Common Misconceptions Surrounding Cerebral Palsy

Cerebral palsy is a well-known reality to the families and friends of those who have it. To many of the rest of us, sadly, it has received little consideration. Because cerebral palsy (aka CP) is rarely just one thing, many misconceptions about it has persisted for decades. Here are 4 common misconceptions-myths, if you will-about cerebral palsy and the people who have it:

1) Children with CP are mentally disabled

2) Children with CP will never walk or talk

3) Children with CP can never lead independent lives

4) CP comes from an unknowable and unpreventable neonatal condition

All of the above can be true. For some. BUT NOT FOR MOST.

Cerebral palsy is an umbrella term referring to a (currently) incurable, non-progressive set of neurological conditions that produce physical and neurological abnormalities during human development. Cerebral palsy is caused by brain damage, either through injury or irregular development during the early stages of life. The damage usually occurs just before, during or shortly after the birthing process. Very few infections are born with noticeable symptoms. Most will begin exhibiting them in the first few years of life as developmental milestones are missed.

MYTH # 1: CHILDREN WITH CP ARE MENTALLY DISABLED

Depending on what part of the brain is affected, CP can present itself as any of a variety of developmental impairments and in varying degrees of severity – from barely noticeable to severe. More than anything, CP affects the motor and muscular development of those afflicted with it.

Some children with CP do, in fact, experience damage to the parts of the brain that controls thinking and there before suffer lifelong cognitive disabilities. However, many children with CP suffer little to no cognitive disadvantage and are very bright. Google ” famous people with cerebral palsy ” and you will find an impressive list of scholars, authors, actors and doctors.

MYTH # 2: CHILDREN WITH CP WILL NEVER WALK OR TALK

Because CP primarily affects the parts of the brain associated with movement and muscle control, learning to walk, and then walk with a steady gait, can sometimes be a challenge for children with CP, but many walk in such a way that you would never know they were impaired. There are those who will absolutely require a wheelchair, walker or cane to get around, but advances in early intervention, physical therapy and more advanced medical procedures have allowed more CP kids becoming independent ambulatory.

For some children, the brain injury affects the muscles that control the mouth and tongue, which is why some labor to speak clearly or speak at all. Unfortunately, uninformed people often equate speech impediments with a lack of cognitive ability. This is simply not the case.

MYTH # 3: CHILDREN WITH CP WILL NEVER LEAD INDEPENDENT LIVES

Again, some can not. However, hundreds of thousands of adults with cerebral palsy live completely independent lives. They may have needed a little extra help preparing for independent living. Occupational therapists help prepare teens and young adults with basic skills such as preparing meals, handling money, knowing when and where to seek medical care and driving a car or using public transportation. Sometimes adults with CP require specially designed living spaces in order to live alone.

MYTH # 4: CP CAUSE IS UNKNOWABLE AND UNPREVENTALBE

Because the diagnosis of cerebral palsy often occurs after the event that triggered it, it is sometimes difficult or impossible to trace it back to one specific, documentable event. It may have been the physical or emotional lifestyle of the mother, an undetected infection or an error by one or more healthcare providers that went unnoticed or was intentally covered up. Historically and unfortunately, the myth has been perpetuated in the courtroom as doctors, healthcare management companies and insurance providers have endeavored to deflect blame and cloud certainty in the minds of jurors to avoid financial liability.

Make no mistake about it, the cause of cerebral palsy CAN be knowable and IS OFTEN preventable.

As the medical community, legal community and insurance industry continue to battle it out in the courtroom, we inch ever-closer to understanding all the things we need to do to prevent and eradicate these injuries from ever occurring in the first place. After all the finger-pointing, it's the children and the families that need to be put first.

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Assistive Communication Devices and Applications for Children With Cerebral Palsy

Cerebral palsy can result in some or many of a wide array of imperairments or developmental delays, some minor, others major. For many children with CP, the ability to communicate effectively can be a real challenge. This may be the result of cognitive impairments, where they struggle with vocabulary and idea processing, or it may be more about the motor skills that govern the mouth, lips and tongue. CP related hearing impairments can also have a substantial effect on a child's ability to communicate. Learning complex language and speech skills is exclusively human. So is the ability to invent and utilize adaptive devices to aid those who struggle with this process.

Children develop and use language at roughly their own pace, but a child who fails to meet certain developmental milestones for communication should be tested for speech and hearing issues. Babies should react to sound from birth and even look toward the source of a sound by 6 months. If a child is not hearing sound well enough to react to it, they will have a difficult time learning to speak. Hearing screenings are available to infants of any age.

In our highly technical world, many new techniques and devices have been developed aimed at assisting young people with hearing and speech impairments in their efforts to communicate. AAC (Augmented and Alternative Communication) strategies and devices exist in many formats from high-tech to low-tech. With the proliferation of highly sophisticated assistive devices comes the fear that children will lose their motivation to attempt speech.

Before choosing which specific method of intervention or technology will be of greatest benefit to your child with cerebral palsy , seek the nearest rehabilitation or teaching hospital that offers evaluation and assistance in choosing AAC systems. Many of them offer assistive technology clinics where teams of AAC specialists along with speech pathologists, occupational and physical therapists can work directly with AAC technology vendors to design a service plan customized for your child. Having all these professionals under one roof streamlines the process by facilitating effective communications between professionals and you may otherwise have to visit individually in multiple cities. The result is an AAC system customized specifically to your child's abilities and needs and the training that both you and your child will need.

Science has made mind-boggling advances over the past decade and there's no end in sight. Laboratories have developed brain / computer interface systems that provide communication and control capabilities to individuals with severe motor disabilities.

VOCAs (voice output communication aids), such as those used by famous physician Dr. Stephen Hawking, allow individuals with severe speech impairments to communicate verbally by using voice synthesizers filtered through computers, including laptops and hand-held devices.

