Right here you can find literature about Health condition, Impairment, Activity limitation, Personal factors and Environmental factors.
To help you as a professional and the community.
Read, learn, spread love and share your knowledge

Health Condition

Types of CP

Cerebral palsy is different in every child.  Experts have worked out different ways of describing the types of CP. It is good to know that CP can appear in four main ways. It may appear in one or more of these ways, mostly in some sort of combination.
The four different types are:

  • Muscle stiffness or tension, also known as ‘Spasticity’
    • Movements are slow
    • Stiffness increases when a child is excited or upset
    • The child has no control over these movements
  • Uncontrolled Movements, also known as ‘Athetosis’ or ‘Dyskinetic’
    • Children can find it hard to stay still
  • Muscles can be floppy
    • It will make the child tired quickly
    • It can make it difficult for a child to move
  • Poor balance, known as ‘Ataxia’
    • This will make it difficult for a child to sit
    • The child falls often because of poor balance

Early signs of CP/how to diagnose  

In some cases, early signs are visible when a child is a few months old, but many children are not diagnosed until age 2 or later. When you can recognize the early signs and the signs and symptoms, you can, in a simple way, diagnose CP. 

Assessment of Neurodisability and Malnutrition in Children in Africa 
This research describes the relation between neurological developmental delays, Neurodisability and malnutrition. Also, where improvements can be made, in assessing children. 
If there is no integrated approach, children and families will not be sufficiently supported to achieve their best potential results.

Early markers for cerebral palsy: insights from the assessment of general movements
In this study, they are looking for early signs for cerebral palsy. Children aged a half year old, do not show clear symptoms. One of the most reliable early marks is abnormal ‘general movements’

Risk factors

A review of the incidence and prevalence, types and aetiology of childhood cerebral palsy in resource-poor settings
80% of children living in resource-poor settings have a disability. It is likely that there is a high prevalence of cerebral palsy in these settings. This study’s aim is to review recent literature relating to the incidence, prevalence, aetiology and type of cerebral palsy in low-income settings.

Evaluation of risk factors of cerebral palsy in tertiary health facility, Nnewi, Nigeria: a case-control study
This case-control study evaluates the risk factors associated with cerebral palsy in Nnamdi Azikwe University Teaching Hospital in Nnewi, Nigeria. The study shows that birth asphyxia is the biggest risk factor associated with cerebral palsy. After that, neonatal jaundice and postnatal infection and then intrauterine infection.

The Interaction of Malnutrition and Neurologic Disability in Africa 
Malnutrition and Neurodisability are both major public health problems in Africa. This review describes the main similarities and how they can reinforce each other. It starts with the neurological development of the fetus that can have lifelong implications. Maternal malnutrition can also increase the risk of perinatal problems. It is concluded that there is an urgency need for nutrition and disability programs to work more closely together. 

How CP can affect the body 

CP affects the body in many ways, examples are: 

  • Difficulty in seeing and hearing 
  • Intellectual disabilities  
  • Oral diseases 
  • Abnormal touch or pain perceptions 
  • Seizures  
  • Mental health conditions 
  • Bowel and bladder control 

These articles will give more information about Cerebral Palsy and how it affects the body.  

Early intervention

There are many psychical and speech development activities. You can learn these interventions and can learn the parents or other healthcare workers how to do it, for children with CP. 

Global perspective on early diagnosis and intervention for children with developmental delays and disabilities
This study discusses the current practice of early detection and intervention, the feasibility of early detection and intervention, the barriers in governments and other agencies and the path forward.

Screening for developmental delays

Community-based parent-delivered early detection and intervention programme for infants at high risk of cerebral palsy in a low-resource country 
This study determined the accuracy of the General Movements (GMs) / Hammersmith Infant Neurological Examination (HINE). This is for detecting CP at aage of children from 18 months. The effectiveness of early intervention for infants conducted by the community in West Bengal and India is being investigated.Positive results indicate the effects of early interventions. These are, for example: significant improvements in children’s cognition, language and social-emotional development. 

