Health and social outcomes of children with cerebral palsy
Section snippets
Clinical factors and the classification of cerebral palsy
Lloyd and Gould4 noted that variability is the fundamental reality of nature. One of the striking characteristics of CP is its variability. CP can be classified according to the type of motor impairment, which includes spasticity, dyskinesia (dystonia and choreoathetosis), and ataxia. Sometimes hypotonia is included in this classification scheme. Many children have mixed CP that involves two or more of these elements. Another way to classify CP is by location—for instance, quadriplegia,
Secondary conditions
The International Classification of Functioning, Disability and Health10 provides a classification scheme for understanding outcomes that includes body function and structure (impairments), activities, and participation (Fig 2). Environmental and personal factors are postulated to affect outcomes in all categories. Children who have CP have outcomes in all three categories. They are likely to have comorbid conditions that accompany the primary diagnosis and affect outcome, as well as secondary
Mortality
Most children with CP survive to adulthood, although the death rate is higher than in children who do not have CP. Strauss et al20 found that children with severe impairment of mobility and feeding skills had the greatest risk of dying during childhood. Data from the Western Australian Cerebral Palsy Register of children with CP born between 1958 and 1994 showed a mortality rate greater than 1% per year in the first 5 years of life; it then declined to 0.35% over the period of the next 20 years.
Interventions to improve outcomes
Most children who have CP receive multimodal therapy—for example, physical, occupational, and speech therapies; orthopedic surgery; spasticity management; and special educational support services. These therapies tend to be complementary. For example, orthopedic interventions have no effect on spasticity but address secondary problems such as contractures and lever-arm dysfunction. On the other hand, reducing spasticity has no effect on existing bony problems. Neither can improve selective
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Cited by (69)
Numerical cognition in children with cerebral palsy
2021, Research in Developmental DisabilitiesCitation Excerpt :The diversity of the motor and cognitive impairments is due to the heterogeneity of brain injuries (Sankar & Mundkur 2005; Bax et al., 2005; Straub & Obrzut, 2009; van Rooijen et al., 2015). Around 75 % of children with CP show disorders of higher cortical functioning (Liptak & Accardo, 2004). Consequently, they run the risk of presenting learning difficulties, especially regarding mathematical skills (Critten et al., 2018; van Rooijen et al., 2011).
Automatic classification of gait patterns in children with cerebral palsy using fuzzy clustering method
2020, Clinical BiomechanicsCitation Excerpt :The variability in clinical presentation and gait pattern in cerebral palsy (CP) may complicate the decision-making process (Liptak and Accardo, 2004).
From numeracy to arithmetic: Precursors of arithmetic performance in children with cerebral palsy from 6 till 8 years of age
2015, Research in Developmental DisabilitiesDeficit in implicit motor sequence learning among children and adolescents with spastic Cerebral Palsy
2013, Research in Developmental DisabilitiesCitation Excerpt :Although visible motor difficulties like spasticity and limited range of motion are defining characteristics of the impairment in CP, it has been recently acknowledged that higher-order motor planning and motor learning deficiencies also exist (Bar-Haim et al., 2010; Steenbergen & Gordon, 2006). Considering intensive efforts invested in teaching motor skills to children with CP with only limited results (Liptak & Accardo, 2004), it has been suggested that the implicit system might offer a better avenue for improvement (Steenbergen, van der Kamp, Verneau, Jongbloed-Pereboom, & Masters, 2010). This necessitates investigation of the implicit system in children with CP.