It's an undeniable fact that people with severe speech and motor impairments are having their lives changed for the better as a result of these amazing advances in the field of assistive technology and augmentative communications. Some of the more impressive AAC devices and assistiveware applications on the market today include: Proloque, Proloque2Go, KeyStrokes, TouchChat, TouchStrokes, SwitchXS, LayoutKitchen, Minspeak, VisioVoice, GhostReader, Digit-Eyes, Pictello. Go to each products website to learn more about what systems the work on and other details.

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Analysis Of Paralysis

Overcoming paralysis will forever change the way we think and the way we live.

The neurological signals may fade in and out and cause various degrees of weakness leading to paralysis; however, strength, in many cases, may be restored. Nerves can be regenerated. Regrowth and strength may return to certain paralyzed regions. This encouraging analysis of paralysis shows that tomorrow can be better than today.

Paralysis is of the body but the body is not alone. There's mental paralysis, physical paralysis, financial paralysis, business paralysis, spiritual paralysis and the list goes on. We have all experienced paralysis of a roadblock of some kind that did not allow us to move forward like we wanted to.

We are all in some state of paralysis and may not even know it. Paralysis slips upon a person slowly without he or she is involved in a traumatic event. The word paralysis literally means to be disabled at the side. Communication is disrupted by pain or something else that weakens or severs the command that the brain is sending to the limb or other motor functions of the body, even a smile.

Damage along any point of the command route reduces the brain's ability to control muscle movement. The reduced efficiency causes fatigue or complete paralysis. Complete loss of communication prevents all forward movement.

The nerve damage causes paralysis may be anywhere along the command route from the brain through the central nervous system, peripheral nervous system, to the region that has become immovable.

Injury and stroke are the main causes for sudden paralysis. Spreading infection leads to degenerative tissue and further paralysis. Signs of approaching paralysis may manifest in numbness, tingling, pain, changes in vision, difficulties with speech, or problems with balance.

Three ingredients to overcome paralysis is will, strength, and communication. Your will, your determination, your designed destiny, gives you hope. Strength is what enables us to go on. And, communication is key to make everything else work. Strength comes from outside our bodies. There is a Scripture that says, “The joy of the Lord is our strength.”

These three: will, strength, and communication are factors in the future of any sustainable, affordable, vibrant healthcare system for you, your family, and our nation. Vital are the will to move, the strength to move, and the communication that relays proper instruction to move. Will is the desire; strength is available; and communication and interpretation can always be improved. As the communication connections are fully functional, your will is aligned and your strength will grow.

Good nutrition is vital and a part of that nutrition is Smart Sugars that cause glycosylation of sugars on the surface of the cells of your body that provide good communication that may just over paralysis so you can move forward. It has worked for others.

Change Your Sugar, Change Your Life http://DiabeticHope.com

© The Endowment for Medical Research, Inc.

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Neuroplasticity – Exercise for Your Child’s Brain

Recent technology has drastically increased the power of treatments and therapies for children with cerebral palsy. Previous research focused treatment on the muscular and skeletal systems of the body, aiming to increase range of motion and motor function in general. However, new data suggests that treatments are available that improve these areas as well as overall body and mental development. Modern medical research into the area of ​​neuroplasticity is arguably one of the most promising areas of research for treating children with cerebral palsy.

What is Neuroplasticity?
Neuroplasticity describes how the brain can adapt to dramatic changes or injuries. Your brain works with a network of over 100 billion neurons that are almost all connected with one another. Imagine a highway filled with cars; if an accident occurs on the road, the cars in the lane of the accident can merge into a new lane to continue onto their destination. The brain can behaving similarly – damage to brain pathways can instruct brain neurons to reroute and create new pathways.

New research in this area can wield promising results for children with cerebral palsy. When damage to the brain results in cerebral palsy, there is a chance that the brain will form a new pathway, which can circumvent the damage and restore functionality to the affected area. This is more likely to happen in milder cases of cerebral palsy, but it is not entirely out of the question for sever cases (though it may take longer to occur). Activities such as exercise, education, interacting with others and cognitive remediation can increase the likelihood of these new pathways being formed. On the other hand, loss of sleep, bad nutrition and anxiety can serve to hinder their development.

Exercise is good for the brain
We all know physical activity is good for our bodies, but it can be good for our minds, as well. An article published in 2008, exercise can improve mood, cognition, processing and learning capability. However, such activity should not be strenuous – intensive physical activity might cause more stress and tension than it relieves. Neverheless, exercise has shown to be one of the best activities for rebuilding brain connections.

There are many ways you can step in to help your child get the most out of physical activities. Keeping the activity consistent and routine ensures that progress is being made. This can be much easier to achieve if you have a specific therapist to work with during each session. Aside from physical therapy sessions, consider incorporating physical activity into your child's playtime. If you can, take part in these activities – swing your child from a swing set or do some exercise with them to encourage them to continue.

Once your child with cerebral palsy is of age to attend school, they will likely take part in physical education. Talk to your child's instructor and make sure you understand what the class curriculum will be. You'll also want the instructor to know the severity of your child's condition so that they take it into account when devising the day's activities. If possible, see if the instructor can create an alternative program tailor to your child's needs. Once the school season is over, consider encouraging your child to take part in an after-school exercise program.

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Space-Age Robotic Suits Helping Cerebral Palsy Kids Walk

In the ever-evolving world of technology meets medicine meets cerebral palsy, comes two very interesting stores about young people who are learning to walk with the aid of devices that look more like they belong in a science fiction movie.

The first story comes from WCBS in New York and features 13-year old MacKenzie Maher, unable to walk since birth due to cerebral palsy. A big breakthrough in her quest to walk came courty of a high-tech machine called a Lokomat. MacKenzie participated in a 6-week clinical trial at Shriner's Hospital in Chicago. The Lokomat is a robotic device that “walks” her body with all the appropriate movements for several hours a day. The patient is attached to the harness and leg straps prior to a computer controlling the movement of her legs on a treadmill. The computer controls the speed and the harness forces her legs to mimic natural motion. The repetitive motion re-trains the muscles to proper movement and strength without the miscommunications that typically happen when MacKenzie's brain tries to tell her legs what she wants them to do. After time, the therapy retrains the nervous system to bypass damaged areas and restores healthy neuromuscular function.

