Transcript File - Impact of Special Needs

Cerebral Palsy
A condition that is caused by the failure of the brain to develop
properly or neurological damage to the child’s brain. It affects motor
skills, movement and muscle tone.
Leia, Tracy and Mary
How Common is CP
• More than 500,00 people in the United States have CP
•CP occurs in approximately 2 per 1,000 live births
•Every year almost 8,00 infants and 1,500 preschool
children are diagnosed with the condition
•This frequency rate hasn’t changed in more than four
decades, even with the significant advances in the medical
care of newborns
•Higher in males than females
Etiology
*Usually occurs during fetal development or infancy, but
can also occur after infancy
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Exposure to radiation
Infection
Asphyxia before birth
Hypoxia of the brain
Birth trauma during labor and delivery
Drowning
Severe Jaundice
Lead Poisoning
Physical brain injury
Shaken baby syndrome
Meningitis
Between 40-50% of children with CP were born
prematurely
Identifying Factors:
Lethargy/lack of alertness
Irritibility/fussiness
Abnormal/high-pitched cry
Trembling of the arms/legs
Poor feeding abilities secondary to sucking& Swallowing
Low muscle tone
Abnormal Reflexes
Seizures
Child holds his/her hand in tight fists
Asymetries of movement-one side of the body may move
more easily than the other
 Tongue pushing food out of mouth when eating
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*Some doctors hesitate to diagnose CP right away.
Types of Cerebral Palsy
*CP is often classified by the type of motor
dysfunction
• Spasticity: the most common type of dysfunction.
Involves a mild to severe exaggerated contraction
of muscles when the muscle is stretched. It can
involve the entire body or only parts of the body.
70-80% of all cases fall under this category.
*Hemiplegia-one side of body affected, limp
*Diplegia-lower extremities affected with little to no
upper body spasticity (70-80% of known cases)
*Monoplegia-One single limb affected
*Triplegia- Three limbs affected
*Quadriplegia-Four Limbs affected. Some have
tremors and uncontrollable shaking
 Dyskenesia/Athetoid: characterized by involuntary
extraneous motor activity, especially under stress.
It is caused by injury to the basal ganglia, the
brain’s motor switchboard. Occurs in 10-20% of all
cases.
 Ataxia: Occurs when an injury has occurred in the
cerebellum. The child has a lurching walking gait.
Occurs in 5-10% of all cases.
*Abnormal sensation/perception, impairment of sight,
hearing or speech, seizures
* A child can have more than one type of CP
Some health issues:
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Bone thinning or osteoporosis
Delayed growth and development
Poor sight, hearing and speech
Hip problems
Higher incidence of being injured when falling,
Osteopenia
Joint contractures
Incontinence
Abnormal perception of sensations
Poor nutrition
In some patients, reduced communication skills
Scoliosis and other spinal deformities
Seizures, though this only occurs in about half of
patients
Epilepsy
These health problems can lead to:
 Depression
 Premature aging
 Arthritis
 Post-impairment syndrome
 Other medical conditions
Treatment
*Treatment is based on the person’s symptoms and
the need to prevent complications
 There is no cure for Cerebral Palsy.
