According to the American Academy of Neurology, about 12% of individuals with cerebral palsy experience hearing impairments, although some studies have found a prevalence of up to 40%. Despite their likelihood to co-occur, the two conditions are not directly related to one another.

To help you understand why cerebral palsy and hearing loss often co-occur, this article will discuss:

• The Link Between Cerebral Palsy and Hearing Loss
• 3 Types of Hearing Loss That Can Occur in Individuals with Cerebral Palsy
• Signs of a Hearing Impairment to Look Out For
• Treatments for Hearing Loss in Individuals with Cerebral Palsy

Understanding Hearing Loss in Individuals with Cerebral Palsy

Hearing loss is an associative condition of cerebral palsy, meaning that they are caused by two different areas of damage to the brain but Hearing loss is an associative condition of cerebral palsy, meaning that they are caused by two different areas of damage to the brain but often co-occur. Cerebral palsy is caused by damage to the motor cortex, cerebellum, thalamus, or basal ganglia. In contrast, damage to the parietal and temporal lobes of the brain, or to the ear itself, may cause hearing loss.

Individuals with mild cerebral palsy are less likely to experience hearing impairments than those with more severe forms of CP. This may be because individuals with more severe CP often have more widespread brain damage, which may extend to the areas of the brain associated with hearing. Furthermore, they may have sustained an injury that affected the ears in addition to the brain, resulting in hearing loss.

Many risk factors for cerebral palsy are also associated with hearing problems, including:

• Genetic abnormalities
• Lack of oxygen to the developing brain
• Jaundice
• Infections
• Premature birth
• Low birth weight

With these similarities, it makes sense that hearing loss can co-occur with cerebral palsy, even if they are not directly related.

Types of Hearing Loss That Can Occur in Individuals with Cerebral Palsy

Generally, individuals with cerebral palsy experience 1 of 3 types of hearing loss: conductive, sensorineural, or mixed. Because they vary in causes, symptoms, and prognosis, it’s essential to understand the differences between them to get the right treatment.

1. Conductive Hearing Loss

Conductive hearing loss affects the transmission of sound in the middle and outer ear. Because hearing is affected before sounds reach the nerves in the inner ear, individuals experience muffled, unclear sound.

Luckily, conductive hearing loss is often temporary and can usually be treated through surgery, medications, or hearing aids.

2. Sensorineural Hearing Loss

Sensorineural hearing loss occurs when there’s damage to the nerve pathways in the inner ear, the hearing-associated neural pathways in the brain, or the part of the brain responsible for perceiving auditory stimuli.

This type of hearing loss is permanent and generally cannot be treated with medicine or surgery. However, hearing aids may be able to help your child manage their hearing impairment.

3. Mixed Hearing Loss

Mixed hearing loss describes when a person experiences a combination of symptoms characteristic of both conductive and sensorineural hearing loss.

Both the inner ear and middle/outer ear are affected, which makes it both a physical and neurological complication.

Identifying Signs of Hearing Loss in Children with Cerebral Palsy

Because of their difficulties with movement, it is especially important for  individuals with cerebral palsy to learn how to effectively communicate to relay their needs. However, hearing loss can significantly affect the development of a child’s language and social skills, which is why early identification and intervention are essential.

Signs of hearing loss include:

• delayed or no reactions to sudden bursts of sound
• lack of response when asked questions or when their name is called
• frequently asking others to repeat themselves
• confusion when spoken to
• incoherent responses

Hearing loss can range from mild to profound and affect various parts of one or both ears.

Generally, the younger a child is and the milder their impairment, the more challenging it will be to notice hearing loss. Many times, hearing impairments can be mistaken for cognitive impairment due to a lack of response and confusion.If your child is demonstrating signs of a hearing impairment, consult with an audiologist to get a professional evaluation. Use this link from the American Academy of Audiology to find an audiologist near you.

Treatments for Hearing Loss in Individuals with Cerebral Palsy

Managing both hearing loss and cerebral palsy can be complicated. Cerebral palsy affects movement, and hearing loss makes it difficult to understand directions, have conversations, and be aware of one’s surroundings.

Because everyone experiences cerebral palsy and hearing impairments differently, a personalized approach to treatment is essential.

For example, children that only have hearing impairments typically learn sign language to communicate. However, children with cerebral palsy and hearing impairments might not be able to use sign language because they may lack fine/gross motor control necessary to sign.

Below, we’ll discuss some of the most effective interventions to help individuals with cerebral palsy manage hearing impairments.

Work with Variety of Specialists

Individuals with cerebral palsy may see a variety of specialists to address and treat various complications.

Examples of specialists that can help treat complications associated with hearing loss include audiologists and speech-language pathologists.

Audiologists can help evaluate the severity of your child’s hearing impairment and provide helpful management tips.

Speech-language pathologists can help your child learn how to effectively communicate (verbally or nonverbally) and improve their social skills.

Surgery

If hearing loss is caused by problems with the ears, surgery may be recommended to remove whatever is blocking sound from reaching the inner ear.

This can include problems like deformity, dysfunction from head trauma, fluid buildup, tumors, and otosclerosis (a bone growth disorder).

Medications

Doctors may prescribe antibiotics or antifungal medications to treat ear infections and reduce fluid buildup.

Powerful steroids may also be used either orally or by injection to reduce inflammation and swelling in the ear, although the evidence for improving hearing loss through steroids is mixed depending on the type of hearing loss experienced.

Hearing Aids

Hearing aids are devices that are placed on the ear to amplify sound, allowing individuals to hear more clearly.

They don’t heal ear damage, but they may allow individuals to hear much better.

Cochlear Implants

In cases of severe sensorineural hearing loss, a cochlear implant may be recommended. To clarify, a cochlear implant cannot restore normal hearing. Instead, it works around the damaged part of the ear and directly stimulates the auditory nerve.

Cochlear implants consist of an internal piece that is surgically inserted under the skin and an external component that you place on your ear. They convert sounds into electric impulses and send them off to various frequency electrodes, which gives the sensation of sound.

The sound experienced with a cochlear implant is different from natural sound. However, younger children tend to quickly adapt to it, which is another reason early intervention is ideal.

Cerebral Palsy and Hearing Loss: Key Points

Cerebral palsy and hearing loss don’t share a direct relation, but they do occur together often enough that they are associative conditions for one another.

Hearing loss can be mild and difficult to notice, or profound to the point of deafness. Depending on the severity of your child’s hearing loss, treatment methods can be minimal or more invasive.

If you think your child may be showing signs of a hearing impairment, don’t hesitate to get a professional diagnosis. Early intervention can help prevent hearing complications from progressing and significantly improve your child’s communication skills.

Hopefully, this article helped you get a better understanding of what to expect, signs to look out for, and treatment options for hearing loss in children with cerebral palsy.

The post Cerebral Palsy and Hearing Loss: Why It Happens & How to Treat It appeared first on Flint Rehab.

W-sitting is a seated position where the knees are bent, the hips are rotated inward, and the heels are positioned on either side of the hips. From above, the legs appear to form a “W” shape.

This article will explain why W-sitting can be problematic in children with cerebral palsy and how to correct this harmful habit.

What is W-Sitting?

When they are young, some children prefer to use a W-sitting posture when seated on the floor. W-sitting involves sitting with the knees bent, with the feet resting on the floor on either side of the hips. In this position, the child’s bottom, knees, ankles and feet are all resting on the ground, with the feet placed outside of the hips.

W-sitting provides children with a wide base of support, which can allow them to sit comfortably for periods of time with minimal activation of the core muscles. In this position, children can easily use both hands to play or work with objects on the floor in front of them.

Although opinions are divided on whether w-sitting for prolonged periods on a regular basis has detrimental effects for neurotypical children, children with cerebral palsy may be more likely to experience difficulties as a result of w-sitting.

At What Age is W-Sitting a Problem?

W-sitting is commonly seen among babies as they are learning to sit independently. In fact, it is developmentally appropriate around 10-12 months of age, and is among many preferred seating positions of 3-6 year olds. By 8 to 10 years old, most kids have completely “grown out” of w-sitting. At this age, the hip muscles begin to further stabilize, losing some flexibility and making it uncomfortable to rotate into w-sitting position. 

