Cerebral palsy is a neurological disorder occurring in infants and young children that results in loss of muscle and motor coordination. If your child has CP, he may have problems with excessive drooling and swallowing, also called dysphagia . Exercises have been developed to help train his muscles, prevent disuse atrophy and help him swallow safely.
Significance
The experts at the National Institute of Neurological Disorders and Stroke, National Institutes of Health have made strides in the last twenty years to get a better understanding of cerebral palsy. Originally, CP was thought to be the result of oxygen deprivation at birth, but MRI studies have revealed that it is actually due to brain damage occurring during fetal development, birth or soon afterward. The studies of cerebral palsy have resulted in new medications to help control muscle spasm as well as refined surgical techniques to help correct abnormal muscle and bone formation.
Considerations
Cerebral palsy causes permanent disability and can result in a variety of symptoms. The United Cerebral Palsy Foundation believes that there are approximately 800,000 individuals in the U.S. living with the disorder. Of these, some individuals have mild symptoms that barely affect their ability to function and others have severe symptoms that result in almost total disability. The Centers for Disease Control estimates that each year approximately 10,000 infants are born with CP.
Therapy
Therapy for CP is based on individual needs and abilities. There is no one-size-fits-all therapeutic approach or exercise. As soon as your child is diagnosed, a team of experts generally do an assessment and evaluation of his needs. You are likely to work with physical, occupational, speech and behavioral therapists who will customize a treatment and exercise plan for your child. Expect to be given written materials to take home that detail each exercise so you can help your child practice. The therapists are invested in your child's improvement; ask questions any time you need additional clarification.
Your child may also undergo various tests to determine her ability to swallow. The videofluororaphic swallowing study or VFSS is the best test to determine her swallowing abilities as suggested by the experts at the Swallowing Rehabilitation Program at the Good Samaritan Hospital in Baltimore, Maryland. Other tests may include oral-motor assessments performed by a speech therapist.
Drooling and Swallowing
Drooling and swallowing difficulties are fairly common in children with CP. They can lead to skin infection, cavities, choking and an inability to maintain a normal body weight. Clinical studies have been conducted to determine if children with CP produce more saliva than normal. In a 2004 study conducted by Jill E. Senner and colleagues at Cambridge University and published in "Developmental Medicine and Child Neurology," it was determined that study participants did not produce excess saliva and that drooling is related to difficulty swallowing. If your child has swallowing difficulties, they can be caused by poor motor abilities as well as a reduced sensation in his mouth.
Exercises
Your insurance company may cover the costs of therapy to improve your child's ability to swallow. Interventions that might be covered include exercises designed to take advantage of changes in posture to help with swallowing. Some exercises help strengthen weakened muscles, and others are performed during the act of swallowing. These will be tailored to your child's age and abilities. You may also be taught to modify the consistency of her food, pacing of feedings and the type of nipples or utensils used during feeding. Your doctor will work with the therapists to create a treatment plan that best suits her needs. Talk with member services at your health plan to determine all types of therapy available to you.
References
- National Institute of Neurological Disorders and Stroke: Cerebral Palsy - Hope Through Research
- Cigna Medical Coverage Policy: Speech Therapy for Swallowing and Feeding Disorders
- "Developmental Medicine and Child Neurology": Drooling, Saliva Production and Swallowing in Cerebal Palsy
- PubMed: Evaluation and Treatment of Swallowing Impairments
