[manatee]

My husband and I are thinking about fostering 2 children. The foster parents before us thinks on of the children might have CP. It has not be confirmed by a doctor yet and she is 5. WHat should we look for? Thank you. Alleson

[sues250]

There is many ways CP can effect a person but it does not always mean that the person will be mentally retarded. I have a friend with CP that is a lawyer. The major things that CP have effected is his walking and speech pattern. There is also a comedian I have not seen on tv in a while but she was an actress on a old sitcom. I also work with individuals that are mentally retarded and have CP check with the dr. as to the severity of it.

[shanickcj]

CP is NOT always a Bad thing, my daughter was premature at birth and has it, her left side is effected by it, and you can tell more when she walks but, she goes the bathroom fine, eats fine, dresses fine, It just depends on how severe the cp is, there are different levels of CP, it could be way bad or it could be hardly noticable.

[kalynn]

Alleson, CP is a motor disability which runs the spectrum from mild to severe. People with mild CP may just look a bit awkward in their movements or speech patterns, while people with severe CP may require a wheelchair and not be intelligible in their speech. If the child is 5 and undiagnosed then I would suspect that you are looking at a child who may have very mild CP. Moderate or severe CP would be easily recognized and diagnosed. CP is not a progressive disorder, in other words, the child's condition will not get worse. Cognitive skills are not necessarily affected. Social skills are not affected unless the child is also cognitively impaired or has difficulty communicating, which of course could affect social interactions.

Good luck with your decision, Kalynn.

[3natutal+2neice]

I have a son that is now 7 he has mild CP. Out of all my children he is the most loving child. He is also very bright. He walks a little ackward and his speech is a little off. But he is a joy to have around and everyone that meets him loves him dearly. CP is not a bad thing. They just need a little more attention sometimes than others.

[emily18]

Cp can effect the child in different ways and they are a very smart person and they can have a smart mind and cool to hang out with , i have a friend with mild cerebral palsy and he is cool and he is fun to hang out with.

Cerebral palsy--caused by damage to the brain that then affects fine and/or gross and/or oral motor function. The damage causes an interruption in the signals that the brain tries to send to the muscles.



KidPower is providing this developmental page for informational purposes only. The below can be warning signs that your baby is not developing as they should be. All babies develop at their own pace, however, so the below examples are approximations. If you have any concerns about your infant's development please address those to your pediatrician who can refer you to a pediatric neurologist. They use adjusted age for premature infants so keep this in mind. However, even if your baby is premature, they need to be hitting milestones regularly, though they may be slightly behind the typical timeline. Most of the information on this page describes cerebral palsy, however the information can be used for other disabilities as well.

Risks for the child later being diagnosed with cerebral palsy, a brain injury that causes delays in motor, speech, and other areas, include the following:
Prematurity
meconium aspiration
fetal distress
lack of oxygen before, during or after birth
maternal anemia, seizures, diabetes, high blood pressure, bleeding early in pregnancy(not spotting but actually bleeding)
Loss of twin, triplet, etc. during the pregnancy

The above are just some of the reasons a child should be closely monitored for delays in gross and fine motor, speech as well as other areas including seizure activity. Children with none of these warning factors can also later be diagnosed with cerebral palsy if there was an event that caused brain damage during pregnancy or birth that went undetected.


Hemiplegic Cerebral Palsy affects one side of the body, such as right hand/arm and foot/leg or left hand/arm and foot/leg. It can also affect the child's visual fields and cause a problem called visual field cuts. If the brain damage that causes the cp is located on the left side of the brain it can also possibly affect language development. Hemplegics brain damage is usually located in the temporal and parietal lobes of the brain but can be located in the frontal or occipital lobes as well if the damage is mainly to one side or the other.
For hemiplegia concerns, look for one hand that is always fisted while actively using the other. One leg, same side of body as hand that is fisted, is unusually stiff while other seems to actively move.


Diplegic Cerebral Palsy affects both legs(gross motor) and at times can also affect one or both hands(fine motor). If the hands are affected they will not be as affected as the legs. Diplegics can also have vision and eye involvement. Diplegic cp is caused by damage to the frontal lobe of the brain.
For diplegia concerns look for unusually stiff legs that are hard to move but can usually move arms and hands actively. Some diplegics also fist their hands and can be hypotonic(floppy) or hypertonic(stiff/spastic) in their trunk. Diplegia is the most common type of cp among premature infants.


