Behavior And Emotional Wellbeing
Behavioral problems occur in 1 in 4 children with cerebral palsy. At greatest risk are those with an intellectual disability, epilepsy, severe pain or a milder level of physical disability. Problem behaviors include dependency, being headstrong, hyperactive, anxious, or prone to conflict with their peer group, or exhibiting antisocial behaviours. Children with cerebral palsy may also have emotional problems such as difficulties with their peer group and strong emotional responses to new challenges. Teenagers and adults with cerebral palsy may be more prone to depression and anxiety disorders.
How Does Cerebral Palsy Affect The Nervous System
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Cerebral Palsy can interfere with the bodys ability to carry out commands coming from the nervous system. How Cerebral Palsy affects the nervous system depends on the type and severity of the Cerebral Palsy and whether there are other co-existing conditions.
This information was compiled from medical journals, non profit support organizations, and experts who study Cerebral Palsy.
Read more to learn about how Cerebral Palsy can affect the nervous system.
How Does Cerebral Palsy Affect Development
Developmental disorders can be difficult to identify, as they can exhibit symptoms of other physical disabilities or learning disabilities. Parents may notice that their child seems to be on a different path of growth and development through the early years, but the child may not exhibit enough symptoms for a straightforward diagnosis. One of the most common developmental disorders to be aware of is cerebral palsy.
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Cerebral Palsy Isnt An Intellectual Impairment But
Cerebral Palsy is a series of muscle and movement disorders. People with Cerebral Palsy have limited mobility or coordination of their arms and or legs. Although permanent, CP is fortunately non-progressive, meaning it does not worsen over time.
Cerebral Palsy does not on its own affect a persons intelligence. However, as many as 30-50% of children with CP have some form of cognitive impairment caused by a coexisting condition. Although we do not always understand what causes cognitive impairment, often the same trauma that causes CP during labor and delivery can also affect other areas of the brain and cause a cognitive impairment.
For example, if a child experiences hypoxic-ischemic encephalopathy, also known as HIE, meaning that parts of the brain do not receive sufficient oxygen flow during labor and delivery, the brain injury that occurs may cause both CP and other disorders.
Common coexisting conditions that relate to intellectual or learning barriers during childhood development may include:
- Short attention spans
- Language and communication difficulties
- Emotional and behavioral struggles
There does seem to be a correlation between more severe cases of CP and intellectual impairment. However, some children with severe CP have no intellectual impairments whatsoever, and some children with mild CP have severe intellectual impairmentsso nothing is a certainty.
Premature Aging & Fatigue
Many people with cerebral palsy experience premature aging due to compromised mobility, motor function, and balance.
Living with impaired movement your whole life can add extra stress to your mind and body. In fact, individuals with cerebral palsy must use up to 3-5 times more energy to move around than those without a disability.
Body distortions can also add extra strain on certain organs or connective tissues. As a result, premature aging may be evident in the form of chronic pain and musculoskeletal problems.
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How Is Cerebral Palsy Treated
Cerebral palsy cant 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 childs 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 and activities can maintain or improve muscle strength, balance, and motor skills, and prevent contractures. Special braces may be used to improve mobility and stretch spastic muscles.
Occupational therapy focuses on optimizing upper body function, improving posture, and making the most of a childs 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.
Screening For Intellectual Impairments
If you notice that a child is not meeting common developmental milestones, you should start by contacting your primary care physician or family doctor and telling the doctor your concerns.
Writing down your questions and observations ahead of time may help you remember to get answers to all of your concerns during the appointment. Following the appointment, the doctor may wish to start with an observational screening period.
During the screening process, the doctor may wish to conduct developmental tests or observe the child for a period of time. Additionally, the doctor may order imaging such as x-rays, CT scans, or an MRI to help further investigate potential issues.
All of this information gathering period is helpful for determining a diagnosis, especially in young children when it may be challenging to diagnose what is wrong.
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If you would like help investigating your childs birth injury, please contact us. Our birth injury attorneys will be happy to give you a free case evaluation. We can also point you to great non-legal resources that can help you figure out your next steps.
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How Common Is Cerebral Palsy
Cerebral palsy is the most common motor disability in kids in the United States. Of every 1,000 babies born in the U.S. every year, between 1 and 4 have cerebral palsy. Boys are slightly more likely to get CP, and the condition is more common among multiples. Babies born prematurely or with a low birth weight have a higher risk of CP.
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Lifelong Financial Assistance For Your Child’s Birth Injurycerebral Palsy
Damage to the white matter of the brain, known as periventricular leukomalacia , appears as small holes in the babys white matter of the brain. PVL can affect movement, tighten muscles, and cause vision problems. PVL can also be associated with developmental delays.