The stated benefits of Lokomat therapy are 1) the ability to maintain a consistent walking pace, allowing the therapeutic exercise to be sustained for long periods of time 2) improving circulation, strengthening muscles and improving muscle tone 3) strengthening bones that are otherwise at risk of osteoporosis from lack of use.

The Lokomat, patented by Hocoma, a Swiss company, received FDA approval in 2002 and is therefore covered by some insurance programs. At the time of the CBS story, there were 6 Lokomats in the United States.

The second story revolves around 18-year old Austin Hammer, a young man who suffers from spastic diplegia, who has seen major improvements from the use of a specialized compression suit that was initially designed for use by the Soviet space program to preserve and maintain healthy muscle tone during extended stops in the zero-gravity of space stations. The suit, known as the Euro-Ped Therapy Suit, features a vest, shorts, knee pieces, shoes and a headpiece, all connected to elastic, bungee-like cords. The computer-controlled tension mimics the natural elongation and shortening of healthy human muscles and natural movement. Like the Lokomat, one to two hour, daily sessions of repetitive, machine-controlled walking is enough to retrain muscles and motor skills. Continuing therapy at the Euro-Pads National Center for Intensive Pediatric Physical Therapy in Pontiac, MI has given Austin the ability to walk short distances unassisted, something he could not previously do.

In the United States, this form of therapy is still in the “investigational” stage and therefore, probably not covered by insurance. However, qualifying patients with cerebral palsy can be accepted into clinical trials at no cost to the patient. At the time of the article, there were 4 other clinics other than the Pontiac, MI Center that offered the Euro-Ped Therapy Suit.

Both systems require that patients meet certain qualifications prior to use. They need to have at least some sensation and movement in at least one of the major muscle groups of the leg. Patients with conditions such as high blood pressure, seizures, diabetes, heart disease, unhealed pressure sores, severe osteoporosis may be deemed poor candidates for this type of robotic therapy.

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Down Syndrome and Its Relation With Cerebral Palsy

Down syndrome is a genetic disorder that is characterized by mental retardation as well as delay in normal developmental stages that lasts through the life. The severity of this disorder varies from one person to another. So, it can be serious or it can be moderate. It is mainly a cell division deficiency of chromosome 21. Down syndrome variations include Trisomy 21, Translocation Down Syndrome, and Mosaic Down Syndrome. However, this is not an innate disorder.

While Down Syndrome is considered a chromosomal disorder, it is caused when the immature brain is subjected to trauma or injury or development that is not normal before birth. It is basically a disorder wherein the movement, posture, or muscle tone is affected adversely. It leads to movement that is impaired; there is strictness of trunk, limbs, involuntary actions, abnormal posture or all of these. Down Syndrome, also known as Down's Syndrome, Trisomy 21 or Trisomy G, is a chromosomal disorder caused due to the presence or part-presence of an extra 21st chromosome.

Characteristic features of Cerebral Palsy

Individuals with this disorder show the following symptoms. They include-
1. Too stiff or too loose muscle tone.
2. Spasticity.
3. Absence of coordination in muscles.
4. Normal reflexes but muscles are stiff.
5. Motor skill development is reached late.
6. Tremors.
7. Only one side of the body will be active.
8. Excessive salivating.
9. Difficulty in eating and swallowing.

In individuals, only one side of the body is usually affected.

Correlation between down syndrome and Cerebral Palsy

Strangely, there is a correlation between Down syndrome and Cerebral Palsy now that we already know what both theseorders are. Let us find out what.

Infants or fetuses that suffer from the Down syndrome may not develop Cerebral Palsy in the pre-natal conditions that occurs mainly due to oxygen deficiency. A study conducted in the recent years has revealed the fact that in children with Down syndrome; very few of them actually developed Cerebral Palsy. However, it was also found that among them few did develop Cerebral Palsy but not before birth. The syndrome developed after birth.

Moreover, studies are still underway and clinicians are trying hard to find out what makes the children suffering from Down syndrome resistant to Cerebral Palsy and because some of the children developed the latter disorder after birth whereas it is a disorder that is triggered before birth. Down Syndrome, also known as Down's Syndrome, Trisomy 21 or Trisomy G, is a chromosomal disorder caused due to the presence or part-presence of an extra 21st chromosome.

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Paying for Wheelchairs for Children With Mobility Issues

Roughly 1 in 3 children with cerebral palsy can not walk. Having access to the right wheelchair can mean all the difference to, not only their mobility, but also their sense of freedom and independence. All of this can have a very positive impact on all aspects of development.

Wheelchairs are not cheap. A new wheelchair, even the most basic models, can cost several hundred dollars. Power wheelchairs and custom wheelchairs can cost as much as a car. Children grow, so keep in mind that young children will outgrow their wheelchair and will most likely need to have it adapted or replaced once or twice before they reach full height. The costs can be intimidating at best.

Some funding options that may be presented to you include:

Wheelchair companies, not unlike car companies, frequently offer in-house financing or partner with other financial institutions. By perusing wheelchair manufacturing companies' websites, you can get some idea of ​​how this is done. At some point, you should make an appointment with a representative to talk about funding options. As with automobiles, there is an application process and your credit rating will be considered.

Private Insurance Companies – most insurance companies will cover the costs of a wheelchair, but you must go through a process of documenting exactly what and why your child needs what they need. You will be required to provide documentation from doctors and therapists that claim and verify those needs. It may become a minor battle between what you NEED versus what you WANT. Insurance companies may balk at paying for expensive wheelchairs if they perceive that a less expensive model will suffice, especially if its intended use is for a growing child. You have the right to appeal any denials and return with more extensive documentation regarding your child's needs. You may want to have a doctor advocate on your behalf.

