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Cerebral palsy overview

From the moment of birth, or very soon after, children with cerebral palsy experience their world differently from their non-disabled peers.

Babies experience a short, frustrating, period of helplessness followed by an increasingly active exploration of their world. They experience their world through lying, sitting, reaching, rolling, crawling and standing. In a few months they are up and away.

Some babies born with cerebral palsy do not explore their world independently at the same time as their peers, if at all. Many, in addition to the physical difficulties, have an altered perception of space and altered sensations of touch. The picture they build of their world may well be a very different one to others of their age.

If a child with cerebral palsy joins a nursery where staff have little or no previous experience to draw on, they may feel unsure of their ground. The information in this section aims to reassure them that their experience of working with and understanding the broad range of needs of all children will stand them in good stead. However, it is important for pre-school staff to have a basic understanding of what cerebral palsy is and how it affects children.

What is cerebral palsy?

Cerebral palsy is a condition that affects movement, posture and co-ordination and is caused by an injury - sometimes called an insult - to the brain, usually before or very soon after birth.

Fifteen hundred babies are affected each year, roughly one in 400 children in the UK.

Cerebral palsy is not infectious and, although the effects may become more noticeable with age, it is not progressive. Cerebral palsy jumbles up the messages going from the brain to the muscles, causing them to behave oddly. Different terms are used to specify the type of cerebral palsy corresponding to the areas of the brain most affected by the injury.

HemiHelp is an organisation that deals specifically with hemiplegia, which affects one side of the body. You can find out more about hemiplegia in the Hemiplegia section.

More information about commonly used terms are found on Scope's information sheet Glossary of terms, their parent leaflets When a Child has Cerebral Palsy and What is Cerebral Palsy? and the factsheets An introduction to cerebral palsy and Further information about Cerebral Palsy.

Supporting a child in the early years

There is no 'cure' for cerebral palsy. However, with appropriate early support and intervention, many children with cerebral palsy develop new skills and improve their muscle control and co-ordination. Some children with cerebral palsy, and their families, have contact with an enormous number of professionals in their lives. This might include, very broadly, a physiotherapist for support and advice with movement and positioning, an occupational therapist for support and advice on equipment, play and adaptations and a speech and language therapist for support and advice about eating and communication skills.

Additional needs

Each child is an individual and no two children with cerebral palsy are the same. They may have some additional needs that a setting would need to take into account.

Visual and spatial awareness

Some children have a great deal of difficulty making sense of the information they get through their eyes. In the most severe cases these children may appear blind but many children can improve their useful vision with plenty of stimulation and support. More commonly children may have difficulty with pictures, line drawings and writing.

We have spatial awareness to work out where we are in relation to objects and people around us. For some this is a problem. If a child is walking or using a wheelchair themselves they may bump into things or move into spaces that are far too small. In bookwork they may find it difficult to 'see' an object or picture in their heads and may need to use real objects for counting and other maths games for longer than usual.

Speech and / or chewing and swallowing difficulties

These are common. Speech and language therapists will suggest the best way to help an individual child communicate. They can also give advice on chewing and swallowing problems. Most children will use speech to communicate but speech may be delayed or very difficult for a few children and they will need help to support communication. A speech aid might be the best way forward if it is clear the child will find speaking very difficult but any child can benefit from using pictures or symbols to support playing and learning.

Hearing difficulties

Colds and glue ear can affect all children so hearing needs tend to be kept in mind. Some children with cerebral palsy might be more prone to hearing difficulties.

Epilepsy

This is a common additional need. Usually this is well controlled with medication and the service may only need to find a volunteer to administer it if the child stays all day. However, the medication might affect the child's behaviour, ability to concentrate or need to use the toilet and these possibilities should be discussed. Where children may have a seizure, staff need to feel confident, through discussion and training, that they are able to deal with it effectively.

See the section on hemiplegia and epilepsy and www.epilepsy.org.uk for more information on epilepsy.

Other issues

Although many of these areas are not so apparent until a child moves on to post-five provision, some children may have additional problems with concentration, memory, or sequencing (putting things in order), sleeping or toileting difficulties, a specific learning difficulties.

Both Scope's website and HemiHelp have information to support this period in a child's life.

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