Quadriplegic Cerebral Palsy affects all four limbs equally or almost equally including the trunk and can cause problems with head control. If involvment is not quite equal then the legs will be more affected. Can also affect language/oral motor development, and vision or the eyes as well.
For quadriplegia look for both hands fisted most of the time and both legs unusually stiff and hard to move, for example, hard to get apart when trying to change a diaper.
If the baby is hypotonic instead of spastic or stiff as described above then it would be more of the baby looking as if they have no strength in their limbs. Instead of being unusually stiff they would then be unusually floppy.



There are three other types of cerebral palsy that are not as common. Monoplegia affects only one limb, double hemiplegia is like quadriplegia but the arms are more affected then the legs and triplegia where both legs and one arm are affected fairly equally. One other classification can be made, hemiplegic, diplegic where both legs are affected with one arm affected and the side where the arm is also affected has the most involvment.


Spastic Cerebral Palsy is caused by damage to the motor cortex of the brain.

Dystonic Cerebral Palsy, which affects the movement of the body, presents as slow, rhythmic twisting movements of the trunk, or an arm or leg. Can also include abnormal postures. This is caused by damage to the cerebellum or basal ganglia.

Athetoid Cerebral Palsy also affects the movement of the body. It presents itself as slow writhing movements usually in the wrists, fingers and face. Tone usually fluctuates. Also caused by damage to the cerebellum or basal ganglia.

Ataxic Cerebral Palsy affects balance and coordination. The muscle tone is usually hypotonic(floppy) but there can be some hypertonia(spasticity). Ataxia is caused from damage to the cerebellum.

Mixed Cerebral Palsy is caused by damage to the motor cortex and the cerebellum or basal ganglia. Mixed usually presents with spastic muscles and involuntary movements. Muscle tone can be too high in some muscles and too low in others.



ypical Development by 3 months:
Is holding head up when lying on stomach, smiles when sees familiar faces or is talked to, can visually track objects that move, is actively moving arms and legs. If a baby rolls over before 3 months, from stomach to back, this is usually because they are unusually stiff. They will usually hold their head up well when pushing up with arms and this can force them over when combined with holding their legs stiff.

Atypical Development by 3 months:
Is having and has had trouble with their sucking reflex, not able to hold head up while lying on stomach, legs and/or arms are unusually stiff or unusually floppy, keeps one or both hands fisted most of the time and is hard to get their hands open.


Typical Development by 6 months:
Rolls from back to stomach and stomach to back, sits with support, will turn toward sounds, will pass toys from hand to hand using each hand about equally, will put toys in mouth, cooing.

Atypical Development by 6 months:
Rolls by extending back and legs "toned rolling", cannot sit even with support--will either round back forward or will push backward, eyes are noticeably crossed, legs scissor or cross and are hard to get apart, only using one hand--not switching toys back and forth--other hand is constantly fisted, not making any cooing sounds, only turns head to one side unless forced to turn it to the other.


Typical Development by 9 months:
Sitting unsupported, saying one to two words such as Mama, Dada or the name of a favorite toy, crawling, getting in and out of a sitting position, knows their name and will respond to it, drinking from a tippy/sippy cup with some assistance.

Atypical Development by 9 months:
Not sitting or has just started sitting unsupported, rounds back forward while sitting, arches back, has a hard time with fine motor control in hands--hard to pick up and manipulate objects, army crawls--pulls self with just one side of the body, will not support weight on legs, gags excessively on thin liquids, has trouble with head and/or trunk control, toes are continually pointed.



Typical Development by 12 months:
Pulling to a stand and walking around furniture. Some children are beginning to take a few independent steps, saying more words, has pincer grasp--picks things up with thumb and first finger.

Atypical Development by 12 months:
Cannot pull to a stand or has a lot of trouble trying, continually walks on toes, still has an immature grasp in one or both hands--no pincer grasp--will grasp objects with all fingers and palm or cannot grasp objects.



Typical Development by 15 months:
Stands without support, most are also walking without support, can feed self, using 4 or 5 words.

Atypical Development by 15 months:
Not standing independently, continually stands or walks on toes and cannot bring them down easily if at all, cannot sit unless is W sitting, sits to one side.



