Cerebral palsy causes abnormal motor development that makes it challenging to achieve motor milestones such as lifting the head, rolling over, sitting and walking. Children may be afflicted to varying degrees of severity and are also diagnosed according to what parts of the body are affected as follows:
Hemiplegia--one side of the body is affected
Quadriplegia--both sides of the body are affected
Diplegia--the legs, hips and pelvis are affected
Children with cerebral palsy are usually diagnosed at a very early age and physical and occupational therapies can help to promote normal movement patterns and hand skills. Children may also present with abnormal speech and benefit from services from a speech and language pathologist. In addition, some children with cerebral palsy have cognitive delays and require special education to meet their learning needs.
Promoting Motor Skills
Step 1
Positioning to Reduce Reflexes
Babies have reflexes that influence movement--such as grasping a finger placed inside the palm. These reflexes typically diminish over time. However, for the child with cerebral palsy, the reflex persists and interferes with voluntary movement. For example, a child might reflexively extend the arm when turning his head toward it. Certain positions such as lying on the back increase abnormal reflexes, whereas other positions such as lying on the side with knees bent decrease the influence of reflexes.
Step 2
Normalizing Muscle tone
Cerebral palsy causes abnormal muscle tone so that children appear to be:
Overly stiff (hypertonic or spastic)
Loose (hypotonic) or
Athetoid (characterized by involuntary movements)
Children who are spastic are at risk of developing contractures and need regular stretching of all joints. Their muscles tend to relax during slow, rhythmic movement such as rocking while on top of a large ball or swinging in a hammock. Children with low muscle tone typically benefit from fast, irregular movements such as jumping or bouncing that are stimulating.
Step 3
Promoting Fine-Motor Skills
Abnormal muscle tone, reflexes and movement patterns impact a child's fine-motor development. Some children do not develop the refined grasp to pick up small cereal pieces or the dexterity to wind up a toy or control a crayon. Optimal chair positioning is important for best trunk and shoulder stability. Children should be seated with their hips, knees and ankles at 90-degree angles with feet flat on the floor. Young children with decreased coordination are more successful manipulating larger materials. An example is stringing a yogurt lid with a large hole in the center using cord rather than flimsy string that is difficult to grasp. Parents should buy clothing with stretch waist bands, Velcro fasteners and zippers with pull tabs to make dressing easier and faster. Older children benefit from computer technologies that enable them to focus on learning rather than struggling with handwriting.
Step 4
A Team Effort
Like all children, those with cerebral palsy want to make friends and play. Early therapies can help these children to be as independent as possible and achieve these goals. As parents and teachers help children develop their strengths--such as artistic ability or sense of humor--children will build confidence and self-esteem. Continued success may then motivate children with cerebral palsy to become part of the team effort.
Things You'll Need
- Speech and language pathologist
- Physical therapist
- Occupational therapist
- Special education teacher
References
- "Handling the Young Cerebral Palsied Child at Home," Nancie R. Finnie; 1975.
- Teaching Motor Skills to Children With Cerebral Palsy and Similar Movement Disorders," Sieglinde Martin; 2006.
- "The Recycling Occupational Therapist," Barbara Smith, M.S., OTR/L; 1997.