W-sitting may allow babies and toddlers to easily move into and out of crawling position, and many children find it to be a comfortable sitting position. However, w-sitting may become a problem if, at any age, children have a hard time getting out of the position or rarely use any other seated position. 

Despite the belief that w-sitting can cause long-term problems, research has not supported this claim. However, in some children, primarily using the w-sitting position may be a sign of underlying medical conditions, such as cerebral palsy. For these children, regularly w-sitting may exacerbate differences in muscle tone and structure.

Why W-Sitting is Dangerous for Children with Cerebral Palsy

Because children with cerebral palsy may struggle with abnormal muscle tone, poor posture, uncontrollable movements, balance, and coordination, they may prefer w-sitting. However, habitually w-sitting may significantly interfere with development.

Below, we’ll discuss 3 complications that W-sitting can cause in children with cerebral palsy.

Decreased Core Activation

Children with cerebral palsy often W-sit to compensate for weakness in the core muscles.

Low muscle tone in the core can cause children to become hands-dependent sitters, meaning that they often lean forward and use their hands to stabilize the body. Because their hands are occupied, hands-dependent sitters cannot play or interact with their surroundings.

To free up the hands, children with cerebral palsy may begin to W-sit. W-sitting creates a wider, more stable base, which makes it easier to sit upright and participate in activities.  

However, W-sitting does not engage the core muscles, and disuse only causes the muscles to get weaker. The only way to improve balance and strengthen the core is to consistently practice movements and postures that require core engagement.

Limited Trunk Rotation          

Another potential consequence of W-sitting in children with cerebral palsy is limited trunk rotation. When children sit in a W-position, their bodies become stuck in place and trunk range of motion becomes limited.

Reducing trunk rotation makes it more difficult to reach across the body, also known as crossing midline. The ability to cross midline is important not only to physical development, but also to brain development, as it encourages communication between the right and left brain hemispheres.

When trunk rotation is limited, children can get accustomed to grabbing everything on their right side with their right hand and everything on their left side with their left hand. Similarly, rather than reach across their bodies to grab an object, children may move their entire bodies.

As a result, children may not develop bilateral movement skills (the ability to use both the right and left sides of the body simultaneously) and may struggle with poor coordination.

Abnormal Gait Development

Especially because children with cerebral palsy are prone to involuntary muscle contractions (spasticity), W-sitting can affect a child’s gait and balance.

When children with CP W-sit, they’re promoting the inwards rotation of the hips. If spastic muscles tighten in that position, it can contribute to the development of an in-toeing gait.  

Now that you understand why W-sitting can be harmful in individuals with cerebral palsy, let’s discuss what you can do to correct it.

How to Correct W-Sitting in Children with Cerebral Palsy

Habits are difficult to break, so early intervention is crucial. The sooner W-sitting is addressed, the easier will be to correct.

In this section, we’ll discuss 3 ways to address W-sitting.

1. Encourage Alternative Sitting Positions

Ultimately, parents should keep an eye out for W-sitting and encourage their children to sit in alternative positions that engage the core and promote cross-body movements.

Some alternative sitting positions you can encourage your child to try include:

• Side sitting involves bending one knee behind the body and the other in front. Both knees should face the same side.
• Crisscross apple sauce involves crossing the legs over each other. It promotes a more neutral orientation of the pelvis and minimizes strain on the joints.
• Long sitting involves sitting with the legs straightened in front of you. This posture helps stretch the calves and hamstrings. However, it may be difficult to maintain this position for long periods. Spreading the legs in a V-shape can create a more stable base.

While these alternative sitting positions may be uncomfortable at first, they will get easier as your child’s core muscles get stronger. Using a combination of these sitting positions can help improve your child’s balance and stretch muscles that may not get stretched otherwise.

Regardless of which sitting positions are used, be aware of how often your child is leaning forward on their hands or leaning back against a wall. Try to minimize consistent leaning in any sitting position to work on strengthening the core.

2. See a Pediatric Physical Therapist

Every individual experiences cerebral palsy differently. Some cases only affect one side of the body, while others can affect both legs, single limbs, or the entire body.

A pediatric physical therapist can help assess how cerebral palsy affects your child’s posture and functional abilities. Then, they can create a customized rehabilitation program to strengthen the core and lengthen the leg muscles.

Often physical therapy may include stretching and exercises, along with more engaging activities, such as playing games while sitting on a therapy ball or completing animal walks.

3. Manage Spasticity

Minimizing spasticity will help prevent complications associated with W-sitting like pain, abnormal gait, and underdeveloped muscles.

Spasticity management can consist of:

• Stretching to lengthen spastic muscles
• Physical therapy to maximize mobility through exercise
• Botox injections or muscle relaxants to temporarily relieve high muscle tone so individuals can focus on physical therapy exercises
• Surgery to reduce the hyperexcitability of spastic muscles or manually lengthen them
• Wearing orthotic devices to support proper musculoskeletal alignment and mildly stretch spastic muscles

Reducing the effects of spasticity can make it easier for your child to maintain other sitting positions and avoid the need to resort to W-sitting.

Understanding W-Sitting in Children with Cerebral Palsy: Key Points

While W-sitting can make it easier for children with cerebral palsy to sit upright, it can also be problematic and contribute to further motor impairments.

To minimize the harmful effects of W-sitting, early intervention is necessary. The sooner a habit is addressed, the easier it will be to correct.

Hopefully, this article helped you understand how W-sitting can affect children with cerebral palsy and how to manage it. Good luck!

The post W-Sitting and Cerebral Palsy: Why It’s Harmful and How to Correct It appeared first on Flint Rehab.

To help you understand what to expect when cerebral palsy affects the muscles in the face, this article will discuss:

• Is it common for cerebral palsy to affect the face?
• What are the effects of motor impairments in the face?
• What’s the difference between cerebral palsy and Bell’s palsy?
• Is it possible to treat motor impairments in the face?
• How to manage cerebral palsy that affects the facial muscles

Is It Common for Cerebral Palsy to Affect the Face?

Cerebral palsy is the result of damage to the areas of the brain that control motor functions. Depending on the location and severity of the damage, voluntary control over the muscles throughout the body can be affected. This can include a  decreased ability to use the muscles in the face.

Motor impairments in the face can occur in all types of cerebral palsy (spastic, dyskinetic, and ataxic). However, they are more common in individuals with dyskinetic cerebral palsy than spastic or ataxic forms.

Additionally, the prevalence of facial motor impairments in individuals with cerebral palsy increases as overall gross motor function decreases. This means that the more severe the individual’s cerebral palsy becomes, the more likely it is for the facial muscles to be affected.

Motor impairments in the face are common amongst individuals with cerebral palsy. In fact, research suggests that:

• 25% of individuals with CP are non-verbal
• 1 in 15 individuals with CP require non-oral feeding
• 50% of individuals with CP experience motor-based speech impairments (dysarthria)

In the following section, we’ll discuss the effects of facial motor impairments in individuals with cerebral palsy.

Effects of Facial Motor Impairments in Individuals with Cerebral Palsy

Cerebral palsy can affect various muscles in the face, including the ones that control the tongue, throat, and mouth. These muscle groups we use both voluntarily and involuntarily. This can affect a wide range of functions, making it challenging to communicate, eat, and breathe.

Secondary effects of facial motor impairments include:

• Difficulties with chewing and swallowing
• Drooling
• Choking
• Difficulties controlling breathing
• Impaired speech or inability to speak
• Difficulties with facial expression
• Prolonged feeding times
• Snoring
• Malnutrition and consequently impaired growth
• Quiet or soft speech

Many of these symptoms can cause individuals with cerebral palsy to experience social isolation, which can lead to loneliness and a decrease in overall emotional wellbeing. It’s important to understand that if an individual uses an alternative form of communication, it does not mean that they are any less intelligent.

Many individuals with cerebral palsy can understand what you are saying and know what they want to say back. However, their facial motor impairments may prevent them from communicating their thoughts verbally.

