Page 128-131: Cerebral Palsy

Part 2 - Disorders Demystified

Page 128-131: Cerebral Palsy

Cerebral Palsy

Cerebral Palsy is the name for a group of lifelong conditions affecting movement and co-ordination, caused by a problem with the brain that occurs before, during or soon after birth. Cerebral means to do with the brain and palsy means weakness or problems using the muscles. The condition is normally diagnosed during the child’s first or second year, but if symptoms are mild, it is sometimes difficult to make a diagnosis until the child is a few years older. There are different types of Cerebral Palsy and different parts of the body may be affected. There is currently no cure, but treatments are available to help people with the condition to lead as active and independent a life as possible.

All children with Cerebral Palsy have difficulties with motor skills which can affect muscle control, coordination, reflexes, posture and balance. The severity of these difficulties varies greatly. A person with severe Cerebral Palsy may need to use special equipment to be able to walk or may not be able to walk and need lifelong care. In contrast, mild Cerebral Palsy may cause a person’s movements to appear awkward, but they may not need any specialist help.

In addition to difficulties with movement and co-ordination, other body functions that involve motor skills and muscles can be affected, such as breathing, eating and talking. Again, this varies greatly between individuals with Cerebral Palsy and depends on how much, and which parts of, the brain are affected. Common difficulties occurring in children with Cerebral Palsy are epilepsy (affecting 40%), SLCN (affecting 20%), ASD (affecting 10%) and Learning Disability (affecting 30-50% of children).

The severity of SLCN in children with Cerebral Palsy is also very variable. This can include difficulties understanding language, difficulty using spoken language and unclear speech sound production. Some children have severe SLCN resulting in significant difficulty communicating verbally to other people, meaning that they require an alternative means of communicating. For other children, they may have no significant communication difficulties or have mild difficulties meaning that they require extra time to understand spoken language and to create their responses, but generally they are able to communicate successfully.

Myth Busting

Speech and Language Myth Busting Icon

Is Cerebral Palsy a progressive condition that will get worse as the child gets older?

The original problem with the brain that causes Cerebral Palsy does not get worse with time and instead may improve with time. The condition can put a lot of strain on the body and cause problems such as painful joints in later life.

Are children with Cerebral Palsy able to communicate?

Some children with Cerebral Palsy, around 1 in 5, will have communication difficulties, but many do not and can communicate successfully without support. If a child does have communication difficulties these vary in severity from very mild difficulties to severe communication difficulties resulting in very limited functional communication.

Do all children with Cerebral Palsy have a Learning Disability?

As with communication difficulties, not all children with Cerebral Palsy have a Learning Disability, with 30-50% of the children having some level of cognitive impairment. It should not, therefore, be assumed that all children with the condition have below average cognitive ability.

Prevalence

Cerebral Palsy is the most common motor disability in childhood, with about 1 in 400 babies being diagnosed in the UK. Globally over 17 million people have Cerebral Palsy.

Strategies

Speech and Language Strategies Icon

While it is important that assumptions are not made about the communication abilities of children with Cerebral Palsy, 20% of children with the condition have SLCN, so it is important that any difficulties in this area are identified so that the correct support can be provided. Using a screen, such as the Language Link assessment, will identify whether a child with Cerebral Palsy has any difficulties understanding language and determine whether they would benefit from further, detailed assessment from a SaLT. If you have concerns about the speech sound skills of a child with Cerebral Palsy, the Speech Link assessment will determine whether they need further support for this area and whether a more thorough assessment from a SaLT is needed.

For children with Cerebral Palsy who have identified SLCN, our general strategies will be appropriate in supporting them.

Role of SaLT

Most children with Cerebral Palsy will be under the care of a variety of professionals, which may include SaLT, and school staff will need to work closely with them to ensure the best support strategies are in place for the child. SaLT may be involved if a child has difficulties with understanding language, using language and being able to functionally express themselves, speech sound difficulties resulting in unclear speech, or swallowing difficulties.

The focus of support from a SaLT is likely to be on supporting children to functionally understand language, ensure that they are able to functionally communicate and to support with recommendations for parents and school staff in adapting their communication environments. If you have concerns about the speech, language or eating and drinking skills of a child with Cerebral Palsy that you are working with, it is recommended that you discuss them with SaLT.