Orthopedic Impairment—Cerebral Palsy
Our nation’s special education law, the Individuals with Disabilities Education Act (IDEA) defines orthopedic impairment as follows:
“…a severe orthopedic impairment that adversely affects a child's educational performance. The term includes impairments caused by congenital anomaly, impairments caused by disease (e.g., poliomyelitis, bone tuberculosis, etc.), and impairments from other causes (e.g., cerebral palsy, amputations, and fractures or burns that cause contractures).”
[34 Code of Federal Regulations §300.8(c) (8)]
Cerebral palsy—also known as CP—is a condition caused by injury to the parts of the brain that control our ability to use our muscles and bodies. Cerebral means having to do with the brain. Palsy means weakness or problems with using the muscles. Often the injury happens before birth, sometimes during delivery, or soon after being born. CP can be mild, moderate, or severe. Mild CP may mean a child is clumsy. Moderate CP may mean the child walks with a limp. He or she may need a special leg brace or a cane. More severe CP can affect all parts of a child's physical abilities. A child with moderate or severe CP may have to use a wheelchair and other special equipment. Sometimes children with CP can also have learning problems, problems with hearing or seeing (called sensory problems), or mental retardation. Usually, the greater the injury to the brain, the more severe the CP. However, CP doesn't get worse over time, and most children with CP have a normal life span. (NICHCY, 2010)
It is estimates that 2 out of every 1,000 newborn children will develop cerebral palsy. And approximately 40% of those born with cerebral palsy will have a severe case. Right now, about 10,000 babies and infants are diagnosed with the condition each year. (UCP, My Child Without Limits, 2012)
Cerebral palsy does not have a single cause like chicken pox or measles. There are many reasons why someone might have cerebral palsy. An unborn child might have suffered a brain injury, an infection, or abnormal development of the brain tissue. These are called "prenatal" causes, meaning they happened before birth. These causes are responsible for about 70% of the cases of cerebral palsy. Another 20% of cerebral palsy cases are caused by brain injury that takes place during the birthing process. In the United States, about 10% of children who have cerebral palsy got it after they were born. This is called "acquired cerebral palsy." (The figures are higher in underdeveloped countries.) Acquired cerebral palsy happens when there is brain damage during the first few months or years of life. This damage can be caused by brain infections, like bacterial meningitis or viral encephalitis. It can also be caused by a head injury -- usually from a motor vehicle accident, a fall, or child abuse during the first few years of life when the brain development is still taking place. Most of the time the actual cause of cerebral palsy is not known. And, although there may have been brain injury or a developmental problem, the problem may not be notice for months. (UCP, My Child Without Limits, 2012)
There are many risk factors for cerebral palsy. They include:
Certain medical advances (such as vaccines) as well as better prenatal care and nutrition have lowered the number of babies born with CP in poorer countries. During pregnancy a woman can take precautions to prevent CP. These include:
There are four main types of CP:
More words used to describe the different types of CP include:
Cerebral palsy can't be cured, but treatment will often improve a child's capabilities. Many children go on to enjoy near-normal adult lives if their disabilities are properly managed. In general, the earlier treatment begins, the better chance children have of overcoming developmental disabilities or learning new ways to accomplish the tasks that challenge them. Treatment may include physical and occupational therapy, speech therapy, drugs to control seizures, relax muscle spasms, and alleviate pain; surgery to correct anatomical abnormalities or release tight muscles; braces and other orthotic devices; wheelchairs and rolling walkers; and communication aids such as computers with attached voice synthesizers. (NINDS, 2011)
Cerebral palsy doesn't always cause profound disabilities. While one child with severe cerebral palsy might be unable to walk and need extensive, lifelong care, another with mild cerebral palsy might only be slightly awkward and require no special assistance. Supportive treatments, medications, and surgery help many individuals improve their motor skills and ability to communicate with the world. (NINDS, 2011)
A child with CP can face many challenges in school and is likely to need individualized help. Fortunately, states are responsible for meeting the educational needs of children with disabilities.
For school-aged children, including preschoolers, special education and related services will be provided through the school system. School staff will work with the child's parents to develop an Individualized Education Program, or IEP. The IEP is similar to an IFSP in that it describes the child's unique needs and the services that have been designed to meet those needs. Special education and related services, which can include PT, OT, and speech-language pathology, are provided at no cost to parents.
In addition to therapy services and special equipment, children with CP may need what is known as assistive technology.
Examples of assistive technology include:
The ability of the brain to find new ways of working after an injury is remarkable. Even so, it can be difficult for parents to imagine what their child's future will be like. Good therapy and handling can help, but the most important "treatment" the child can receive is love and encouragement, with lots of typical childhood experiences, family, and friends. With the right mix of support, equipment, extra time, and accommodations, all children with CP can be successful learners and full participants in life. (NICHCY, 2010)
1660 L Street NW, Suite 700
Washington DC 20036
(800) 872-5827 Voice/TTY
For more than 55 years, United Cerebral Palsy (UCP) has been committed to change and progress for persons with disabilities. The national organization and its nationwide network of affiliates strive to ensure the inclusion of persons with disabilities in every facet of society—from the Web to the workplace, from the classroom to the community. As one of the largest health charities in America, the mission of United Cerebral Palsy is to advance the independence, productivity and full citizenship of people with disabilities through an affiliate network.
1726 Franceschi Road
Santa Barbara, CA 93103
(866) CNS-5580 (267-5580) 805-965-8838
Our primary goal is to promote development of effective treatments for children with neurological disorders as quickly as possible. Guided by our mission, vision, and core values we do the following: fund high-quality research focused on brain repair and regeneration; sponsor meetings where physicians and scientists can work together; encourage young scientists to pursue children’s neurological research; advocate for increased funding for children’s neurological research; and educate families about options for treating their children.
4101 West Green Oaks Blvd., Ste. 305
Arlington, TX 76016
Online Support for Children with Hemiplegia or Hemiplegic Cerebral Palsy. Includes local support groups and an e-mail discussion group to keep parents of children with CP connected.
This is a list of assistive technology resources for students and teachers. It includes directions for making your own assistive technology devices.
“4 My Child” provides a wealth of knowledge to help you with the difficulties of caring for children with Cerebral Palsy or other special needs.
An informed Question & Answer presentation of the origin and diagnosis of cerebral palsy in children and babies from the book, "Cerebral Palsy: A Complete Guide for Caregiving".
This is the home page of the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM). Browsing is welcome. Health Professionals, Parents, and Patients can begin their online research by visiting the Library and Resources sections.