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Understanding Cerebral PalsyQuinci JonesMarietta CollegeAbstractThis paper uses information from ten different sources and personal experience to explore the many factors of Cerebral Palsy. It explores the causes of the disease, both preventable and nonpreventable. It also describes the medical measures that are often taken to improve the livelihood of those with Cerebral Palsy. Also, it describes some tactics and devices that can be used for teachers who are educating a student who has Cerebral Palsy. Finally, it describes the adulthood of someone who has Cerebral Palsy and the strain CP has on caregivers and family members. The reason for the paper is to raise awareness of Cerebral Palsy and to give others enough information so that they will be able to better understand and embrace the disability and those who have the disability. When exploring the field of education, it is important to consider all types of students that you may encounter. One important factor of this is understanding many different types of disabilities. It is not just enough to know how to define each disability, but also to understand how to interact, teach and assist students who have that disability. One disability that I am passionate about is cerebral palsy. As an educator, it is important to understand the factors of cerebral palsy and work to spread awareness to others as to how those with cerebral palsy wish to be treated. To understand how to educate and interact with people who have Cerebral Palsy, it is important to first understand what CP is. Cerebral Palsy (also known as CP) “is considered a neurological disorder caused by a non-progressive brain injury or malformation that occurs while the child’s brain is under development” (Stern, 2017). The non-progressive component of the brain means that it does not worsen, but it also does not improve. The only aspect of Cerebral Palsy that can improve is the physical side effects, but even those will not resolve completely. The physical side mostly deals with muscles as “Cerebral Palsy affects body movement and muscle coordination” (Stern, 2017). People who have CP often has a lot of trouble with fine motor skills (Straub & Obrzut, 2009, p. 156). For example, there is a student who has Cerebral Palsy who struggles with completely grasping objects. She can move her arms and pick things up, but she needs assistance when it comes to things like brushing her teeth because it is difficult for her to grasp something as small as a tooth brush. This lack of fine motor skills is a result of her Cerebral Palsy. The most common CP is spastic Cerebral Palsy which has three subtypes. The first subtype is Quadriplegia Spastic CP which is the most severe and can cause stiffness or spasms in the arms and legs, and even difficulty with swallowing and speaking (Straub & Obrzut, 2009, p. 154). There is a student who has this type of Cerebral Palsy and he is unable to speak and often has spasms in his joints. Secondly, there is Diplegia spastic CP which mainly targets the lower part of the body, specifically the legs with some clumsiness in the hands (Straub & Obrzut, 2009, p. 154). There is a different student who has CP and it seems she has this type of spastic CP because she is able to speak move her arms more than he is. Although she has some spasms, she does not experience them as intensely as he does. The last type of spastic CP is Hemiplegia spastic CP which only affects one side of the body in both the arm and leg (Straub & Obrzut, 2009, p. 154). Not only does Cerebral Palsy affect the muscles, but it also can cause intellectual impairment, loss of hearing or vision, and seizures (Stern 2017). Another type of Cerebral Palsy is Athetoid Cerebral Palsy which is caused by damage to the basal ganglia part of the brain (Aitken Law). This causes mixed muscle tones (some are overly relaxed and vice versa) as well as slow movements that are uncontrollable (Aitken Law). The third type, which is much less common, is Ataxic Cerebral Palsy which is a result of damage to the cerebellum (Aitken Law). This usually causes trouble with movement and balance and impacts about 5% of those with Cerebral Palsy (Aitken Law). The final type is Mixed Cerebral Palsy which is a combination of Athetoid and Spastic CP (Aitken Law). Once again, these complications vary from person to person depending on the severity and the causes. There are many factors that can contribute to a newborn developing Cerebral Palsy, and some of these factors are even unpreventable. Some factors that may cause CP before the child is born include; an infection of the mother or baby that attacks the baby’s central nervous system, the baby being born prematurely, Rh disease of mother (blood type not matching up with the baby’s), and a viral disease infection in the mother (United Cerebral Palsy, 2017). None of these specific factors occurring immediately cause CP, but one or more of these factors occurring raises the chance that the child will be born with Cerebral Palsy. For most of the time, CP is caused by damage to the brain which could have been caused by any of these factors or by others that are not listed (Stern, 2017). CP can also