Risk Factors For Cerebral Palsy At Birth
In rare cases, some babies develop CP as a result of complications during the mother’s pregnancy or at birth. Risk factors include:
- Premature birth. Premature babies are more likely to have bleeding in the brain or a brain injury called periventricular leukomalacia . Either of these problems may cause CP.
- Difficult or prolonged labour.
- Brain infection or physical trauma can increase a baby’s risk of getting CP.
- A lack of oxygen also increases a baby’s risk. This isn’t common.
- CP can itself cause a baby to have a difficult birth because of body movement and posture problems related to the condition.
Movement Coordination And Control
Some signs will be more apparent when the child is under stress. Some may be task related, such as reaching for an object. Sometimes signs will seem to disappear when the child is asleep and muscles are relaxed.
It is common for a child to experience different types of impaired muscle control in opposite limbs. Coordination and control can likewise be affected differently in each limb.
The impairment of coordination and control fall under the following types:
- Spastic movements hypertonic movements where the muscles are too tight resulting in muscle spasms, scissoring of the legs, clonus, contracture, fixed joints, and over-flexed limbs
- Athetoid or dyskinetic movements fluctuating muscle tone causing uncontrolled, sometimes slow, writhing movements which can worsen with stress
- Ataxic movements poor coordination and balance making tasks such as writing, brushing teeth, buttoning shirts, tying shoes, and putting keys into slots difficult
- Mixed movements a mixture of movement impairments, most commonly a combination of spastic and athetoid types, affecting different limbs
- Gait disturbances control impairments affecting the way a child walks
Gait disturbances include:
Types Of Cerebral Palsy
Cerebral palsy is a disorder that can affect the patient in a number of ways, and the type and severity of symptoms will vary depending on the extent of the brain injury sustained.
For this reason, no two people with CP will have exactly the same circumstances. However, basic similarities between cases make it possible for CP to be divided into a number of identifiable types.
By understanding the type of cerebral palsy your child has, you can better understand the treatment options available. However, bear in mind that it is possible to have more than one type of CP, which will affect symptoms and treatment.
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Orthotics In The Concept Of Therapy
To improve the gait pattern, orthotics can be included in the therapy concept. An Orthosis can support physiotherapeutic treatment in setting the right motor impulses in order to create new cerebral connections. The orthosis must meet the requirements of the medical prescription. In addition, the orthosis must be designed by the orthotist in such a way that it achieves the effectiveness of the necessary levers, matching the gait pattern, in order to support the proprioceptive approaches of physiotherapy. The characteristics of the stiffness of the orthosis shells and the adjustable dynamics in the ankle joint are important elements of the orthosis to be considered. Due to these requirements, the development of orthoses has changed significantly in recent years, especially since around 2010. At about the same time, care concepts were developed that deal intensively with the orthotic treatment of the lower extremities in cerebral palsy. Modern materials and new functional elements enable the rigidity to be specifically adapted to the requirements that fits to the gait pattern of the CP patient. The adjustment of the stiffness has a decisive influence on the gait pattern and on the energy cost of walking.
Advances In The Field Of Developmental Disability
The ethos of human rights and rapid advances in understanding of the basic sciences of human development have been viewed as both productive and challenging for the field of developmental disability. Advances in biology and medicine, for example, could lead to new therapies while also creating difficult ethical challenges. The emergence of human and civil rights as a relevant agenda item for persons with severe disabilities in the post-World War II era dramatically altered the character of the developmental disability dialogue. Humane care was replaced by human rights as a guiding force for shaping services and policy. Yet the logical extension of advances in the biological sciences is the elimination of impairments and prevention of defects, perceived or real. The ability of persons with significant developmental disability to fit into society remains an issue in countries throughout the world, and in many cases that issue is anchored to the discussion of how humanity is defined. The juxtaposition of these questions of disability, inclusion, and humanity represents a major challenge in the evolving conceptualization of developmental disability.
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What Is Cerebral Palsy
Cerebral palsy is a group of disorders that affect a persons ability to move and maintain balance and posture. CP is the most common motor disability in childhood. Cerebral means having to do with the brain. Palsy means weakness or problems with using the muscles. CP is caused by abnormal brain development or damage to the developing brain that affects a persons ability to control his or her muscles.
The symptoms of CP vary from person to person. A person with severe CP might need to use special equipment to be able to walk, or might not be able to walk at all and might need lifelong care. A person with mild CP, on the other hand, might walk a little awkwardly, but might not need any special help. CP does not get worse over time, though the exact symptoms can change over a persons lifetime.
All people with CP have problems with movement and posture. Many also have related conditions such as intellectual disability seizures problems with vision, hearing, or speech changes in the spine or joint problems .
