Chapter 26: Cerebral Palsy Pages 387-408

1. Chapter 26: Cerebral PalsyPages 387-408 Melissa Ewerth Adapted Physical Education West Chester University http://www.youtube.com/watch?v=ICpl0F6AqdE&feature=youtu.be

2. Objectives • Define Cerebral Palsy • Identify the causes of cerebral palsy • Understand the diagnosis for cerebral palsy • Explain ways to help children with cerebral palsy • Identify useful strategies for teachers

3. What is Cerebral Palsy? • Cerebral palsy is a movement and posture disorder that is caused by a non- progressive abnormality of the immature brain. • Cerebral palsy is a developmental disability that is associated with signs of neurological dysfunction.

4. Causes of Cerebral Palsy • Cerebral palsy is most often caused by a brain injury. • In some cases, cerebral palsy is caused by genetic problems with brain development. • Birth asphyxia is only the cause of cerebral palsy in a minority of cases.

5. Causes of Cerebral Palsy:Prematurity-Related • Premature infants are at increased risk for cerebral palsy. • The increased risk comes from the weakness in the white matter of the brain. • Two common causes of white matter injury at this stage of life are periventricularleukomalacia (PVL) and intraventricularhemmorage (IVH) • Both of these conditions can result from immature brain development.

6. Causes of Cerebral Palsy:Full-Term Infants • Full-term infants with cerebral palsy are often smaller than average at the time of their birth or have deformities of the central nervous system (CNS) or other body systems. • Birth asphyxia can be a cause of cerebral palsy in a full term infant as it can cause severe brain damage at the time of birth.

7. Causes of Cerebral Palsy:Infection • Infections are also a known cause of cerebral palsy in both premature and full-term infants. • Fetal viruses and other agents of infections such as parasites are an uncommon cause of cerebral palsy. • Chorioamnionitis is an intrauterine infection of the mother and is known to be linked with the Cerebral Palsy.

8. Diagnosis • Cerebral palsy is diagnosed based on delays in motor development paired with dysfunction in the central nervous system. • Cerebral palsy cannot be diagnosed at birth. • Severe cerebral palsy is usually diagnosed by age one. • Mild cases of cerebral palsy are usually diagnosed by two years of age

9. Diagnosis:Delayed Motor Development • The most common cause of motor delay in children is not cerebral palsy. • Individuals with motor delays that are related to cerebral palsy tend to have more severe motor delays that are related to signs of upper motor neuron dysfunction.

10. Upper Motor Neuron System • Two Primary Components • Pyramidal Tract/Corticospinal Pathways • Extrapyramidal System • Upper Motor Neuron dysfunction is often characterized by positive and negative signs.

11. Persistent Primitive Reflexes • Primitive reflexes are reflexes that are present early in life. • Suckling reflex, hand-grasp reflex • These reflexes are controlled by the primitive regions of the nervous system • Spinal cord, lower brain areas, brain stem • For children with cerebral palsy, it is common for primitive reflexes to continue on past infancy. • The asymmetrical tonic neck reflex and the tonic labyrinthine response are primitive reflexes that that are helpful in the diagnosis of cerebral palsy.

12. Persistent Primitive Reflexes Continued

13. Persistent Primitive Reflexes Continued

14. Involuntary Movements & Ataxia • Dyskinesias- atypical, involuntary movements • Chorea- rapid, random, jerky movements • Athetosis- slow, writhing movements • Dystonia- rigid posturing that is centered in the trunk and neck • Ataxia- abnormal voluntary movement when it comes to balance and the spacial position of the limbs and trunk.

15. Walking and Cerebral Palsy • Walking • Maintain upright posture • Move forward smoothly with coordination • Protective safety responses • Even those with the mildest forms of cerebral palsy have trouble walking. • Scissoring: Increased muscle tone/internal hip rotation. • Toe Walking: Tightness of calf muscles and Achilles • Quick Fact: Children with better motor skills at a younger age have a better prognosis for walking than those with more underdeveloped skills.

16. Subtypes of Cerebral Palsy • Spastic Cerebral Palsy • Spastic hemiplegia • Spastic diplegia • Spastic quadriplegia • Dyskinetic cerebral palsy • Athetoid cerebral palsy • Dystonic cerebral palsy • Ataxic cerebral palsy • Mixed cerebral palsy

17. Impairments associated with Cerebral Palsy • Intellectual Disability • Visual Impairments • Hearing Impairments • Speech and Language Disorders • Seizures • Feeding and Growth Abnormalities • Behavior and Emotional Disorders

18. Gross Motor Function Classification • There are 5 levels of function classification. • Each level is broken into age classification. • Compare and contrast levels 1 and 5.

19. Helping Children with Cerebral Palsy • Habilitation • Therapy • Neurodevelopmental Therapy (NDT) • Hippotherapy • Aquatic Therapy • Bracing and splinting • Orthotic Devices • Positioning Devices • Adaptive Equipment • Crutch, walker, cane • Wheelchairs • Cushions • Car seats

20. Useful Information for Teachers • Know your students! • Physical exercise is important and can be modified. • Swimming, dancing, horseback riding • Be creative in adaptations! • Work with the family and additional resources to best meet the needs of the student as an individual.

21. Did You know? • Most children with CP will live into adulthood, although life expectancy is shorter than the general population. • The ability to successful function in society is based more on the cognitive ability than physical ability. • Young Adults Study • 30% lived with parents • 12.5% lived with a partner • 32.5% lived alone • 53% had secondary education • 36.3% had paid employment

22. Summary • Cerebral palsy is a disorder resulting from brain damage or dysfunction of the developing brain. • There are different types of cerebral palsy that must be taken into account when treating and teaching individuals with the disorder. • Physical activity is beneficial in a variety of ways for individuals with cerebral palsy.

23. Contact Information Melissa Ewerth: ME796843@wcupa.edu Presentation Link: http://www.youtube.com/watch?v=ICpl0F6AqdE&feature=youtu.be