Red Flags Early Identification Guide
This guide is for health professionals who are working with families with children who have cerebral palsy. With the guide you can help families to identify developmental concerns early.

This is for children aged from birth to five years old and is divided into three categories: social emotional, communication, cognition fine motor selfcare and gross motor.

Developmental screening in South Africa: comparing the national developmental checklist to a standardized tool
In South Africa the only nationally implemented developmental ‘screening’ tool is integrated.
From this it emerges that the development checklist identified no more than half of infants at risk of delays or conditions. The nationally implemented development checklist is not effective in identifying babies at risk.

Impairment

Co-morbidities

Pediatric Cerebral Palsy in Botswana: Etiology, Outcomes, and Comorbidities 
This research is specifically about children with Cerebral Palsy in low-resource settings. It shows that children with Cerebral Palsy in these kinds of setting have a higher prevalence of comorbidities than children with Cerebral Palsy in high-resource settings. 

Cerebral palsy in children in Kampala, Uganda: clinical subtypes, motor function and co-morbidities.  
This research was set up because there is limited information about Cerebral Palsy and co-morbidities in Sub-Saharan Africa. The research was done in a tertiary hospital in Uganda, attending children with Cerebral Palsy. The most common co-morbidities of children with Cerebral Palsy were signs of epilepsy (45%) and learning disability (75%).

Pain

Eina! Ouch! Eish! Professionals’ Perceptions of how Children with Cerebral Palsy Communicate About Pain in South African School Settings: Implications for the use of AAC.
This study is about the communication of pain in children with Cerebral Palsy in South African schools. The children were observed and interpreted by professionals. It is providing evidence that the communication of pain is verbal or non-verbal (body position changes of expression in their faces).

Professionals’ Perceptions about the Need for Pain Management Interventions for Children with 
Cerebral Palsy in South African School Settings 
This study is about the need for pain management in children with Cerebral Palsy at South African schools. This study says that pain management would be more effective if professionals at South African schools were offered to increase their knowledge through education. It would also help if professionals had access to a prevention and follow-up program for children with Cerebral Palsy. If this will happen, it will provide children with Cerebral Palsy to participate in school activities, despite their pain.

Sleeping

Prevalence and factors associated with sleep disorders among children with cerebral palsy in Uganda; a cross-sectional study 
This study is about children with Cerebral Palsy in Uganda and the factors and signs of sleep
 disorders. It shows that children with Cerebral Palsy have a higher prevalence of sleep disorders. It also says that the presence of epilepsy and severe disability were associated with sleep disorders among children with Cerebral Palsy.

Epilepsy

What is epilepsy?
A seizure is a uncontrolled, sudden, electrical disturbance in the brain. A seizure can cause a change in behavior, feelings, movements and in levels of consciousness. Most seizures last no longer than two minutes. After a seizure the child might feel weak, confused or sick.
If a child has two or more seizures or a tendency to have recurrent seizures, he/she has epilepsy.

What can you do?

  • Do not force movements, protect the child
  • Lay the child on their side
  • Do not put anything in the child’s mouth
  • The child’s head need to be turned to one side
  • Go to a clinic and see a doctor for medications. A seizure is not an evil spirit an cannot be cured by a traditional doctor

Feeding problems- eating and drinking

Children with cerebral palsy in Ghana: malnutrition, feeding challenges and caregiver quality of life
This study shows that the prevalence of malnutrition is very high among children with cerebral palsy in Ghana. 65% of children aged under five years were categorized as underweight, 54% as stunted and 58% as wasted. There is a need for accessible and appropriate caregiver training and support around feeding practices of children with cerebral palsy.

Controlling saliva

It is difficult for a child with cerebral palsy to move their tongue, that is why it is also difficult to swallow. A child with cerebral palsy drools a lot and has his mouth open most of the time. This situation allows germs to collect in the mouth. If a child chokes, it is possible that these germs are going down into the lungs. That is why it is important to brush a child’s teeth and take extra care.