Children are all born with certain involuntary reflexes that disappear usually within the first year of life. By 3 to 4 months of age they should be starting to loose some of these newborn reflexes. Watch for a prolonged babinski reflex--this is when you tickle the bottom of their feet--they should stop fanning out their toes and start curling them under when you stroke the foot from heel to toe by a year old. Prolonged startle reflex--the babies arms and legs come together, the legs then shoot out and the hips flex. This reflex disappears by 4-5 months of age. Asymmetric tonic neck reflex--When the child's head is turned to one side the leg and arm on the side the baby is facing extend and the arm and leg on the opposite side bend(flex). This reflex should disappear by 5-6 months of age. If you notice any of these reflexes persisting longer then listed above consult your pediatrician.
If your child is not rolling over and sitting with support by 9-10 months you should get a referral to a pediatric neurologist, this includes premature infants.
At one year if your child is only rolling over and is not close to sitting or supporting the weight of their heads or their body weight when put in a standing position you need to be referred to a pediatric neurologist, this includes premature infants.
If your child is not walking by 18 months you should bring this to the attention of your pediatrician.

For links to information about cerebral palsy and more, go to our Special Needs Links page.




Cerebral palsy (CP) is a neurological disorder affecting body movement and muscle coordination. CP is typically caused by an injury to the brain before, during, or shortly after birth. (However, it is also used as an umbrella term to describe disorders which impair the control of movement resulting from faulty development of areas of the brain.) When the brain injury occurs while the baby is still in the womb (80% of reported cases), it is difficult to explain what caused the problem. It may be caused by abnormal fetal brain development, an infection, an accident in which the mother was injured, a medical condition that the mother had during pregnancy, such as high blood pressure or diabetes, or unknown biochemical or genetic factors. If the injury occurs during birth (10% of reported cases), it is usually due to a deprivation of oxygen or an injury upon having a difficult delivery. Last, if the injury occurs after birth (10% of reported cases), it may be due to a baby being born prematurely, where his or her body is not ready to survive outside the mother’s womb, an infection, an accident where the baby is injured (i.e., motor vehicle), or bleeding in the brain. Approximately 1 in every 1,000 infants have some form of CP.

CP was first described in the 1860's by an English physician named William Little. He wrote about children who were stiff, had spastic muscles (more so in the legs than arms), and had difficulty grasping objects, crawling, and walking. The condition was called Little’s disease, however, he was describing what is now known as spastic diplegia cerebral palsy.



Features and Characteristics

Children with CP have the inability to control their muscle coordination. Depending on where the damage to their brain occurred, they may have muscle tone that is too tight, too loose, or a combination of both. In addition, some children may have abnormal sensation and perception; impaired sight, hearing or speech, seizures, mental retardation, feeding difficulties, learning disabilities, bladder and bowel control, and difficulty breathing due to postural difficulties. There are four different types of cerebral palsy:

Spastic Cerebral Palsy

If the muscle tone is too high or too tight, the individual has spastic CP. Children with spastic CP often have stiff and jerky movements due to their tone. They often have a hard time moving from one position to another, and often times have difficulty letting go of an object with their hand. Spastic CP is the most common type; approximately 50% of individuals with CP have spastic CP.

Ataxic Cerebral Palsy

When the individual has low muscle tone and poor coordination of movement, they are described as having ataxic CP. Children who are ataxic, look shaky (tremor-like) when trying to perform a task. They often have poor balance and may be very unsteady when they walk.

Athetoid Cerebral Palsy

Athetoid CP is used to describe the individual who has both low and high tone. Children with this type of CP have difficulty holding themselves upright or steady for sitting or walking and have involuntary movements in their arms, upper bodies, and face. Because of these movements, it takes a lot of hard work and concentration to reach for an object. In addition, mixed tone causes them to have difficulty holding onto things.

Mixed Cerebral Palsy

This type of CP is used to describe the individual who experiences both low and high tone.

In addition to having the different types of CP, there are also classifications for the areas of the body that the CP affects:

Quadriplegia

This refers to the individual who is affected in all four limbs. Children with quadriplegia have difficulty moving all of their body parts, and often times require a wheelchair for mobility. Due to the problems controlling the muscles in their face and upper body, they may have trouble speaking and eating.

Hemiplegia

This term is used to describe individuals who have CP that affects only one side of their body - either the right arm and leg or the left arm and leg - while the other side functions normally. Children with hemiplegia are able to walk and run, however, may have a slight limp or awkwardness in their gait.

Diplegia

Individuals who have diplegia are only affected in their legs. Walking or running may be difficult for them, however, since their upper body is not affected, they are able to hold themselves upright and have good use of their arms and hands.



