What is Cerebral Palsy?
Cerebral Palsy is a disorder of muscle control which results from some damage to part of the brain. The term cerebral palsy is used when the problem has occurred early in life, to the developing brain.
There are five different types of Cerebral Palsy:
- Spasticity – increased tone resulting in some tight muscles and/or muscle groups
- Dyskinetic cerebral palsy/athetosis – fluctuating or changing tone
- Hypotonia – low tone
- Ataxia – coordination difficulties
- Or combinations of these.
Tone is the tension in muscles, which is controlled by different parts of the brain. Normal tone enables us to hold ourselves up against gravity and to make smooth, controlled movements with correct accuracy, rhythm, strength and coordination.
With Spasticity, the trunk has lower than normal tone. The child needs opportunities to strengthen the trunk and mobilise shoulders. Movement is slow and child fatigues easily which affects energy levels, initiation and participation. The child needs to practise movement and function to build stamina, speed of response and participation.
Dyskinetic Cerebral Palsy
With Dyskinetic Cerebral Palsy, involuntary movements occur when the child makes a voluntary movement. It is therefore important for the child to learn strategies to stabilise their body and move just one part. Emotional changes will increase involuntary movement. When in a resting or relaxed state the child may not respond quickly. Conversely, when excited, the child can respond with increased involuntary movements. It can be very difficult to interpret responses or understand communication. The child needs to learn strategies to regulate emotional responses and communicate using language.
Ataxia is a disorder of balance usually with lower than normal tone in the body. The child has difficulty maintaining balance and upright position against gravity, resulting in an unsteady, wide based gait. The child needs opportunities to strengthen the trunk and strategies to learn to stabilize their body. They have difficulty directing, grading and timing movements of the mouth, arms and legs, hands and feet. Initiation of movement is slow, as is the speed of responses. Speech has poor pronunciation, volume and little tone variation. Fine motor skills are affected as is targeting, which results in overshooting. As a result, the child needs to learn strategies for stabilising the rest of the body except that part which is moving, as well as learning strategies to assist initiation, direction, speed and rhythm of movement.