Drooling 
This review article is about drooling. Drooling can be caused by neurological disorders, causing saliva to spill from the mouth. The purpose of this research is to emphasize the clinical aspects of the assessment and drool management. 
In this review the next subjects will be explained: 

  • Salivary secretion and physiology of swallowing
  • Etiology and prevalence of drooling
  • Clinical features of drooling
  • Assessment of drooling
  • Management of drooling 

Controlling bladder and bowel

Lower Urinary Tract Dysfunction in Children With Cerebral Palsy
This study evaluates possible renal damage and urodynamic findings in children with cerebral palsy that have urinary symptoms. Around one-third of the children with cerebral palsy and urinary symptoms presented with normal urodynamic findings. The findings that were most frequent were:

  • Detrusor overactivity
  • Reduced bladder capacity
  • Increased post-void residual

There were no urinary tract complications observed.

Urinary Incontinence in Adults With Cerebral Palsy: Prevalence, Type, and Effects on Participation
This study wants to assess the type, impact and prevalence of urinary problems in adults with cerebral palsy and their relation with the GMFCS. 91 adults with cerebral palsy participated in this study. The study shows that there are high levels of incontinence in adults with CP. These adults tell that this is a barrier in their quality of life. Although they have these issues, it does not relate to employment.

Seeing

Ocular Manifestations in Children with Cerebral Palsy
This study was set up to determine the frequency and nature of ocular abnormalities in children with cerebral palsy in Nepal. The average age of children that participated in this study was between 4 and 6 years old. Ocular abnormalities were shown in 86% of the children. It is important to increase awareness to the health professionals and parents.

Activity Limitation

Effect on daily life

It is hard for children with Cerebral Palsy to participate in ADL’s. It is important for parent to be supported and trained in how they can involve their child in ADL’s. There are a few points were parents can be trained in: 

  • Help the child participate to the best of their ability/potential 
  • Try to develop new skills 
  • Engage in communication/cognitive/play activities with the child 
  • Give the child options 
  • Create a bond between the child and the caregiver 
  • Activities of daily living = therapy/development time 
ADLs

Personal Factors

Intellectual disabilities

Children can laugh at children with CP. This may be because he is not as fast as he is, or because he cannot understand, follow, or remember things as easily as others can. Some children may seem dull or lacking intelligence, because they move slowly or are limp. Other children with CP move so awkwardly that is seems that they lack of intelligence.
This activity is designed to help children gain greater appreciation for both the needs and capabilities of the mentally slow child, at his or her own pace. The child has the same need for friendship, play and respect as she does. They will explore possible ways to help the child feel part of their group and learn new things.

Love, sex and social adjustment

Making sense of sex With People With Cerebral Palsy
This study addresses three questions:

  1. The relative salience of public, interactional and private sexual schema in the construction of sexuality for people with cerebral palsy
  2. How people with cerebral palsy construct sexual participation, and particularly sexual spontaneity and
  3. How people with cerebral palsy describe their sexuality

Environmental Factors

Adapt a home and the community for a child with cerebral palsy 
The village, school or/and home of a child with cerebral palsy needs adjustments. This allows the child to move around (walking, crawling, in a wheelchair, with crutches). In the house and outside the house; the community.

Role of parents

This book has been written by Undine Rauter a German Physiotherapist working for many years in rural South Africa. She further developed the Parent Guidance Centre was started in 1986 into a centre that is meaningful to mothers, fathers and children with cerebral palsy. A highly recommended book to read!

‘We create our own small world’: daily realities of mothers of disabled children in a South African urban settlement
Parents of disabled children can face a lot of challenges. Although studies of parents from low-income countries are rare, there were 30 mothers from a South African township that participated in this study. The mothers lived in an isolated manner. The study shows that for the development of disabilities to be successful, programmes should support mothers by sharing the care responsibility. This can provide room for these mothers to increase the well-being of themselves and their children.

Appropriate paper-based technology

Thinking outside the cardboard box: insights from a course to train rural Kenyans to make postural support devices from appropriate paper-based technology (APT) for children with cerebral palsy
This article is about a 2-week training course about appropriate paper-based technology. The participants made the devices for children with cerebral palsy. All participants found the training beneficial.