Medicare – SSDI (Social Security Disability Income), should your child quality, can also help with the purchase of a wheelchair, provided, once again, you provide adequate documentation of necessity. There are rules and regulations that vary from state to state regarding the funding of equipment. Your local Center for Medicare and Medicaid Services should be able to provide you with information relating to your state. Again, do not expect them to want to pay for anything more than the minimum required equipment.

Medicaid and CHIP (Children's Health Insurance Program) both offer health programs for children of low-income adults. Again, the need for a wheelchair, including the type and cost need to be well-documented and submitted for approval. And while all Medicaid and CHIP programs must meet certain federal guidelines, full regulations can vary from state to state. Some states are willing to pay for 100% of an approved wheelchair, while others do not pay for wheelchairs at all. Your best bet is to thoroughly research your state's Medicaid policies, including how soon and under what circumstances will they participate in the payment of a 2nd or 3rd wheelchair.

For families who fail to qualify for state assistance because they earn too much and are otherwise underinsured or uninsured, there are other private assistance programs that they can turn to. Organizations such as Disabled Children's Relief Fund, Kids Mobility Network Inc., United Healthcare Children's Foundation and Children's Relief Fund raise money and accept pledges in an effort to see that every child that needs a wheelchair gets one. If your child needs a wheelchair and you are struggling with financial resources, do not be afraid to let your needs be known to your community. Many churches and social organizations such as the Lion's Club nurture funds and organize fundraisers for just such requests.

Getting your cerebral palsy child's mobility needs met is never a simple task, even when money is not the issue. When money is the issue, the closed doors and endless red tape can seem insurmountable. But there's always an answer for those willing to put in the work.

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An Overview of Music Therapy for Children With Cerebral Palsy

It is widely accepted that music and rhythm have healing powers because they speak more to our emotions than to our intellect. Distraint children often calm when sung to and the extremely find solace when listening to classical music. Music therapy and training has had consistent and comprehensive effects on children suffering from cerebral palsy, leading to improvements in cognitive performance, spatial reasoning, verbal skills and an overall sense of well-being.

Music can actually alter the landscape of the brain, something that has been proven in recent years due to advanced imaging technology such as MRI's. Neurologic Music Therapy is now a recognized and emerging field of science and is becoming commonplace as treatment for patients who suffer brain injuries.

Music can actually grow and heal neural pathways in the brain, linking areas dedicated to speech, touch, movement, sound and emotion, all areas of the brain required for making music. Neuroplasticity, also known as cortical re-mapping, refers to the ability of the human brain's neural pathways and synapses to change as a result of one's behavior, environment and neural processes. This allow the brain to reorganiz itself and bypass areas of injury to promote the development of skills in other areas.

Studies have shown that fetuses are quite capable of hearing sound while in the womb and that they demonstrate a preference for the same music when they are approximately 1 year old. Music is a source of delight for children, and a pleasure that continues beyond childhood, into the teen years and beyond.

Since it has been demonstrated that music has an effect on so many parts of the brain, that it is enjoyed through life and that it helps facilitate brain plasticity, there is no wonder it has become a therapeutical science of its own and is used to enhance many of the traditional therapies. Therapists and researchers have documented cases where music therapy has provided substantial benefits to patients with cerebral palsy. Both music and CP affect multiple areas of the brain and, even though CP is most commonly defined as an impairment of motor skills, it is also known to create discrepancies in perception, behavior, communication, cognition, sensation and lead to seizure disorders. Music aids in the bridging of missed cross-brain connections.

Researchers and therapists are increasingly listing music therapy as integral part of cerebral palsy intervention. Because music can affect the brain's ability to link movement, sound, patterns and emotion, it has effectively promoted improvements in many areas for patients with cerebral palsy, including: communication, gait control, head and torso control, hand movement, introduction of rhythms to children who are deaf, hand-eye coordination, relaxation, muscle response and group play.

Music therapy can begin in the home at virtually any age. Professional music therapists (ones who are board certified as trained in music, assessment, documentation and counseling) can be provided at no cost through state-funded programs and as a part of many IEP's (Individualized Education Programs) in the public school systems. Music therapy is frequently a cross-therapy tool and used in conjuction with other clinical skills. Many music therapy programs are now covered by insurance plans.

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Spastic Diplegia in Children With Cerebral Palsy

The form of cerebral palsy known as “spastic diplegia” is one of five categories of spastic CP that help indicate what parts of the body are primarily affected. In the case of diplegia, the lower extremities (legs, hips and pelvis) show spasticity abnormalities while the upper extremities function at a normal or near-normal capacity. Children born with this form of cerebral palsy exhibit near-normal cognitive development and performance, but are frequently delayed in their ability to walk. Once they are able to walk, they usually have a pronounced scissoring gait, with legs crossing over each other in a stiff, scissor-like pattern.

Even though spastic diplegia is generally considered one of the lesser forms of cerebral palsy, people who suffer from it can expect lifelong difficulty with all voluntary and passive leg movement, as well as pain associated with muscle and joint breakdown that can lead to arthritis and tendinitis . Some forms of spastic diplegia are mild enough to result in barely noticeably abnormalities in balance and gait.

The cause of spastic diplegia, as with many forms of cerebral palsy, is from neonatal asphyxia, a sudden depravation of the oxygenated blood that passes to the fetus through the umbilical cord. This is sometimes combined with a pre-term birth. Spastic diplegia can also be the result of bladder, kidney, urinary tract, STD's, yeast infections or bacterial vaginosis in the mother during pregnancy. These conditions can lead to infant hypoxia, which inhibits proper development of upper motor neuron function associated with movement.

Dr. William John Little's first recorded encounter with cerebral palsy during the 1860's is reported to have been children exhibiting signs of spastic diplegia. For this reason, spastic diplegia is sometimes referred to as “Little's Disease.” Diagnosis of spastic diplegia usually can not be made until a child is several months or even several years old, but a child can be labeled “high risk” if they experienced birth trauma before, during or shortly after delivery. This includes prematurity of more than 3 weeks. If a child does not meet standard development milestones regarding movement of the legs (usually around 18 months), a preliminary diagnosis of spastic diplegia may be made. Around this time, a parent may observe a child's legs as unusually stiff or floppy (which will lead lead to stiffness). The cause of this is the failure of the motor neurons to properly develop muscle tone. Normal muscles function in pairs-one contracting while the companion muscle relaxes. When this function is compromised, both muscles contract simultaneously. Hypertonia is the result of too much muscle tone. Hypotonia is too little muscle tone.

