THE SOCIAL, EMOTIONAL, & PSYCHOLOGICAL EFFECTS OF ADULTS WITH CEREBRAL PALSY


Cerebral palsy (CP) is a cluster of brain disorders that affect an individual’s ability to move, balance, and control posture, muscles, and reflexes. It results from impaired brain development during pregnancy or soon after birth. Those afflicted with cerebral palsy experience its effects and severity differently. Muscles may be weak or stiff. Many cerebral palsy persons experience tremors or unpredictable or uncontrollable reflexes and muscle movements. They may also be visually, hearing, or speech impaired. Severe cases may also have trouble breathing and swallowing, which leads to eating, digestive, and dental problems.

Medical advancements have enabled individuals with cerebral palsy to live well into adulthood. However, there appears to be a limited commitment to help physically disabled adults obtain maximum mental and physical health and well-being. As a result, those with cerebral palsy tend to experience high levels of social and emotional distress as well as physiological challenges.

Social Effects

Cerebral palsy affects one’s mobility and ability to effectively communicate. As a result, cerebral palsy individuals tend to be socially and professionally limited. Employment, marriage, and living independently are viable options only for those with mild cerebral palsy.

Inclusion is important to mitigate feelings of isolationloneliness, and depression. Having a disability does not eliminate the need to be accepted and respected by one’s peers. Cerebral palsy adults may be encouraged to join groups or socialize with individuals their age that have similar disabilities or who do not normally participate in physical activities. Organized crafts, recreational activities, and events aid socialization. Psychologists and behavioral or developmental specialists are often consulted to assist with socialization needs.

Emotional Effects

Aggressiveness, hyperactivity, belligerence, withdrawal, or fearfulness are signs the cerebral palsy individual is having difficulty adjusting to their surroundings or to others. They may act frustrated, mad, or sad. This may be due to painful physical maladies associated with their CP (i.e.: poor sleep, scoliosis, acid-reflux, skin irritations, etc.). This acting-out may also be due to feelings of low self esteem or a negative self-imageAttentiveness to these signs of distressanxiety, and depression provides the impetus for early mental health intervention.

Comprehensive care must include mental health observation and support in addition to customary medical and physical care. Helping the cerebral palsy adult adapt to their disability and/or limitations can help improve mood.

Psychological Effects

Fifty percent of cerebral palsy individuals have a learning disability. The degree of learning disability depends on which area of the brain is damaged. Approximately one-third of individuals with cerebral palsy have moderate-to-severe intellectual impairment (mental retardation). One-third has mild intellectual impairments. One-third shows no signs of cognitive impairment.

More adults with cerebral palsy are furthering their education and entering into the workforce due to advancements in medical treatment, ADA and educational accommodations, and adult cerebral palsy support services. Ensuring physically disabled adults maintain mobility, find inclusion, and have full access to community and adult support services helps ensure they achieve maximum health, well-being, and quality of life.

Pet Therapy for Cerebral Palsy

Photo by Josh Hild on Pexels.com

Pet therapy, or animal-assisted therapy, is a great way for children with cerebral palsy to get greater benefits from physical therapy sessions as well as other types of treatment. Working with animals is proven to be beneficial in many ways and, when added to standard therapies, can help children meet their goals.

Parents should be cautious about choosing therapists and animals that are trained and licensed and have experience working with children with cerebral palsy.

What is Pet Therapy?

Also referred to as animal therapy or animal-assisted therapy, pet therapy is the use of specially trained animals to promote wellness, boost mood, aid therapy, and other broad uses in mental and physical health care. [1]

Pet therapy can be informal, such as when a therapy dog visits a nursing home or hospital to cheer up residents and patients, or it can be more formal with guided therapy sessions that include the animal as a central aid or participant.

