What is Cerebral Palsy?

The term cerebral palsy refers to any one of a number of neurological disorders that appear in infancy or early childhood and permanently affect body movement and muscle coordination but don’t worsen over time. Even though cerebral palsy affects muscle movement, it isn’t caused by problems in the muscles or nerves. It is caused by abnormalities in parts of the brain that control muscle movements. The majority of children with cerebral palsy are born with it, although it may not be detected until months or years later. The early signs of cerebral palsy usually appear before a child reaches 3 years of age. The most common are a lack of muscle coordination when performing voluntary movements (ataxia); stiff or tight muscles and exaggerated reflexes (spasticity); walking with one foot or leg dragging; walking on the toes, a crouched gait, or a “scissored” gait; and muscle tone that is either too stiff or too floppy. A small number of children have cerebral palsy as the result of brain damage in the first few months or years of life, brain infections such as bacterial meningitis or viral encephalitis, or head injury from a motor vehicle accident, a fall, or child abuse.

WHAT MEDICAL PROBLEMS ARE ASSOCIATED WITH CEREBRAL PALSY?

Children with cerebral palsy have many problems, not all of them related to the brain injury. Most

of these complications are nevertheless neurological. They include epilepsy, mental retardation,

learning disabilities, and attention deficit-hyperactivity disorder. These problems are discussed in

chapter 3, as are problems that occur less commonly, such as swallowing problems in children with

spastic quadriplegia. In the next chapter, we look at normal pediatric development, to establish a basis with which to compare the development and behavior of a child with cerebral palsy.

Children with cerebral palsy may also develop hip subluxation or have problems with the gait.

HOW CAN REALISTIC GOALS BE DESIGNED FOR THE CHILD WITH CEREBRAL PALSY?

When it comes to expectations and questions of what the future holds for the child with CP, it is important to maintain a combination of optimism and realism, just as one would with any child. Suppose, for example, that the parent of a non-disabled three year old has hopes and expectations that the child will go to college and law school, enter politics, and eventually become President of the United States. Some of these expectations are realistic and are likely to be met, while others are extremely unlikely to occur to the point of being clearly unrealistic. Regardless of these realistic and not realistic expectations, however, the parent needs to care for the child as a three year old and

not as a college student or as a politician. It is equally important for the parent of a child with

cerebral palsy to understand the child's present and future abilities. That parent's expectations are

also probably a combination of realistic and unrealistic goals for the child, but in time, with

professional help, the parent will develop a set of mostly realistic goals and it is to these goals that

the parent, child, and professional will dedicate their effort. Occasionally, difficulties in communication arise when the parents, educators, and medical care providers discuss present abilities. As stated in the Preface, a significant goal of this book is to., improve this communication so that parents, educators, and medical care providers can communicate their impressions to each other regarding a specific child and in this way help the child function at his or her maximum ability. An attempt to define future expectations is usually most important in the teenage years and beyond, when function is better defined and the future looks more clear to everyone involved.