What’s the Difference Between Cerebral Palsy and Bell’s Palsy?

Cerebral palsy and Bell’s palsy are conditions that can cause weakness or paralysis of the facial muscles. However, there are several distinct differences between the two.

Bell’s palsy is most commonly characterized by paralysis of one side (left or right) of the face. As a result, individuals with Bell’s palsy often demonstrate drooping of the mouth and eyelid on the affected side of the face. Although rare, there are instances where Bell’s palsy affects both sides of the face. Additionally, Bell’s palsy is a temporary condition caused by dysfunction of the peripheral nervous system and most people recover full control over their facial muscles.

In contrast, cerebral palsy is a lifelong condition caused by damage to the central nervous system. Cerebral palsy can cause weakness throughout the entire body, not just the face. Additionally, it often affects both sides of the face, which can make it difficult to chew, speak, and swallow.

Luckily, many individuals with cerebral palsy may be able to improve motor control in the face by engaging their brain’s natural ability to adapt, neuroplasticity. Up next, we’ll discuss what neuroplasticity is and the most effective way to promote it.

Is it Possible to Treat Motor Impairments in the Face?

Lack of facial control in individuals with cerebral palsy is caused by damage to the brain, not the muscles. Therefore, to improve these functions, you must target adaptive changes in the brain.

Neuroplasticity is the brain’s ability to make neuroadaptive changes based on the behaviors we repetitively practice. The key to strengthening control over the facial muscles is to consistently engage them.

Task-specific and repetitive practice helps stimulate the brain and reinforces demand for those functions. As a result, facial functions affected by brain damage can be rewired to unaffected regions of the brain and strengthened for active use.

Up next, we’ll discuss management interventions that can help individuals with cerebral palsy promote neuroplasticity or compensate for lack of facial motor control.

How to Manage Cerebral Palsy that Affects the Face

Every case of cerebral palsy is unique and individuals may experience various degrees of facial motor impairments. Management techniques should be personalized for each individual’s specific functional outcomes.

Below, we’ll discuss interventions that can help individuals with cerebral palsy manage facial motor impairments.

Participate in Speech Therapy

Participating in speech therapy can help individuals with facial motor impairments strengthen their communication and feeding skills. A speech-language pathologist can assess the severity of one’s facial motor impairments and create a custom rehabilitation plan consisting of activities and exercises to help strengthen the facial muscles, improve communication skills, and increase social participation.

They may also use specialized electrical stimulation devices for the face, such as VitalStim, to promote increased communication between the orofacial muscles and the brain.

Implement New Feeding Techniques

Another helpful way to manage facial impairments is to implement adapted feeding techniques. This may include:

• Blending food to change the consistency, reduce chewing, limit the likelihood of choking, and make food easier to swallow
• Thickening drinks to reduce the likelihood of aspiration (breathing liquid into the lungs)
• Scheduling longer meal times
• Using a surgically-inserted feeding tube
• Taking supplements to help fill in gaps in nutrition

These practices can help ensure that children with cerebral palsy have adequate nutritional intake to support optimal growth and development.

Use Augmentative and Alternative Communication

Individuals with severe facial muscle impairments may be unable to generate verbal speech. To compensate and allow the individual to be an effective communicator, a speech-language pathologist may recommend learning how to use augmentative and alternative communication (AAC).

AAC consists of using various techniques and devices such as communication boards, gestures, and voice generators to effectively communicate with others.

Use Speech Therapy Apps

One way to practice more repetitions of facial muscle exercises and promote neuroplasticity is to download speech therapy apps onto your phone or tablet. For example, the CT speech and cognitive therapy app includes over 100,000 speech therapy exercises designed by speech-language pathologists. Speech therapy apps provide 24/7 access to effective speech therapy activities so you can practice wherever and whenever is convenient for you.

Practice Correct Posture

Compromised posture can limit lung capacity and make it challenging for individuals to breathe normally. Along with difficulties controlling the muscles that make up the mouth, individuals with cerebral palsy may be susceptible to respiratory complications.

By promoting correct posture (through the use of orthotic devices and practicing core-strengthening exercises), individuals can improve breathing efficiency. This may lead to less fatigue and improved functioning of the body due to increased oxygen supply.

How Cerebral Palsy Affects the Face

Cerebral palsy can affect motor functions throughout the entire body, including the face. As a result, individuals may struggle with communication, feeding, and breathing. Fortunately, there are several ways to ensure that individuals with facial motor impairments receive adequate nutrition and learn to be effective communicators.

We hope this article helps you understand how cerebral palsy can affect the muscles in the face and know that treatment options are available to improve your quality of life.

The post Can Cerebral Palsy Affect the Face? Statistics, Treatment, & Management Techniques appeared first on Flint Rehab.

Mental health disorders such as anxiety and depression can interfere with motivation to participate in therapy regardless of whether the individual with cerebral palsy is a child or an adult. To help you understand the link between cerebral palsy and mental health disorders, this article will discuss:

• Causes
• Mental health in youth and adults
• Signs
• Treatment

What Causes Mental Health Problems in People with Cerebral Palsy?

There are several categories of mental health disorders. Some common issues that individuals with cerebral palsy may struggle with include:

• Mood affective disorders such as depression and bipolar disorder
• Anxiety disorders such as generalized anxiety disorder or obsessive-compulsive disorder
• Adult personality and behavior disorders such as antisocial or avoidant personality disorder

The prevalence of mental health disorders in individuals with cerebral palsy is not necessarily related to the severity of one’s disability. Rather, it’s more closely related to levels of stress, pain, fatigue, and perception of belonging.

Some social situations that can increase the risk of mental health disorders in individuals with cerebral palsy include:

• Bullying or teasing
• Abuse
• Inability to learn as quickly as peers
• Loneliness

All these situations have something in common: they make the individual feel different. This can cause a ripple effect into someone’s mental health and cascade into their physical health, too.

Poor sleeping patterns, low physical activity, and pain (which are all commonly experienced by people with cerebral palsy) also increase the risk of developing mental health disorders. For example, individuals with chronic pain may have reduced sleep quality, which can consequently lead to lower energy levels to participate in physical activity.

Cerebral Palsy and Mental Health in Children and Adults

Some experts say that youth with cerebral palsy are particularly vulnerable to mental health problems. It’s helpful to treat mental health regardless of age, though. No matter what stage of life someone is in, mental health should be treated as a priority.

Studies show that adults with CP have a greater risk of mental health disorders than those without CP, especially individuals with comorbid neurodevelopmental disorders like autism or epilepsy.

It’s important to address mental health concerns early, as it can lead to a vicious cycle of getting worse as time goes on or a virtuous cycle of improving as the individual moves into adulthood. During a vicious cycle, an individual’s CP may cause mental health distress which drains energy and motivation for rehabilitation. Without rehabilitation, the individual’s mobility, self-care, and communication skills may worsen, which may increase feelings of isolation.

However, during a virtuous cycle, an individual receives early intervention for mental health, which may increase their energy and motivation for therapy. With consistent therapy over time, their mobility, ability to perform personal care, and communication skills will likely improve. This can increase feelings of self-efficacy, self-esteem, and other positive feelings.

Because of this, individuals with cerebral palsy should seek counsel for any mental health concerns, and clinicians should be advised to help in any way possible, regardless of the person’s age.

Signs of Mental Health Problems in Children and Adults

Behavioral changes are often among the first outward signs of a mental health disorder in children. As such, being able to recognize when someone is showing signs of behavioral challenges is crucial to preventing mental health disorders from progressing.

According to the National Alliance on Mental Illness, symptoms of mental health conditions in young children include:

• Changes in school performance
• Excessive anxiety
• Hyperactive behavior
• Frequent nightmares
• Aggressive or disobedient behavior
• Frequent temper tantrums
• Withdrawal from activities they usually enjoy

In moderation, these behaviors are typical of young children; however, when they occur excessively, they may suggest the need for help from a mental/behavioral health professional.