Dogs are most commonly used in pet therapy, but all kinds of animals may be involved including cats, horses, and even guinea pigs. A study published by the U.S. National Institutes of Health indicated that “individual and social benefits gained by dog-assisted therapy may aid in the prevention, improvement and development of children with various disabilities.” [2]

Specific situations in which pet therapy may be used include chemotherapy sessions, dental work and other potentially scary or stressful procedures for children, or even adults, physical therapy to rehabilitate from an injury or a stroke, mental health therapy sessions, or for residents in long-term care facilities.

Pet therapy is also commonly used to assist children with disabilities, including cerebral palsy.

The Benefits of Working with Animals

For anyone, including children with special needs, there are proven benefits of working with animals of all types in unstructured or more formal settings. For mental health, being around animals and interacting with them has been proven to lower anxiety, increase relaxation, reduce loneliness, provide comfort, and increase mental stimulation. [3]

These benefits alone are helpful, but they are also useful in breaking the ice or any initial resistance or fear about going through a therapy session.

There are also physical benefits of working with animals, which include lowering blood pressure and heart rate, improving cardiovascular health, and reducing pain. Petting and being around animals has been shown to increase hormones like serotonin and reduce others, like cortisol, which together promote less stress in the body. Pet owners are known to live longer than people who do not have pets in the home.

Animal-Assisted Physical Therapy for Cerebral Palsy

One important use of animals for children with cerebral palsy is to assist with physical therapy. Physical therapy is an important aspect of treatment for most children with cerebral palsy because it helps with muscle tone and balance, mobility, pain reduction, and other physical issues. There are a number of reasons to have an animal in the therapy session, including:

  • Working with animals during physical therapy helps children meet their goals.
  • Therapy sessions are less stressful and children are more engaged and enthusiastic about doing the work.
  • Animals provide physical support to help children perform exercises.
  • Children are often more willing to use the animal than an object for support.
  • Animals motivate children to work harder, to meet their goals, and to return for subsequent sessions.

Pet Therapy Promotes Mental and Emotional Health

The role of animals in helping children with cerebral palsy is not limited to physical health and mobility. Children with cerebral palsy often struggle with mental health issues and behavioral challenges. For instance, ADHD, depression, and anxiety are common coexisting conditions.

Working with animals can help improve mood, reduce anxiety, and reduce stress. Animals can also provide many of the same benefits in behavioral therapy sessions as they do in physical therapy: motivation, support, encouragement, and someone to bond with and help a child be more engaged and enthusiastic about treatment[4]

Other Benefits of Pet Therapy for Children with Cerebral Palsy

Physical benefits and mental health benefits are important aspects of pet therapy, but children with cerebral palsy can also get other benefits from working with animals. One study of disabled children with cerebral palsy set goals for therapy and used trained dogs to assist.

The children previously were all unable to complete standard therapy sessions, but all completed the animal sessions and met their goals. The animals were able to help them break down resistance and fear and to carry on with successful therapy sessions.

These children also saw improvements in communication, becoming better able to tell others what they need or want. They developed greater empathy from working with the dog and were better able to ask for help and provide help to others as a result. Their social skills improved thanks to these benefits they received from working with animals.

Specialized Types of Animal Therapy

Dogs are often used as therapy animals because of how easy they are to train and their love of people, but other animals can be trained to work with special needs children as well. Two interesting options for children with cerebral palsy include equine therapy and dolphin therapy.

Equine therapy is working with horses, which may include riding, petting, or actually caring for horses. Exactly what happens in the sessions depends on an individual’s goals, but working with horses has the added benefits of getting children outside and improving self-confidence.

Dolphin therapy is not common, but it is practiced in some specialized settings. Sessions with trained dolphins can provide many of the same benefits as other types of animal therapy, but there are additional potential benefits.

For a child with mobility issues and pain, as are common with cerebral palsy, it can be easier to work in the water. However, dolphin therapy is relatively new and there is little available evidence that it helps. The number of facilities offering this expensive therapy is growing, and parents should be cautious and only work with those that are staffed by trained and licensed therapists.

Therapy Animals in the Hospital

Children with cerebral palsy may have to spend time in the hospital for treatments, for surgery, and for recovery after surgery. Informal visits from pet therapy programs can help these children feel more relaxed in a stressful environment.

