Cerebral Palsy

Cerebral palsy is a condition caused by injury to parts of the brain before, during, or after birth, which results in impaired muscle control and affects a person's ability to move and maintain balance and posture. Cerebral palsy is considered to be a static disorder that will not get progressively worse as time goes on; it is characterized by damage to the brain during early periods of development, usually up to six years of age.

Individuals with cerebral palsy may have varying difficulties with movement, muscle tone, and posture. This condition affects muscle movement in four distinct patterns:

• 1.
  Spastic (high tone)—This, the most common type, is present in approximately 70% to 80% of individuals with cerebral palsy (Turnbull & colleagues, 2002). It is characterized by muscle tightness, or hypertonia, which results in stiff or restricted movements.
• 2.
  Athetoid (low tone)—This type includes abrupt, involuntary movements of the head, neck, face, and extremities, resulting in difficulties with controlling movement and maintaining posture.
• 3.
  Ataxic—This is characterized by unsteadiness, lack of coordination and balance, and difficulties with standing and walking. 4. Mixed—This form of cerebral palsy is a combination of high (spastic) and low (athetoid) muscle tone, resulting in stiff and involuntary movements from muscles that are either too tight or too loose. This type of cerebral palsy is often the result of injury to more than one area of the brain, and commonly leads to quadriplegia.

Cerebral palsy is also classified by the parts of body that are affected, including monoplegia (one limb), paraplegia (legs only), hemiplegia (one half of the body), triplegia (three limbs), quadriplegia (all four limbs), diplegia (more affected in the legs than the arms), and double hemiplegia (arms more involved than the legs).

Approximately 500,000 people in the United States have some form of cerebral palsy. In addition, 8,000 infants and 1,500 preschoolers are diagnosed with this condition each year (National Dissemination Center for Children with Disabilities [NICHCY], 2003). A number of prenatal factors may contribute to the occurrence of cerebral palsy, including genetic disorders, intrauterine infections, exposure to toxins, brain malformations, birth complications, and abnormal blood flow to the brain (Myers & Shapiro, 1999). Numerous perinatal (during or shortly after birth) factors such as lack of oxygen, brain hemorrhage, or jaundice may also cause cerebral palsy. In addition, factors such as traumatic brain injury, brain infection, and cardiac arrest that occur after birth may contribute to its occurrence. However, both perinatal and postnatal causes are rare, occurring in less than 10% of cases.

Children with cerebral palsy may face many challenges in school. Impairments in muscle movement, posture, and balance may require the use of assistive devices such as wheelchairs, scooters, or braces. In addition, language and articulation difficulties may result from limited muscle movement around the mouth and throat. Communication devices such as communication boards, photograph albums, or computerized talkers can help children with cerebral palsy to “talk” with others in the hopes of gaining the social, emotional, and academic benefits that often accompany communication. Because the disease is a result of injury to the brain, mental retardation often occurs. Approximately 66% of people with cerebral palsy have some degree of mental retardation. This has significant impacts on a child's ability to function in daily life and to learn in the academic environment.

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