Adults tend to have greater self-awareness than children. However, it can still help to understand the signs of a mental health disorder in adults, which include:

• Excessive worry, fear, or feelings of sadness
• Extreme mood changes, including uncontrollable “highs” or feelings of euphoria
• Avoiding friends and social activities
• Difficulties understanding or relating to other people
• Changes in sleeping habits or feeling tired and low on energy
• Thinking about suicide

If you or a loved one ever think about suicide, or need help with your mental health, contact the NAMI HelpLine to find out what services and supports are available to you.

Treatments for Cerebral Palsy and Mental Health Disorders

For non-urgent mental health concerns, such as persistent anxiety and depression, don’t be afraid to reach out to your doctor or a mental health professional. Seeking professional help is necessary to get a proper diagnosis and treatment.

Mental health disorders are generally treated through behavioral psychotherapy or medications. In therapy, individuals can benefit from talking about their struggles in a judgment-free environment. They can also learn practical ways to cope and improve their thought patterns.

For individuals that wish to receive more help, talk to your doctor to see if medications such as antidepressants are a good fit for you. Keep in mind that medications for mental disorders may cause further motor impairment. Make sure to notify your doctor if you experience reduced motor function. You may be prescribed a different medication to prevent further functional impairment.

Understanding Cerebral Palsy and Mental Health

There is growing awareness around mental health concerns in both youth and adults with cerebral palsy. By pursuing treatment through psychotherapy or medication, individuals can encourage a virtuous cycle of improved mental and physical health.

If you are a parent of a child with cerebral palsy, it’s important to be aware of behaviors that may point to the development of mental health disorders. And if you are an adult with CP, you can take care of your mental health by seeking help and talking to someone.

Mental health professionals are great resources and would make a great addition to your medical team/regimen. We hope this article helped you understand how to pursue improved mental health with CP.

The post Cerebral Palsy and Mental Health: Why Psychological Care Matters appeared first on Flint Rehab.

To help you understand the connection between cerebral palsy and intellectual disabilities, this article will discuss:

• Does cerebral palsy affect intelligence?
• Signs of an intellectual disability
• How motor impairment can be mistaken for intellectual impairment
• Management interventions

Does Cerebral Palsy Affect Intelligence?

Cerebral palsy is a neurologically-based motor disability. Individuals with cerebral palsy have sustained brain damage to areas of the brain associated with movement. This damage results in impaired motor skills, such as irregular movements, high or low muscle tone, and poor posture. However, up to 50% of individuals with cerebral palsy also experience intellectual impairments.

Intellectual disabilities are an associative condition of cerebral palsy, which means the two conditions often occur together. However, cerebral palsy and intellectual disability are not directly related because they are caused by damage to two separate areas of the brain.

Cerebral palsy is caused by damage to areas of the developing brain that regulate movement, including the motor cortex, thalamus, basal ganglia, and/or cerebellum. When an individual with cerebral palsy has an intellectual disability, it is because areas of the brain associated with cognitive functioning are also damaged.

Generally, intellectual disabilities are more common amongst individuals with more severe forms of cerebral palsy. This is because more severe motor impairments are associated with greater amounts of damage to the brain.

To understand how to identify an intellectual disability in individuals with cerebral palsy, the following section will discuss common signs.

Signs of an Intellectual Disability

While cerebral palsy does not cause intellectual disability, the two conditions co-occur often enough that it’s worth being aware of potential signs of impaired cognition. The sooner an intellectual disability is diagnosed, the earlier therapeutic intervention can begin.

Intellectual disabilities can present themselves differently in each individual. Depending on the severity of the brain damage, intellectual disabilities can be mild (IQ 50-70), moderate (IQ 36-49), severe (IQ 20-35), or profound (IQ below 20). Milder intellectual impairments may go unnoticed in young children and become more apparent as they get older.

Signs of intellectual disability include:

• Difficulties communicating
• Delayed responses
• Poor memory
• Emotional outbursts
• Difficulties with logical thinking and problem-solving
• Developmental delays (language, crawling, walking, etc.)
• Avoiding social interaction
• Poor concentration
• Inability to recognize familiar voices or faces
• Difficulty processing auditory or visual stimuli

While these signs aren’t absolute indicators of an intellectual disability, they can serve as a sign to speak with your child’s doctor for an official diagnosis. Early intervention may prevent the development of problematic behaviors like self-harm and aggression.

Up next, we’ll discuss how motor impairments can be mistaken for an intellectual disability.

Measuring Intelligence in Children with Cerebral Palsy

Often, an individual’s motor impairments can cause them to struggle with communication despite having completely normal intellectual capacity. Therefore, it is essential to make accommodations to accurately identify if an individual with cerebral palsy has impaired intelligence.

To diagnose an intellectual disability, children are often asked to take a cognitive assessment. However, many pediatric cognitive assessments can cause children with cerebral palsy to score much lower than their actual intellectual capacity because their motor impairments are not accounted for.

For example, children with impaired oral motor skills may not perform well on a verbal subscale, and children with poor fine motor skills may not be able to point to objects or fill in answers accurately. Therefore, a traditional cognitive assessment may not provide the best measure of a child’s cognitive abilities.

When testing children with cerebral palsy for cognitive impairments, it’s essential to consider their motor impairments. This may involve having them take a completely different type of test or allowing more time to complete it.

In the following section, we’ll discuss various interventions that may help children with cerebral palsy manage their intellectual disabilities.

Managing Intellectual Disabilities in Children with Cerebral Palsy

While an intellectual disability can interfere with an individual’s ability to interact with their surroundings and care for themselves, there are management interventions that can help significantly improve one’s quality of life.

Management for intellectual disabilities in individuals with cerebral palsy may include:

Educational Assistance

Educational assistance can help provide the personalized support and attention your child needs to succeed academically. Legally, schools must provide reasonable accommodations (often through an Individualized Education Program, or IEP) to help individuals with intellectual disabilities learn and succeed.

Speech Therapy

Speech therapy techniques can help individuals develop their articulation, listening, and receptive language skills. If someone with cerebral palsy is non-verbal, a speech-language pathologist may teach them how to use augmentative and alternative communication methods to improve their communication skills. They may also help individuals learn ways to improve or compensate for cognitive difficulties.

Occupational Therapy

Occupational therapy focuses on developing an individual’s functional independence. This may involve practicing everyday activities or learning how to use adaptive tools to compensate for restricted movements.

Physical Therapy

Physical therapy focuses on improving an individual’s motor functions through the repetitive practice of targeted exercises. While this mainly addresses motor improvement, it’s an essential part of cerebral palsy management that can help improve overall quality of life.

Cognitive Behavioral Therapy

Cognitive behavioral therapy focuses on improving negative thought patterns, such as those associated with depression and anxiety, which those with cerebral palsy and intellectual disabilities may experience. Additionally, it focuses on identifying problem behaviors and replacing them using positive reinforcement. This can promote improved skills in areas such as communication and problem-solving.

Everyone experiences cerebral palsy and intellectual impairments differently. Participating in various management interventions will provide your child with the personalized care they need to address their specific weaknesses.

Cerebral Palsy and Intelligence: Key Points

While cerebral palsy does not affect intelligence, many individuals with CP experience co-occurring intellectual disabilities. However, the two conditions are caused by damage to two separate areas of the brain.  With the right support and management, individuals with intellectual disabilities can learn how to maximize their independence and engage in everyday life.

The post Does Cerebral Palsy Affect Intelligence? Understanding Cognitive Effects appeared first on Flint Rehab.

This guide will explore the various signs and symptoms of cerebral palsy at various stages of a person’s life. Please use the links below to jump straight to any section of this article.

Signs and symptoms of cerebral palsy in:

• Infants
• Toddlers
• Adults
• Spastic CP
• Other types of CP

Signs of Cerebral Palsy in Infants

Cerebral palsy is a condition that starts early in life as it is caused by damage to the brain before, during, or shortly after birth. Because of the early onset, it might seem like infants should show obvious signs if they have cerebral palsy or not. However, since cerebral palsy presents itself outwardly through motor impairments, it can be challenging to diagnose it in infants under age 1.

