1. Cerebral Palsy
A Brief Introduction

2. What is Cerebral Palsy?
Cerebral palsy is a condition that affects muscle control and movement. It is usually caused by the brain being underdeveloped or injured before, during or after birth. Messages between the brain and muscles become jumbled. Children with cerebral palsy have difficulties in controlling muscles and movements as they grow and develop.
Cerebral palsy does not progress; the brain injury does not change. However, the effects may change over time.
Around 150 people are diagnosed with cerebral palsy every month.
There is no cure for cerebral palsy, but physiotherapy and other therapies can often help people with cerebral palsy become more independent.
No two people will be affected by their cerebral palsy in the same way, and it is important to ensure treatments and therapies are tailored to your child’s individual needs.
People with cerebral palsy have it all their lives.

3. The main causes of Cerebral Palsy are:
• Infection in the early part of pregnancy
• Lack of oxygen to the brain
• Abnormal brain development
• A genetic link (though this is quite rare)

4. Types of Cerebral Palsy
There are three main types of cerebral palsy; many people have a mixture of the three types.

6. Hemiplegia – the person is affected on one side of the body.
Mixed cerebral palsy
Many people with cerebral palsy will have a combination of the three types. The terms hemiplegia, diplegia, monoplegia and quadriplegia are commonly used when referring to cerebral palsy.
Hemiplegia – the person is affected on one side of the body.
Diplegia- the person has two limbs that are affected by cerebral palsy.
Quadriplegic – all four limbs are affected.

7. Symptoms of Cerebral Palsy:
Not all signs of cerebral palsy are visible at birth, but they may become more obvious as babies develop.
Symptoms that babies might show:
Low muscle tone (baby feels ‘floppy’ when picked up)
Unable to hold up its own head while lying on their stomach or in a supported sitting position
Muscle spasms or feeling stiff
Poor muscle control, reflexes and posture
Delayed development (can’t sit up or independently roll over by 6 months)
Feeding or swallowing difficulties
Preference to use one side of their body

8. Symptoms that toddlers and children might show:
Although the brain of toddlers/children with cerebral palsy remains injured, the injury does not get worse as they develop however, the severity of the symptoms can increase as they grow and get bigger.
Depending on the severity of their cerebral palsy, toddlers and children may experience difficulties with their physical development, speech, eating and drinking, learning and emotional development, organisational skills, sight, hearing, proprioception and understanding of abstract concepts.

9. Associated conditions
Some people with cerebral palsy may have associated conditions; while others may not. These can include:
Learning difficulty (although children with cerebral palsy cover the same range of intelligence as other children)
Epilepsy (1/3 of children with cerebral palsy have epilepsy)
Hearing impairment (only 8% of children)
Problems with sleep
Communication difficulties
Feeding difficulties
Drooling
Problems with toileting
Behaviour issues (one in four children with cerebral palsy)

10. Some Simple Things That you can do to Make things Easier for Pupils With Cerebral Palsy

11. POSITIONING

14. Handwriting
Being ready to handwrite is dependent on a number of pre-requisites:
Developmental readiness
Body awareness
Sensory experiences
Postural stability and balance
Control of trunk, shoulders, forearm and wrist
Ability to cross midline
Bilateral integration
Good coordination of arm, hand / eye movements
Grasp and hand function

15. RECORDING
Recording is often very difficult for children with cerebral palsy. ALWAYS consider why you are asking a child to handwrite.
Why should a child be copying from the board? What are they learning?
Date and Learning Objective. What are they learning by copying it down?
Consider:
Pre-prepare sheets so they only have to tick boxes, give single word answers or use a highlighter pen to show what they know.
Pre-prepare diagrams
Short bursts of handwriting rather than sustained eg note taking
Pair with a buddy to record work
Use IT to record eg Clicker 6 or Write on Line
Record work using a Dictaphone (notes or sustained work)
Develop touch typing skills BBC Bitesize Dance Mat Typing
Always strive for independence and ascertaining what the pupil knows rather than how much they can handwrite in a given time/legibly.

16. Cerebral Palsy Checklist:
Positioning
Stability, balance, view of activity, concentration
Fluctuating health
● What a pupil was able to do yesterday they may not be able to do today
Energy Conservation
Muscles have to work harder – so may get more tired
Reducing Recording
Always consider the purpose of the lesson
Encourage Independence
Facilitate, but don’t create over dependency