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November 14, 2020Cerebral Palsy, Therapy and Practices
The majority of people with Cerebral Palsy spend their lives being judged by their diagnosis. They are seen as their diagnosis, and viewed far too often, as being unable to accomplish great things. When caregivers unwittingly believe this lie, they stay locked in their place of trauma and don’t make the effort to dream big dreams for their children, and then set about making them come true. The truth is far too many CP children have great potentials and they can also reach those potentials
Cerebral Palsy is a motor disability that affects the ability to move and maintain posture. CP can make otherwise simple tasks like walking, running, tying shoes, writing, or sitting, either challenging or impossible. Every person with CP has some level of difficulty with movement; some may have a learning disability, or vision, speech, and hearing problems on top of that. CP can look different on different people—someone with severe CP may need special equipment, like crutches or a wheelchair, to get around while someone with mild CP may walk on their own but appear unstable.
Cerebral Palsy is caused when the outer layer of a baby’s brain is injured before, during or shortly after birth. CP is the most common physical disability in children and most cases stem from an injury during pregnancy or delivery. For example, CP can result during pregnancy if an infection damages the unborn baby’s nervous system. CP can occur during delivery if the baby suffers brain damage. Studies show that a baby is born with CP every hour.
Each type of cerebral palsy presents different symptoms that may hinder a child’s ability to live independently and complete daily activities
Spastic – Muscle stiffness in the upper and/or lower limbs and jerky movements characterize spastic cerebral palsy. Among other things, this can lead to difficulty getting dressed, bathing, using the bathroom, eating, drinking, writing and holding objects.
Athetoid – Children with athetoid cerebral palsy are unable to regulate muscle tone, which makes it difficult to control their movements. Trouble with grasping objects, posture, drooling, swallowing, and speaking are common among children with athetoid CP.
Ataxic – Problems with balance and coordination are common among children with ataxic cerebral palsy. These children often struggle with precise movements and have tremors or shakiness. This makes it difficult to perform tasks like writing or eating that require precise finger movements, or repetitive movements like clapping.
There is currently no cure for cerebral palsy. But many options are available to help children with the disorder deal with physical and mental difficulties. Symptoms of cerebral palsy can sometimes affect many parts of the body, making it hard for someone to live on their own. But not every person with cerebral palsy will be very physically or intellectually challenged. Some can overcome many limitations with early intervention and have normal — or near-normal, sometimes even above-average — levels of intelligence.
Treatments for cerebral palsy vary depending on the severity of symptoms. Some common treatment approaches include:
- Special education training and resources
- Physiotherapy and stretching muscles to prevent shortening and risk for deformities
- Using a walker or braces to help stabilize posture
- Speech therapy especially Oral Motor and articulation Exercises to improve speech clarity
- Speech therapy for Feeding/Swallowing
For children with cerebral palsy, occupational therapy can help with muscle and joint coordination issues — issues that can make everyday tasks difficult. Some of these tasks include eating, brushing teeth and bathing. Occupational therapy can help to improve physical, cognitive and social abilities, as well as fine motor skills and posture. This therapy can also help address difficulties with processing sensory information
Professional speech pathologists assess development and treat disorders, assisting with speech, language and swallowing difficulties. Successful speech therapy improves communication and muscle control, correcting chewing and eating problems, as well as drooling, sometimes affecting kid with celebral palasy
Occupational therapy can help with managing everyday activities and functions, like eating, getting dressed and using the bathroom. It does so by improving physical and cognitive ability and fine motor skills. Occupational therapy helps people develop or recover the skills needed to lead independent, satisfying lives. The “occupation” in occupational therapy does not refer to one’s profession. Rather, it refers to the everyday activities that give life meaning. For a child, these meaningful activities include playing and learning. Pediatric occupational therapy focuses on improving the child’s ability to play and learn.
For children with cerebral palsy, occupational therapy can help with muscle and joint coordination issues — issues that can make everyday tasks difficult. Some of these tasks include eating, brushing teeth and bathing. Occupational therapy can help to improve physical, cognitive and social abilities, as well as fine motor skills and posture. This therapy can also help address difficulties with processing sensory information. Occupational therapy is beneficial for children with cerebral palsy in many ways. Increasing their chance for independence, Improving their ability to play and learn, Boosting their self-esteem and confidence, helping them develop a workable routine,Giving them a sense of accomplishment, Improving their quality of life. Parents and caregivers spend a lot of time helping children with cerebral palsy perform basic day-to-day activities. As the child begins to see the benefits of occupational therapy, the parents and caregivers do, too. Success depends on an ecclectic team.