be acquired in the first few months or years of a baby’s life through postnatal factors including; head injury, abuse, or an infection to the brain (Straub & Obrzut, 2009, p. 154-155). The difficult thing with CP is often the factors are uncontrollable. When the factor is controllable like an unhealthy environment, the parent is often unwilling to change the environment before it is too late. This leads to many people being affected by this disease without a cure in sight. Considering few people know the details of Cerebral Palsy, it may seem as though it is not a common disability. This conception is far from the truth. O’Callaghan and other researchers state that the condition is common, and the amount of people affected has barely changed in the last fifty years even with extensive research and changes in the care for those with CP (O’Callaghan et al., 2013, p. 575). When looking at the prevalence of Cerebral Palsy in the United States, “it is estimated that 764,000 children and adults in the U.S. manifest one or more of the symptoms of cerebral palsy” (United Cerebral Palsy, 2017). Also, United Cerebral Palsy reports that every year about 10,000 babies that are born in the U.S. will either be born with or will eventually develop Cerebral Palsy (2017). These number show that Cerebral Palsy is more common than most people perceive. The prevalence and lack of a cure is causing those in the medical field to further their research to provide the best health care for those with CP.The first step of the medical process for children with Cerebral Palsy is to be diagnosed. Usually children with Cerebral Palsy are diagnosed within the first two years of life unless the symptoms are mild (National Institute of Neurological Disorders and Stroke, 2013). If the symptoms are mild, it could be until the child is four or five when he or she is diagnosed (NINDS, 2013). Another thing that can assist with diagnosis is observing what took place during the prenatal, and postnatal times. If the mother had multiples, has seizures, came into contact with mercury, or has a thyroid problem, the baby is more at risk for Cerebral Palsy (Benaroch, 2017). Also, the baby being born prematurely, having a low birth weight, or being born in the breech position or with other complications during labor can cause a greater chance of Cerebral Palsy (Benaroch, 2017). If any of these things occurred, the doctor is more likely to test the baby extensively for Cerebral Palsy because of the greater risk. Once diagnosis takes place, there are many therapies and medications that are implemented to ensure the most improvement as possible, although it is known that a cure is nonexistent. The difficult thing with diagnosis when the child is young is ensuring that the signs show Cerebral Palsy and not another disability which has similar symptoms. For example, one symptom of Cerebral Palsy is the loss of sight. A child may have a loss of sight for a different reason, but if the doctor goes into the diagnosis with narrow-mindedly he or she may determine that the cause of blindness is Cerebral Palsy when it is not. Therefore, the doctors must perform multiple tests on the child to determine if he or she has Cerebral Palsy. Some of the testing used to determine if a child has CP or not includes testing on vision, hearing, muscle tone, development, and motor skills (NINDS, 2013). Researchers are beginning to implement the idea of using imagining techniques and other tests to predict if babies will have Cerebral Palsy when they are born (NINDS, 2013). This could raise issues if the parent does not accept the news well. It could also benefit the parents if they are able to have more preparation time before the child is born. These techniques are not yet being implemented, but if researchers are successful, the techniques may begin to be used by doctors. There are also physical tests that doctors perform to determine the status of the brain of a child and whether that status reveals that the child has Cerebral Palsy. A Cranial ultrasound-picture of the brain of a young child determines if the tissue damage aligns with the damage of Cerebral Palsy (NINDS, 2013). Also, MRI’s and CT’s are used to diagnose Cerebral Palsy by studied the brain damage that has taken place (NINDS, 2013). Once these tests and diagnoses are complete, the next step is to determine the types of medications and therapies that will best suit the child’s needs in relation to the severity of their Cerebral Palsy. Without a cure, the usual plan for people who have Cerebral Palsy is to participate in therapies and take medicine to help with the complications associated with the disease. Therapies such as occupational, recreation, speech/language, and ones to help with drooling and eating (NINDS, 2013). If therapies do not help the patient, surgery may take place to cut nerves in the affected areas (NINDS, 2013). Also, oral medications can be taken to relax muscles and BT-A can be injected to help with over-acting nerve cells that can over-activate the muscles (NINDS, 2013). One student who has Cerebral Palsy and uses a wheel chair must go through physical and occupational therapies. She must lay on a table and have her legs stretched once a week