Category: Cerebral Palsy

How Dyspraxia Differs from Other Development Delays in Children

On By KennethIn Apraxia, Brain Injury, Cerebral Palsy, Dyspraxia1 Comment

Dyspraxia definition

Dyspraxia is a brain-based motor disorder. It affects fine and gross motor skills, motor planning, and coordination. It’s not related to intelligence, but it can sometimes affect cognitive skills.

Dyspraxia is sometimes used interchangeably with developmental coordination disorder. While some doctors may consider these separate conditions, due to a lack of formal definition, others consider them the same.

Children born with dyspraxia may be late to reach developmental milestones. They also have trouble with balance and coordination.

Into adolescence and adulthood, symptoms of dyspraxia can lead to learning difficulties and low self-esteem.

Dyspraxia is a lifelong condition. There’s currently no cure, but there are therapies that can help you effectively manage the disorder.

Dyspraxia symptoms in children

If your baby has dyspraxia, you might notice delayed milestones such as lifting the head, rolling over, and sitting up, though children with this condition may eventually reach early milestones on time.

Other signs and symptoms can include:

  • unusual body positions
  • general irritability
  • sensitivity to loud noises
  • feeding and sleeping problems
  • a high level of movement of the arms and legs

As your child grows, you might also observe delays in:

Dyspraxia makes it hard to organize physical movements. For example, a child might want to walk across the living room carrying their schoolbooks, but they can’t manage to do it without tripping, bumping into something, or dropping the books.

Other signs and symptoms may include:

  • unusual posture
  • difficulty with fine motor skills that affect writing, artwork, and playing with blocks and puzzles
  • coordination problems that make it difficult to hop, skip, jump, or catch a ball
  • hand flapping, fidgeting, or being easily excitable
  • messy eating and drinking
  • temper tantrums
  • becoming less physically fit because they shy away from physical activities

Although intelligence isn’t affected, dyspraxia can make it harder to learn and socialize due to:

  • a short attention span for tasks that are difficult
  • trouble following or remembering instructions
  • a lack of organizational skills
  • difficulty learning new skills
  • low self-esteem
  • immature behavior
  • trouble making friends

Dyspraxia symptoms in adults

Dyspraxia is different for everyone. There are a variety of potential symptoms and they can change over time. These may include:

  • abnormal posture
  • balance and movement issues, or gait abnormalities
  • poor hand-eye coordination
  • fatigue
  • trouble learning new skills
  • organization and planning problems
  • difficulty writing or using a keyboard
  • having a hard time with grooming and household chores
  • social awkwardness or lack of confidence

Dyspraxia has nothing to do with intelligence. If you have dyspraxia, you may be stronger in areas such as creativity, motivation, and determination. Each person’s symptoms are different.

Dyspraxia versus apraxia

Though these two terms sound familiar and are both brain-based conditions, dyspraxia and apraxia are not the same.

Dyspraxia is something that someone is born with. Apraxia can develop following a stroke or brain injury at any point in life, though certain types may have genetic components.

There are several types of apraxia which affect different motor functions. It’s often thought to be a symptom of a neurological, metabolic, or other type of disorder.

Apraxia may go away on its own within weeks, especially if it’s the result of stroke.

It’s possible to have both dyspraxia and apraxia.

Dyspraxia causes

The exact cause of dyspraxia isn’t known.

It could have to do with variations in the way neurons in the brain develop. This affects the way the brain sends messages to the rest of the body. That could be why it’s hard to plan a series of movements and then carry them out successfully.

Dyspraxia risk factors

Dyspraxia is more common in males than females. It also tends to run in families.

Risk factors for developmental coordination disorders may include:

It’s not unusual for a child with dyspraxia to have other conditions with overlapping symptoms. Some of these are:

Although some symptoms are the same, these other conditions don’t involve the same fine and gross motor skill issues of dyspraxia.

Other conditions like cerebral palsy, muscular dystrophy, and stroke can cause physical symptoms similar to dyspraxia. That’s why it’s so important to see a doctor to get the correct diagnosis.

