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Cerebral Palsy

Definition
The Individuals with Disabilities Education Act (IDEA) guides how early intervention services and special education and related services are provided to children with disabilities. Under IDEA, cerebral palsy is considered an "orthopedic impairment," which is defined as ". . . a severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments caused by congenital anomaly (e.g. clubfoot, absence of some member, etc.), impairments caused by disease (e.g., poliomyelitis, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures)." -34 Code of Federal Regulations Section 300.7(c)(8)

Identification
There are three major types of cerebral palsy: 

  • Spastic cerebral palsy. Most children with cerebral palsy have spastic cerebral palsy. This form of the condition causes muscles to stiffen, which makes movement difficult. It can affect both legs (spastic diplegia), or it can affect one side of the body (spastic hemiplegia). In the most severe cases, all four limbs and the trunk are affected (spastic quadriplegia). 
  • Athetotic cerebral palsy. About one in five people with cerebral palsy have this form, which is also referred to as extrapyramidal cerebral palsy. It affects the entire body and often causes uncontrolled, slow movements. 
  • Ataxic cerebral palsy. This is the least common of the major types of cerebral palsy. It affects balance and coordination.
  • Some children have signs and symptoms of more than one type of cerebral palsy, which may be referred to as a mixed form of the condition.

In general, children with cerebral palsy exhibit a wide variety of signs and symptoms, ranging from mild to severe. Cerebral palsy symptoms do not worsen with age. They may include:

  • Lack of muscle coordination when performing voluntary movements (ataxia)
  • Stiff muscles and exaggerated reflexes (spasticity)
  • Asymmetrical walking gait, with one foot or leg dragging
  • Variations in muscle tone, from too stiff to too floppy
  • Excessive drooling or difficulties swallowing, sucking or speaking
  • Tremors
  • Difficulty with precise motions, such as writing or buttoning a shirt

Some children with cerebral palsy have severe mental retardation, but others are extremely bright. Many need a wheelchair and extensive, lifelong care, but some require little or no special assistance. For more information from the National Institutes of Health: Cerebral Palsy

There is no specific cure for Cerebral Palsy. The goal of treatment is to maximize the individual's independence. Treatment is guided by the symptoms. Treatment may include:

  • Physical Therapy to increase gross motor skills,
  • Occupational Therapy for fine motor skills and daily living skills
  • Speech and Language Therapy for communication, including speech or sign language

The National Institute of Neurological Disorders has an extended list of symptoms and treatments based on research. Symptoms and treatments

Educational Recommendations
Students with Cerebral Palsy will display a varied set of physical limitations.

The following list includes some strategies for working with students who have mobility impairments.

  • Individuals with upper body limitations may need note takers, extended test times or assistance in recording answers
  • An upper body weakness may make it difficult to the student to raise their hand to participate. You may want to establish a visual signal to indicate when the student wishes to contribute to the discussion.
  • Students may require additional time to change classes. Architectural barriers and personal limitations may make moving more difficult and slow.
  • Sitting arrangements may include a lower table for writing, chairs with additional support and removal of architectural barriers to obtain full participation.
  • Field trips  and internships need to be reviewed beforehand to assure equal accessibility.

Deafness and Cerebral Palsy

The Gallaudet Research Institute reported in their State Summary, 2006-2007, 1,439 of 35,706 Deaf students had a disability of Cerebral Palsy.

An individual with Deafness and Cerebral Palsy faces a unique set of obstacles.  A primary mode of communication for the Deaf and Hard of Hearing is Sign Language (ASL). Due to impaired motor control, including hand movement, communication may be slow and require a great amount of effort.  Educational placement should be considered on the basis of the extent of the disability.  As with other disabilities, communication is a primary concern in education and life. Placement in a school for the deaf can support language development in the Deaf individual with Cerebral Palsy who uses sign language as a primary mode of communication.

Resources

Cerebral Palsy and Deaf Organization
http://www.cpado.org/

The Cerebral Palsy and Deaf Organization was founded in November of 1998, by a group of individuals who realized that having Cerebral Palsy and Deafness, was a different experience than having the disabilities individually.   In April of 1999, the group developed its own website. The group meets monthly for fun and/or meetings to discuss any improvements on our website. Activities may also include eating out, picnics and other group activities.

Deafness and Family Communication Center
3440 Market St., 4th floor
Behavioral Health Center
Philadelphia, PA 19104
Voice: (215) 590-7440
TTY: (215) 590-6817
Fax: (215) 590-1335
E-mail: info@raisingdeafkids.org

Raising Deaf Kids is a web site supported by the National Institute on Deafness and Other Communication Disorders and the Children's Hospital of Philadelphia. Information on Cerebral Palsy and other disorders may be found under Special Needs on their home page.

United Cerebral Palsy (UCP)
1660 L Street, NW  Suite 700
Washington, DC   20036
national@ucp.org
http://www.ucp.org
Tel: 202-776-0406 800-USA-5UCP (872-5827)
Fax: 202-776-0414

United Cerebral Palsy (UCP) has been committed to change and progress for persons with disabilities. Founded in 1949, the national organization and its nationwide network of affiliates strive to ensure the inclusion of persons with disabilities in every facet of society-from the Web to the workplace, from the classroom to the community. As one of the largest health charities in America, the mission of United Cerebral Palsy is to advance the independence, productivity and full citizenship of people with disabilities through an affiliate network

Cerebral Palsy International Research Foundation
1025 Connecticut Avenue   Suite 701
Washington, DC   20036
national@ucp.org
http://www.cpirf.org
Tel: 202-496-5060 800-USA-5UCP (872-5827)
Fax: 202-776-0414

The mission of the Research Foundation was 3-fold: to fund research (for cure, care and best practices), to advocate for more Federal support for research relevant to developmental disabilities, and to foster superb educational programs in medical schools so that the next generation of children with developmental impairments would have knowledgeable doctors, nurses and therapists prepared to care for them.

American Academy for Cerebral Palsy and Developmental Medicine (AACPDM)
6300 North River Road, Suite 727
Rosemont, IL 60018-4226
(847) 698-1635 (voice)
(847) 823-0536 (fax)
Email: woppenhe@ucla.edu
http://aacpdm.org/

This organization is a multidisciplinary scientific society devoted to the study of cerebral palsy and other childhood onset disabilities, promoting professional education for the treatment and management of these conditions, and improving the quality of life for people with these disabilities.

ONLINE RESOURCES: 

Medical Guide: Cerebral Palsy