Diagnosis

Physicians diagnose CP by looking at the child’s motor skills, medical history, development, and characteristics described above. The physician will also test reflexes and look for early development of hand preference (babies younger than 12 months generally do not show hand preference). In addition, the physician must also rule out other disorders that can cause movement problems. The doctor must rule out that the disorder is not getting worse, as CP is not progressive. If the child is losing skills, he or she may have a genetic disorder, metabolic disorder, or muscle disease. Many times, a CT-scan, MRI, and a sonogram may be ordered as well to identify brain disorders or areas that are underdeveloped.



Treatment

While there is no cure for cerebral palsy, there are several effective treatments available to improve muscle coordination and function. The child with CP should be involved in a program that addresses movement, speech, learning, and social and emotional development. Physical therapists may help children with such tasks as walking, operating their wheelchair, and standing. They can also work on more pleasurable skills such as throwing a ball or learning to ride a bike. Speech therapists can work with the child to teach them how to speak, use sign language, or use a communication device. Occupational therapists can assist children with skills such as brushing their teeth, dressing themselves, and feeding themselves. Recreational therapists help the children have fun! They can work on dance, swimming, or horseback riding. In addition to these therapists, the child should be seeing a pediatric neurologist to coordinate the child’s care and an orthopedist to predict, diagnose, and treat muscle problems associated with CP.

Those individuals who are experiencing spasticity, may find drug therapy beneficial. Baclofen is a muscle relaxant and antispasmodic that works by inhibiting the nervous system. It is administered by a pump implanted under the skin of the abdomen (it can be taken by mouth, however, high doses are needed when taken orally). The drug does have some side effects, however. It can cause drowsiness, confusion, and difficulties with balance, and in high doses, it can cause breathing difficulties and problems with heart and kidney functions. Baclofen is not recommended for children under 12 years of age. Other drugs sometimes used include Dantrolene, which interferes with the process of muscle contraction, and Diazepam, which acts as a general relaxant of the brain.

Botox is also sometimes used for the treatment of spasticity. It relieves muscle spasms by blocking the transmission of a nerve impulse to a muscle, causing the muscle to be weakened or paralyzed. It is administered by a needle into an affected muscle, and results are usually seen within 3 days, lasting up to six months. This method is usually very closely followed by an organized physical therapy program.

Electrical stimulation has been used to treat muscle spasticity and tendon contracture, however, the effects of the stimulation appear to be temporary. It is usually used intermittently with a broader treatment program.

Surgery is often needed when contractures are severe. Surgeons can lengthen tendons and muscles after determining the exact muscles at fault. Selective dorsal rhizotomy is another type of surgical procedure that is used with individuals who have spasticity, in which sensory nerve fibers just dorsal to the spinal cord are identified, and then are selectively cut to diminish tone in spastic muscles of the lower limbs.



What to Expect

The symptoms of CP differ from person to person, however, it doesn’t always cause profound limitations. While some individuals may require a wheelchair for mobility and require life-long care, others may be only slightly awkward and need no special care at all. As the child matures, many times they will need additional services to help them function in society, such as educational and vocational training, independent living services, counseling, transportation, recreation/leisure programs, and employment opportunities - all essential to the developing adult. People with cerebral palsy can go to school, have jobs, get married, raise families, and live in homes of their own. Most of all, people with cerebral palsy need the opportunity for independence and full inclusion in our society.

[Cheahahoney]

I am so devasted about my poor grandbaby girl who has cp because of a housefire she was in when she was 5 mos,she is now 20 mos.There are not to many services it seems for cp children.I had to quit my job to care for my granddaughter and the assistance I get from SSI is only 376.00 the max is 569.00.I have been on the wait list but have been approved for Easter Seals since March 2004-Sep 2004 we have not had 1 therapy session because the president has cut funds to help these children,what r ppl like us suppose to do to survive.We did save the state several thousands of dollars supporting r own but I can not live off 376.00 plus food stamps.My granddaughter is survivng off her brainstem and dr's say she could die at anytime.That babies like her dont live long maybe 6 or 7 yrs.I have not meant 1 person that was in a housefire and survived with CP if there is anybody out there please let me know I feel as though I'm alone.I would love to go back to work but that is not possible right now.The state said if I would of let her go to foster home then got custody I would get more money.Be real r they serious its awful to see children suffer enough but to not get what they need is not right,if anybody can think of anything to help me plz let me know I need it Ty and God Bless,and by the way I would love to find some penpals to talk to with CP it would help