Diagnosing dyspraxia

The severity of symptoms can vary a lot from child to child. It may not be apparent that your child isn’t developing certain skills for several years. A diagnosis of dyspraxia may be delayed until a child is 5 years or older.

If your child often runs into things, drops things, or struggles with physical coordination, it doesn’t mean they have dyspraxia. These symptoms could be a sign of a number of other conditions — or nothing at all.

It’s important to see their pediatrician for a thorough evaluation. A doctor will assess such factors as:

  • medical history
  • fine motor skills
  • gross motor skills
  • developmental milestones
  • mental abilities

There are no specific medical tests to diagnose dyspraxia. The diagnosis may be made if:

  • motor skills are significantly below what’s expected for their age
  • a lack of motor skills has a persistent negative effect on day-to-day activities
  • symptoms began early in development
  • other conditions with similar symptoms have been ruled out or diagnosed

Dyspraxia is more often diagnosed as developmental coordination disorder (DCD).

Dyspraxia treatment

For a small number of children, symptoms resolve on their own as they age. That’s not the case for most children, though.

There’s no cure for dyspraxia. However, with the right therapies, people with dyspraxia can learn to manage symptoms and improve their abilities.

Because it’s different for everybody, treatment must be tailored to individual needs. The treatment plan will depend on a number of factors. The severity of your child’s symptoms and other coexisting conditions are key to finding the right programs and services.

Some of the healthcare professionals you may work with are:

  • behavior analysts
  • occupational therapists
  • pediatric specialists
  • physical therapists
  • psychologists
  • speech and language therapists

Some children do well with minor interventions. Others need more intense therapies to show improvement. Whatever therapies you choose, they can be adjusted along the way.

Your healthcare team can help identify problem areas. Then they can work on breaking tasks down into manageable pieces.

With regular practice, your child can learn how to better manage tasks such as:

  • tying shoes or self-dressing
  • using eating utensils properly
  • using the toilet
  • walking, running, and playing
  • organizing an approach to schoolwork

Therapy can help your child gain confidence, which may also help them socially. Your child’s school can provide special services and accommodations to make learning easier.

Adults can benefit from occupational therapy as well. This can help with practical, everyday matters involving small motor skills and organizational skills.

Cognitive behavioral therapy, or talk therapy, can help modify thinking and behavior patterns that shake your confidence and self-esteem.

Even if you have physical difficulties, it’s still important to exercise regularly. If this is a problem, ask a doctor for a referral to a physical therapist or look for a qualified personal trainer.

Takeaway

Dyspraxia is a developmental coordination disorder. This lifelong condition affects gross and fine motor skills, and sometimes cognitive function.

It shouldn’t be confused with an intellectual disorder. In fact, people with dyspraxia can have average or above average intelligence.

There’s no cure for dyspraxia, but it can be successfully managed. With the right therapies, you can improve organizational and motor skills so you can live life to the fullest.

Growing up with Cerebral Palsy

On By KennethIn Cerebral Palsy, Mobility, Muscle Coordination4 Comments

Children who have cerebral palsy cannot always count on having a “normal” life in many regards. The first thing they always face as a challenge is mobility. Even if they have excellent mobility most of the time, many cerebral palsy sufferers suffer from debilitating muscle spasms from time to time. People with cerebral palsy can live rich, fulfilling lives. Growing up, however, can be difficult for several reasons.

Cerebral Palsy

One of the risks that anybody with mobility impairments has is becoming isolated. It’s simply harder to get around if you have mobility impairment. If your child requires a wheelchair to get around but enjoys spending time with their friends, it’s easy to see how the mobility impairment could become a problem at a certain point. When your child’s friends all start getting driver’s licenses, they may not be able to take your child out with them because of not having room to stash the wheelchair in transit. This is why mobility vans are oftentimes among the first purchases when people have a child with cerebral palsy.