Bleeding in the brain, known as an intracranial hemorrhage, happens when broken or blocked blood vessels cause a fetal stroke. Intracranial hemorrhaging is considered dangerous and medical assistance is needed as soon as possible.
The severity of intracranial hemorrhage will depend on how much bleeding has happened and how much of the brain tissue has been affected. A grading system, consisting of Grade I through IV, is generally used to determine the seriousness of the hemorrhage.
Seizures are also associated with intracranial hemorrhage.
Asphyxia is the lack of oxygen to the brain. This can happen while the baby is still in utero and during childbirth.
Loss of oxygen for prolonged periods can lead to hypoxic-ischemic encephalopathy, a medical issue marked by damaged cerebral motor cortex tissue and damaged tissue in and other areas of the brain.
Spinal And Hip Abnormalities
Abnormalities of the spine and hips are associated with cerebral palsy and can make sitting, standing and walking difficult, and cause chronic pain. 1 in 3 children with cerebral palsy have hip displacement. Children and adults who have a severe physical disability or those whose body is affected on both sides are at greater risk of hip problems. This means that people who use wheelchairs most of the time are more at risk of hip problems than those who walk with assistive devices or independently.
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Body Parts Affected By Cerebral Palsy
As previously mentioned, the body parts affected by cerebral palsy will depend on the severity and the type of the disorder.
All four limbs are affected when children have quadriplegic cerebral palsy, also known as spastic quadriplegia. Its a subset of spastic cerebral palsy and the most severe form of the disorder.
Children with quadriplegic cerebral palsy may have mouth issues and difficulties with swallowing. They could also have issues dealing with bowel and bladder control.
In severe cases, children with quadriplegic cerebral palsy are unable to walk or talk and may develop limb deformities.
Diplegia, also known as spastic diplegia, is a subset of spastic cerebral palsy marked by issues in the limbs, specifically in the legs. Spasticity in the legs leads to stiff, jerky movements and hypertonia.
According to the U.S. Department of Health and Human Services, along with muscle weakness and stiffness in the limbs, children with spastic diplegia tend to walk on their toes. They can also have problems with their eyes crossing, balance issues, and delayed milestones.
Due to stiff and tight muscles, some children with spastic diplegia walk with a scissor gate. In a scissor gate, the legs turn inward and the knees close together or crossed. In extreme cases, children may not be able to walk.
With mild spastic diplegia, children can typically have good muscle tone and a good range of motion.
Dyskinetic Cerebral Palsy
What Other Conditions Are Associated With Cerebral Palsy
Intellectual disability. Approximately 30 50 percent of individuals with CP will be intellectually impaired. Mental impairment is more common among those with spastic quadriplegia than in those with other types of cerebral palsy.
Seizure disorder. As many as half of all children with CP have one or more seizures. Children with both cerebral palsy and epilepsy are more likely to have intellectual disability.
Delayed growth and development. Children with moderate to severe CP, especially those with spastic quadriparesis, often lag behind in growth and development. In babies this lag usually takes the form of too little weight gain. In young children it can appear as abnormal shortness, and in teenagers it may appear as a combination of shortness and lack of sexual development. The muscles and limbs affected by CP tend to be smaller than normal, especially in children with spastic hemiplegia, whose limbs on the affected side of the body may not grow as quickly or as long as those on the normal side.
Spinal deformities and osteoarthritis. Deformities of the spinecurvature , humpback , and saddle back — are associated with CP. Spinal deformities can make sitting, standing, and walking difficult and cause chronic back pain. Pressure on and misalignment of the joints may result in osteoporosis .
Drooling. Some individuals with CP drool because they have poor control of the muscles of the throat, mouth, and tongue.
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What Is Cognitive Functioning
Cognition or the ability to use ones intellectual capacity to reason, accurately perceive, and learn informs many aspects of our lives. Its the cornerstone of our ability to use what we know to achieve goals, communicate with others, and build relationships.
If a child has Cerebral Palsy, it doesnt mean that he or she has impaired cognitive functioning. Sometimes, a childs Cerebral Palsy will only affect his or her physical functioning. However, about 30 to 50 percent of children with Cerebral Palsy have some level of cognitive impairment. Children with severe Cerebral Palsy have a greater likelihood of having cognitive impairments.
Like many other aspects of having a child with Cerebral Palsy, cognitive impairment requires management. Not doing so can have undesirable consequences studies show that individuals with Cerebral Palsy who are struggling with cognitive impairment have more general health concerns, and a higher mortality rate.
Once parents learn that their child is cognitively-impaired, they may become worried that their childs full potential may not be realized. However, children with cognitive impairments lead enjoyable and meaningful lives.
Some of the brains functions that fall under cognition include:
- Attention span
- Preterm complications
Is Cerebral Palsy An Impairment
Yes. Impairment is the loss or limitation of function. Impairment is a condition that limits a person to some degree.
