This is a general term for a variety of disorders that prevent the brain from controlling muscle and body movement. There are many causes of cerebral palsy, including birth injuries, pregnancy infections in early pregnancy, cranial injuries and genetic disorders.
There are three main types of cerebral palsy, and some cerebral palsy is a mixed type.
Spastic cerebral palsy: This type of cerebral palsy stiffens the muscles, which in turn reduces the amount of muscle movement. It is the most common type of cerebral palsy and can affect different parts of a child’s body.
Hysteretic cerebral palsy: This type of cerebral palsy causes sudden irregular movements as the muscles constantly change in strength, sometimes tensing and sometimes relaxing. The child is unable to control these movements. The child’s speech is also affected because of the inability to control tongue and breathing movements. There may also be some hearing problems.
Dim ataxic cerebral palsy: This type of cerebral palsy causes impairments in balance and spatial awareness, and hand movements and speech are also affected, but most children with this type of cerebral palsy can walk.
Incidence and diagnosis
One in every 400 children has some type of cerebral palsy. Some children are diagnosed at birth, while others are diagnosed at 1 year of age when their motor development has not progressed.
Health and Development
Cerebral palsy affects children in different ways. Some children with cerebral palsy do not have obvious symptoms, while others may have impairments in motor coordination and language. Be careful not to assume that they have a learning disability. Because there are individual differences in each child, it is important to ask the parents about the child and to get to know the child better. The physical development of a child diagnosed with cerebral palsy is impaired, so many children require mobility assistance such as the provision of a standing frame, walker or wheelchair. Control of large muscles and fine motor skills can also be affected to varying degrees.
Spatial awareness
Some children can see but cannot process visual information, resulting in poor spatial awareness and a “clumsy” appearance, such as a child reaching for a cup but dropping it when his or her hand is tilted slightly to the side.
Tactile sensation
Some children’s sense of touch is affected, and some tactile sensations can be annoying or distressing. When introducing sensory materials such as sand or water, be sure to carefully observe children’s reactions.
Communication
Some children’s speech and language skills are affected and often require a visit to a speech and language therapy specialist. You should also find out how you can assist.
Toilet training
Constipation is common in children, so if toilet training is difficult, postpone it.
Feeding
Some children may have difficulty eating because the muscles of the throat and mouth are affected. Parents or physical therapists can be consulted on how to help children eat.
Some children also have one or more of the following conditions.
(i) epilepsy
(ii) Hearing impairment
(iii) Visual impairment
Information needed from parents
Because each child’s needs are different, it is important to consult with the parents as much as possible and have them demonstrate to you as much as possible.
How to respond to the child’s needs.
What does your child like to do at home?
Does your child have any walking needs?
What kind of care does your child need, such as toileting and eating?
How are you responding to these needs at home?
Is the child receiving physical therapy and are there any precautions?
Is the child receiving speech and language support, and if so, how should the preschool assist?
Does the child have an auditory or visual impairment?
Is the child receiving medication and does the preschool need to cooperate?
Is the child in contact with a professional and do we need to contact him?
Is laxative medication or toilet training being used at home?
For specific children
Cerebral palsy affects children differently and it is important that we understand each child’s specific situation. We should find out more information from parents and other professionals who support the child and his or her family.
Once we know the child, we must also consider how to integrate the child into the daily activities of the nursery. This requires a great deal of flexibility and creativity, including the use of information and communication technology (ICT).
Important questions
Who is responsible for direct contact with parents and other professionals?
Who will be the key caregiver for the child?
What resources and equipment do parents and physical therapists recommend?
Do staff need to come up with a training plan and conduct training?
Do staff need to learn to feed the child?
Do staff know how to make children physically comfortable?
Some daily questions
Are there activities designed to meet the needs of the children?
Are the necessary resources and equipment in place?
Only when early detection is achieved can early treatment and recovery is not without hope.