What Teachers Should Know About Children with Cerebral Palsy

Children with cerebral palsy can often function adequately in a classroom environment. Yet, in most cases, they require additional assistance from teachers and teachers' aides. This poses many challenges to teachers and students alike. By the same token, properly motivated and well-taught disabled students can thrive in a classroom environment and perform academically as well as their non-disabled classmates.Teachers, whether they are assigned to teach students in regular or Special Education classes, should learn as much as they can about cerebral palsy (CP), and how it affects children with the disorder.

Cerebral palsy (CP) is defined as a group of conditions that affect the developing brain of a child and impair body movement, muscle coordination, and posture. It's caused by damage to specific parts of the brain - usually the motor control center - and usually occurs before, during, or after the baby's birth. There are many risk factors that can cause CP, including:

• Premature birth
• Low birth weight
• Inability of the placenta to provide the developing fetus with oxygen and nutrients
• Bacterial infection of the mother, fetus or infant that directly or indirectly attack the infant's central nervous system
• Lack of growth factors during intra-uterine life
• Prolonged loss of oxygen during the birthing process
• RH blood type incompatibility between mother and infant

Cerebral palsy is the most common neuromuscular disability that affcts a person's ability to control movement and posture. It is estimated that there are currently 764,000 adults and children in the U.S. that show symptoms of one or more types of CP. According to the Centers for Disease Control and Prevention (CDC), "About 1 in 323 children has been identified with CP according to estimates from CDC's Autism and Developmental Disabilities Monitoring (ADDM)." It is not a disease; it can't be transmitted from one person to another. CP is also not a progressive condition; it doesn't get worse over time.

There are four types of cerebral palsy - spastic, athenoid (or dyskinetic), and ataxic are the three major types. The fourth, mixed, occurs when a person manifests symptoms of two (or all) of the other variations of CP. Per the United Cerebral Palsy Association, each major type of CP affects the body differently:

• Spastic Cerebral Palsy: characterized by muscle stiffness and permanent contractions (This is the most common type of the disorder; it affects 80% of individuals with CP)
• Athetoid or Dyskinetic Cerebral Palsy: characterized by uncontrolled, slow, writhing movements
• Ataxic Cerebral Palsy: characterized by poor coordination and balance

The effects of CP vary from individual to individual, depending on the severity of the injury to the affected part of the brain. For instance, a child with a mild version of spastic CP may walk somewhat unsteadily but will not need braces, crutches, or a walking cane. Conversely, a child with a severe variant of athetoid or ataxic cerebral palsy might not be able to get around without a wheelchair, talk understandably, or even swallow. In addition, many children with CP also have intellectual disabilities, problems with hearing and vision, and emotional issues such as depression, social anxiety, and a propensity to show anger. Again, these issues vary from child to child - there is no such thing as a "typical child with CP.

As a result of this vast variation among school-age children with CP, teachers need to plan their teaching strategies on a case-by-case basis. Educators must base these individualized plans not on a "one-size-fits-all" formula. Instead, each of these strategies have to be tailored to each student based on the gravity of the child's symptoms and requirements.

IEPs for students with CP

Per the Individuals with Disabilities Education Act (IDEA) of 1990, every student who receives Special Education services in school must have an Individualized Education Program (IEP). This is a detailed document that explains what services the school will provide, what the student's learning strengths and weaknesses are, and how the student's academic progress will be measured. An IEP is supposed to focus on the child's specific learning issues and set detailed educational goals for the school year. Under IDEA regulations, schools must provide every service they promise they make in the IEP.

IEPs are created by a team that includes teachers, school administrators, the student's parents, and the student. During the creation of an IEP, teachers must keep in mind that each child with CP is unique. As I mentioned earlier, some students have symptoms, such as an unsteady gait, that are barely noticeable and won't affect their ability to participate in class or extracurricular activities. Students with severe ataxic cerebral palsy, on the other hand, may require a great deal of personal assistance, including help with mobility, communicating with the teacher and/or their classmates, and note-taking or writing essays during class.

Understand bullying, address stereotypes

Bullying in school is a serious issue that affects all schoolchildren, but students with cerebral palsy are more likely to be targeted by bullies because they are more physically and emotionally vulnerable. Being in an environment full of intolerance or suffering from social anxiety are also factors that make children with CP more likely to be bullied. Because bullying can cause grievous physical and emotional harm to children with special needs, it is important to factor this in when teachers, administrators, parents, and students craft an IEP for the school year.

IEPs can include the creation and implementation of programs to prevent and respond to bullying at school. In many cases, children tease or bully their disabled peers because they don't know enough about cerebral palsy. They may be afraid that CP is contagious or feel uncomfortable around a child who is twitching, drooling, or can't speak clearly. Thus, it's important for teachers to educate non-disabled students by explaining what CP is and how it affects the brain and muscles of people who have it. By dispelling stereotypes about "spazzes" and "cripples," teachers can reduce the risk of bullying of children with disabilities in schools.

Include children with CP in lectures and class participation

One of the biggest emotional problems faced by many children with cerebral palsy is that they often feel excluded from mainstream society. As a result, they suffer from feelings of isolation, depression and low self-esteem. This can have adverse effects on their academic performance and conduct in the classroom.

To alleviate this problem, teachers should always encourage their students with CP to participate in group activities in the classroom, such as small "buzz groups" to start discussions or generate ideas after lectures or multimedia presentations. The disabled students may be shy at first, but once they get the hang of it and get to demonstrate that they can contribute ideas to group discussions, they'll be more confident and feel better about themselves. Also, be sure to call on them to answer questions after a lecture; students with disabilities, including those with CP, are often bright and excel academically if they are properly motivated.

Need more information?

While I hope that this article will be useful for teachers, especially those who have not taught children with disabilities in their classrooms, it is just a brief overview of a complex topic. If you need more information about cerebral palsy, its causes, symptoms, available treatments, and other related issues, please visit Cerebral Palsy Guidance. There you'll find the latest information about CP, the latest medical advances to treat it, and a blog with inspiring and entertaining true stories about individuals who try to overcome the limits of their disability.

About the author

Alex Diaz-Granados is a freelance writer, blogger, and entertainment writer based in South Florida. He majored in journalism/mass communications at Miami-Dade College, and is the author of Save Me the Aisle Seat: The Good, the Bad and the Really Bad Movies: Selected Reviews by an Online Film Reviewer. He also writes in the Cerebral Palsy Guidance blog about his life experiences as an individual with CP.