In some cases, people with cerebral palsy need some extra assistance in school. Sometimes, people with cerebral palsy attend normal classes like everyone else. There are quite a few people with cerebral palsy who do very well at school but who have difficulty with one subject or another. You may have to accommodate this by paying for tutors or extra classes. This can be somewhat isolating, as well.

The most severe cases of cerebral palsy are very debilitating. It may be almost impossible for your child to do anything on their own. For people with cerebral palsy, the most difficult tasks are oftentimes those that require the most developed muscle coordination. For example, opening a door can be exceptionally difficult if you can’t get your arms to stop shaking every time you try to grasp the knob. This is an example of what quite a few cerebral palsy sufferers have to deal with in terms of negotiating everyday life.

Spastic Cerebral Palsy

On By KennethIn Cerebral Palsy, Nerves, Posture, Sinal Cord, Spastic1 Comment

Spastic cerebral palsy is the most common form of the disorder, affecting around 70% to 80% of all people diagnosed. This form of cerebral palsy mainly affects the muscle groups, but may cause associated disorders as well. [1]

Spastic cerebral palsy occurs as a result of brain damage, usually before or during birth, or sometimes within the first years of a child’s life. It’s a disorder that affects coordination and control of motor function. This causes the child to be delayed in reaching normal developmental milestones, and that is when it becomes more evident. [2]

Muscles need enough tone in them to maintain correct posture, to enable standing and walking, and to maintain speed and flexibility. Motor nerve fibers, via the spinal cord, interact with the muscles to help control how they move.

For someone with spastic cerebral palsy, brain damage affects muscle control, coordination, and movement, mainly in the arms and legs. In turn, this influences the way the spinal cord and nerves react, which then causes the muscles to become tense, and spastic. [3]

Children born with spastic cerebral palsy do not usually have limb deformities at birth, but over time these may develop, due to muscle tenseness and stretching limitations.

Spastic cerebral palsy may be classified as quadriplegic, diplegic, or hemiplegic, according to how and where it affects the body.

Spastic Cerebral Palsy Symptoms

Spastic cerebral palsy, also known as hypertonic cerebral palsy, is characterized by hypertonia, meaning increased muscle tone, and leads to stiff, and sometimes painful limbs. [4]

Symptoms may include:

  • Involuntary limb movements
  • Continuous muscle spasms and contractions
  • Abnormal walking, marked by knees crossing in a scissor-like movement
  • Joint contractures
  • Limited stretching abilities
  • Flexion at the elbows, wrists, and fingers
  • Poor coordination and control of muscle movements

These symptoms can make it difficult for those with spastic cerebral palsy to walk, get dressed, brush their teeth, use the bathroom, and take a shower without assistance. The limitations on activities of daily living (ADLs) will depend on how severe the disorder is. Children with mild cases of spastic CP may not need any help but may still have mild difficulties with ADLs.

If both legs are affected, children may also have problems transferring from one position to the next, standing and sitting upright, walking, and running.

Children with spastic cerebral palsy may also develop other nervous system-related symptoms, which may include:

  • Speech difficulties
  • Hearing problems
  • Vision abnormalities
  • Cognitive, learning and behavioral disabilities [5]
  • Seizures

Related problems may include:

  • Drooling
  • Difficulties with chewing and swallowing
  • Hoarse voice or speech problems
  • Breathing irregularities
  • Failure to thrive or poor weight gain
  • Gastric reflux
  • Constipation and bladder incontinence
  • Spinal and joint deformities

Treatment Options for Spastic Cerebral Palsy

Although there’s no cure for any form of cerebral palsy, there are a number of treatment options available to help control the symptoms, including:

  • Physical therapy, as well as language, occupational, and behavioral therapies
  • Medications to control symptoms, such as muscle spasms or seizures
  • Baclofen pump (to help control muscle spasticity)
  • Spine or spinal cord surgery (to repair scoliosis or reduce spasticity)
  • Muscle-release and tendon-lengthening surgery
  • Devices to aid in communication
  • Orthotics, braces or other devices to help with positioning, standing or muscle control
  • Constraint-induced therapy (CIT)

Keep in mind that treatment options will depend on the age of the child, how severe the symptoms are, and any associated disorders. Most parents will work with a team of medical experts to implement the best treatments for the child, including therapists, surgeons, dietitians, and neurologists. [6]

Spastic Cerebral Palsy Prognosis

Again, there is no cure for spastic cerebral palsy, but with the proper treatment, children can grow up and thrive as adults. It’s essential, however, to start a treatment plan as early as possible for the child to have the best outcomes, not only as an adult but as he or she grows along the path through childhood and into adolescence.

