How are the symptoms of cerebral palsy most commonly managed?
Cerebral palsy can’t be cured, but treatment will often improve a child’s capabilities. Many children go on to enjoy near-normal adult lives if their disabilities are properly managed. In general, the earlier treatment begins, the better chance children have of overcoming developmental disabilities or learning new ways to accomplish the tasks that challenge them.
There is no standard therapy that works for every individual with cerebral palsy. Once the diagnosis is made, and the type of cerebral palsy is determined, a team of health care professionals will work with a child and his or her parents to identify specific impairments and needs, and then develop an appropriate plan to tackle the core disabilities that affect the child’s quality of life.
A comprehensive management plan will pull in a combination of health professionals with expertise in the following:
- physical therapy to improve walking and gait, stretch spastic muscles, and prevent deformities;
- occupational therapy to develop compensating tactics for everyday activities such as dressing, going to school, and participating in day-to-day activities;
- speech therapy to address swallowing disorders, speech impediments, and other obstacles to communication;
- counseling and behavioral therapy to address emotional and psychological needs and help children cope emotionally with their disabilities;
- drugs to control seizures, relax muscle spasms, and alleviate pain;
- surgery to correct anatomical abnormalities or release tight muscles;
- braces and other orthotic devices to compensate for muscle imbalance, improve posture and walking, and increase independent mobility;
- mechanical aids such as wheelchairs and rolling walkers for individuals who are not independently mobile; and
- communication aids such as computers, voice synthesizers, or symbol boards to allow severely impaired individuals to communicate with others.
Doctors use tests and evaluation scales to determine a child’s level of disability, and then make decisions about the types of treatments and the best timing and strategy for interventions. Early intervention programs typically provide all the required therapies within a single treatment center. Centers also focus on parents’ needs, often offering support groups, babysitting services, and respite care.
The members of the treatment team for a child with cerebral palsy will most likely include the following:
A physician, such as a pediatrician, pediatric neurologist, or pediatric physiatrist, who is trained to help developmentally disabled children. This doctor, who often acts as the leader of the treatment team, integrates the professional advice of all team members into a comprehensive treatment plan, makes sure the plan is implemented properly, and follows the child’s progress over a number of years.
An orthopedist, a surgeon who specializes in treating the bones, muscles, tendons, and other parts of the skeletal system. An orthopedist is often brought in to diagnose and treat muscle problems associated with cerebral palsy.
A physical therapist, who designs and puts into practice special exercise programs to improve strength and functional mobility.
An occupational therapist, who teaches the skills necessary for day-to-day living, school, and work.
A speech and language pathologist, who specializes in diagnosing and treating disabilities relating to difficulties with swallowing and communication.
A social worker, who helps individuals and their families locate community assistance and education programs.
A psychologist, who helps individuals and their families cope with the special stresses and demands of cerebral palsy. In some cases, psychologists may also oversee therapy to modify unhelpful or destructive behaviors.
An educator, who may play an especially important role when mental retardation or learning disabilities present a challenge to education.
Regardless of age or the types of therapy that are used, treatment doesn’t end when an individual with cerebral palsy leaves the treatment center. Most of the work is done at home. Members of the treatment team often act as coaches, giving parents and children techniques and strategies to practice at home. Studies have shown that family support and personal determination are two of the most important factors in helping individuals with cerebral palsy reach their long-term goals.
While mastering specific skills is an important focus of treatment on a day-to-day basis, the ultimate goal is to help children grow into adulthood with as much independence as possible.
As a child with cerebral palsy grows older, the need for therapy and the kinds of therapies required, as well as support services, will likely change. Counseling for emotional and psychological challenges may be needed at any age, but is often most critical during adolescence. Depending on their physical and intellectual abilities, adults may need help finding attendants to care for them, a place to live, a job, and a way to get to their place of employment.
Caring for the caregivers
Addressing the needs of parents and caregivers is also an important component of the treatment plan. The well-being of an individual with cerebral palsy depends upon the strength and well-being of his or her family. For parents to accept a child’s disabilities and come to grips with the extent of their caregiving responsibilities will take time and support from health care professionals. Family-centered programs in hospitals and clinics and community-based organizations usually work together with families to help them make well-informed decisions about the services they need. They also coordinate services to get the most out of treatment.
A good program will encourage the open exchange of information, offer respectful and supportive care, encourage partnerships between parents and the health care professionals they work with, and acknowledge that although medical specialists may be the experts, it’s parents who know their children best.