The motor skills of infants are still developing and changing rapidly. Therefore, it’s hard to spot motor impairments like poor fine motor skills or abnormal walking patterns in infants, even though they’re easier to recognize in adults. Furthermore, when the signs and symptoms of cerebral palsy are mild, diagnosing cerebral palsy in infants is even harder.

With this in mind, there are some common signs of cerebral palsy in infants:

Developmental Delays

Possibly the most common sign of cerebral palsy in infants is developmental delays. There are specific developmental milestones that infants achieve as they grow. All infants progress at their own pace, however infants with cerebral palsy often may not progress toward major developmental milestones as quickly as expected.

Examples of developmental milestones include:

• 2 months: able to lift their head, move arms and legs evenly
• 4 months: able to reach for and grasp objects, sit upright with assistance, roll over
• 6 months: able to sit up independently, babble, use both hands to handle objects
• 9 months: able to crawl, pull up to stand, use a pincer grip, purposefully engage with toys
• 1 year: able to stand and sit down independently, point to objects, may be walking or using simple words.

Children may fall behind in meeting these milestones regardless of whether or not they have cerebral palsy. It is important to check with your doctor if you feel that your infant is not progressing as they should. However, doctors can be hesitant to officially diagnose milder cases of cerebral palsy at such an early age as infants often “grow out” of cerebral palsy-like symptoms by age 2.

Irregular Muscle Tone

Another sign of cerebral palsy in infants is abnormally high or low muscle tone. High muscle tone (spasticity) results in stiff movements and is characteristic of the most common type of CP, called spastic cerebral palsy. Infants with spasticity may demonstrate prolonged hand clenching, leg crossing, or bent knees.

On the other hand, those with low muscle tone (hypotonia) can be identified by lack of strength, floppy limbs, and inadequate head control. Generally, infants with only low muscle tone have ataxic cerebral palsy.

Infants with dyskinetic cerebral palsy will experience uncontrollable fluctuations between both high and low muscle tone, which can make it appear as if they are always moving.

Tremors

Although not as common, if you notice your infant’s arm starts shaking as they reach for objects, they may have ataxic cerebral palsy. This type of cerebral palsy causes a lack of balance and coordination. Purposeful movements can overwhelm the cerebellum (which is responsible for fine-tuning and precision) and cause tremors.

Poor feeding

Cerebral palsy can affect all different parts of the body, including the muscles in the mouth. If your child doesn’t seem to eat very much, it may be a sign of an oral motor impairment. This can make it difficult for your child to open or close the mouth and swallow. You can generally identify feeding difficulties easily and should report them to a doctor quickly to prevent malnutrition.

Although it may be challenging to find out that your infant has cerebral palsy, early diagnosis is ideal for promoting optimal motor development. The brains of infants experience high levels of neuroplasticity, or their ability to adapt and rewire themselves to learn and improve skills. Taking advantage of early intervention therapies during a child’s first year can help your infant continue progressing toward appropriate developmental milestones and minimize or even prevent future complications.

Signs of Cerebral Palsy in Toddlers

Since toddlers are typically further along in their development of motor skills, it is often easier to identify signs of cerebral palsy in toddlers. In fact, while most cases of cerebral palsy are diagnosed by the time the child reaches 1 or 2 years old, milder cases of cerebral palsy may not be diagnosed until the child is 4 or 5.

There are similar signs and symptoms of cerebral palsy in toddlers and infants such as slower progression toward developmental milestones, irregular muscle tone and poor feeding. However, some signs of cerebral palsy appear in toddlers but not in infants. Let’s take a look at a few of these examples.

Abnormal Gait

In toddlers with cerebral palsy, uneven muscle pull can result in abnormal walking patterns, including consistent tiptoeing, crouch gait, and scissor gait. Toddlers with cerebral palsy who struggle with balance may continue to walk with their feet spread far apart because it creates a more stable base and will prevent them from falling. These atypical walking patterns may be signs of cerebral palsy.

Speech Difficulties

By 2 years old, your toddler should be piecing words together. If you notice significantly delayed responses, poor pronunciation, stuttering, or jumbled speech, your toddler may have difficulties controlling the muscles in their mouth.

Also related to oral motor impairments are breathing difficulties. If your toddler struggles to breathe in between words or has nasally speech, this may also be a sign of cerebral palsy.

Poor Coordination

If your toddler has difficulties with fine motor tasks, such as grabbing and picking up small objects, using silverware, or holding up a pencil, they may have ataxic cerebral palsy. This type of cerebral palsy causes poor balance and coordination.

Although the above signs do not “prove” that your toddler has cerebral palsy, they may be causes for concern. Discuss any motor impairments you notice with your toddler’s pediatrician.

While toddlers have had some time to develop poor movement patterns and habits, they still can benefit from early intervention methods to minimize the effects of cerebral palsy on their development and promote optimal functional abilities.

Cerebral Palsy Symptoms in Adults

Not unlike the signs of cerebral palsy in infants and toddlers, cerebral palsy symptoms in adults include irregular muscle tone, abnormal walking patterns, and poor balance and coordination. However, adults are unique in that they have had many years to either focus on managing their cerebral palsy symptoms, or allowing these symptoms to progress.

Adults who have been actively managing their cerebral palsy symptoms may still experience irregular muscle tone and difficulties with coordination. However, they may have improved their gait patterns, and addressed communication and feeding difficulties through compensatory techniques.

Adults with milder cases of cerebral palsy are often able to live fully independent lives by appropriately managing their symptoms. Even those with more severe cases can limit the progression of their symptoms and prevent complications through active management techniques.

Passively “living with” cerebral palsy symptoms may result in increased symptom severity over time. Although the brain damage that caused cerebral palsy in early life does not change, the associated motor impairments may worsen if not addressed. Therefore, some adults with cerebral palsy may have more spasticity or develop further complications, such as chronic pain, fatigue, joint contractures, and incontinence.

While the signs and symptoms of cerebral palsy change with age, they also vary greatly depending on the type of cerebral palsy. There are four main types of cerebral palsy: spastic, dyskinetic, ataxic and mixed.

Spastic Cerebral Palsy Symptoms

The vast majority of individuals with cerebral palsy experience spastic CP. As its name suggests, this type of CP is characterized by spasticity, which involves stiffness in the affected muscles. Anywhere from one limb to the entire body may be affected.

Other common spastic cerebral palsy symptoms include:

• Stiff, slow, or rigid movements
• Abnormal gait patterns
• Difficulties with balance
• Chronic pain
• Clenching of the fingers or toes
• Chewing, swallowing, or speaking difficulties

Since spastic cerebral palsy varies in severity and in which areas of the body it affects, it can present itself very differently in each individual.

Signs and Symptoms of Other Types of Cerebral Palsy

Dyskinetic, ataxic, and mixed cerebral palsy make up only about 20% of cerebral palsy cases.

Dyskinetic CP is distinguished from the other types of CP by its uncontrollable movements. Some movements are characterized by repetitive, twisting motions and abnormal postures (a condition called dystonia), while other movements are rapid and jerky due to fluctuating muscle tone (a condition called choreoathetosis).

Difficulties with balance and coordination are the main symptoms associated with ataxic cerebral palsy. Individuals with this type of CP often have low muscle tone, limited fine motor skills, speech difficulties, and poor posture. Due to difficulties with balance, they may walk with a wide-based gait and experience frequent falls.

Mixed cerebral palsy involves a combination of any of the above types of CP. Although symptoms of mixed CP may vary depending on the areas of brain damage involved, it most often presents as a combination of spastic and dyskinetic CP.

Understanding Signs and Symptoms of Cerebral Palsy: Key Points

Cerebral palsy can result in many different signs and symptoms throughout one’s lifetime. While it can be difficult to see signs and symptoms of CP in infants, they begin to become more prominent in toddlers. Depending on how dedicated individuals are to managing their symptoms, adults may have similar symptoms to those experienced in childhood or they may have improved.

It is important to remember that regardless of the type or severity of CP, you can always work on improving and managing your symptoms at any age for a better quality of life.

