Cerebral Palsy: Team Care Helps Families Reach Their Potential

Learning your child has cerebral palsy raises a host of questions.

Only one, though, will really matter: How can I help my child live the best, happiest life possible?

That's where AdventHealth for Children's coordinated team of medical experts comes in. We can treat both the physical symptoms of cerebral palsy as well as help a family meet its emotional and spiritual challenges.

When choosing a health care provider to care for a child with cerebral palsy, parents are likely to value the coordination of care. In other words, they want a team that works together to help their child reach his or her potential, instead of stitching together a plan from disconnected doctors.

We understand cerebral palsy can lead to emotional issues for children and stress for parents. Empowering families with the tools and treatments to surmount these barriers is as much a part of care as any physical symptom is.

On the way to answering the big questions about your child's future, smaller ones pop up along the way.

What is cerebral palsy?

Because it depends on the level of damage to a child's brain, each case of cerebral palsy is unique. But, in most cases, cerebral palsy is:

• Incurable, but treatable: Because it is caused by injury to the brain, which cannot heal itself, cerebral palsy will last for a child's entire life.
• Non-life-threatening: Though the disorder can carry serious implications, cerebral palsy is typically survivable well into adulthood.
• Non-progressive: Cerebral palsy is the result of damage to the brain just after birth or, most often, before birth. Its complications do not intensify, though symptoms may change.

One question why may never be answered. Cerebral palsy is most often caused by brain damage in the womb, though the specific cause is often not known.

Cerebral palsy encompasses many symptoms and a range in severity. All cases, though, stem from a brain injury, which is why it starts with cerebral (palsy refers to the muscle weakness that happens as a result).

In most cases about nine in 10, according to the Centers for Disease Control and Prevention this brain damage occurs before birth. Therefore, doctors often do not know specifically what causes the illness.

Though it is the most common movement disorder among children, it is still relatively rare. About one in every 323 children is born with the condition.

Children born prematurely or with a low birthweight have a greater chance of being born with cerebral palsy.

The illness is divided into four broad types based on the specific problem with movement:

• Spastic palsy, which represents about six in 10 cases, causes muscles to be very stiff, making it hard to coordinate their movement. Some cases primarily affect the legs, others one side of the body and still others affect the entire body.
• Dyskinetic Palsy affects the control of the hands, arms, feet and legs, leading to jerky movements. If the face and tongue are affected, it can be difficult to swallow or talk.
• Ataxic Palsy leads to difficulties with coordination and balance, often resulting in difficulty walking.
• Mixed Palsy combines at least two of the first three types, most commonly dyskinetic and spastic.

In each of these cases, if a child with cerebral palsy has difficulty controlling his or her muscles, it is not due to a problem in the muscles themselves. Rather, the brain controls muscle contraction, so a brain injury makes it difficult to use our muscles. Over time, certain muscles can become tighter due to unusual movements.

Furthermore, cases range from mild to severe.

Some children with cerebral palsy are born with little thinking impairment, so they can live productive and independent lives. Others will need special equipment and lifelong care.

Many fall in between. About 58 percent of children with cerebral palsy can walk by themselves, and 11 percent use a hand-held mobility device like crutches. The other 30 percent have little to no ability to walk.

AdventHealth for Children Physical Therapist Kris Fought PT, PCS, c/NDT, says that each child with cerebral palsy is different and has unique needs.

We work with each child and their family to determine these specific needs and set up a treatment plan to allow for maximum independent function, she says.

Signs a baby might have CP

Since there is no single course for cerebral palsy, it can be difficult to identify infants with the condition. In general, delays in reaching developmental milestones can be (but are not always) a sign of cerebral palsy. More specifically, according to the CDC:

In babies younger than 6 months:

• His head lags when you pick him up from his back.
• He feels stiff or floppy.
• When cradled in your arms, he overextends his back, as if is constantly pushing away.

In babies older than 6 months:

• She doesn't roll over.
• She can't bring her hands together.
• She has a hard time bringing her hands to her mouth.
• She keeps one hand fisted while reaching out with the other.

In babies older than 10 months of age:

• The baby crawls in a lopsided way, pushing off with one hand and leg while dragging the opposite side.
• Instead of crawling on all fours, the baby scoots on his buttocks or hops on his knees.

If you're concerned, bring up these symptoms with your doctor, though they are often spotted in routine checkups. Though it is not curative, earlier treatment can be more effective.

AdventHealth for Children's pediatric rehabilitation program specializes in child development, which means they're the experts in both spotting potential issues and developing individualized therapies to address them.

The program focuses on working with families to assemble a team across the many disciplines it takes to care for children with cerebral palsy.

In addition to identifying delays in development, tests for cerebral palsy include:

Neurological exam to test movement abilities

• CT scan
• A hearing test
• A head MRI
• X-rays

Because its symptoms are so pervasive your brain controls virtually every part of your body, after all cerebral palsy care calls for a team of experts. At AdventHealth, they include:

• Surgeons to diminish muscle spasms.
• Occupational therapists to teach daily living skills such as eating, talking and learning to live by yourself.
• Speech therapists work on eating and communication
• Physical therapists assist with positioning and mobility in the community
• Neuropsychologists to help patients and their caregivers deal with the isolation, stress and depression often association with cerebral palsy.

We provide therapy for the child through their entire life. Kids do best when they alternate between learning new skills, often during growth spurts or following a surgery, and then having time to practice them.

Therapy also works best when its both fun and functional, says AdventHealth for Children Physical Therapist Susan Robins, PT.

Families are encouraged to be involved in therapy sessions and carryover these techniques at home, she says.

At AdventHealth for Children, we treat children with cerebral palsy as an individual, both in terms of their personality and the manifestation of their illness. In the end, we know the best therapy is being a kid.

Furthermore, we don't treat diseases, we care for families. After all, a child's first and most effective caregivers are their parents. Anything we can do to support parents and guide them along their path including its emotional and spiritual peaks and valleys will ultimately benefit their child, too.

For more information, call us at Call855-303-KIDS (5437) or schedule an appointment on our website.