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Table of Contents
Each person is unique, and each disability affects each person differently. The information in this section is a very simple overview of some common disabilities. It is aimed to provide a starting point for more research. Use the assessment tools to learn as much as you can about the individual. The person with the disability and/or their caregiver will understand their abilities better than anyone else.
Cerebral Palsy (CP)
A group of disorders that affect the ability of the brain to control muscle movement. The damage to the brain occurs during pregnancy or during or just after birth. Depending on which part of the brain is affected CP may affect muscle tone, coordination, control, reflex, balance, and posture. The effects may or may not improve or worsen over time.
Individuals with cerebral palsy may or may not have an associated epilepsy, cognitive impairment, and/or sensory impairment. There are different terms used relating to the classification of CP that may refer to severity, the area of the body affected, or motor function.
Severity
- Mild – does not need assistance.
- Moderate – Needs assistance and some aids.
- Severe – faces significant challenges and usually uses a wheelchair.
Area of Body Affected
- Hemiplegia – one side
- Paraplegia – legs
- Diplegia – legs more than arms
- Tetra/Quadriplegia – all four limbs affected
Muscle Tone
- Hypertonic, spastic refers to high muscle tone or stiff, tight muscles.
- Hypotonic, flaccid refers to low muscle tone or loose floppy muscles (less common).
Motor Function
- Spastic, the most common type of CP around 70-80%. Normally when one muscle group tightens another corresponding muscle group will relax. With spasticity, both muscle groups will tighten. Depending on the stiffness of the muscle’s movement may also be stiff or jerky. If the muscles are permanently shortened, movement may be fixed or difficult.
- Dyskinetic affects 10-20%. The muscle tone can quickly change from stiff to relaxed causing uncontrolled involuntary movements or spasms, often described as slow writhing movement. Can affect the muscles movements used for speech which is known as dysarthria. The effects may be more pronounced in stressful situations. It is sometimes referred to as Athetoid when it affects the limbs with a resultant writhing movement, and Dystonic when it refers to the trunk often resulting in a twisted posture.
- Ataxic affects around 10%. Ataxia relates to coordination of movement and is often accompanied by low muscle tone. Individuals may have poor coordination with an unsteady gait and characteristic shakiness. Balance and depth perception may also be affected.
- Mixed affects around 10%. As several or all movement centres of the brain are affected the resultant effects are a mix of the above.
Teaching Considerations
- Do not force or stress limbs into specific positions; loosely support or strap limbs if necessary to prevent injury.
- Monitor the effects of fatigue, temperature, and anxiety on the person’s movement.
Common Red Flags
- Balance problems
- Bladder problems
- Fatigue
- Alignment
- Affected muscle control
- Speech aphasia/dysarthria