CEREBRAL PALSY

Have you ever heard a family member talk about your first step or the first word you spoke? For kids with cerebral palsy, called CP for short, taking a first step or saying a first word is not as easy. That's because CP is a condition that can affect the things that kids do every day.


What's CP?

Some kids with CP use wheelchairs and others walk with the help of crutches or braces. In some cases, a kid's speech may be affected or the person might not be able to speak at all.

Cerebral palsy (say: seh-ree-brel pawl-zee) is a condition that affects thousands of babies and children each year. It is not contagious, which means you can't catch it from anyone who has it. The word cerebral means having to do with the brain. The word palsy means a weakness or problem in the way a person moves or positions his or her body.

A kid with CP has trouble controlling the muscles of the body. Normally, the brain tells the rest of the body exactly what to do and when to do it. But because CP affects the brain, depending on what part of the brain is affected, a kid might not be able to walk, talk, eat, or play the way most kids do.
Types of CP

There are three types of cerebral palsy: spastic (say: spass-tick), athetoid (say: ath-uh-toid), and ataxic (say: ay-tak-sick). The most common type of CP is spastic. A kid with spastic CP can't relax his or her muscles or the muscles may be stiff.

Athetoid CP affects a kid's ability to control the muscles of the body. This means that the arms or legs that are affected by athetoid CP may flutter and move suddenly. A kid with ataxic CP has problems with balance and coordination.

A kid with CP can have a mild case or a more severe case — it really depends on how much of the brain is affected and which parts of the body that section of the brain controls. If both arms and both legs are affected, a kid might need to use a wheelchair. If only the legs are affected, a kid might walk in an unsteady way or have to wear braces or use crutches. If the part of the brain that controls speech is affected, a kid with CP might have trouble talking clearly. Another kid with CP might not be able to speak at all.

For some babies, injuries to the brain during pregnancy or soon after birth may cause CP. Children most at risk of developing CP are small, premature babies (babies who are born many weeks before they were supposed to be born) and babies who need to be on a ventilator (a machine to help with breathing) for several weeks or longer. But for most kids with CP, the problem in the brain occurs before birth. Often, doctors don't know why.
What Do Doctors Do?

Doctors who specialize in treating kids with problems of the brain, nerves, or muscles are usually involved in diagnosing a kid with cerebral palsy. These specialists could include a pediatric neurologist (say: nyoo-ral-uh-jist), a doctor who deals with problems of the nervous system and brain in kids.

Three other kinds of doctors who can help kids with CP include a pediatric orthopedist (say: or-tho-pee-dist), who handles problems with bones or joints, a developmental pediatrician, who looks at how a kid is growing or developing compared with other kids the same age, and a pediatric physiatrist, who helps treat children with disabilities of many kinds.

There is no special test to figure out if a kid has cerebral palsy. Doctors may order X-rays and blood tests to find out if some other disease of the brain and nervous system may be causing the problem. To diagnose CP, doctors usually wait to see how a kid develops to be sure.

A case of cerebral palsy often can be diagnosed by the age of 18 months. For example, if a child does not sit up or walk by the time most kids should be doing these things, the kid might have CP or some other problem that is causing development to go more slowly. Doctors follow infant and child development closely and look for problems with muscle tone and strength, movement, and reflexes.
How Is CP Treated?

For a kid with CP, the problem with the brain will not get any worse as the kid gets older. For example, a kid who has CP that affects only the legs will not develop CP in the arms or problems with speech later on. The effect of CP on the arms or legs can get worse, however, and some kids may develop dislocated hips (when the bones that meet at the hips move out of their normal position) or scoliosis (curvature of the spine).

That is why therapy is so important. Kids with CP usually have physical, occupational, or speech therapy to help them develop skills like walking, sitting, swallowing, and using their hands. There are also medications to treat the seizures that some kids with CP have. Some medications can help relax the muscles in kids with spastic CP. And some kids with CP may have special surgeries to keep their arms or legs straighter and more flexible.
Living With CP

Cerebral palsy usually doesn't stop kids from going to school, making friends, or doing things they enjoy. But they may have to do these things a little differently or they may need some help. With computers to help them communicate and wheelchairs to help them get around, kids with CP often can do a lot of stuff that kids without CP can do.

Kids with cerebral palsy are just like other kids, but with some greater challenges that make it harder to do everyday things. More than anything else, they want to fit in and be liked.

Be patient if you know someone or meet someone with CP. If you can't understand what a person with CP is saying or if it takes a person with CP longer to do things, give him or her extra time to speak or move. Being understanding is what being a good friend is all about, and a kid with CP will really appreciate it.

Reviewed by: Steven J. Bachrach, MD