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Cerebral palsy (CP) is a collection of motor disorders resulting from damage to the brain that occurs before, during, or after birth. The damage to the child’s brain affects the motor system, and as a result, the child has poor coordination, poor balance, or abnormal movement patterns-or a combination of these characteristics. The causes of cerebral palsy, which are known in approximately 80% of cases, include prenatal maternal diseases and infections, prolonged or abnormal deliveries, birth trauma, prematurity, and several post-natal causes, such as respiratory distress and infections.
CP is a static disorder of the brain, not a progressive disorder. This means that the disorder or disease will not get worse as time goes on. The motor skills associated with CP are not temporary. Therefore, a child who has temporary motor problems, or who has motor problems that get worse over time, does not have cerebral palsy. Children who have CP may have many other kinds of problems, including medical problems. Most of these problems are related to brain injury. They include epilepsy, mental retardation, learning disabilities, and/or attention deficit hyperactivity disorder.
The most common occurrence of CP is called congenital, which means it exists at birth. It is far less common for CP to occur during the birthing process or in early childhood. Cerebral palsy is one of the more common congenital disorders. Approximately 5 of every 2000 infants born have CP. Improvements in medical care have decreased the incidence of CP among children who would have otherwise developed the disorder. Medical advances have also resulted in the survival of children who previously would have died at a young age.
When CP was first studied in the 1880’s, the main cause was thought to be from a lack of oxygen at birth. The current studies have determined this to be the cause in a very small percentage of the cases of CP. The great majority of CP is caused by damage to the brain during fetal development, well before the birth process begins. Although the cause of the damage is not usually known, studies and testing have shown that some cases of CP are caused by strokes or hemorrhaging in the brain in later stages of fetal development. Other causes of CP are:
As the child with cerebral palsy grows and becomes an adult, they are faced with the same challenges as people without disabilities. There are extra challenges faced by a person with CP. Concerns usually center on independence, intimate relationships and employment. There may be significant psychological issues, as well, and the adult with cerebral palsy may find it more difficult than the child to find medical care.
The degree of difficulty a person encounters in establishing independence depends on the individual person and his or her family, as well as on the severity of the disability. This transition is much more difficult for the adults who need the most care. The transition can be very difficult for some and if signs of depression or behavioral changes become apparent, they should be taken seriously and psychological counseling should be obtained. Adults in their twenties and thirties with cerebral palsy are in a growing number, as medical advances increase the potential of people with disabilities for living longer and more productive lives. The effects of aging become more noticeable in people with CP. They start to notice getting stiffer and weaker, especially if they have not stayed active and done stretching exercises. Many adults with CP commonly report fatigue, deterioration of functional skills and low life satisfaction.
To some extent getting weaker is part of normal aging, but it happens at a different rate and level for the person with CP. For adults with a disability who often push their bodies to the maximum for activities of daily living, the muscles may wear out prematurely from overuse. The main treatment for this is modifying the activity, for example, using a power wheelchair for long distances such as shopping at the mall. Strength training for the lower limbs is also helpful. Arthritis occurs frequently and at an earlier age in people with cerebral palsy.
Socialization skills, especially the development of intimate relationships, are learned during the transition to adulthood. Dating and gaining acceptance from peers can be very traumatic for any young adult, but the effort required of people with CP can be draining. They may have to use all their energy just to keep up with their peers. Without having the previous social supports of school and family, individuals with CP may become easily fatigued and stressed. In addition, prejudice in the job market towards people with disabilities can compound a person’s stress and possible loss of self-esteem.