diagnosis, he is usually looking for delays in these milestones. They will look at how long the delay has been, and look to see if there are any other factors that may be contributing to physical characteristics such as abnormal muscle tone, muscle movement, and reflexes. Most children can be diagnosed by the time they reach 18 months of age. It is a common misconception that CP can be diagnosed through using x-rays or blood tests. This is false, but doctors often order these tests to rule out other diseases and disorders to best get a diagnosis that fits the patient (2).

There are some common signs and symptoms that are characteristic with most types of cerebral palsy. All types have abnormal muscle tone, posture, reflexes, and motor development and coordination problems. Many children also have problems with walking and balance, and are commonly seen scissor walking (where the knees come in and cross) or toe walking. They often have irregular posture, either being very floppy or very stiff. Some children have symptoms that are less common such as birth defects like a spinal curvature, a small jawbone, or a small head. Cerebral palsy also has some secondary conditions that may occur in children such as: seizures, epilepsy, speech or communication disorders, eating problems, sensory impairments, mental retardation, learning disabilities, or behavioral disorders (1).

In one journal article I read, a study was done to find out about the quality of life of people with cerebral palsy. There is a common misconception that people with this disease are not happy with themselves, and therefore have a lower quality of life. But when a survey was done of 500 children aged eight to twelve with CP in several European countries, it was found that they view life with the same quality as their agemates without the disease. It was also noted that the children viewed the same things important as their agemates without the disease, emphasizing more internal qualities than focusing on their physical limitations (3).

Another study reported findings that were focused on the physical aspects of the disease rather than the emotional aspects. This study grouped children with cerebral palsy by the level of their physical disabilities, and compared levels of physical activity participation over time. Level I corresponds to people who can walk with no restrictions and only have limitations in advanced gross motor activities. These childrens' results were comparable to children without musculoskeletal limitations and higher than individuals with mild disabilities, which means they participated just as much over time as children with no disabilities. Children who were grouped in levels II through V could not perform most of the personal care or daily mobility activities, and they needed physical assistance throughout the day. These groups of children were resulted to have the least amount of time with physical activity participation over the study period (4).

CP itself does not worsen as a person ages, meaning that the brain will stay the same for a person’s entire lifespan. The symptoms, however commonly worsen over time. People diagnosed with cerebral palsy are more likely to have a learning disability as well as physical limitations, but this does not affect their intellect or IQ scores. Most of the people with cerebral palsy are also expected to have a normal life expectancy (1). Sadly though, the employment rate for adults with CP is only about 40% (5). This number has been on the rise though because of new laws that protect people with disabilities from discrimination.

Since there is no cure for cerebral palsy, people with this disease must get treatment for their various symptoms. In general, the earlier the treatment starts in childhood, the better the outcome of the child, and the better the chance they will be able to overcome their developmental disabilities or learn to compensate in other ways. There are many areas of treatment that can help these young individuals such as physical, occupational, and speech therapy; and drugs to control seizures, alleviate pain, and relax muscle spasms.

Many such treatments have proven to be effective with helping people with cerebral palsy. Swimming seems to be the universal helping agent with many diseases. Children with CP can float in the water on tubes, and learn to hold their heads up slowly, without the weight of gravity making it much heavier when on dry land. These children can start off with small exercises to build up muscle tone in the pool, and then advance to more sophisticated ones on dry land.

These children can also play a variety of sports just like their agemates can without physical or developmental disabilities. They can play sports such as soccer, tennis, bowling, and tee ball. All of these sports, however, must be adapted so that they will tend to the children’s disabilities and make it more functional for them to participate.

In soccer, children with cerebral palsy who cannot walk and are in wheelchairs can play on a hard surface such as a basketball court, and “kick” around a large ball (instead of a small soccer ball) with their wheelchairs. Others can set up goals on each side of the basketball court so they can score.

For tennis, children with cerebral palsy that have gross motor function disabilities can have a special racket that can be fastened with Velcro to their hand/arm, so that they can hit the ball over the net. A bigger ball might be used in this sport as well to make it easier for the child to hit with only a limited range of motion. This can also be adapted so children in wheelchairs can play as well.

Bowling can be modified in that a bowling ball ramp can be used. When the child is in a wheelchair or can get up and walk on his/her own, this is a useful tool. The child can just push the ball from the ramp and get a strike! Tee ball can also be modified for children with cerebral palsy in that the bases can be put closer together, a bigger ball can be used, and the bat may be strapped to the child’s hand just like a tennis racket. Each of the adaptations can help children with cerebral palsy have fun with other kids and play sports, just like “regular” kids want to do.

“It is important to separate the disorder from the person, and not make assumptions about what life must be like for that child or their family” (3). This is a very important part of accepting people for who they are, and not what kind of disabilities they may have. Every child wants to be treated with the same respect and patience they deserve. Treating children with a developmental disability such as cerebral palsy normally is vital to their growth and development throughout life. If they are treated equally among other children their age, they will have a better outlook on life, and will appreciate who they are more than what they can or cannot do. Cerebral palsy is not this terrible disease that has to be “dealt” with, but rather a minor setback in life that may be overcome in the mind, as long as one thinks positively and keeps a positive outlook on life.


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