Talking to a child with cerebral palsy about puberty and her period should happen as soon as possible. Children with cerebral palsy often show signs of puberty at a very young age. Writing in the 1999 issue of the Developmental Medicine and Child Neurology journal, Dr. Siraj Siddiqi states that children with cerebral palsy have been known to begin puberty as preschoolers. So it is important that your girl understands about periods before hers arrives for the first time -- this way, she won't be confused or frightened about her changing body.
Step 1
Make sure your knowledge about periods and cerebral palsy is complete and up to date. Be prepared with additional materials such as books, videos or social stories which can provide further information or answer any questions you are unsure of or are uncomfortable with.
Step 2
Integrate discussions about periods into several shorter discussions with the girl. A single, long discussion session about periods may be overwhelming and tiring for her. A series of shorter discussions gives her a chance to absorb the information and ask different questions as she thinks of them.
Step 3
Use the correct terms for body parts right from the start. Euphemistic expressions for body parts are confusing and imprecise for all children, including girls with cerebral palsy. Dena Kirchoff of the Cerebral Palsy Network suggests that establishing proper names for a child's body parts early on makes it much easier to have subsequent conversations about puberty, pregnancy and privacy.
Step 4
Pick your time for the first discussion about periods. Make sure the girl is well rested and in a mood that will allow her to listen and absorb information. Let her know that you want to talk about the changes that will happen to her body, and explain that starting periods is one part of this change.
Step 5
Tailor the discussion to the child's level of functioning and her communication skills. If she communicates non-verbally -- for example, if she uses a picture exchange communication system or physically operated voice assistance -- make sure you have appropriate materials and communication strategies to enable as much genuine discussion and exchange as is possible.
Step 6
Ask her what she already knows about puberty and periods. If the girl communicates verbally, she may have already heard a lot of misinformation from other kids. Use any existing knowledge she has as a starting point to fill in her understanding with medically accurate information. A clear way to start this conversation might be: "Your body is starting to change and this is called puberty. It's what happens as you grow up. I want to talk to you about getting your period. What have you heard about periods?" Reassure her that there are no right or wrong answers -- this isn't a test.
Step 7
Explain that she may start noticing changes in her body earlier than her friends, but also that she could take longer to complete puberty and start her period. According to Susan Agrawal's article for "Complex Child E-Magazine," children with cerebral palsy may show early signs of puberty much earlier than their peers, with girls entering puberty earlier than boys. However, Agrawal notes that girls with cerebral palsy take longer to complete puberty, and will likely start menstruation later than their peers.
Step 8
Establish whether or not the girl will be able to apply and change sanitary products independently, or whether she will need assistance with this. This is a good time to reinforce the girl's understanding of her own right to physical privacy. If she will need assistance in this area, establish which of her caregivers or family members will provide help.
Step 9
Get an appropriate supply of sanitary products and put them in a special bag or case. The child could choose this with you so that it is something she likes -- a favorite color, cartoon character or animal design. Make sure this bag is accessible to her for whenever her period starts.
Tips and Warnings
- Social stories can help communication about puberty and periods. They provide visual reinforcement of information, and characters to identify with.
References
- University of Michigan: Friends, Dating, Sex {and CP}
- Complex Child E-Magazine: Early Signs of Puberty in Very Young Children with Cerebral Palsy and Similar Conditions
- "Developmental Medicine and Child Neurology"; Premature Sexual Development in Individuals with Neurodevelopmental Disabilities; Siraj U. Siddiqi, et al.; 1999
- Cerebral Palsy Network: Puberty and Teens
