Early Greek mythological examples of congenital deformities included limb anomalies in which individuals had limited movement of their limbs or sometimes even extra or missing limbs. Implications of cerebral palsy are believed to be evident in early 19th-century literature such as Shakespeare’s The Tragedy of King Richard the Third in which Shakespeare makes a point to describe Richard III’s appearance using phrases such as “ill- featured of limbs” or “crook-backed”. (Williams 7) In the late 20th century the late neurologist and philosopher Sigmund Freud concluded that cerebral palsy can not only be caused by problems at the time of childbirth but can be caused much earlier while the child is still inside the womb.
(Morris 2) Previously, medical doctors and the public believed that cerebral palsy could only be caused by problems during childbirth. Despite the discrepancy, it is apparent that Cerebral palsy is a condition that is a result of damage or maldevelopment of the brain or more specifically the cerebellum which is the portion of the brain that controls movement, posture, and coordination of the human body.
To understand the causes of cerebral palsy it is first detrimental to understand that cerebral palsy can be broken into two categories: spastic cerebral palsy and non-spastic cerebral palsy. Spastic cerebral palsy is characterized by muscles or movements that are stiff. With spastic cerebral palsy muscle movement can even be impossible. (Mandelson 1) Non-spastic cerebral palsy is characterized by weak muscle or poor muscle control, poor posture, walking difficulties or abnormalities, and lack of facial expression control.
(Damiano 1) Both forms of cerebral palsy are caused by damage to the back of the brain which is responsible for muscle control throughout the body. This damage can be a result of a lack of oxygen to the brain during delivery, maternal infections, cranial hemorrhaging, or birth injury. Lack of brain oxygen is the cause of many common developmental disabilities because the neurons in the brain required ample amounts of oxygen to develop and function properly. Maternal infections such as herpes simplex virus, rubella, Genito-urinary tract infections, and toxoplasmosis which is a parasitic infection can attack the unborn child’s brain causing cerebral palsy. (Miller 2) Cranial hemorrhaging is the internal bleeding of the brain and can happen as a result of the child acquiring a head injury while in the womb or exiting the birth canal. If Brain hemorrhaging occurs in a fetus or newborn baby, several parts of the brain may be affected resulting in one or multiple developmental abnormalities. Birth injuries may occur as a result of medical malpractice or incorrect diagnosis. Mothers must understand that their child’s cerebral palsy could have been caused by a medical fault and are aware of their rights. Mothers may also understand that cerebral palsy may have been inevitable in their child’s case and may have been no fault of the medical team in any way. It was once believed that lack of brain oxygen was the sole cause of cerebral palsy but now with modern medicine, there is a roof that asphyxiation proves to be the cause in only about 10% of cerebral palsy cases. (CPG 1)
Although there is currently no known cure for cerebral palsy, there is a myriad of treatment options available to those who are diagnosed with this disorder. One treatment option is neurodevelopmental treatment (NDT) which is a hands-on treatment designed to improve posture, movement, muscle control, and even speech of an individual with cerebral palsy. During this treatment, movements are repeated in an attempt to create muscle memory and allow movement to become easier and much more natural. (Redstone 32) NDT can improve the effects of cerebral palsy such as stiff muscles or speech difficulties but cannot make the effects of the disorder completely vanish. Another treatment option available for those with cerebral palsy is a medication that improves the stiffness and spasticity of muscles and may help with the pain. Medications typically prescribed for patients with cerebral palsy include: Botox injections or muscle relaxers such as dantrolene, diazepam, and baclofen. When Botox is determined to be the best treatment option, the doctor will inject Botox into the patient’s muscles to improve muscle spasticity. When muscle relaxers are determined to be the best treatment option, doctors will weigh the pros and cons of each muscle relaxer to determine which is best for that particular patient. Many muscle relaxers may have side effects such as nausea, drowsiness, and dependency. Baclofen is a medication that can be taken orally or pumped directly into the body via the spinal cord. Baclofen may have side effects such as confusion, drowsiness, and nausea. (Bierman 47) In addition to medications used to alleviate the effects of cerebral palsy, there are also medications to help prevent at-risk mothers from having a child with cerebral palsy. These preventative medications include Antenatal steroids and magnesium sulfate. Antenatal steroids may be given to a mother who is at risk of premature birth which may cause cerebral palsy if the fetus’s skull and head have not formed enough to fully protect the brain. Magnesium sulfate is also given to mothers who are at risk of extremely premature birth to protect the fetus from a potential brain injury that may have may lead to cerebral palsy. (CPA 1)
The effects of cerebral palsy can affect children greatly in many areas of their life which is why early diagnosis and intervention is crucial. If a child is diagnosed as soon as possible, they have a greater chance of improving the effects of their condition and reaching their goals through intervention strategies that may involve physical or occupational therapists, accommodations, or medical treatments. Intervention can be used for children with cerebral palsy as young as age two. One of the more invasive intervention strategies used for cerebral palsy is a surgical procedure called Dorsal Rhizotomy which is a neurological procedure designed to reduce the spastic movement of the legs. Dorsal Rhizotomy is done by severing some of the nerve roots in the brain and spinal column that send messages to the lower extremity muscles. (SLC 1) Methods or strategies such as physical and occupational therapy are used to greatly improve children’s abilities and help them to reach any personal goals they may have.