Individuals diagnosed with Cerebral Palsy have a neurological condition which primarily causes physical impairment involving limitation or loss of function and mobility. They experience difficulty with muscle coordination, muscle control, muscle tone, reflexes, balance or posture. They may have difficulty with fine or gross motor skills. Their facial muscles may be affected.
Individuals with Cerebral Palsy often have associative and co-mitigating conditions that also impose additional challenges, such as a learning impairment, seizures, and vision or hearing loss.
A person can have impairment without having a disability.
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Definition Of Cerebral Palsy
While Cerebral Palsy is a blanket term commonly referred to as CP and described by loss or impairment of motor function, Cerebral Palsy is actually caused by brain damage. The brain damage is caused by brain injury or abnormal development of the brain that occurs while a childs brain is still developing before birth, during birth, or immediately after birth.
Cerebral Palsy affects body movement, muscle control, muscle coordination, muscle tone, reflex, posture and balance. It can also impact fine motor skills, gross motor skills and oral motor functioning.
Possible Complications Of Cerebral Palsy
Contractures. Contractures occur when the stiff, spastic muscles pull too tightly on the bones and joints the muscle cannot move and the bone and/or joint may become deformed from the pressure.
Falls. Because of difficulty with movement and balance, CP patients who can walk may be prone to falling.
Aspiration pneumonia and other respiratory problems because of swallowing difficulties and difficulty with diaphragmatic breathing. Such problems are especially likely for CP patients who are confined to a wheelchair.
Malnutrition because of swallowing and chewing difficulties.
Indigestion because of poor muscle motility. The food does not move in the esophagus and the rest of the digestion tract as it should.
Behavior and emotional problems. The brain damage or brain malformations present in CP combined with the stress of dealing with physical disabilities can lead to behavioral and emotional problems for many CP patients.
Delayed development and growth. Developmental delays are generally the first sign that an infant may have CP.
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What Are The Types Of Cerebral Palsy
There are different types of CP:
- Spastic cerebral palsy, which is the most common type. It causes increased muscle tone, stiff muscles, and awkward movements. Sometimes it only affects one part of the body. In other cases, it can affect both arms and legs, the trunk, and the face.
- Dyskinetic cerebral palsy, which causes problems controlling the movement of the hands, arms, feet, and legs. This can make it hard to sit and walk.
- Ataxic cerebral palsy, which causes problems with balance and coordination
- Mixed cerebral palsy, which means that you have symptoms of more than one type
What To Do If You Suspect Your Child Has Cp
Like many developmental disorders, cerebral palsy can be diagnosed right after birth, or it may take months to a couple of years for milder cases. The best thing that a parent can do is monitor their child, look out for important developmental milestones, educate themselves on potential conditions and seek professional care from a certified health care provider as soon as any questions or concerns arise. Aside from cerebral palsy, other conditions to look out for include Erb’s palsy and Klumpke’s palsy.
While there is no cure for many of these conditions, early intervention can set children up with assistive devices and other resources needed to combat any mobility or cognitive concerns.
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Can Cerebral Palsy Be Treated
The goal of treatments for CP are to improve movement, speech and quality of life. Therapy is the most common treatment for cerebral palsy.
Its crucial to start therapy as early as possible. Skilled therapists can help children learn to walk, communicate and take care of themselves. They can also help you learn how to provide therapeutic opportunities for your child at home. Treatment plans are different for everyone and may include:
- Therapy: Physical, occupational and speech therapies improve how a child moves, plays and interacts with the world.
- Medications: Botulinum toxin injections temporarily weaken the muscles to improve range of motion and stiffness. Muscle-relaxing drugs such as baclofen can help with stiffness and spasms.
- Surgery: Your provider may recommend surgery to improve mobility. Surgeons can lengthen tendons and muscles or repair problems in the spine. Certain patients may benefit from a procedure called selective dorsal rhizotomy . In SDR, surgeons decrease muscle spasticity in the legs by cutting through overactive nerves in the spine.
How Cp May Affect Your Child
How much a child is able to move around and do things depends on the type of CP the child has and how much of his or her body is affected. The way CP affects a child also depends on the child’s level of intellectual disability, if any, and whether he or she has other complications or other medical conditions.
Most people who have CP have a type of spastic cerebral palsy. This can affect the whole body but may only affect parts of the body in some children. For example, a child with spastic cerebral palsy may have symptoms mostly in one leg or on one side of the body. Most children usually learn ways to adapt to their movement problems, like using special devices and equipment to move around.
Total body cerebral palsy causes the most severe problems. Many of those affected are not able to take care of themselves, either because of severe physical disabilities or intellectual disability. But some people can live on their own with the help of family members, health care aides, or both.
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