Cerebral Palsy and Pregnancy

On By KennethIn Brain Damage, Cerebral Palsy, Genetics, Infections, Oxygen, PregnancyLeave a comment

Brain damage during pregnancy can have severe effects on a child and can occur for many different reasons. In any case where a child is born with cerebral palsy, there will be an investigation into the cause of that brain damage so that doctors can determine what happened. There may be a range of reasons that a child’s brain was damaged at birth, but some of them are more common than others are.

Brain injuries that occur during pregnancy can have many different causes. Genetics can certainly play a role. In some cases, the genetic factors involved will prevent the brain cells from forming and migrating where they would normally be located, and this can lead to cerebral palsy.

There is also a condition that sometimes causes cerebral palsy that involves the development of nerve cell fibers. These fibers have a protective covering that sometimes fails to form as expected. When this happens, it can cause problems with the nerves being able to transmit signals as they normally.

Illnesses

Sometimes, the mother will contract an infection or other ailment that will end up harming the child while they’re in the womb. This may not be known until the child is born and the condition is actually diagnosed. In such cases, it may be found that the damage could not have been prevented, or conversely, the child may have been damaged due to a lack of appropriate and timely care or due to another medical mistake. It’s important to understand that not all brain damage is the result of a mistake on any medical provider, or most certainly, not because of anything the mother did. Sometimes, people simply fall ill and brain damage is a result of that illness.

Pregnancy Complications

Children sometimes suffer brain damage in the womb due to low amniotic fluid or for other reasons. This is sometimes avoidable, sometimes, not. When a woman has a high-risk pregnancy, doctors may recommend that a Cesarean section is performed to minimize the risk to mother and child. With today’s medical technology, it’s much easier for physicians to detect these issues before they manifest into more serious problems, and because of that, children are oftentimes spared such injuries today when they almost certainly would have suffered them before.

Trauma

Sometimes, trauma that ruptures blood vessels or that causes oxygen deprivation can end up causing CP injuries. This trauma may occur in the womb or it may occur during birth. The trauma can sometimes cause the connections that provide proper communication between the nerves and the brain cells to be severed, as well, and this can lead to cerebral palsy in the newborn.

Cases where trauma could have been prevented are among the most tragic cases when children end up suffering with CP. This is sometimes the result of negligence on the part of a physician, a midwife or a nurse. There are options for the families that have been affected by this type of negligence and it’s not necessary for those families to assume that they’re on their own in these instances.

Negligence

Negligence is sometimes the reason that children suffer brain damage during pregnancy. This may be because the doctor fails to diagnose a condition or because they make a wrong diagnosis. It also may be because the doctor fails to deliver care that the child and mother need, creating a delay during which the child is injured.

In situations where negligence is the issue that caused the injury, the families sometimes sue for compensation. This is one way that they can get financial assistance so that they can support their child. These cases do not always win but, when they do, the jury awards or settlements are sometimes enough to help the family pay for needed medical care.

Cerebral Palsy – Athetoid

On By KennethIn Ataxia, Athetoid, Brain Trauma, Cerebral Palsy, Lack of oxygen, MeningitisLeave a comment

What is Athetoid Cerebral Palsy?

Athetoid cerebral palsy (also known as “dyskinetic cerebral palsy”) is a movement disorder caused by damage to the developing brain.

