What is Cerebral Palsy (CP)?
Cerebral palsy, commonly called CP, is the name used to describe a group of conditions that cause problems with movement. CP is a permanent condition and is the most common cause of physical disability in children. 1 in 500 Australian babies will be diagnosed with CP. Children with CP may also have problems with talking, eating, seeing, hearing, and learning.
Causes of Cerebral Palsy (CP)
CP can be caused by problems with early brain development or damage to the brain during pregnancy, during birth, or in the first few years of life. For many children there is no known cause. Babies born prematurely or with small birth weight, infections, birth defects, lack of oxygen or severe jaundice, are at increased risk of CP. There are also some genetic conditions that are linked to CP.
Key points:
- CP is the most common cause of physical disability in children.
- Not every child with CP is the same.
- Currently there is no known cure, however active management from an early age is recommended to achieve your child’s best potential.
- Management requires a team approach from parents/carers, therapists, doctors and nurses.
Types of Cerebral Palsy
CP can be described by;
- the type of movement problem,
- what parts of the body are most involved, and
- how severely it affects children’s ability to carry out daily activities (function).
Movement is affected because the brain has difficulties in sending messages to the muscles. Common types of movement problems include:
Spasticity
This is the most common movement problem. Muscles are stiff, which can make movement difficult.
Dyskinesia
The most common type of dyskinesia is Dystonia, which is seen as slow twisting or repetitive movements, or abnormal sustained postures. Other dyskinesias are Chorea, (abrupt jerky movements), and Athetosis (slow writhing movements.)
Ataxia
Ataxia is seen as unsteady shaky movements or tremor. It is the least common movement problem.
Every child with CP is different. Some children may have a combination of the types of movement problems described above. Understanding the type of CP helps with deciding appropriate treatment options.
CP can also be described by the parts of the body affected (see figure 1). These include:
Hemiplegic CP:
One side of the body is affected.
Diplegic CP:
Both sides of the body are affected, but more often just the legs.
Quadriplegic CP:
Both arms and legs are affected.
Figure 1: Hemiplegic, Diplegic and Quadriplegic CP
CP can also be described by how severely it affects children’s functioning in everyday activities. There are 3 classification systems used to describe the functional activities of mobility, hand use and communication. Each activity is rated according to the child’s level of ability, on a scale of 1 to 5. Each level is distinguished by the degree of independence and how much support and adaptations are needed to perform the activity.
The Gross Motor Function Classification System (GMFCS) levels are most commonly used. They describe children’s mobility.
Level 1: Walks independently without limitations.
Level 2: Walks independently in most settings. Needs a rail for stairs.
Level 3: Walks with a walking frame indoors and uses a wheelchair in the community.
Level 4: Needs physical assistance and/or a powered wheelchair for mobility.
Level 5: Needs a manual wheelchair for transportation by carers.
Early Goals
Children with CP and their families benefit greatly from therapy started as early as possible. This may include physiotherapy, occupational therapy and speech pathology. Education and support for families to care for their child with CP is also helpful. Early use of services help children to learn and practice new skills, encouraging activity. The goals and focus for therapy may include sitting, walking, playing, dressing, toileting, eating, and talking. Using services from an early age helps children with CP to reach their full potential.
For more information on Cerebral Palsy here are some website addresses you may find helpful:
Cerebral Palsy Alliance: a provider of therapy and support services in NSW and ACT www.cerebralpalsy.org.au
CP Register: a database that collects information about people with CP that helps with research into CP www.cpregister.com
National Disability Insurance Scheme: a national scheme to provide funding for essential support and therapy for people with disability, including children with CP www.ndis.gov.au
Cerebral Palsy Australia www.cpaustralia.com.au
The GMFCS – ER (2007) can be sourced online by visiting the CanChild website athttp://www.canchild.ca/en/measures/gmfcs.asp
Cerebral Palsy Foundation: http://yourcpf.org/
