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Children with cerebral palsy have an impairment in the area of the brain that controls movement and muscle tone. Many of these youngsters have normal intelligence, even though they have difficulty with motor control and movement. The condition causes different types of motor disability in each child. Depending on the severity of the problem, a child with cerebral palsy may simply be a little clumsy or awkward, or he may be unable to walk. Some children have weakness and poor motor control of one arm and one leg on the same side of the body, called hemiparesis. Many have problems in all four extremities, with the legs mostly involved, called diplegia. In some children, the muscle tone generally is increased (spasticity or hypertonia), while others are abnormally limp (hypotonia). Speech may be affected as well.
Cerebral palsy frequently is caused by malformation or damage to the brain during pregnancy, delivery or immediately after birth. Premature birth is associated with an increased risk of cerebral palsy. A baby also can get cerebral palsy from very severe jaundice after birth, or later on in infancy from a brain injury or an illness affecting the brain. In most cases, the cause is unknown.
Signs and Symptoms of Cerebral Palsy
The signs and symptoms of cerebral palsy vary tremendously because there are many different types and degrees of disability. The main clue that your child might have cerebral palsy is a delay in achieving the motor milestones. Here are some specific warning signs.
In a Baby Over 2 Months:
· Head lags when you pick him up while he's lying on his back.
· He feels floppy.
· When held cradled in your arms, he seems to overextend his back and neck, constantly acts as if he is pushing away from you.
· When you pick him up, his legs get stiff and they cross or "scissor."
In a Baby Over 6 Months:
· He continues to have the asymmetrical tonic neck reflex.
· He reaches out with only one hand while keeping the other fisted.
In a Baby Over 10 Months:
· He crawls in a lopsided manner, pushing off with one hand and leg while dragging the opposite hand and leg.
· He scoots around on buttocks or hops on knees, but does not crawl on all fours.
Diagnosis of Cerebral Palsy
If you have any concerns about your child's development, talk to your pediatrician at your routine visit. Because children's rates of development do vary so widely, it is sometimes difficult to make a definite diagnosis of mild cerebral palsy in the first year or two of life. Often, a consultation from a developmental pediatrician or pediatric neurologist will assist in the diagnosis. A CAT/CT or MRI of the head may be recommended to determine whether a brain abnormality exists. Even when a firm diagnosis is made during these early years, it often is difficult to predict how severe the disability will be in the future. However, usually by 3 to 4 years of age there is enough information to predict accurately how a child will function in years to come.
Treatment of Cerebral Palsy
If your pediatrician suspects that your child has cerebral palsy, you will be referred to an early intervention program. These programs are staffed by early childhood educators; physical, occupational and speech and language therapists; nurses; social workers; and medical consultants. In such a program, you'll learn how to become your child's own teacher and therapist. You will be taught what exercises to do with your infant, what positions are most comfortable and beneficial to him, and how to help with specific problems such as feeding difficulties. Through these programs you also can meet parents of other children with similar disabilities and share experiences, concerns and solutions.
The most important thing you can do for your child is to help him develop competence and grow up feeling good about himself. When he is old enough to ask or understand, explain to him that he has a disability, and reassure him that he'll be able to make adjustments in order to succeed in life. Encourage him to perform the tasks he is ready for, but do not push him to do things at which you know he will fail. The professionals at early intervention centers can help you evaluate your child's abilities and teach you how to reach appropriate goals.
Do not make the mistake of searching for magical cures or undertaking controversial treatments. They will waste your time, energy and money. Instead, ask your pediatrician or contact the United Cerebral Palsy Association for information about resources and programs available in your area.