Nicole Johnson
I.
I have chosen to this research paper on ‘cerebral palsy’. For several years I have
been curious as to what causes this life-changing disability. About 5 years ago I worked
for United Cerebral Palsy in Arizona and I started babysitting for a little boy named Paul,
who had cerebral palsy. I grew very close to Paul and his family. He had two little sisters
who were perfectly normal. I always thought that cerebral palsy was a disability that a
person got from an injury of some sort. (I worked with a little boy once who had cerebral
palsy from a near drowning accident). After I started working with Paul I became very
curious as to why he was so different than the rest of the family. Paul had a ‘g-tube’,
because he couldn’t chew and swallow food very easily so that is how he ate. The
Doctors told his mother that he would never be able to doing certain things, walk being
one of them, which he overcame. He could walk but he was extremely unsteady on his
feet and often lost his balance and fell. He often had spasms that would cause him to kick
his legs and throw his arms. By doing this report I hope to get a better understanding of
how and why Paul is the way he is. I also hope to learn how a parent of a child with this
disability deals with everyday life and helps this child live from day to day.
II.
As I was doing my research, I found that every book had just about the same
information. They all started with the definition of cerebral palsy and then went into how
one becomes diagnosed with cerebral palsy. Then they would go on to describe the
different types of this disease. I had to do some very extensive research to find a medical
journal. I came across a magazine in the library called the “Exceptional Parent”.
Unfortunately this magazine did not have any information on my subject, but rather it
was full of advertisements for items such as wheelchairs and special beds, for parents of
children with special needs. It also has names of hospitals and schools for these children.
I did come across a book in the library called “Children with Disabilities 5th Edition”
written by Mark L. Batshaw, M.D (1). This was like most of the other information that I
was coming across, but since it was written by a Doctor, a very credible source, I decided
to use this as one of my resources. In his article on cerebral palsy I learned several of the
different causes of this disability, how many people are affected, the different types of
cerebral palsy, how ones reflexes are affected, the different types of treatment, therapies
and medications and who can help a child with cerebral palsy. I was disappointed that
this book didn’t have more information on how a child is diagnosed with cerebral palsy
(i.e. testing). It did have a very small section that discussed the signs and symptoms and it
did mention a few tests that can be done, but did not go into to much detail.
After a lot of research on the internet, I came across the main resource that I used
in this report. The website was the “National Institute of Neurological Disorders and
Stroke” (2). This had a lot of information about scientific facts and research that has been
done, but it also had a lot of the same information that the other resources had. This had a
much more extensive section dedicated to how cerebral palsy is diagnosed. It listed the
different types of testing and what they would find with that type of testing and what type
of treatments are available if any. I did a lot of searching on the internet and I had a very
difficult time finding a medical journal that discussed this disability. I did however, come
across a few different medical websites (3, 4 and 5) and a website that was designed to
describe cerebral palsy to children (which I thought was cute and very appropriate) (6).
III.
Cerebral Palsy is a developmental disability that is caused by a lack of oxygen to
the brain. The lack of oxygen usually occurs from complications during the birth of the
child, or may be caused by an accident after birth, such as near drowning or child abuse.
Most cases are now known to be caused by problems before the child is born. A child
who is born weighing less than 3 ½ pounds, or born less than 37 weeks into the
pregnancy is at high risk of developing C.P, but not all babies born at such a low weight
develop cerebral palsy. A child who was carried a full nine months and fully developed
that is diagnosed with cerebral palsy, are known to have “malformations inside and
outside the Central Nervous System” (Children with Disabilities, Mark Batshaw), often
because of a fetal developmental problem. The most common type of C.P. that a full term
baby develops is Athetoid, “which reflects damage to deep brain tissues” (Children with
Disabilities, Batshaw). Another high risk group is children that are given low Apgar
scores within the first 20 minutes of life, or a child who has seizures in the first 5 minutes
after birth. This disability affects more than 500,000 people. It is estimated that “1.4-2.4
in 1,000 cases” (Children with Disabilities, Mark Batshaw) will be diagnosed with
cerebral palsy.
