Knowing Cerebral Palsy
Cerebral Palsy (CP) is an umbrella term for a group of neurological disorders caused by a non-progressive brain injury or malformation that occurs while the child’s brain is under development.
It is a disorder of movement, balance and posture. It is said to be the most common motor disability of childhood.
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According to the United States’ Centre for Disease Control and Prevention, CP is more common among boys than girls, and more common among black children than among white children.
The risk factors for development of CP can be grouped under antenatal, perinatal and postnatal. Prematurity and low birth weight, intrauterine infections, multiple gestations, drugs and toxins like alcohol and pregnancy complications are few of the antenatal risk factors.
Birth asphyxia (lack of oxygen to the brain) and complicated labour and delivery are a couple of perinatal factors. After delivery, the risk factors include brain trauma, meningitis/encephalitis.
Symptoms
The symptoms of CP can include delay in reaching developmental milestones such as poor neck control by six months or not sitting by nine months or not walking by 18 months; seeming too stiff or too floppy, weak arms and legs, uncontrolled movements, fidgety or clumsy movements; vision difficulties, swallowing difficulties, communication difficulties and learning disabilities.
Symptoms vary from person to person as well as the impact on the individual. The effects of CP can range from minor/mild difficulties to severe impairment.
For example, a person with severe CP may need to use special equipment to help with walking, or may not be able to walk at all and need lifelong care, while a person with mild CP may walk (with) an unstable gait, but may not need any special help.
CP does not get worse over time, but, however, the exact symptoms can change over a person’s lifetime.
There are different types of CP, namely, spastic, dyskinetic and ataxic CP. The type is often determined by the timing, site, type and extent of brain lesion.
Knowledge of the type of CP can alert professionals to possible associated difficulties.
Treatment, management
There is currently no cure for CP. The symptoms are managed with different interventions. Treatment may include physiotherapy to help maintain physical ability and improve movement difficulties, occupational therapy to help with activities of daily living, speech and language therapy to help with speech, language, communication, feeding and swallowing difficulties (and) medical intervention (in some cases surgical intervention).
The aims of treatment include improving functional abilities (for example, helping client to walk), improving participation in activities and ultimately improving the quality of life of people with CP & their families.
Feeding, communication
Cerebral palsy can affect motor control throughout the entire body. For example, it can affect one side of the body, legs or a limb.
It can also affect the muscles around the mouth and impact on chewing, speaking, breathing, and swallowing.
The most common motor speech disorder associated with CP is dysarthria, which is difficulty with controlling the muscles in the mouth and generating enough breath to speak.
This may result in poor pronunciation, poor speech intelligibility and feeding difficulties, among others.
Difficulties with speech and feeding may significantly affect the quality of life of persons with CP. Speech and language therapy can help individuals improve speech production, chewing and swallowing, listening & comprehension, breathing, use of augmentative or alternative communication systems (e.g. pictures, technology - tablet), and expressive language and voice.
The writer is a Speech & Language Therapist/Clinical Tutor, University of Ghana/Korle Bu Teaching Hospital.
E-mail: [email protected]