Some of the indicators of spastic diplegia include:

1) Children often prefer sitting in a “W” position. Physical therapists will encourage sitting cross-legged or chair sitting.
2) Children may fail in early attempts to crawl, or begin crawling by pulling them forward with the use of their forearms, letting their legs drag behind.
3) Children who have failed to pull themselves to a standing position by age 2 and a half may require devices, such as braces, to assist with standing. Standing puts important stress on leg bones and joints, thus promoting healthy growth.
4) Toe walking or feet-rolling – can be improved with low profile / low impact leg braces.
5) Spastic diplegia can lead to gradual hip dislocation, a condition that promotes arthritis and pain. For this reason, regular hip x-rays and exams are needed to monitor the disease.

Physical therapy, including massage therapy, is the most important treatment for any form of spasticity, aimed at training and strengthening muscles to promote healthy bone growth, balance and motor functions. There are medication that can be taken to relax tight muscles and minimize spasms. Injecting Botox into overly tight muscles has provided to provide at least temporary relief. In more extreme cases, surgery can be performed to lengthen muscles. Other treatments include electrical muscle stimulation, hyperbaric oxygen therapy and hippotherapy.

If pain and spasticity are severe enough to inhibit walking, orthopedic surgery can become an option. First, it must be determined which of the 30 major muscles are causing the problem. Gait analysis, a computerized diagnostic technique, is used as a guide in making

Before surgery occurs, doctors must determine which among the 30 major muscles involved in walking are causing the problem. Doctors today use a computerized diagnostic technique known as gait analysis to guide them in making surgical decisions. Gait analysis uses:

1) cameras that record how an individual walks
2) force plates that detect how the feet land
3) a test called electromyography that records muscle activity
4) a computer program that gathers and analyzes the data.

Using this information, doctors can reasonably locate which muscles would benefit from surgery and how much improvement in gait can be expected. The timing of such surgeries is based on the child with cerebral palsy 's motor development and age. Surgery to correct spasticity in upper leg muscles is likely to occur between ages 2 and 4, while surgery to correct spasticity in the lower muscles (hamstring, Achilles tendon) would likely occur around age 7 to 8. Orthopedic surgery had evolved into a relatively simple procedure, often being done on an outpatient basis.

In cases of extreme spasticity and associated pain, SDR (selective dorsal rhizotomy) surgery may be required. SDR surgery involves varying specific nerves at the base of the spinal column to release stress on the targeted muscles.

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Developmental Delays in Children With CP – Ages 4 to 5 Years

Cerebral Palsy is a unique condition in that, even though its genesis frequently occurs prior to, during or soon after birth, the symptoms may not be enough for a diagnosis until the child is several years old and already in school. Some 1500 preschool age children receive a diagnosis of cerebral palsy each year in the United States. Only 10 percent of these children received their brain injury later than 1 month old from events such as physical abuse, a car accident, bacterial meningitis or infant stroke. Developmental or social delays may be the result of other conditions such as autism, Asperger's Syndrome, or ADHD.

Brain injury / damage occurring any time from fetus to a few years old can result in cerebral palsy, a condition that impairs the brains ability to effectively control muscles. Some of the conditions known to cause cerebral palsy include: untreated infections in the mother, substance abuse during pregnancy, physical abuse during pregnancy, premature births, lack of oxygen to the fetus, breech birth and head injuries during the birth process. Impairments associated with cerebral palsy are usually related to movement and speech, so mild cases may not provide diagnosable symptoms until years later.

A typical 4-year old can stand on one foot, run up and down stairs, throw and kick balls and hop on one or both feet. Signs that a child of this age may be experiencing certain impairments in the development of motor skills can include not being able to throw a ball overhand, ride a tricycle, scribble, jump in place, grasp writing utensils, stack 4 or more objects or copy a circle.

By age five, children with developmental impairments may not be able to stack 6 to 8 objects, hold a drawing utensil comfortably, brush teeth, copy simple geometric shapes, dress and undress themselves, use silverware, clap hands to rhythm, turn somersaults, wash and dry themselves.

Another indicator, for a child of any age, is if they lose the ability to accomplish a task they once could.

By federal law (IDEA – Individuals with Disabilities Education Act of 2004) public schools must assist in the identification, location and evaluation of children with disabilities. Children, ages 3 to 12th grade, are eligible for special education through their local school district at no cost to the family.

To have your child with cerebral palsy access for special education services, contact any area grade school. They will direct you to area offices where a free screening can be scheduled. Additionally, NICHCY (the National Dissemination Center for Children with Disabilities) provides contact information for all 50 states with local agencies qualified to handle disability services.

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Developmental Delays in Children With CP – Ages 3 to 4 Years

Developmental disabilities such as ADHD, autism, Asperger's Syndrome and cerebral palsy affect an estimated 13 percent of children in the US Many of these children are not diagnosed until they reach school age where comparison to a large group of peers reveals impairments.

Children with cerebral palsy are often diagnosed by about 18 months because they are walking as they should. But if the symptoms are mild enough, the diagnosis may not come until years later when the child is struggling to master more complicated and refined movements. Children who experience a brain injury from events such as physical abuse, car accidents, a near-drowning, extreme choking, also may not develop signs of cerebral palsy until a later age.

Because cerebral palsy affects the brains ability to effectively communicate with the muscles, symptoms commonly related to movement. This includes the muscles in the mouth that affect speech. Speech impairments can be difficult to assess prior to the age of three or four, whether or not the child has minor cognitive impairments.