There are four forms of cerebral palsy. The first is Spastic, which affects 70 to 80
% of all C.P. patients. Spastic cerebral palsy is when “the muscles are stiffly and
permanently contracted” (NINDS, internet). There are forms under the Spastic group
which are named depending on the limbs that are affected. Hemiplegia, predominantly
affects one side of the body (ex. Right arm and/or right leg). More often than not,
Diplegia affects the legs more than the arms. Diplegia is also more often associated with
a premature birth. Quadriplegia includes “all four limbs, the trunk and the muscles that
control the mouth, tongue, and pharynx” (Children with Disabilities, Batshaw). A child
with spastic quadriplegia usually has several other problems, which include “mental
retardation, seizures, sensory impairments, and other medical complications” (Children
with Disabilities, Batshaw).
The second form is Athetoid, also know as dyskinetic. This form affects between
10 and 20 % of cases. The characteristics of this form of cerebral palsy is involuntary
muscle spasms ( rapid, jerky movements) which could involve the entire body and not
one specific area, feet, hands, arms, legs, and sometimes may include the muscles of the
mouth which in some cases may cause drooling. During periods of sleep muscle tone
maybe decreased and during periods of awake time the muscles maybe very rigid. Also
associated with this form of cerebral palsy is the likeliness of hearing loss.
The third type is called Ataxic. Ataxic cerebral palsy affects 5 to 10 % of patients.
For someone diagnosed with this form their balance and depth perception is affected.
Walking may be difficult due to the way the person’s feet are positioned widely apart and
very unsteady.
The fourth and final type is mixed cerebral palsy. This is when the patient has
symptoms from more than one of the other forms listed above. It is possible to have a mix
of any of the forms. However, “The most common form includes spasticity and
athetoid….” (NINDS, internet). The least common forms together are athetoid and ataxic.
There are symptoms that should be watched in children that may suggest that a
child has cerebral palsy. Insufficient development of fine motor skills; increased or
decreased muscle tone; developmentally delayed at reaching developmental milestones,
such as rolling over, crawling, or walking; favoring of one side of the body; weak cries;
poor sucking reflex; excessive sleep and irritability when awake; while sleeping the child
may “lie in a floppy, rag doll way” (Children with Disabilities, Batshaw); clenched fists;
movement and posture problems; vision difficulties; dental problems such as enamel
defects; hearing loss; and joint problems. If any of these signs are noticed the child
should be seen by his/her pediatrician, who made order testing be done to properly
diagnose whether or not the child has cerebral palsy. First the child’s motor skills are
tested, which “assess the presence of normal of normal movement patterns…” (Children
with Disabilities, Batshaw). Other testing that maybe done include, MRI, which can
identify brain disorders; CT scan, which can identify areas of the brain that are
underdeveloped; ultrasonography, which can show problems with brain tissue. Doctors
also look for seizure disorders. If this type of disorder is suspected than an EEG
(electroencephalogram) may be done, this records the brain’s electrical activity.
A child with cerebral palsy will more than likely have other disabilities, such as
“mental retardation, visual or hearing impairments, speech disorders, feeding and growth
abnormalities, and behavioral and emotional disorders” (Children with Disabilities,
Batshaw), and seizures and/or epilepsy. A child with Spastic hemiplegia has the best
intellectual outcome, which is approximately 60%, but these patients are more prone to
develop epilepsy. Hearing, speech and language impairments occur in 30 % of all
children diagnosed with cerebral palsy. Mental retardation affects approximately twothirds of children that are diagnosed with cerebral palsy.
Cerebral palsy is not contagious, but it is a disability that the patient will live with
his whole life, and is not curable. It will not get worse as time goes on, what you have is
what you get. There are many people that should be involved in the life of a person with
C.P., such as a physical therapist who will design a special exercise program to improve
their movement and strength. An occupational therapist that will help the person learn
everyday skills. An orthopedic surgeon to help diagnose and treat muscle problems. A
speech and language pathologist to help treat communication problems. A social worker
that will help the child and their families locate educational programs. The family of a
person with cerebral palsy needs a lot of support and help with decision making and
treatments.
IV.
By doing this research paper I have learned the many different causes of cerebral
palsy. I was not aware of all the ways that one can develop cerebral palsy and they can be
prevented. I was also unaware of the different types of the disease and what parts of the
body are affected. By having these questions answered now, I feel I can understand more
of what someone is going through and how I can help them. I know that helping anybody
with a disability is very important, but after doing this research it makes me want to work
with and help a person with this disability even more. One day I am planning to be a
special education teacher and I will use this as a very handy tool in teaching. I hope that I
will be able to share my new found knowledge with co-workers and other students to
help them understand about the special children around them. I am very glad that I chose
to research on this subject as it will benefit me in the future and has answered several
questions about past work that I have done.