The post Signs and Symptoms of Cerebral Palsy at Different Life Stages appeared first on Flint Rehab.

In this article, we’ll cover the progression of cerebral palsy and the best ways to manage it. Use the links below to jump straight to any section.

• Understanding the progression of CP
• Symptoms that may progress
• 9 ways to manage the progression of symptoms

Understanding the Progression of Cerebral Palsy

Cerebral palsy is caused by damage to the brain before, during, or shortly after birth. This brain damage is static and nonprogressive, meaning that it will not get worse or heal itself.

While the physical damage to the brain will not change, the resulting symptoms can get better or worse over time depending on how they’re managed. Addressing symptoms early on can prevent symptoms from progressing and resulting in further complications.

Aside from stopping one’s symptoms from progressing, appropriate symptom management can actually help individuals to improve! One way this is possible is through a process called neuroplasticity. Neuroplasticity allows your brain to rewire functions affected by brain damage to healthy areas of the brain.

The more you practice affected movements, the stronger the neural pathways for those movements will become due to neuroplasticity. This results in more natural feeling (and less effortful) movements. The more you move, the more you stimulate the brain’s ability to adapt.

Cerebral Palsy Symptoms that May Progress

Everyone experiences cerebral palsy differently. While symptoms may vary, the following list includes some of the most common symptoms of cerebral palsy that can progress over time.

Spasticity

One of the most common symptoms of cerebral palsy is spasticity, which occurs when the muscles involuntarily contract and movements become stiff. Around 80% of all individuals with cerebral palsy have spasticity.

Spasticity can range from mild to severe and can affect one or more areas, ranging from affecting just one limb to the entire body. Unmanaged spasticity can progressively restrict one’s mobility, and potentially lead to muscle contractures. Uneven pulling of the muscles and excess pressure on the joints due to spasticity can affect an individual’s posture, growth, and walking patterns.

Musculoskeletal Problems

Other than spasticity, here are a few common musculoskeletal problems individuals with cerebral palsy may experience:

• Scoliosis is a condition that occurs when the spine curves sideways. Although statistics vary, studies suggest between 21% and 64% of people with CP have scoliosis, typically due to poor trunk control and/or spasticity.
• Osteoarthritis occurs when cartilage (the cushioning between your bones at a joint) wears down.
• Osteoporosis occurs when the bones become weak and porous due to lack of use or poor nutrition.
• Hip dislocation can occur due to irregular muscle tone, and is estimated to affect between 15% and 20% of children with CP. Tightness in the muscles and joints can progressively limit one’s mobility, making it easier to accidentally dislocate a joint.

Fatigue

Individuals with cerebral palsy frequently experience fatigue. Because of their motor impairments, individuals with CP tend to use more energy to complete daily activities. For example, individuals with cerebral palsy may require 2-3 times more energy to walk than typically developing peers. Cerebral palsy can also be psychologically draining.

Communication Skills

Cerebral palsy can also affect the facial muscles, making it difficult for people to speak and eat. When communication skills are affected, individuals may need to use alternative forms of communication or repeat themselves several times to be understood.

Some people may decide it is easier not participate in social conversations because it is too frustrating. This can lead to social isolation, resulting in minimal communication with others. When communication skills are not frequently practiced, they are likely to decline.

Pain

Approximately 75% of people with cerebral palsy experience pain. Spasticity, poor postures and abnormal movement patterns may contribute to the development of musculoskeletal pain. If not appropriately addressed, pain can become chronic and may progress in intensity over time.

Mental Health

Although cerebral palsy is a motor disability, it can also indirectly affect an individual’s mental health. Adults with cerebral palsy are more likely to experience mental health disorders, including depression and anxiety, than the general population.

Despite the potential for all of these symptoms to progress, there are many excellent ways to prevent the progression of cerebral palsy.

9 Ways to Prevent the Progression of Cerebral Palsy

As mentioned above, if appropriately addressed, individuals have the ability to slow or prevent the progression of cerebral palsy symptoms. While early management is optimal, individuals of any age can take steps to maximize their functional abilities and quality of life. This is because the brain is always adapting through neuroplasticity to promote improved functions.

Here are nine of the best ways to prevent the progression of cerebral palsy:

1. Physical Therapy

Physical therapy focuses on training proper movement patterns, stretching tight muscles, and strengthening underused muscles. Through physical therapy, individuals can focus on combating spasticity and other musculoskeletal problems in order to manage pain and increase functional skills.

2. Occupational Therapy

During occupational therapy, individuals focus on how to most easily participate in their daily activities. This can include learning strategies to manage spasticity, fatigue, and pain.  Engaging in valued activities using strategies learned in occupational therapy can also promote mental health and wellbeing.

3. Speech Therapy

The best way to manage communication difficulties is through speech therapy. During speech therapy, individuals may focus on strengthening their oral motor muscles and articulating their speech more clearly. Those who are non-verbal can learn how to utilize alternative forms of communication like sign language, voice generators, or communication boards.

4. Psychotherapy

Mental health problems, such as depression and anxiety, are often manageable through a combination of psychotherapy and medications. Psychotherapy helps individuals identify ways to effectively cope with mental health symptoms.

5. Orthotics

Braces and other types of orthotics can be used to support proper musculoskeletal alignment and mildly combat spasticity.

6. Medications

Various medications, such as Botox and baclofen, can be used to manage spasticity. Although the effects of Botox and baclofen can wear off, participating in therapy while under their effects can result in long-lasting improvements due to neuroplasticity. Medications can also help manage mental health symptoms and pain.

7. Heathy Habits

Regular physical activity and proper nutrition can keep cerebral palsy symptoms from progressing. Engaging in physical activities, even for just a few minutes per day, is a great way to address fatigue and mental health problems.

Daily physical exercise can also help to manage spasticity and alleviate pain. Proper nutrition is essential to promote development and growth. It can also help keep the muscles and bones strong to deter the onset and progression of musculoskeletal problems.

8. Surgery 

For those with severe spasticity, surgery may be recommended to prevent the progression of cerebral palsy. Surgery may involve manually lengthening tight muscles and/or denervating hyperactive nerve roots.

9. Support Groups

Joining a cerebral palsy support group is a great way to meet others with similar challenges and learn new ways to manage cerebral palsy symptoms. A support group can also help individuals gain motivation to manage their cerebral palsy symptoms and improve their quality of life.

Using these strategies, individuals may slow or prevent the progression of cerebral palsy symptoms. Furthermore, they may even be able to improve their symptoms for a better overall quality of life.

Progression of Cerebral Palsy: Key Points

The brain damage that caused cerebral palsy will not progress, but symptoms of CP can worsen and interfere with your day-to-day life. Cerebral palsy is a lifelong condition, so it’s essential to stay on top of managing its symptoms.

Hopefully, this article helped you understand why CP can appear to worsen over time and how to prevent symptoms from progressing.

The post Progression of Cerebral Palsy: How Symptoms May Change with a Non-Progressive Disorder appeared first on Flint Rehab.

This article will explain why people with cerebral palsy experience fatigue and the most effective ways to stabilize energy levels in order to accomplish daily tasks and enjoy leisure activities. Use the links below to jump straight to a specific section.

• What is fatigue?
• Link between cerebral palsy and fatigue
• Causes of CP-related fatigue
• Management

What is Fatigue?

Many people think of fatigue as simply feeling tired. The Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5) defines fatigue as “a state usually associated with a weakening or depletion of one’s physical and/or mental resources, ranging from a general state of lethargy to a specific, work-induced burning sensation within one’s muscles”. Fatigue is more significant than just feeling tired, and may be experienced very differently depending on the individual and the situation.

Physical fatigue is generally what people first think of when talking about fatigue. It occurs when the muscles of the body are worn out. Like each type of fatigue, physical fatigue can be a temporary or long-lasting, chronic condition. Physical fatigue interferes with the ability to continue performing daily activities at your normal functional level.

Mental fatigue, while not as easily visible from the outside, can be equally as debilitating as physical fatigue. There are different types of mental fatigue, including cognitive, social and emotional fatigue.