to make sure that her joints do not stiffen up because of the Cerebral Palsy. Also, she must go through different exercises like brushing her teeth and cooking to work on life skills. One of the positive aspects of Cerebral Palsy is that there are scientists constantly researching new ways to improve the lives of those with the condition. One thing being investigated is stem cell therapy. One thing being studied is if this type of therapy is effective and safe for patients. Stem cells are being used because they are able to change into other types of cells, so scientists hope stem cells will be able to repair damages made by Cerebral Palsy (NINDS, 2013). Until this is further studied, stem cells will not be used because there are too many risks. Sometimes surgeries take place to help correct sight, hearing, or walking/pain associated with walking (NINDS, 2013). Although medical assistance can improve the well-being of someone who has Cerebral Palsy, it can also cause a for a life full of appointments and surgeries which can become miserable. This it is important to create a positive environment in the classroom for all students, but especially those who have Cerebral Palsy. When educating students with Cerebral Palsy, the most important thing to understand is that every student is different. Just because two students have the same disability, it does not mean that they respond the same way to education or need the same types of modifications. The most important thing is to become acquainted with the student on a personal level. A student who has Cerebral Palsy discussed a negative experience she had with a teacher where the teacher penalized her for not typing her own paper when she is blind and unable to type on her own. Also, she stated that her grade was brought down because she missed class for a doctor’s appointment related to her disability. Both instances support the idea that the teacher did not first get to know the student and her need for accommodation. Also, it is important to understand that students who have CP are often too sheltered at home and are not always properly educated on things like sexual education (Murphy, Molnar & Lankasky, 2000, p. 809). This means that it is important to encourage independence as much as possible because they are often not given that opportunity at home. This is not because the parents don’t love their child, but the parent is so used to taking care of the child that it is often hard to let go. If the student has a sight impairment as a result of having CP, it is crucial that teaching is done so in a hands-on manner. Also, it is important to understand that students who have Cerebral Palsy respond best to “environmental sensory information” because it “facilitate[s] perceptual-motor learning and rehabilitation” (Straub & Obrzut, 2009, p. 157). An example of this may be counting money instead of counting numbers because it works on real life skills as well as educational values as well as helps with motor-learning. In one experiment, researchers tested the effect of having a child with Cerebral Palsy use a Wii console to assist in rehabilitation (Deutsch, Borberly, Filler, Huhn, & Guarrera-Bowlby, 2008, p. 1204). The child was unable to participate in the sports in a usual manner, but was able to participate in them on the Wii. This helped with fine motor skills in a way that was enjoyable for the child and seemed to be successful (Deutsch, Borberly, Filler, Huhn, & Guarrera-Bowlby, 2008, p. 1204). By using this research, educators could implement more activities like this experiment into the classroom, especially for students with Cerebral Palsy. This would help develop fine-motor skills and give them a recreational break throughout the day. This, along with other accommodation and devices, would help the student to reach his or her intellectual and physical capacity. As with most disabilities, assistive devices and technologies are a key factor in educating students with Cerebral Palsy. The types of assistive devices recommended depends on the severity of the Cerebral Palsy. For example, if someone has Quadriplegia Spastic CP he or she may need a device that allows them to communicate with others because the disability prevents them from doing so. For example, there is a student who is nonverbal due to his Cerebral Palsy, so he has a communication board which allows him to communicate his thought to those around him. There is a sensor on his head that allows him to place the cursor on the phrase or letter that he is thinking and select it. This device demonstrates the intelligence that the student has, even though he is unable to verbally communicate what he is thinking. Also, students with orthopedic issues may use wheel chairs, braces, or wedges to assist with transportation (NINDS, 2013). Depending on the student, other various devices may be used to assist with learning techniques and other activities. The National Institute of Neurological Disorders and Stroke reports that “computers, computer software, voice synthesizers, and picture books” help to the student’s ability to communicate (2013). One student with Cerebral Palsy uses IntelliKeys which is a typing program often used for students who are