Prevalence Of Cognitive Disabilities
Prevalence data on an aggregate of cognitive disabilities in developing countries are not available. summarizes the range of prevalence estimates for severe mental retardation among children in populations throughout the world. The studies are listed in descending order by per capita income of the countries in which they were conducted. These estimates show a clear tendency toward elevated prevalence in low-income countries. In developed countries, the prevalence of severe cognitive disability is consistently found to be in the range of 3 to 5 per 1,000 children. By contrast, the prevalence of severe cognitive disability in developing countries ranges from a low of 2.9 per 1,000 children in Beijing to a high of 22 per 1,000 in slum areas surrounding Lahore, Pakistan. The majority of estimates from low-income countries are above 5 per 1,000, while no estimates from developed countries are this high.
World Prevalence of Blindness
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Is Cerebral Palsy A Handicap
A handicap is a situational barrier or obstacle that limits activity or restricts participation, often temporarily. The World Health Organization defines two types of handicaps:
Activity limitations are difficulties an individual may have in executing a task or action.
Participation restrictions are problems an individual may have in involvement in life situations.
A handicap is apparent only when the barrier or obstacle exists. For a person who uses a wheelchair for mobility, stairs and narrow hallways may present a handicap. Ramps, elevators, and alternate hallways remove the handicap.
Today, much is being done to remove barriers and obstacles for individuals with impairment. WHO and U.S. government agencies guided by the Americans with Disabilities Act, collaborate with employers, retailers, transportation sources and private groups on a mission to identify obstacles and barriers. They also work to reduce or eliminate handicaps. These organizations promote inclusion, accessibility, and accommodation standards.
For Babies And Young Children
Help prevent CP in your young child by minimizing your child’s risk for getting a brain injury.
- Know how to prevent lead poisoning.
- Keep your child away from people who have serious contagious illnesses, such as meningitis.
- Make sure your child’s immunizations are up-to-date. For more information, see the topic Immunizations.
If your child has not been diagnosed with CP, pay attention to whether your child is reaching early developmental milestones. Report anything you notice to your doctor at regularly scheduled well-child visits or anytime you have concerns.
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What Can You Do To Cope
Meeting the daily needs of a family member with cerebral palsy isn’t easy. If your child has cerebral palsy, seek family and community support. It may help to join a support group or talk with other parents who have a child with special needs, so you don’t feel alone.
You may also find counselling useful. It may help you understand and deal with the wide range of emotions you may feel. Your child will need help too. Providing emotional support for your child can help him or her cope with having cerebral palsy.
Learning that your child has cerebral palsy isn’t easy, and raising a child who has it can be hard. But the more you know, the better you can care for and provide for your child.
Prevalence Of Hearing And Speech Disabilities
Estimates of hearing loss and profound deafness vary from 1 per 1,000 in developed countries to 1.4 to 4 per 1,000 in developing countries. WHO estimates the worldwide prevalence of hearing impairment to be 120 million, with 78 million of those affected living in developing countries. Limited studies from developing countries reflect the frequent variability found in prevalence data on disabilities described earlier due to non-standardized methods of testing and reporting. A study from Kenya revealed rates from 1 to 3 percent while studies in Sri Lanka and Thailand found rates as high as 12 and 13.6 percent, respectively. Studies in India have estimated that 80 million individuals suffer from some level of disabling hearing impairment. A 1990 official survey of the handicapped in China reported 23.1 million hearing-impaired individuals among which six million suffered from profound hearing loss. Prevalence rates of profound hearing loss of 2.7 per 1,000 in the Gambia and 4 per 1,000 in Sierra Leone are three to four times the prevalence rates of developed countries. Chronic otitis media has been determined as the most frequent cause of hearing impairment in many developing countries. High prevalence of the infectious diseases that cause CMO, such as meningitis and measles, in developing countries suggests a greater risk for hearing impairment in these populations. Estimates suggest that as much as 50 to 66 percent of all hearing impairment is preventable.
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Eight Clinical Signs Of Cerebral Palsy
Since Cerebral Palsy is most often diagnosed in the first several years of life, when a child is too young to effectively communicate his or her symptoms, signs are the primary method of recognizing the likelihood of Cerebral Palsy.
Cerebral Palsy is a neurological condition which primarily causes orthopedic impairment. Cerebral Palsy is caused by a brain injury or brain abnormality that interferes with the brain cells responsible for controlling muscle tone, strength, and coordination. As a child grows, these changes affect skeletal and joint development, which may lead to impairment and possibly deformities.
The eight clinical signs include muscle tone, movement coordination and control, reflexes, posture, balance, gross motor function, fine motor function and oral motor function. These are detailed below.