Children with athetoid CP fluctuate between hypertonia and hypotonia. Hypertonia is used to describe unusually high muscle tone, which creates stiffness and tension in the muscles. Hypotonia is used to describe unusually low muscle tone, which causes “floppiness” in the muscles. This inability to regulate muscle tone is what causes CP symptoms.

Athetoid CP can also result in issues surrounding voluntary movement in the hands, arms, feet and legs — making it hard to walk or grasp objects. Treatment for this type of cerebral palsy is centered on various therapies, medications and surgeries that can help to manage symptoms and prevent any future complications.

Types of Athetoid CP

Athetoid cerebral palsy may be given other distinctions to further classify the condition based on the specific type of involuntary movement.

The various types of athetoid CP include:

  • Dystonia – Slow, rotational movement of the torso, arm or leg.
  • Chorea – Sudden involuntary movements, especially in fingers and toes.
  • Athetosis – Sluggish, writhing movements, mainly in fingers and face.
  • Choreoathetoid – A combination of chorea and athetosis.
  • Ataxia – Loss of balance and coordination.
  • Rigidity – High muscle tone due to hypertonia causes restricted movement.
  • Dyskinesia – General term to describe involuntary movements. Athetoid CP is often interchangeably referred to as dyskinetic CP for this reason.

Causes and Risk Factors

Athetoid cerebral palsy is one of several types of movement disorders caused by a brain injury. Each type of cerebral palsy differs based on which part of the brain is damaged. 

Basal ganglia damage

The basal ganglia are a group of nuclei in the brain responsible for coordinating voluntary movement. The basal ganglia are located within the cerebral cortex, a part of the brain that helps control motor function. The basal ganglia also help regulate thinking and learning. Damage to the basal ganglia affects motor function development and causes involuntary movements.

Cerebellum damage

The cerebellum is responsible for regulating coordination and precision of movements — both of which are essential to fine motor skills and balance. When the cerebellum is damaged, balance and coordination become more challenging. The cerebellum is also an important part of cognitive functions, such as communication and attention. A damaged cerebellum can cause co-occurring disorders, such as autism or epilepsy.

Damage to the cerebellum and/or basal ganglia can be caused by:

Certain risk factors increase the chances of brain injuries that cause athetoid cerebral palsy. In general, the risk factors for all types of CP are the same, including: premature birth, severe infantile jaundice and blood clotting in the placenta.

Symptoms of Athetoid Cerebral Palsy

The signs and symptoms of athetoid CP vary based on the severity of the condition and location of movement issues. The symptoms of athetoid cerebral palsy are a result of problems with both high and low muscle tone, which can vary on a daily basis. High muscle tone causes stiffness and jerky movement. Low muscle tone causes floppiness in the muscles, characterized by issues such as trouble sitting up.

The most common symptoms associated with athetoid CP are:

  • Involuntary movement
  • Tremors
  • Poor posture
  • Unsteadiness
  • Twisting of the torso
  • Slow, writhing movements
  • Abrupt movements
  • Grimacing or drooling

The symptoms of athetoid CP depend on whether the damage was solely to the basal ganglia, or if both the cerebellum and basal ganglia were damaged. If both areas are damaged, this will likely cause problems with balance and coordination.

Parents and caregivers usually begin noticing signs of involuntary or jerky movements when their child is around 9 months or older. In many young children, irregular movement may be indicative of a developmental delay, but not necessarily a sign of cerebral palsy.

Athetoid cerebral palsy may be present in a child who:

  • Doesn’t kick legs
  • Seems stiff or rigid
  • Seems limp
  • Doesn’t hold up head at three months old
  • Doesn’t reach for objects
  • Doesn’t smile by three months old
  • Doesn’t roll over

Treatment for Athetoid CP

Although there is no cure for cerebral palsy at this time, children with this condition generally grow up to live healthy, meaningful lives as they transition into adulthood.

Treatment for cerebral palsy helps children with this disorder become more independent and confident in their abilities. Treatment methods such as physical therapy and speech therapy help improve existing symptoms, while also preventing any future complications later in life.