Occupational therapy helps by: Works on fine motor, sensory and adaptive skills that improving their quality of life, allowing parents to watch their child improve and become independent
Pediatrician or psychiatrist. A pediatrician oversees the treatment plan and medical care.
Physiotherapists. May help your child improve strength and walking skills, and stretch muscles.
Occupational therapist. An occupational therapist can provide therapy to your child to develop daily skills and to learn to use adaptive products that help with daily activities.
Speech-language pathologist. diagnoses and treats speech and language disorders may work with your child if your child suffers from speech, swallowing or language difficulties.
Developmental therapist. A developmental therapist may provide therapy to help your child develop age-appropriate behaviors, social skills and interpersonal skills.
Mental health specialist. A mental health specialist, such as a psychologist or psychiatrist, may be involved in your child’s care. He or she may help you and your child learn to cope with your child’s disability.
Recreation therapist. Participation in art and cultural programs, sports, and other events that help children expand physical and cognitive skills and abilities. Parents of children often note improvements in a child’s speech, self-esteem and emotional well-being.
Social worker. A social worker may assist your family to find services and plan for care transitions.
Special education teacher. A special education teacher addresses learning disabilities, determines educational needs and identifies appropriate educational resources.
Prescription Medications: Medications that can lessen the tightness of muscles may be used to improve functional abilities, treat pain and manage complications related to spasticity or other cerebral palsy symptoms.
It’s important to talk about drug treatment risks with your doctor and discuss whether medical treatment is appropriate for your child’s needs. Medication selection depends on whether the problem affects only certain muscles (isolated) or the whole body (generalized). Drug treatments may include the following:
Isolated spasticity. When spasticity is isolated to one muscle group, your doctor may recommend onabotulinumtoxinA (Botox) injections directly into the muscle, nerve or both. Botox injections may help to improve drooling. Your child will need injections about every three months.
Side effects may include pain, mild flu-like symptoms, bruising or severe weakness. Other more-serious side effects include difficulty breathing and swallowing.
Generalized spasticity. If the whole body is affected, oral muscle relaxants may relax stiff, contracted muscles. These drugs include diazepam (Valium), dantrolene (Dantrium) and baclofen (Gablofen).
Diazepam carries some dependency risk, so it’s not recommended for long-term use. Its side effects include drowsiness, weakness and drooling.
Dantrolene side effects include sleepiness, weakness, nausea and diarrhea.
Baclofen side effects include sleepiness, confusion and nausea. Note that baclofen may also be pumped directly into the spinal cord with a tube. The pump is surgically implanted under the skin of the abdomen.
Your child also may be prescribed medications to reduce drooling. Medications such as trihexyphenidyl, scopolamine or glycopyrrolate (Robinul, Robinul Forte) may be helpful, as can Botox injection into the salivary glands.
Therapies
A variety of nondrug therapies can help a person with cerebral palsy enhance functional abilities:
Physical therapy. Muscle training and exercises may help your child’s strength, flexibility, balance, motor development and mobility. You’ll also learn how to safely care for your child’s everyday needs at home, such as bathing and feeding your child.
For the first 1 to 2 years after birth, both physical and occupational therapists provide support with issues such as head and trunk control, rolling, and grasping. Later, both types of therapists are involved in wheelchair assessments.
Braces or splints may be recommended for your child. Some of these supports help with function, such as improved walking. Others may stretch stiff muscles to help prevent rigid muscles (contractures).
- Occupational therapy. Using alternative strategies and adaptive equipment, occupational therapists work to promote your child’s independent participation in daily activities and routines in the home, the school and the community.
- Adaptive equipment may include walkers, quadrupedal canes, seating systems or electric wheelchairs.
- Speech and language therapy. Speech-language pathologists can help improve your child’s ability to speak clearly or to communicate using sign language.
- Speech-language pathologists can also teach your child to use communication devices, such as a computer and voice synthesizer, if communication is difficult.
- Another communication device may be a board covered with pictures of items and activities your child may see in daily life. Sentences can be constructed by pointing to the pictures.
- Speech therapists may also address difficulties with muscles used in eating and swallowing.
- Recreational therapy. Some children may benefit from recreational therapies, such as therapeutic horseback riding. This type of therapy can help improve your child’s motor skills, speech and emotional well-being.
Surgical or other
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