Every child is unique making it only natural that every child who has been diagnosed with cerebral palsy is unique and their individual needs should be met. Appropriate classroom accommodations or modifications for students with cerebral palsy are oral exams in the place of written exams, extra exam time, wheelchair-accessible work areas, larger writing utensils for easier grip, wording questions differently, etc. The goal of accommodations and modifications should be to create a learning environment where each child can benefit and grow without restriction or limitation. Children with cerebral palsy are often left out because others assume that they cannot do certain things when in reality they are perfectly capable of doing those very things with accommodations. To make the proper classroom accommodations or modifications teachers and caregivers must first understand the individual child and their condition. Cerebral palsy varies in severity which means each child with this condition will have different abilities. Some children with cerebral palsy have issues walking, standing, or speaking and require major accommodations while others may have difficulty writing or engaging in other fine motor activities and require minor accommodations. (O’Shea 4) An accommodation that may be necessary for a classroom with students with cerebral palsy might be wheelchair ramps since many children with cerebral palsy use wheelchairs or crutches.
Many children with cerebral palsy have an aide accompanying them wherever they go to assist in their daily activities. This aide typically understands the child and their condition significantly more than the teacher does making it beneficial for the teacher and the aide to work together closely and communicate effectively. A child’s aide, who may also be called a paraprofessional, may be assigned to either one child or a group of children with the same disorder.
There has been an investigation conducted regarding the functionality of families that have a child with cerebral palsy vs families that do not have a child with cerebral palsy. The investigational study found that there are noticeable differences in the family dimension including communication, family cohesiveness, and inclusion. (Masood 1) Families of children with cerebral palsy tend to have more stress, strain, and financial hardship in the home than families who do not have a child with cerebral palsy. These differences are believed to be directly related to the condition and all that it entails including frequent doctor appointments and expensive treatments and medications. Families of children with cerebral palsy tend to face many complexities within their family dynamic but these complexities can be overcome by support and understanding of the condition. Families should first educate themselves on the child’s condition. There are many different ways that parents and family members can learn more about this condition starting with the internet which provides endless amounts of information on the subject. Now through the internet, parents can also find support groups, doctors, aides, and other beneficial particulars. Support groups such as The Cerebral Palsy group provide information from parents and professionals designed to help parents understand their child’s condition and give insight into raising a child with cerebral palsy. (CPG.ORG 1)
Parents of children with cerebral palsy often must take on the role of a caregiver by monitoring, keeping track of medications, and assisting in daily activities. Parents of children with cerebral palsy must monitor their children closely because although cerebral palsy is not progressive, it is unpredictable. Children with cerebral palsy can have spastic and unpredictable muscle movements which could lead to accidents or injury making close monitoring crucial. (Dean 3) Parents must keep track of their child’s medication to ensure that they are administering the accident the proper dosage and monitor the children around clock for-the-clock children to see how the medication is affecting them. It is also the family’s responsibility to assist the child in tasks that they may have difficulties accomplishing by themselves. Many families may choose to have an in-home caregiver for the child especially if they are employed and their child requires around-the-clock care and monitoring. Ideally, an in-home caregiver would prepare meals, administer medication, help with bathing and dressing, and fulfill any of the child’s needs while the parents are away or occupied. Families have the right to refuse treatments ormedications and are not required to hire an aide or caregiver, but all these resources would prove to be highly beneficial for the child’s growth and development.
Families may look for someone to advocate for them and their situation because of the stress and discomfort it may cause that can be difficult to discuss. It is equally if not even more important to have the condition, the children living with these condithe accidents or medications have an advocate because being different can often lead to loneliness as a result of others not understanding the condition. Many individuals who are not educated about cerebral palsy may have many incorrect preconceived notions about it. If the family feels as though they need advocacy there are advocacy groups designed to help in that area. Advocacy groups such as Amnesty International, World Institute on Disability (WID), and Administration on Intellectual and Developmental Disabilities help families by offering health services, financial planning, research information, training programs, public education on disabilities, advocacy for, families and children with disabilities. And strategies to promote wellness. (CPO 1) These groups are just a few of the many readily available family advocacy resources.