5. WHAT IS
1. What is cp and how does it affect children?
Cp is caused by abnormalities in the brain usually before, during
or soon after, birth. One in 400 babies is affected by cp, with
approximately 1,500 babies in England and Wales being affected
each year. It is not catching and, although the disability may
become more noticeable with age, it is not progressive. Cp jumbles
up the messages going from the brain to the muscles causing them
to behave oddly. There are three types of cp corresponding to
the three areas of the brain that can be affected.
2. The Cortex, in the front of the brain,
controls thought, movement and sensation. When this is affected
the result is usually the spastic form of cp. "Spastic"
means "stiff" and the stiffness can affect the arms
and legs. The muscles in the neck and trunk may also be involved.
When all the arms and legs are affected the condition is called
"quadriplegia". Sometimes the legs are very affected
with the arms and hands only mildly involved, this is called "diplegia".
Sometimes the arm and leg on one side of the body are very affected
with the other side being mildly affected; this is called "hemiplegia".
Quadriplegia is sometimes called "tetraplegia". In all
these conditions the muscles are very tight and the arms and legs
get pulled out of line by the tightness of the muscles.
3. The basal ganglia, in the mid-brain,
help movement organisation and gracefulness. When this is affected
the result can be the athetoid form of cp. Children with this
kind of cp have floppy muscles and uncontrolled movements of their
arms and legs. As children try to send messages to their arm or
leg the muscles can change rapidly from being floppy to being
tight causing the limb to fly outwards. Children may have problems
with the fine motor movements of the mouth and tongue making speech
and eating difficult.
4. The cerebellum, at the base of the brain,
co-ordinates movement. When this is affected the result can be
ataxic cp. Children with this kind of cp find it very difficult
to balance. They have shaky, jerky movements particularly with
fine motor movements. Walking may be unsteady.
5. Children may have some effects and not
others. Some are only mildly affected while others are profoundly
affected. Some may experience two or all three types of cp. There
is no treatment to cure cp but some of the effects can be helped
by therapy and teaching. Because the muscles pull abnormally they
can cause the child to sit or lie in odd ways which can result
in stiffness and pain. Correct relaxation of the muscles with
correct positioning in sitting, standing or lying can go a long
way to prevent these painful contractures.
6. Medical treatments: young children with
cp often are away from education and other pre-school activities
for long periods, or at home convalescing. Hence there is a need
for a close co-operation between education, social services and
health services. Often, drugs have to be administered during the
day. Issues, including child protection issues, arise regarding
a child with epilepsy for example: who administers the drug, the
relevant training required, and who takes responsibility.