Physical therapy

Physical therapy typically incorporates a series of strength training exercises, resistance bands and machines to help improve low muscle tone. Physical therapists work with children and adults with CP to overcome any sensory impairments, such as touch and depth perception, that make movement more difficult.

Therapy for this type of CP is typically based on improving overall mobility. This includes exercising the face and tongue muscles, as grimacing and drooling is common in children with this type of CP. Athetoid CP can also cause difficulties holding posture or keeping the body in a steady, upright position. Physical therapists will use various exercises to increase the strength in these muscles and prevent any further complications.

Occupational therapy

Occupational therapy is used to enhance a child’s ability to independently play and learn. An occupational therapist will help to make everyday tasks, such as grasping objects, writing or using assistive mobility devices, easier on a child with this type of CP.

Specific exercises used in occupational therapy for athetoid CP include stretching with weights and resistive equipment, as well as incorporating functional and playful activities to keep children interested. Occupational therapy will allow children to form relationships and respond to the demands of daily life with increased mobility and confidence.

Speech therapy

For those diagnosed with CP, speaking, eating or breathing can be a challenge. Speech therapy is used to alleviate these problems, as well as increasing language and vocabulary development, articulation and breathing control.

After working with a speech therapist for a series of sessions, people with CP often begin to have more control over their face and tongue muscles. Speech therapy can also make daily tasks easier on a child with athetoid CP, allowing for increased independence.

Medication

Most of the medications prescribed for athetoid cerebral palsy are used to treat secondary conditions that result from developmental brain damage. For example, anticonvulsants are used to reduce seizures and over-the-counter acid reflux medications, such as Zantac, are prescribed for children with weak gastroesophageal muscles.

Ritalin and other medications treat attention deficit hyperactivity disorder (ADHD), which is diagnosed in up to 20 percent of children with CP. Medications to control drooling and incontinence are also useful for those with athetoid cerebral palsy.

Surgery

Surgery for children with cerebral palsy is used to correct and prevent issues with the joints, muscles and tendons by correctly aligning parts of the body to foster healthy growth. Although it is not common in athetoid CP, surgery can be used to correct joint deformities and dislocations due to high muscle tone.

Embracing A Life with CP

While a cerebral palsy diagnosis may come as a surprise to many families, this is a condition that can be managed effectively through proper treatment and continued care. There are bound to be some challenges along the way, however, maintaining a positive outlook can allow children and adults to embrace life with CP.

To learn more about athetoid cerebral palsy, try downloading our free Cerebral Palsy Guide. This guide includes 60 pages of in-depth information for families affected by cerebral palsy.

Cerebral Palsy in Children

On By KennethIn Ataxic, Athetoid, Cerebral Palsy, Neurological, SpasticLeave a comment

WHAT IS CEREBRAL PALSY?

Cerebral Palsy is a term used to cover several neurological conditions.

These conditions are caused before, during or shortly after birth as a result of injury to the brain due to any of the following reasons:Limited or interrupted oxygen supply to the brainA bleed within the baby’s brain
A premature or difficult birth processThe mother catching an infection whilst pregnantChanges in genes which affect the development of the brain 
Cerebral Palsy can affect muscle control, coordination, and tone, reflexes, posture and balance. Often a person with Cerebral Palsy will display signs of the condition, but the effects can vary greatly from person to person		‘Cerebral Palsy’ comes from the Latin words ‘Cerebrum’ and ‘Paralysis’

WHAT ARE THE DIFFERENT TYPES OF CEREBRAL PALSY?

The NHS describes three different categories of Cerebral Palsy, it is also possible to have a combination of categories which is referred to as ‘Mixed Cerebral Palsy’.

Spastic Cerebral Palsy
This affects muscle stiffness or weakness. Click here to learn more.
Athetoid Cerebral Palsy
This affects muscle tone, causing involuntary spasms. Click here to learn more.
Ataxic Cerebral Palsy
This affects balance and coordination. Click here to learn more.

The affect Cerebral Palsy has on individuals ranges from the very mild, to more severe cases that can make it difficult for people to control their limbs.