They provide comfort, reduce anxiety, make the hospital setting feel more like home, and offer a feeling of love and acceptance for children who are struggling. They can also help children communicate with and relate better to doctors and nurses.

Pet therapy can be a great way for children with cerebral palsy and other disabilities to get more out of their therapy sessions. From meeting physical therapy goals for mobility to learning how to better socialize and be more engaged with treatment, animals can provide a number of benefits for children with special needs.

As long as parents are careful to select services with trained, experienced, and licensed therapists and animals, pet therapy can be a great addition to a child’s treatment plan.

Lost Voice Guy Gig.

Lee Ridley (Lost Voice Guy) & Me!

Here it is as promised. After a meal at a local pub with my Wife, Daughter and Son in law it was of to see and hear ‘The Lost Voice Guy’ who is best known for winning Britain’s got talent in 2018.

I felt that The Lost voice Guy’s type of stand up comedy was different from that of your normal stand up comedian in the sense that his was part life story part comedy, where as your normal comedian is able to walk on and deliver the jokes/stories from memory. Lee has to use a computer to set up his routine. For someone with Cerebral palsy or Cerebral Lolsy as Lee calls it must take longer than a normal comedian setting up their routine.

Lee revealed to us how he came to have the name ‘Lost Voice Guy’ and that was when he was at school that’s what his nick name was.

It was good to see that either the theatre staff or someone from The Lost Voice Guy team had not only someone to sign for the deaf but someone to walk lee onto stage.

At the end of the gig he said he would be out in the entrance area signing books and for sellfies, so as you can see I got a sellfie. I also got the book “I’m only in it for the Parking”

Are Cerebral Palsy & Epilepsy connected

Around half of all children with cerebral palsy also have epilepsy. Both cerebral palsy and epilepsy are neurological disorders that often coexist with one another.

What is Epilepsy?

According to the National Institute of Neurological Disorders, epilepsy encompasses a “spectrum of brain disorders,” in which the pattern of normal neuronal activity is disrupted. [1] When the activity of brain cells, or neurons, is disturbed, convulsions (known as seizures) and muscle spasms result.

During these episodes, some children will experience loss of consciousness. As the fourth most common neurological disorder in the world, epilepsy can affect anyone at any age. Around 1 out of every 100,000 people develop epilepsy each year.

There are a number of different types of seizures, and people with epilepsy may experience one or several of the various types. It’s important to note that there is a difference between epilepsy and seizures. Someone who has only one seizure generally does not have epilepsy.

Epilepsy is marked by recurrent seizures. If someone has at least two but usually more seizures as an ongoing condition, they are more likely to be diagnosed with a seizure disorder, otherwise known as epilepsy.

What Causes Epilepsy?

For about half of epilepsy cases, there’s no known cause. Among the known causes of epilepsy, the most common include:

Prenatal Injuries

During intrauterine life, the developing brain of a fetus is highly susceptible to damage. This can occur from prenatal infections, maternal alcohol and drug use, when the oxygen or blood supply is low, and with poor nutrition or vitamin deficiencies.

Developmental and Genetic Disorders 

As mentioned earlier, cerebral palsy and epilepsy often coexist. Other neurodevelopmental and genetic disorders that can be associated with epilepsy include conditions like autism, neurofibromatosis, Angelman syndrome, and many others.

Sometimes a mutation in one or more genes can cause abnormalities in the brain that can be passed down and make a whole family more susceptible to epilepsy or other brain disorders.

Head Trauma

Head trauma, such as birth injuries, motor vehicle collisions, or any accident in which the head undergoes traumatic damage can lead to epilepsy. [2]

Diseases

A number of infectious diseases can cause direct damage to brain tissue, such as viral encephalitis and meningitis, which can result in epilepsy.

