Cerebral Palsy

Types of Cerebral Palsy

• 1. Spastic CP (Most Common):
  Stiff muscles, awkward movements, tightness in arms or legs.
• 2. Dyskinetic CP:
  Involuntary, uncontrollable movements, twisting, or repetitive motions.
• 3. Ataxic CP:
  Problems with balance, coordination, and precise movements (like picking up small objects).
• 4. Mixed Type:
  Combination of two or more types mentioned above.

Common Causes of CP

• Premature birth
• Lack of oxygen during or shortly after delivery
• Brain infections (meningitis, encephalitis) in early infancy
• Severe jaundice in newborns
• Traumatic brain injury
• Genetic or metabolic disorders (rare)

Signs of Cerebral Palsy: What Should Parents Watch For?

Early Signs in Infants:

• Poor head control by 3–4 months
• Stiff or floppy muscles (increased or decreased tone)
• Delayed milestones (not rolling, sitting, crawling on time)
• Fisting of hands beyond 3 months
• Abnormal posture (arching back, crossing legs)
• Asymmetrical movements (using one side of the body more)
• Persistent primitive reflexes (like Moro or tonic neck reflex)

In Toddlers and Older Children:

• Delayed walking or inability to walk
• Difficulty with balance or coordination
• Walking on toes or scissoring gait (legs crossing while walking)
• Difficulty grasping objects or using hands effectively
• Drooling, feeding, and swallowing problems
• Speech delay or unclear speech

Associated Problems in CP (May Vary by Child):

• Intellectual disability
• Seizures (epilepsy)
• Hearing or vision problems
• Speech and communication difficulties
• Feeding and nutritional challenges
• Behavioral and emotional issues
• Orthopedic problems (hip dislocation, scoliosis)

Red Flags for Immediate Medical Evaluation:

• Loss of previously acquired motor skills (regression)
• Severe feeding difficulties (choking, poor weight gain)
• Frequent unexplained falls or injuries
• Inability to use both sides of the body equally

Whom Should Parents Contact?

• Developmental Pediatrician:
  For diagnosis and overall developmental evaluation.
• Neurologist:
  To assess brain function and detect seizures or other neurological issues.
• Physiotherapist:
  For movement, balance, posture, and mobility training.
• Occupational Therapist:
  For daily living skills like dressing, feeding, grasping, and writing.
• Speech-Language Pathologist:
  For speech, communication, feeding, and swallowing problems.
• Orthopedic Surgeon:
  If there are joint deformities or contractures.
• Clinical Psychologist:
  For cognitive assessment, behavior issues, or emotional support.

What Should Parents Do After Diagnosis?

• 1. Accept and Understand the Diagnosis:
  Learn about your child’s specific type and severity of CP.
• 2. Start Early, Multidisciplinary Intervention:
  A team-based approach (therapy, medication, possibly surgery) ensures the best outcomes.
• 3. Plan for Regular Therapy:
  Physiotherapy, Occupational Therapy, and Speech Therapy form the backbone of management.
• 4. Evaluate for Associated Conditions:
  Hearing, vision, and cognitive assessments are essential.
• 5. Apply for Government Support (if applicable):
  Disability certificates, benefits, and educational concessions are available for CP in India.

What Interventions Might the Child Need?

• Physiotherapy (Most Important):
  To improve posture, strength, flexibility, and mobility.
• Occupational Therapy:
  To teach self-care skills like dressing, feeding, and playing.
• Speech Therapy:
  For communication problems, drooling, and feeding difficulties.
• Medications:
  For spasticity (muscle tightness), seizures, or drooling.
• Assistive Devices:
  Walkers, wheelchairs, splints, braces, and orthotic supports.
• Surgical Interventions:
  In selected cases for muscle/tendon release or correcting bone deformities.
• Special Education and Learning Support:
  If intellectual disability or learning problems coexist.
• Nutritional Support:
  If the child has feeding or swallowing difficulties.

What Can Parents Do at Home?

• Practice Daily Therapy Exercises:
  Follow the physiotherapist’s program to maintain flexibility and strength.
• Create a Safe Environment:
  Modify the home (ramps, railings, non-slip mats) to prevent falls and injuries.
• Encourage Independent Skills:
  Allow the child to perform self-care tasks with support.
• Promote Communication:
  Use simple words, gestures, or communication devices (AAC) if required.
• Celebrate Achievements:
  Every small progress is important — build the child’s confidence.
• Stay Connected with School and Therapists:
  Inform teachers of your child’s needs; integrate therapy into daily routines.
• Join Support Groups:
  Meet other parents and caregivers to share experiences and resources.

Important to Remember:

Cerebral Palsy is Not Progressive.
The brain damage does not worsen, but physical challenges may change as the child grows.

Early and Consistent Therapy Makes a Difference.
Children can achieve greater independence with early support.

You Are Your Child’s Best Advocate.
Parental involvement is crucial in therapy, education, and community inclusion.

A Multidisciplinary Approach is Key.
Therapists, doctors, teachers, and parents working together yield the best outcomes.