 The goal of treatment is to help the person be as independent
as possible
 Treatment requires a team approach:
Primary care doctor
Social Worker
Nurses
Occupational, physical and speech therapists
• Other specialists include: Neurologists, rehabilitation
physician, pulmonologist and gastroenterologist, Mental
Health Practitioner, orthopetic surgeon
 Medical interventions such as braces, surgery and
prescribed therapies can help
 Physical and Occupational therapies: exercise,
strengthen and position muscles, bones and joints
 Prevention of serious and painful contractures,
dislocations, and rigidity is critical for individuals with
CP
 Physical and Occupational therapies facilitate the
development of normal reflexes and maximize the
control a person can have over their environment
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Medications
 Anticonvulsants to prevent or reduce the frequency of
seizures
 Botulinum toxin to help with spasticity and drooling
 Muscle relaxants (Baclofen) to reduce tremors and spasticity
 Diazepam (muscle relaxant)
 Dantrolene sodium (Dantrium)
 Surgery is needed in some cases to:
• Control of gastroesophageal reflux
• Cut certain nerves from the spinal cord to help with pain and
spasticity
• Place feeding tubes
• Release joint contracture
• Eye surgery for cataracts
Self and Home Care include:
• Getting enough food and nutrition
• Keeping the home safe
• Performing exercises recommended by the health care
providers
• Practicing proper bowel care (stool softeners, fluids,
fiber or laxatives)
• Protecting the joints from injury
* Putting child in regular schools is recommended
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The following may help with communication and learning:
Glasses
Hearing aids
Muscles and bone braces
Walking Aids
Wheelchairs
Assistive Technology for Access:
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Adapted handles (e.g. pencil grips)
Adapted Book-page turners or fluffers
Book holders
Built-up stylus/Joysticks/Adapted mouse
A mouth stick to press keys on the keyboard
Foot pedals or hardware switches instead of a mouse to
operate a technology device
Arm support
Slant board/Tilt board
Voice input or output devices
Voice recognition software
Computer-access modification software (touch window,
portable word processor, word-completion utilities,
Keyboards with accessibility options to input or encode
text
If you have a child with CP in
your classroom you should:
• should set up the classroom so that plenty of space is available for the
student to move around the room and to sit comfortably at a desk.
• Items that may interfere with the safety of a child with CP should be
placed out of reach.
• In the classroom, use of a tape recorder or a “note buddy” for writing
notes are simple accommodations that teachers commonly arrange.
• Students who struggle with communication should have the option of
using assistive technological equipment in the classroom
Impact on Language Development
 Speech Problems are commonly associated with poor
respiratory control, laryngeal (monopitch,low, weak and
breathy voice quality), velopharyngeal and articulatory
dysfunction.
 Dysarthria- a condition that occurs when problems with the
muscles that help you talk make it difficult to pronounce
words. Affects 31-88% of people with CP.
*Soft palate (roof of mouth) can affect speech
*Ataxic CP has erratic speech patterns due to diminished ability
to control facial muscles
*Dyskinetic CP-difficulty controlling body movements due to
differences in muscle tone, so they have difficulties
controlling their vocal cords and tongue=slurred speech
*Spastic Quadriplegia-have difficulties swallowing and have
limited motor control, muscles of the tongues and mouth are
affected. Harder to understand speech
Impact on Social Skills:
 Some children with CP are put into mainstream classes and
are able to socialize with children without disabilities
Child can be confronted by barriers that hurt their socialization.
-micro, meso and macro barrier levels:
 Micro: Child’s physical limitations.
Ex) Child may not be able to participate because of lack of
confidence or because they are in a wheelchair
 Meso: Family and Community. Negative attitudes of people
towards disabilities or lack of support within the
family/community
 Macro: Systems and policies that are not in place or hurt
children with CP. Include architectural barriers, lack of
assistive technology and lack of transportation aid
Ex) building without an elevator
Behavior Issues
 Parent-reported behavior problems were 5 times more
likely in children with CP (25.5%) compared with
children having no known health problems (5.4%)
 Frustration is one of the most common problems found
in children
 Attention Deficit Disorder
 Some let their attention wander and become distracted
Bibliography
 National Institute of Neurological Disorders and Stroke www.ninds.nih.gov/disorders/cerebral_palsy/cerebral_palsy.h
tm
 United Cerebral Palsy - www.ucp.org
 Public Medical Health
 http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001734/#a
dam_000716.disease.support-groups
 Assistive Technology to Meet K–12 Student Needs
 http://www.ncrel.org/sdrs/areas/issues/methods/technlgy/t
e7assist.htm
 http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001734
 http://health.nih.gov/topic/CerebralPalsy
 http://www.ucp.org/www.cerebralpalsysource.com/About_CP/
behavioral.../index.html  http://jpepsy.oxfordjournals.org/content/21/3/447.abstract
 http://www.essortment.com/cerebral-palsys-effects-speech26843.html
Discussion
 Imagine you are a person who has Cerebral Palsy on
Wheelock’s campus. Discuss some disadvantages
you’d run into. What would it be like to get to
class, the cafeteria, or the Brookline campus? What
are some advantages that Wheelock’s campus has
over a campus such as Northeastern or Boston
University?
 http://www.youtube.com/watch?v=kr5hHmZbQHw
&feature=youtube_gdata_player