blind. This program allows students to type who normally have trouble typing on a keyboard. The student also used Dragon Speak which is a software program that allows the student to speak into a microphone and it will type whatever the student says. If the teacher previously discussed would have provided the student with a program such as this one, the student would not have had to depend on her mom to complete the assignment. It is important for educators to continually research the new assistive technologies being developed for students with disabilities to improve their education experience. The years spent in school are crucial for the development of a child with Cerebral Palsy. Once schooling is over, there is often a lot of issues that come with becoming an adult with Cerebral Palsy. One major issue for those who have CP is finding employment. When studying one-hundred and twenty-five adults who have Cerebral Palsy, it was observed that only twenty-one percent of them were in employment considered to be competitive, usually requiring no special training (Murphy, Molnar, & Lankasky, 2000, p. 807). Also, some of them were in niche employment, sheltered training, or workshops, or employed completely (Murphy, Molnar, & Lankasky, 2000, p. 807). This factor along with the coping skills of the individual can lead to depression, which is “three to four times higher in people with disabilities such as CP” (Cerebral Palsy Foundation, n.d.). Adults with Cerebral Palsy often experience Post-Impairment Syndrome which is pain and weakness because of bone-deformities, arthritis, and repetitively using the same muscles (Cerebral Palsy Foundation, n.d.). Another issue that may come with adulthood depending on the severity is the loss of caregivers. When a person has Cerebral Palsy, they usually need a constant caregiver to assist them with all aspects of life, if the condition is severe enough. As that caregiver grows older, it can make the situation more difficult. Even when the person with Cerebral Palsy is younger, the caregiving process can cause strain on the caregiver or the family as a whole. One of the biggest issues for caregivers is “to manage their child’s chronic health problems effectively while maintaining the requirements of everyday living” (Raina et al., 2005, p. e627). Also, the preexisting function of the family plays a large role on the health of the caregiver which is why it is suggested that health care providers who work with people with disabilities should also work with the family dynamic to ensure that it is healthy for all those involved (Raina et al., 2005, p. e633). For all disabilities, it is important to understand that there will be strain on the family structure and the persona with the disability, but this does not mean those with disabilities should be looked down upon or treated differently. The most important thing to understand about people who have Cerebral Palsy is that they are often intellectually sound, but their muscles are unable to move. When others understand this, it is easier for them to treat those with Cerebral Palsy the same that they would treat those who do not have CP. Also, when someone stares excessively at a person with CP it makes them feel like they are out of place and misunderstood. Therefore, it is important to understand all the facts of Cerebral Palsy and the type of lifestyle a person with Cerebral Palsy lives so that you can interact with them appropriately. Cerebral Palsy affects a large percentage of people in the world, and those people deserve to be accepted and embraced. Works CitedAitken Law. (n.d.). Types of cerebral palsy. Retrieved from , R. (2017). What is cerebral palsy? What causes it. Retrieved from Cerebral Palsy Foundation. (n.d.) Retrieved from , J. E., Borberly, M., Filler, J., Huhn, K., & Guarrera-Bowlby, P. (2008). Use of a low-cost, commercially available gaming console (wii) for rehabilitation of an adolescent with cerebral palsy. Physical Therapy, 88, 1196-1207. doi:10.2522/ptj.20080062 Murphy, K. P., Molnar, G. E., & Lankasky, K. (2000). Employment and social issues in adults with cerebral palsy. Archives of Physical Medicine and Rehabilitation, 81, 807-811. Retrieved from Institute of Neurological Disorders and Stroke. (2013). Cerebral palsy: Hope through research. Retrieved from ’Callaghan, M. E., MacLennan, A. H., Gibson, C. S., McMichael, G. L., Haan, E. A., Broadbent, J. L., . . . Australian Collaborative Cerebral Palsy Research Group. (2013). Genetic and clinical contributions to cerebral palsy: A multi-variable analysis. Journal of Paediatrics and Child Health, 49, 575-581. doi:10.1111/jpc.12279 Raina, P., O’Donnell, M., Rosenbaum, P., Brehaut, J., Walter, S. D., Russell, D., . . . Wood, E. (2005). The health and well-being of caregivers of children with cerebral palsy. Pediatrics, 115, e626-e636. doi:10.1542/peds.2004-1689Stern, K. (2017). Definition of Cerebral Palsy. Retrieved from Straub, K., & Obrzut, J. E. (2009). Effects of cerebral palsy on neurological function. Journal of Developmental and Physical Disabilities, 21, 153-167 doi: 10.1007/s10882-009-9130-3United Cerebral Palsy. (2017). Retrieved from ................
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