Pre-school teachers and day care workers frequently identify developmental disorders in children ages 3 and 4 because they are in a position to see them regularly perform tasks and engage socially in a group of similar-aged children. Informing parents about their child's lagging performance can trigger a visit with a health-care professional where a proper diagnosis can be made.

The manifestations of cerebral palsy vary greatly in terms of type and severity, so any “guide,” including this one, is just that … a guide. If you suspect developmental anomalies, seek appropriate health care professionals for guidance. Here are some warning signs specific to children between 3 and 4 years old that may be experiencing developmental delays:

A typical 3-year-old should be able to run, climb, bend over (without falling down), kick a ball, hold a writing utensil and scribble both up and down and side-to-side. They should be able to communicate in short phrases, speak and eat without drooling, stack 4 or more objects, copy a circle, “pret” play, understand simple instructions, exhibit an interest in other children, make eye contact and show an interest in toys.

In addition to the above, a typical 4-year old can throw a ball overhand and catch it much of the time, ride a tricycle, jump in place, keep calm when a parent leaves, demonstrate an interest in interactive games, engage in fantasy play, respond to people outside the family, exhibit self-control when angry, dress and undress (even if help), speak in sentences longer than 3 words.

Also, a child losing a skill they had previously mastered could be a sign of developmental delay.

By law (IDEA – Individuals with Disabilities Education Act of 2004), special education services are available, without cost, to families of children 3 years old and up for any kind of diagnosed developmental delay or injury.

Special Education is available through each state's Board of Education. Any elementary school can give you the local contact information you need if you believe your child may require specialized help. The school, by law, is required to “identify, locate and evaluate” children with developmental disabilities. They have a free screening process to help you evaluate your child's needs.

Preschool is a major transition for any child. Parents of all children should be actively involved in assisting this transition, but parents of children with developmental promises must do so even more. An IFSP (Individualized Family Service Plan) is a written plan that focuses on the child and family and the services that a family needs to help them enhance the development of their child. It differs slightly from an IEP (Individualized Education Program) which focuses on the educational needs of the child.

The IFSP reflects your child with cerebral palsy 's level of development, your family income and the concerns and priorities of the parents. It sets goals for both family and child and recommends specific services, such as therapy, that should be employed to meet the goals. An IFSP specifically identifies projected start days, projected length of services and any other steps to be taken to transition the child into preschool. It also assigns a service coordinator to the case.

There are variations, but one useful guide was developed by The College of Education at the University of Illinois. It details 6 strategies for parents, family members and service providers to follow as part of the transition to preschool. In general, they are 1) begin planning the transition early – 6 to 9 months before the planned transition date 2) express positive perspectives about the new setting – including expressing pride in the child's increasing maturity and independence 3) sensitively encourage the child to express fears and ask questions and never make light of their concerns 4) engage the child in concrete experiences such as exposing them to larger groups of children (such as story time at your local library) 5) teach the child specific skills and routines that will be useful in the new program – such as placing toys away and simulating “circle time” 6) communicate and share information between programs (such as feeding, positioning and handling techniques) in advance.

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Developmental Delays in Children With CP – Ages 2 to 3 Years

Children grow and develop on different timetables, often influenced by injury, illness or environmental conditions. Cerebral palsy, a brain injury disorder, originating from pre -birth, delivery or shortly after birth, can take several months to several years to exhibit enough indicators to warrant a diagnosis. Most children with CP are diagnosed by about 18 months because the common age of walking (between 10 and 14 months) came and went without the child mastering the task and the parents bought a medical explanation.

Accepting that your child may be developmentally delayed is not an easy pill to swallow and many parents are related to do so, wanting instead to embrace that their child is just a “late bloomer.” Other parents do not want to appear a “worry wart” and are there before hesitant to bother doctors about “every little thing.” To those parents, while we all hope and pray for the best for our children, early diagnosis and intervention for ANY problem beats addressing it only when the symptoms are undeniable. If “better safe than sorry” ever applied, this is it. Also, doctors must ride that thin line between over-reacting and causing undue worry for the parents and missing a pre-diagnosis hunch. “Let's wait and see,” is not the correct response to ongoing worries about your child's developmental issues.

One of the more common causes of cerebral palsy is a mysterious and significant lack of oxygen to the brain (brain asphyxia) during pregnancy or the birth process. However, young children can also experience this if they experience a near drowning, poisoning or choke on a foreign object, including food. If a child stops breathing for even a brief time, the child should see a doctor.

Because infant brain tissue is so soft and tender, brain injuries can also occur during any blow to the head or from being violently shaken (shaken baby syndrome). Brains also need the active participation of parents and caregivers to ensure that they receive proper stimulation and develop correctly. Children deprived of a loving, nurturing, stimulating environment can experience developmental promises regardless of the health of their brain. Bacterial and viral infections such as encephalitis and meningitis and can also lead to brain damage in the very young.

Signs of brain damage from any of these circumstances may not become evident for months or even years to come. Parents need to know what to look for and remain vigilant for developmental promises until the child is well into his or her school years.

By the time a child is 3 years old, they should be walking alone, climbing on and off furniture and able to stand on tiptoe. The manifestations of cerebral palsy vary greatly in terms of type and severity, so any “guide,” including this one, is just that: a guide. If you suspect developmental anomalies, seek appropriate health care professionals for guidance. Here are some warning signs specific to children between 2 and 3 years who may be experiencing developmental delays:

By 15 months, a child should understand the use of objects such as cutlery, brushes, telephones and bells. By 18 months, they should be walking. If walking, it should be in a heel-to-toe manner and not only on the toes. 2-year olds should be able to speak at least 15 words, put together 2-word sentences, follow simple instructions and push wheeled toys. Another warning sign is if a child suddenly regresses and loses one or more skills that once had.

By 36 months, children should be able to negotiate floors, speak and eat without excessive drooling, stack 4 or more blocks, manipulate small objects, copy a circle, speak short phrases, participate in “pret” play, exhibit an interest in other children , make eye contact and show an interest in toys.