Oxygen Loss 

Any significant lack of oxygen to the brain before, during, or after birth, can cause seizures in babies. This can also occur with people of any age with a stroke, which is a bleed or obstruction to the blood flow in the brain. The brain damage that occurs is very often permanent and may leave the child with a seizure disorder.

What are the Symptoms of Epilepsy?

The main symptom of epilepsy is recurrent seizures, which are marked by any of the following:

  • Uncontrollable, jerking body movements, usually in the arms and legs
  • Repetitive movements of the face, including lip-smacking or chewing
  • Loss of awareness
  • Drooling
  • Difficulty talking
  • Rigid, tense muscles
  • The skin may look pale or flushed
  • Racing heart
  • Dilated pupils or staring
  • Sweating
  • Tongue biting
  • Tremors

Keep in mind that not every child will experience all of these symptoms.

Epilepsy Treatment

Physicians usually treat epilepsy with medication. [3] The type of medicine prescribed is based on the particular seizure type experienced by the child. However, since each child is different, finding the correct medication, along with the right dosage, can be an arduous process.

Doctors usually prescribe the first medication at a low dosage to see how effective it is, and how many side effects the child will experience. Most epilepsy medications have significant side effects, especially when they are first started, which can include dizziness, weight gain, fatigue, nausea, skin rashes, and more, depending on which medication is prescribed.

Over half of the people who begin medication find success with this method of treatment, and with continued use, may even eventually become seizure-free. There are some for whom the medication works well to control the seizures, but they will have to continue on medicine for life in order to remain seizure-free.

If medications fail to work, physicians may recommend a treatment called vagus nerve stimulation. This involves the placement of a small device into the patient’s chest. This device sends low levels of electrical energy to stimulate the vagus nerve, which may reduce seizure activity between 20% and 40%.

The ketogenic diet is another treatment option for epilepsy that fails to respond to medication. It’s a strict diet, however, that entails substantially lowering carbohydrates while increasing fats. The body will then use fat for energy, as opposed to carbohydrates.

It is a difficult diet for families to follow because of the severe limitations in what the child may eat, as well as the continuous need to monitor for ketones.

You’ll need to work closely with your physician, as well as a dietitian or nutritional counselor, if you decide to have your child try the ketogenic diet, as some children may experience adverse side effects, including dehydration and nutritional deficiencies.

However, with proper medical supervision, the side effects are not too common. Around 10% to 15% of children who go on the ketogenic diet are seizure-free within a year, although it is very rare for people to be able to stay on this diet successfully for long periods of time.

If all other treatments have been exhausted, surgery may be considered as the next option. Surgical procedures are generally only performed as a last resort, and when doctors determine that the seizures occur in a specific part of the brain that doesn’t hinder vision, speech, hearing, or motor function. During the operation, the part of the brain that’s causing seizures is removed.

Studies on Cerebral Palsy and Epilepsy

According to a scientific study published in the European Journal of Epilepsy, spastic quadriplegia and spastic diplegia are the most common types of cerebral palsy associated with epilepsy. [4] Symptoms of epilepsy generally start for children with cerebral palsy during the first year of life, some within the first month after birth.

Epilepsy Prognosis

If children respond well to medication, there’s a good chance that they’ll be seizure-free one day, and may even be able to discontinue epilepsy medication use. It is important to note, however, that many children with cerebral palsy will need to remain on medication to control their seizures for life.

The University of Maryland Medical Center (UMM) states that long-term survival rates are lowered when traditional treatment options, such as medications and surgery, fail to work. Accidents from uncontrollable seizures also play into the lower survival rate.

These are cases in which the severity of the seizure disorder is part of an overall more severe form of cerebral palsy, and many other organ systems are affected, leading to a shortened life span.

Epilepsy – Complex Partial Seizures

Overview

A complex partial seizure is also known as a focal impaired awareness seizure or a focal onset impaired awareness seizure. This type of seizure starts in a single area of the brain. This area is usually, but not always, the temporal lobe of the brain.