• Cognitive fatigue refers to difficulties processing, applying, and concentrating on information due to overwhelming cognitive demands.
• Social fatigue results from having too many, too few, or more challenging social interactions.
• Emotional fatigue, which is also called emotional exhaustion, is often caused by excessive stress from one’s daily duties.

Because of the motor impairments and associated conditions experienced by people with cerebral palsy, individuals may experience one or more types of fatigue.

Is Cerebral Palsy Linked to Increased Fatigue?

Cerebral palsy is caused by damage to areas of the brain associated with movement. This damage results in difficulties with regulating muscle tone and maintaining proper posture, among other motor impairments. Generally, individuals with cerebral palsy have higher levels of fatigue, especially physically, because they have to exert more energy to perform tasks.

For example, individuals with cerebral palsy who are able to walk (ambulatory) require 2-3 times more energy to walk than typically developing peers. Individuals with dyskinetic cerebral palsy and dystonia also tend to have higher energy expenditures. This is because those with dyskinetic cerebral palsy often experience uncontrollable movements and appear to constantly be moving due to fluctuations in muscle tone. Continuous movement is continuous energy exertion, resulting in physical fatigue.

Causes of Fatigue in Individuals with Cerebral Palsy

Aside from motor impairments, there are additional factors that can contribute to both physical and mental fatigue in individuals with cerebral palsy.

Additional causes of cerebral palsy-related fatigue include:

• Breathing difficulties. Individuals with cerebral palsy may develop respiratory complications, making causing them to physically fatigue more quickly.
• Psychological duress. Due to challenges fitting in with peers, some people with cerebral palsy may frequently experience emotional fatigue.
• Speech impairments. People with cerebral palsy who have oral motor impairments often become frustrated due to communication difficulties. These difficulties may contribute to emotional and social fatigue.
• Sleep deprivation. Many conditions associated with cerebral palsy such as pain, epilepsy, GERD, and breathing problems may disrupt sleep. Sleep is essential for recharging both physical and mental energy levels and preventing fatigue.
• Malnutrition from feeding difficulties. Oral motor impairments can make it difficult for children with cerebral palsy to chew and swallow. As a result, many children with CP tend to not eat enough and therefore experience low energy levels.
• Muscle weakness due to limited physical activity. People with cerebral palsy who are unable to walk often don’t get enough physical activity. Therefore, their muscles tend to atrophy from disuse and the simplest movements can become challenging.
• Medications. Fatigue is a common side effect of most medications.
• Chronic pain. Pain may cause sleeping difficulties, frustration, and decreased physical activity, resulting in physical and/or emotional fatigue.

There may be additional causes outside those listed here that contribute to fatigue in individuals with cerebral palsy. However, despite all of these potential causes, there are many ways that individuals with cerebral palsy can address and manage their fatigue.

Managing Fatigue with Cerebral Palsy

Fatigue can be mentally and physically draining, but it can also be managed. Because so many factors can lead to fatigue, effective management will vary case-by-case and require personalized treatment.

 Below are some effective ways to manage fatigue.

Prioritizing and Planning

One of the best practices for minimizing physical fatigue throughout the day is to practice conserving energy.

Pacing your activities with rest periods allows you to complete daily tasks and be more productive throughout the day. Challenge yourself, but don’t overexert yourself. Consider completing tasks in a seated position if you find yourself quickly fatiguing physically and be willing to ask for help with more difficult tasks such as laundry and house cleaning if you need it.

Planning is key. We suggest making a list of tasks and activities in order of importance and challenging yourself to accomplish these tasks by the end of the day. Some days will be more productive than others, so allow yourself to be flexible.

Exercising

It might sound counterintuitive, but exercising actually boosts energy levels. Strengthening your muscles and increasing your heart rate to improve circulation decreases the rate of physical fatigue. Exercise also promotes deeper sleep and the release of energy-boosting hormones. Initially, exercise is challenging, but when your body adjusts to being more active, it will become less tiring.

Regulating Sleep

Getting a good night’s rest is essential for recharging energy levels and reducing fatigue. If you’re experiencing difficulty sleeping, it’s important to identify and address the factors causing it. Is it pain? Anxiety? Respiratory complications?

Getting a good night’s rest helps maintain your circadian rhythm (internal 24-hour clock) and limits fluctuations in energy throughout the day.

Recognize patterns in your energy levels and allow yourself a rest period during the day. If you’re consistently tired, a mid-day nap might be what you need to recharge. However, it’s also important to keep in mind that prolonged naps may interrupt deep sleep at night.

Nutrition

Certain foods may deplete your energy levels. It’s important to consume a healthy, nutrient-dense diet to prevent fatigue throughout the day.

Similarly, eating too much may cause you to feel drowsy and lethargic. Consider eating smaller and more frequent meals throughout the day to prevent spikes and dips in blood sugar.

Additionally, drink water throughout the day to prevent dehydration. Even minimal dehydration may negatively affect physical and mental performance.

Adaptive Tools and Equipment

Adaptive tools are designed to help you become more independent and make daily tasks more manageable. Cerebral palsy can make many tasks more difficult and using adaptive tools like reachers and universal cuffs may help individuals with CP conserve their energy. Using medical equipment such as shower chairs or raised toilet seats can also reduce energy expenditure during daily activities.

Deep Breathing Exercises

Individuals with cerebral palsy who have difficulties controlling their breathing may develop low oxygen levels, which can cause fatigue. Practicing deep breathing exercises helps strengthen the respiratory muscles and increases lung capacity for deeper, more effective breathing. Work on breathing in through your nose like smelling flowers, and out through your mouth like blowing out candles. Place your hand on your belly when you breathe and feel it rise as your lungs expand during inhalation and fall as you exhale.

Cerebral Palsy and Fatigue: Key Points

Individuals with cerebral palsy often are more prone to fatigue due to their motor impairments and associated conditions. Spasticity, uncontrollable movements, poor posture, and/or lack of coordination can force individuals with cerebral palsy to exert more energy to perform simple tasks. The physical challenges related to cerebral palsy can also be mentally fatiguing.

While it may be mentally and physically exhausting to manage cerebral palsy, there are strategies you can use to stabilize your energy levels throughout the day and prevent fatigue.

The post Cerebral Palsy and Fatigue: Types, Causes and Management appeared first on Flint Rehab.

This article will discuss whether having cerebral palsy is related to having temper tantrums and how to effectively manage them.

Causes of Temper Tantrums in Children with Cerebral Palsy

Regardless of whether they have cerebral palsy or not, temper tantrums are completely normal in young children. Temper tantrums occur for a variety of reasons, including feeling frustrated, tired, hungry, or misunderstood. Often, temper tantrums have nothing to do with having CP and instead, are age-related and developmentally appropriate. However, about 25% of people with cerebral palsy have behavioral issues, which can contribute to frequent temper tantrums.

Cerebral palsy is caused by damage to the areas of the brain that affect motor skills like movement, balance, and posture. While cerebral palsy is not directly related to difficulties with emotional regulation, motor impairments can cause children to feel frustrated. This frustration can contribute to explosive temper tantrums.

For example, oral motor impairments can make it difficult for children with CP to talk and/or communicate their needs. This may result in them frequently being tired, hungry, or wanting something, but unable to have their needs met in a timely manner since those around them are unaware of these needs.

Similarly, children who have spasticity in the legs may be limited in their mobility and have difficulties participating in activities with their peers. This can be very emotionally challenging.

Additionally, associative conditions of cerebral palsy such as chronic pain, poor quality sleep, and learning disabilities may contribute to temper tantrums. Children with cerebral palsy can usually tell when they’re not understanding or doing things as quickly or as easily as those around them. As a result, they may act out because they feel different, misunderstood, and unaccepted.

Now that you understand the link between cerebral palsy and temper tantrums, let’s discuss ways to help your child better cope with their emotions.