A Look At The Numbers: 3 Studies On Co
Researchers from the Autism and Developmental Disabilities Monitoring Network found that 60% of children with CP had another developmental disability in addition to cerebral palsy. Out of a sample population of 8-year-olds with cerebral palsy from Alabama, Georgia, Wisconsin, and Missouri:
- About 40% had an intellectual disability,
- About 35% had epilepsy,
- About 15% had vision impairment,
- About 25% had both an intellectual disability and epilepsy.
Children with limited or no walking ability were more likely to have epilepsy: 67%. Autism was rarer overall but more common in non-spastic or hypotonic cerebral palsy . The rate of autism spectrum disorder among children with cerebral palsy was substantially higher than among children without cerebral palsyabout 7% vs. 1%!
The researchers concluded, The higher frequency of autism spectrum disorder in non-spastic than in spastic subtypes of CP calls for closer examination. Such an examination has yet to be published.
Another collaboration by the Surveillance for Cerebral Palsy in Europe noted the following numbers for co-occurring conditions alongside cerebral palsy:
- About 31% of children had a severe intellectual disability.
- About 11% of children had a severe visual disability.
- About 21% of children had epilepsy.
Lastly, a study published in China examined children with cerebral palsy who were treated at a rehabilitation center from January 2007 to June 2009. Of those children:
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What Causes Cerebral Palsy
Cerebral palsy is a neuromuscular disorder caused by damage to the motor cortex of the developing brain. This affects motor functioning, including an individuals ability to move, grasp objects and talk.
It can also affect muscle tone, resulting in individuals with overly toned, tight muscles and rigid joints or loose, floppy muscles and joints.
The type and severity of CP symptoms will depend in large part on the extent of the brain injury and when it occurred. There are four primary situations that will lead to cerebral palsy to arise:
Ibrief History And Nomenclature
Cerebral palsy describes a group of motor-impairment syndromes secondary to a wide range of genetic and acquired disorders of early brain development. This definition allows inclusion of new genetic, metabolic, and other causes of CP that may be discovered in the future and serves as an ongoing reminder to clinicians to remain vigilant to the diagnostic challenges in this group of children. Correct diagnosis has important ramifications for treatment, prognosis, and recurrence risk.
Although there is some variability in etiological antecedents among developing and developed countries, prevalence is approximately 2:1000 children in most areas, making it the most common chronic neurological motor disorder of childhood . Although comprehensive longitudinal studies are limited, the majority of children grow into adulthood, actively participating in societal life but facing specific, recognized challenges.
Table 1. Definition of Cerebral Palsy
|Cerebral palsy describes a group of disorders of the development of movement and posture, causing activity limitation, that are attributed to nonprogressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, cognition, communication, perception, and/or behavior, and/or by a seizure disorder.|
Table 2. Components of Cerebral Palsy Classification
May Loo MD, in, 2009
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Premature Birth And Low Birth Weight
A baby who is born prematurely usually has a low birth weight, less than 2.5 kg . But full-term babies can also have low birth weights. Multiple-birth babies are more likely than single-birth babies to be born early or with a low birth weight.
Most children with CP had a disruption in the normal development of parts of their brain during fetal growth. Low-birth-weight, premature babies are more likely than full-term, normal-weight babies to have had developmental problems during fetal growth that can injure the brain. For example, a condition called periventricular leukomalacia, or PVL, which reflects injury to the white matter of the brain, is more likely in babies born prematurely than in those born at full term.
Questions To Ask Your Doctor:
- Are there early intervention programs available in our area?
- Is it safe for my child to exercise, run and jump?
- Is there anything that my child should avoid doing?
- Will Cerebral Palsy cause my child any long-term problems?
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Evaluating And Monitoring Cerebral Palsy
After CP is diagnosed, a child will also be checked for other medical conditions that can occur with cerebral palsy, such as:
- Other developmental delays in addition to ones already found. Developmental abilities will be checked to find out if new symptoms, such as speech and language delay, appear as a child’s nervous system matures.
- Intellectual disability. This can be checked by intelligence testing.
- Seizures. An electroencephalography is used to check for abnormal activity in the brain if a child has a history of seizures.
- Problems with feeding and swallowing.
- Vision or hearing problems.
- Behavioural problems.
Most of the time, a doctor can predict many of the long-term physical effects of CP when a child is 1 to 3 years old. But sometimes such predictions aren’t possible until a child reaches school age. That’s when learning, communication skills, and other abilities can be checked.
Some children need repeated testing that may include:
- X-rays, to check for loose or dislocated hips. Children with CP are usually X-rayed several times during ages 2 to 5. Spinal X-rays also are done to look for curves in the child’s spine .
- Gait analysis. This helps identify problems and guide treatment decisions.
Other tests may be needed, depending on a child’s symptoms, other conditions, or medicines he or she takes.