What is Cerebral Palsy?
Cerebral Palsy is caused by damage to part of the brain responsible for movement either before, during or within the first year after birth. Each child is affected differently and whilst the brain cannot repair itself there are many options available to ensure that a child's independence and quality of life is maximised. Examples include; therapy, surgery, medication, assistive technology and ensuring the home environment is best suited to a child’s needs.
Cerebral Palsy can also impact on other areas of function such as cognition & learning, speech & swallowing, visual perception, and the processing of sensory information. Cerebral Palsy can be classified by the way the damage to the brain affects the muscles throughout the body. This in turn influences movement, posture and ultimately function in different ways. Below are some examples:
Spastic Cerebral Palsy
This refers to muscle stiffness, caused by high muscle tone, resulting in movement being slow and difficult in the affected areas of the body.
Ataxic Cerebral Palsy
This is caused by damage to the part of the brain that controls balance and planning of movement and impacts on both gross and fine motor skill development such as mobility and hand function.
Athetoid Cerebral Palsy
This refers to the symptoms caused by fluctuating muscle tone. As a result the child will experience difficulty in controlling their movements and especially finer movements that require more effort.
Cerebral Palsy is further classified by the parts of the body that are affected:
This is where one side of the body is affected such as the right arm and right leg as well as often the righthand side of the trunk. Damage to the brain occurs on the opposite side to the limbs affected.
This is evident where the lower limbs are most affected. There is also often some impact on hand function and other areas such as visual perception.
This is where the whole body, including all 4 limbs, are affected.
How would I know if my child has Cerebral Palsy?
Cerebral Palsy is usually diagnosed by a consultant paediatrician or paediatric neurologist. This is often following the results of a brain scan combined with their assessment of how a child is moving and behaving. Before a child receives a diagnosis, the following may be noticed:
- Not moving certain limbs at all or when moving them, does so in an unusual way
- Delay in achieving milestones or not reaching them at all, for example difficulty holding their head up, sitting, rolling or reaching with both hands
- Difficulty controlling the muscles of their mouth in order to breast or bottle feed successfully
- Difficulty in having their nappy changed or being dressed, as their limbs are stiff and difficult to bend
- holding one or both hands in a tightly clenched fist
This is by no means an exhaustive list of the features of Cerebral Palsy and some could also be indicative of other difficulties. Cerebral Palsy will affect each child differently, below are some examples of how a child may be affected.
Muscle tone is the state of muscle tension inside a muscle or muscle group, when it is at rest. A child with Cerebral Palsy will have altered muscle tone and may display low, increased or fluctuating tone as explained above. The extent at which the muscles are affected will determine how movement, and ultimately day-to-day activities are affected.
Cerebral Palsy will affect each child’s mobility differently. For some children, they will use a wheelchair, others may have an atypical walking pattern or gait, some may require a walking aid, and others may tire if walking long distances.
Fine motor skills
This refers to the skills required for successful dexterity. In order for a child to develop good fine motor skills, many other aspects of development are needed. Examples of this include:
- The ability to sit and maintain an upright posture
- The ability to use a variety of grips and grasps - involving the ability to control arm, wrist and finger movements
- The ability to use 2 hands together to complete certain tasks, for example when using scissors and cutlery or tying shoe laces
- Effective interpretation or perception by the brain of visual information.
- The ability to use memory, needed for learning
- The ability to efficiently and unconsciously plan and execute movement, also known as motor planning
How can an occupational therapist help with Cerebral Palsy?
How can an occupational therapist help with Cerebral Palsy? We have a team of paediatric occupational therapists who are highly skilled and experienced in helping children with Cerebral Palsy and supporting their families.
As Cerebral Palsy can affect children in very different ways, the occupational therapist will start with a full assessment. The focus of the assessment will be as much about understanding the child’s abilities as understanding what they are finding difficult and why. During the assessment, the occupational therapist will also want to gain an understanding of the child’s own goals as well the goals of their parents, carers or school.
Once this information is obtained, the occupational therapist will be able to provide tailored advice, support and intervention. Below are some examples of how an occupational therapist can assist:
- Improve the child’s skills by adapting tasks, teaching & training or advise on appropriate assistive technology to maximise independence and increase participation
- Facilitate safe access to school and home environments by providing advice on structural building changes and/or equipment
- Facilitate access to the school curriculum and support school staff in understanding how to best support the child’s education
- Reduce the risk of fixed postural changes over time by providing advice on appropriate equipment and techniques to maintain postural alignment. This include supportive seating, splinting or night time positioning such as sleep systems
If you would like to learn more about how we as occupational therapists can help overcome common difficulties associated with Cerebral Palsy, you will find some useful links at the bottom of this page.