Many of these problems can be helped with early intervention and therapy. Physical therapy aimed at strengthening muscles in the legs, jaw, mouth, tongue and core body can improve mobility, eating and communication skills, all of which provide wholesale benefits to health and well-being. Likewise, hearing and vision issues can be improved with adaptive equipment. The sooner your child with cerebral palsy gets help, the happier they will be and the more likely they will develop the skills required for a full and happy life.

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Developmental Delays in Children With CP – Ages 12 to 24 Months

Brain damage occurring prior to, during or just after birth can result in the condition known as “cerebral palsy.” Cerebral palsy impairs the brains ability to effectively control muscles. The area of ​​the brain damaged determines what muscles in the body are affected and to what severity. Some of the conditions known to cause cerebral palsy include: untreated infections in the mother, substance abuse during pregnancy, physical abuse during pregnancy, premature births, lack of oxygen to the fetus, breech birth and head injuries during the birth process.

Cerebral palsy in children often reveals itself enough to support a diagnosis between the ages of 12 and 24 months. During this period, children's muscles are growing and strengthening as they crawl, pull themselves up and learn to stand on their own. Children with developmental impairments are likely to lag behind to a noticeable degree during this period.

Just because a child is slow to attain a developmental milestone, does not mean that they suffered a brain injury. Sometimes, it's just how the child is and they will develop at their own pace. Other illnesses and disorders may slow the developmental process, especially if it involved a condition that kept the child immobilized for any significant period of time, such as surgery or other prolonged illness. Some conditions such as blood clotting disorders or metabolic / degenerative disorders actually mimic symptoms of CP.

The manifestations of cerebral palsy vary greatly in terms of type and severity, so any “guide,” including this one, is just that … a guide. Well-baby visits to the doctor's office are meant to be developmental screenings. Again, early signs of cerebral palsy can be difficult to detect. You are with your baby enough to know them better than anyone. Trust your instincts. Express any concerns you have and insist they be taken seriously. Below is a list of developmental delays to look for in a child 12 to 24 months of age using the six basic development skills key to all learning and development: gross motor, fine motor, sensory, language, social and emotional.

GROSS AND FINE MOTOR SKILL S: 1) an accessibility to drink from a cup, even with help 2) unable to feed themselves small finger foods such as crackers or grass small objects with the index finger and thumb 3) unable to manipulate small objects such as blocks or rings 4) can not sit up without help 5) not crawling or trying to crawl 6) not walking or walking with legs crossed (scissoring) 7) not standing alone, even momentarily 8) showing stiff or shaky legs or arms 9) difficulty eating, including excessive drooling

SENSORY AND LANGUAGE SKILLS : 1) failure to mimic or attempt to mimic actions and sounds 2) unresponsive to music or body motion 3) not trying to accomplish simple goals (such as crawling to something they want) 4) Consistently distracted during baths or clothes changing 5) unresponsive to sights, sounds and touch 6) not trying to communicate verbally

SOCIAL AND EMOTIONAL SKILLS : 1) does not recognize or respond to family member's names 2) failure to show affection to familiar adults 3) not exhibiting anxiety around strangers 4) not lifting arms to express a desire to be picked up (or only lifting one arm).

Developmental screening and evaluation tools have been developed for use by doctors, nurses and teachers. These simple tests, which consist of large questions for parents and simple task tests for children, take about 15 minutes and can be used to determine if a more in-depth evaluation may be required. Not all pediatricians are adequately trained in screening developmental delays. If you feel the situation warrants it, you may want to make an appointment with a developmental-behavioral pediatrician, a child neurologist, a neurodevelopmental pediatrician or locate an early intervention program that provides accredited assessment services.

If a developmental screening raises concerns, a developmental evaluation may be the next step. These advanced evaluations are conducted by educational diagnologists, psychologists or a certified Infant-Toddler Family Specialist. The CDSA (Children's Developmental Services Agency is the primary licensing entity.

Developmental evaluations concentrate on five specific categories: physical, cognitive, communication, social / emotional and adaptive (self-care).

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Developmental Delays in Children With CP – Ages Birth to 12 Months

Because the clear indicators of cerebral palsy are rarely present at or shortly after birth, a definitive diagnosis often occurs when a child is several months to several years old. Because of this, valuable early therapies and treatments can sometimes be delayed. There are, however, birth events that signal “high risk” babies and miles that, if missed, can also be strong indications of a potential problem.

Brain damage occurring prior to, during or just after birth can result in “cerebral palsy,” a condition that impairs the brain's ability to effectively control muscles. The area of ​​the brain damaged determines what muscles in the body are most affected. Some of the conditions known to cause cerebral palsy include: untreated infections in the mother, substance abuse during pregnancy, physical abuse during pregnancy, premature births, lack of oxygen to the fetus, breech birth and head injuries during the birthing process.

Young children do not reach all millions at the exact same age no matter how healthy they are. There are, however, guidelines that can help you know what to look for and where your child falls on the developmental spectrum. If you are concerned your child is developmentally lagging, do not hesitate bringing this up with the child's doctor. Trust your instincts. There's very little down side to “better safe than sorry,” when it comes to early detection of developmental impairments.

Developmental milestone guidelines list age-specific tasks and functional skills that MOST children reach by a certain age. Children that have suffered a brain injury may reach these milestones later than others, often with the help of specific therapies or, in some cases, not at all.

The manifestations of cerebral palsy vary greatly in terms of type and severity, so any “guide,” including this one, is just that … a guide. Again, if you suspect developmental anomalies, seek appropriate health care professionals for guidance. Here are some indications that there could be a problem:

AGE 2 MONTHS AND UP: 1) infant has difficulty controlling their head when picked up 2) they have shaky or stiff extemities 3) their legs tend to cross (scissor) when picked up 4) they have difficulty feeding and sucking

AGE 6 MONTHS AND UP: 1) any of the above problems persist 2) infant reaches with only one hand and / or keeps the other one in a fist 3) eating and drinking continue to be a problem 4) infant can not roll over on their own 5) infant can not push up with their hands when laying on stomach

AGE 10 MONTHS AND UP: 1) any of the above problems persist 2) when crawling, infant pushes off with one hand or leg while dragging the other 3) infant does not crawl or sit up by oneself

AGE 12 MONTHS: 1) any of the above problems persist 2) can not stand on own without support

There are six basic development skills key to all learning and development: gross motor, fine motor, sensory, language, social and emotional.