While it’s most common in people with epilepsy, this type of seizure has been known to occur in people with cerebral palsy. It includes uncontrolled movement of limbs or other body parts. These seizures are usually very short, and the person having the seizure will be unaware of their surroundings. They may also become unconscious for a brief period of time.

Complex partial seizures and epilepsy

For those with epilepsy, this is the most common type of seizure. But while complex partial seizures are often related to epilepsy, this is not the only reason for someone to have seizures.

Symptoms of complex partial seizures

A complex partial seizure can have multiple possible symptoms. However, these symptoms may occur during one seizure and not another. Complex partial seizures normally only last a few minutes. Seizures beginning in the frontal lobe area of the brain are usually shorter than those that start in the temporal lobe area.

Symptoms will often start abruptly, and the person experiencing the seizure may not know they have had one. The person may:

  • stare blankly or look like they’re daydreaming
  • be unable to respond
  • wake from sleep suddenly
  • swallow, smack their lips, or otherwise move their mouth repetitively
  • pick at things like the air, clothing, or furniture
  • say words repetitively
  • scream, laugh, or cry
  • perform actions that can cause potential danger to themselves, like walking in front of moving cars or removing all or portions of their clothing
  • perform movements like they are riding a bicycle
  • be unaware, either partially or totally, of their surroundings
  • hallucinate
  • try to hurt themselves
  • experience confusion when the seizure ends
  • be unable to remember the seizure when it’s over

Causes of complex partial seizures

While epilepsy is one of the most common causes, there are other conditions that can cause a complex partial seizure. Some of these conditions are:

  • psychological distress or trauma
  • neurologic conditions
  • extreme stress
  • anxiety and depression
  • autism
  • other medical conditions related to the brain
  • damage caused prior to birth
  • neurofibromatosis

Common triggers

A complex partial seizure can happen anytime and usually without much warning. They can even occur when the person is in the middle of an activity. Sometimes the person will have an aura right before having a complex partial seizure. An aura is also called a simple partial seizure. It can act as a warning signal that a bigger seizure is coming.

There are some additional factors that can trigger a seizure, including:

  • flashing lights
  • low blood sugar
  • high fever
  • reactions to some medications

Diagnosing a complex partial seizure

Before deciding on treatment, a doctor will need to confirm that a person is having complex partial seizures. The doctor will need as many details as possible from the person having the seizures as well as from someone who has seen these episodes on a number of occasions. The doctor will need to know what happens before, during, and after each episode.

If a doctor suspects a complex partial seizure, they will usually order a diagnostic test to confirm. An electroencephalogram (EEG) may be done initially. However, the EEG will usually need to record a seizure to be accurate. Other tests that may be given to look for any potential cause of the seizures are a CT scan and an MRI. A blood test and neurological exam may be done as well. These may help the doctor find a cause (if there is a recognizable cause) without seeing an actual seizure while testing.

How are they treated and managed?

There are various types of treatment for complex partial seizures once the condition has been diagnosed. The following are some of the possible treatment options:

The type of treatment used is determined by the cause of the seizures, other medical conditions, and other factors.

Associated health conditions

A complex partial seizure can happen to anyone. However, there are some medical conditions that are more prone to these types of seizures. These medical conditions include:

  • epilepsy (most common)
  • cerebral palsy
  • infection in the brain
  • brain injury
  • tumor in the brain
  • stroke
  • some heart conditions

Sometimes a complex partial seizure will happen to someone without any known medical conditions. There is not always a cause that can be determined in some cases of complex partial seizures.

Outlook

Once diagnosed, seizures — including complex partial seizures — can be managed through a variety of treatment options. In some cases, children will outgrow the seizures.

If you think that you or someone you know is having seizures, it’s important to talk to a doctor for proper diagnosis and treatment.

You should contact a medical professional immediately if someone you know is having a seizure and any of the following is true:

  • this is the person’s first seizure
  • the seizure lasts more than five minutes
  • the person has a high fever
  • the person does not become conscious after the seizure is over
  • the person has diabetes
  • the person is or might be pregnant