How to Manage Cerebral Palsy Temper Tantrums

While a temper tantrum in a child is expected, a temper tantrum in a teen or adult is not typically developmentally appropriate and usually looked down upon.  Furthermore, depending on the size of the individual and the intensity of the response, temper tantrums may be a safety concern for the individual and those nearby. Therefore, it’s ideal to address temper tantrums early and teach your child more effective ways to manage their emotions and communicate their feelings.

Below, we’ll go over mistakes to avoid and some of the most effective ways to manage temper tantrums in children with cerebral palsy.

1. Avoid Giving In

When your child throws a temper tantrum over not getting what they want, the worst thing to do is give in. Giving in only reinforces the idea that the child can get what they want by acting out. While it may quiet them down, you’re not addressing the underlying problem.

2. Behavioral Therapy

Children that continue to act out as they get older are often not developing the social skills necessary to effectively communicate their feelings and emotions.

Consider taking your child to a behavioral therapist to further work on developing social skills like:

• Problem-solving
• Controlling impulses
• Negotiating
• Social expectations
• Delayed gratification

Behavioral therapy will teach your child that there are better ways to cope with frustration than having a temper tantrum.

3. Time-Outs

Sometimes, you just need to take your child away from the situation causing the temper tantrum. Generally, children have short attention spans and will quickly get over what they were overreacting to if you take them out of the situation.

Calmly explain to your child why they are in a time-out and allow for an appropriate amount of quiet, alone time. Generally, the length of the time-out should be about one minute long per each year of age. With this guideline, a five-year-old would have about five minutes in time-out, while a three-year-old’s time-out would be about three minutes long. This will give them time to cool off and reflect on their own before returning to their activity.

4. Be Positive

Diverting your child’s attention away from what they can’t do and encouraging them to do things that they’re good at will help relieve frustration and boost confidence. Acknowledge and praise your child for positive behavior. This will help them distinguish the difference between good and bad behaviors.

5. Encourage Emotional Self-Regulation

Teaching children to find positive ways to deal with their emotions allows them to self-regulate. Emotional self-regulation is the ability to “check in” with yourself and use strategies to ensure your emotions and behavioral reactions are appropriate for the situation. This is ideal for older children, but even younger children can learn to better regulate their emotions with adult guidance.

A good first step for helping young children learn to manage their emotions is to work on simply labeling the emotions they are feeling. When children can name their emotions, they can more easily communicate and seek help to manage what they are feeling.

If your child feels as though they are getting close to having a temper tantrum, having some solid strategies to manage their emotions is essential.

Self-regulation strategies can include:

• Deep breathing with counting: Count as you take 5 deep breaths, breathing in through the nose like smelling flowers, exhaling out through the mouth like blowing out candles
• Self-hugging: Giving yourself a hug (or squeezing a pillow) provides deep pressure, calming the sensory systems and often emotions as well
• Take a break: Go to somewhere different and do a relaxing activity (coloring, listening to music, etc.)

Hopefully these steps can help manage developmentally inappropriate temper tantrums in individuals with cerebral palsy. Caregivers should try not to be hard on themselves if some temper tantrums continue as they can sometimes be developmentally appropriate depending on the individual.

Cerebral Palsy and Temper Tantrums: Key Points

Learning difficulties, motor impairments, and speech disorders can make it difficult for children with cerebral palsy to communicate. This can be very frustrating and result in temper tantrums.

While temper tantrums are typical in young children, they become less socially acceptable as the child gets older. By developing better social skills, reflecting on their actions, and focusing on things they’re good at, children with cerebral palsy can learn to better express and cope with their frustrations.

The post How to Deal with Temper Tantrums in Children with Cerebral Palsy appeared first on Flint Rehab.

To help you get a better idea of what toe walking is, this article will go over its:

• Causes
• Risks
• Treatment

What Causes Toe Walking in Children with Cerebral Palsy?

Toe walking in individuals with cerebral palsy is primarily attributed to spasticity, which refers to involuntary muscle contractions caused by damage to the brain. Spasticity can pull the limbs in abnormal positions and cause stiff movements.

Over 80% of individuals with cerebral palsy experience spastic CP, which explains why abnormal gait patterns like toe walking are so prevalent among this population. Toe walking occurs most commonly in individuals with a type of spastic cerebral palsy that primarily affects the legs called spastic diplegia.

If spasticity isn’t properly managed, the affected muscles in the calves will only become tighter. This can make toe walking even more challenging to reverse. Therefore, early intervention will help minimize chronic pain and correct form before the abnormal gait pattern becomes a habit. In the following section, we’ll discuss additional risks associated with toe walking.

Risks Associated with Toe Walking and Cerebral Palsy

Toe walking caused by cerebral palsy can range from mild to severe. While the brain damage that causes cerebral palsy will not worsen over time, secondary effects of that damage such as spasticity can.

The progression of spasticity in the calves can cause toe walking to become more severe and put children at risk for many other complications, including:

• increased risk of falling due to poor balance and stability
• chronic pain due to muscle tightness and excess pressure on the ankles
• poor posture due to altering center of gravity
• non-ambulation (inability to walk)

Early intervention is crucial to ensuring that spasticity does not harm your child’s growth and development or affect their quality of life. In the following section, we’ll discuss effective ways to correct toe walking.

How to Correct Toe Walking in Children with Cerebral Palsy

In order to correct toe walking in children with cerebral palsy, you have to treat the underlying problem: spasticity. Since spasticity is not caused by damage to the muscle itself, but rather by damage to the brain, therapy will focus heavily on promoting neuroplasticity. Neuroplasticity refers to the brain’s ability to rewire itself and recover functions affected by brain damage.

The best way to activate neuroplasticity is through lots of repetition. By consistently encouraging your child to practice using correct form, they can rewire the brain to develop better walking habits and overcome toe walking.

Below, we’ll discuss some of the most widely-utilized interventions to treat spasticity.

Physical Therapy

Physical therapy is one of the first treatments your child’s doctor will recommend for treating toe walking. A physical therapist will assess the severity of your child’s toe walking and create a personalized exercise regimen that focuses on lengthening tight muscles, strengthening underused muscles, and practicing standing and walking with correct form.

Many physical therapists use fun games and activities in addition to exercises to address toe walking and encourage carryover of skills learned in therapy to a child’s daily life. Some activities they may use to address spasticity in the calves include practicing various animal walks (such as the bear crawl) and trying to stay balanced on a wiggly surface.

Orthotics

Wearing orthotic devices like leg braces and casts help ensure that the joints in the foot are properly aligned. A leg brace or cast will keep the heel down and stretch the muscles in the calf so that your child can learn to walk correctly. If the spasticity is relatively mild and addressed early on, a child may be able to wean off of using the orthotic over time.

Botox

Botox injections are injected into overactive, spastic muscles to reduce tone. It can help temporarily reduce spasticity so that individuals with cerebral palsy can practice walking without spasticity.

Practicing walking with an improved gait pattern can help children develop new and proper walking habits, and can help keep spasticity in check even after the Botox wears off. However, Botox is only approved for children 2+, so to address toe walking in your child before that, other treatments must be used.

Baclofen

Baclofen is a drug that can be taken orally, injected, or pumped into the body to relax spastic muscles.

However, the most popular and effective way baclofen is administered is through an intrathecal baclofen pump. The pump must be surgically implanted under the skin of the abdomen. Since it is directly infused into the spinal canal, baclofen can be delivered in smaller, safer doses.

Surgery

Surgeries are often considered a last resort and are typically only recommended if all other treatments prove ineffective.

Selective dorsal rhizotomy is a surgery that involves cutting specific sensory nerves to permanently reduce spasticity in a muscle. When that nerve is cut off, it can’t grow back, so the muscle can no longer become spastic.

Manual muscle and tendon lengthening surgeries are also commonly performed to combat spasticity in individuals with cerebral palsy.

Understanding Toe Walking in Children with Cerebral Palsy: Key Points

Minimizing spasticity is only the first step to correcting toe walking in children with cerebral palsy. Next, your child has to learn how to stand and walk correctly. It might feel weird or uncomfortable, but the more your child practices walking correctly, the easier it will get.

We hope this article helped you understand why individuals with cerebral palsy experience toe walking and how to correct it.

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