GROSS MOTOR SKILLS allow infections to reach milestones such as sitting, crawling, walking, and head control. FINE MOTOR SKILLS allow garbage small objects such as crackers or a spoon. SENSORY MOTOR SKILLS allow an infant to develop the sense of sight, smell, hearing, touch and taste. Impairments to Sensory Skills can result in either “HYPERsensitivity,” where children seem intolerant to light and sound and dislike being touched or “HYPOsensitivity,” the opposite, where children do not respond to loud sounds and seem to seek stimulation. LANGUAGE SKILLS refer to the development of the muscles in the mouth and tongue necessary to control sound as well as the ability to hear and process sounds correctly. By 5 months, an infant should react to loud sounds and turn their head towards the source of that sound. They should also make sounds reflecting pleasure or displeasure such as laughing, giggling, crying and fussing. SOCIAL AND EMOTIONAL SKILLS, which are linked in the first year of development, should include crying to express distress or attract attention, fixingating on faces, responding favorably to cuddling, smiling purposefully at certain people, responding to their name and exhibiting anxiety in the presence of a stranger.

Normal child development requires the active participation of all care-givers. Children deprived of a loving, nurturing, stimulating environment will experience developmental promises regardless of the health of their brain.

Even without perceived developmental delays, maintain regularly scheduled well-baby visits with your child's pediatrician. If there are developmental delays related to cerebral palsy , your baby's doctor may push for patience and remind you that children develop at different rates and often experience sudden bursts of development rather than slow, steady growth. Or he may recommend a developmental screening to identify potential delays that may warrant more in-depth evaluation.

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Choosing An In-Home Healthcare Provider for Children With Cerebral Palsy

The notion of hiring a stranger to come into your home and care for your disabled child can be an unnerving task, but following simple guidelines, including exhibiting strong patience and instinct, can lead to a mutually rewarding arrangement.

As with most things, research will be your best ally. Internet research will lead you to numerous personal blogs detailing the experiences of parents in a similar situation. In many cases, you will be able to initiate an online dialogue and get answers to most of your questions and learn things you might have not thought of.

The first decision involves where you are going to look for your healthcare worker. You may want to go through a qualified agency to provide you with someone or you may want to go the route of hiring an individual that works as a private contractor. There are pros and cons to each.

Whether going the agency or private individual route, always check the provider or licensee through your state Board of Nursing to ensure that they are currently licensed to practice in your state and to learn from any diplomatic actions or complaints on their record. This can often be done online.

When using an agency, they should first send a representative to your home to assess your child's needs and level of care required. From here, you will be assigned a case manager. A private contractor should also make themselves available for an in-home interview where it can be mutually determined if they can provide the level of care for your child needs. In both cases, insist on references and follow up on them. Keep in mind that whoever you hire will not only care for your child, but need to accurately communicate with you and your child's other healthcare providers.

Once you have contracted with someone for employment, expect to work with them for, at least, the first few sessions. Regardless of their credentials, they will need to be trained on the specifics of your child and in the manner you want things to be done. No two children or cases are the same.

It is wise to put all instructions in writing in an effort to minimize mistakes or confusion. The notes you provide should include:

1) All contact information for you, other members of your family and all other healthcare providers and emergency contacts

2) List of child's likes, dislikes and fears

3) List of child's favorite activities and rough time table of tolerance so as not to over-tire the child.

4) Description of child's cognitive level and ability to communicate.

5) Detailed instructions on the frequency and method for taking vital signs, position changes, baths, diaper changes, linen changes and any other procedures your child requires.

6) Location in the home where important items are kept

7) Detailed instructions regarding medications

A good health-care provider needs to be proficient at their job, but also a comfortable fit within your home. Some of the things you should expect from your in-home provider:

1) Patient, respectful and compassionate interactions with your child. This should include speaking directly to them as often as possible regardless of their perceived ability to understand.

2) Diligence relating disease control – including frequent hand washing and staying out of your home when suffering any contagious illnesses.

3) Punctuality, including advance notice of cancellations or late arrivals

4) Confidentiality. It's not a bad idea to include a confidentiality clause in the contract you sign with your provider. Examples can be found on many legal websites.

5) Communication skills. Providers must be able to effectively communicate all pertinent issues with you (both verbal and written) and to the child's other healthcare providers.

6) Attentiveness to detail – strict adherence to medication schedules, proper use and maintenance of equipment is essential

7) Undivided attention – when your provider is at work, they should not be using their mobile communication devices

8) Good end to day – part of the provider's routine should be leaving the child, the work area and all equipment in its original clean and organized condition.

Your new in-home provider would be remiss if they did not have certain expectations of you as well:

1) Most children experience anxiety at meeting strangers. It is your responsibility to introduce your child to this new presence in their lives and help them feel safe.

2) A clean, safe, well-lit “work” area.

3) All disposable and non-disposable medical supplies, including feeding tubes, hearing aids and suction equipment should be in good working order, clean and well-organized

4) Make them aware of any special circumstances that may arise, such as seizure activity

5) Instructions on the use and maintenance of any adaptive equipment your child uses

6) Your schedule for when away from the home.

7) Healthcare providers do not need to be subjected to your personal business. It may be your home, but it's there place of work. Keep attachments and other personal business out of sight and ear-shot.

Your healthcare provider is there as an extension of your wishes and child care methods. Never allow them to dictate how they will perform their duties. In an optimum environment, you will build a rapport and relationship that will keep your child with cerebral palsy in fine health so that they will have a better opportunity to flourish in other aspects of their lives such as educational and therapeutic situations.

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