Life after Cerebral Palsy
Unlike other diseases a child can develop, cerebral palsy is not a death sentence and kids are expected to live potentially long lives. The goal of the family and the rehabilitative team is to take the disabilities the child is presented with and maximize the child's potential. Depending on the degree of brain damage, the child can suffer from deficits in walking, in using the arms and hands, in speech, in swallowing and in cognition. He or she may have developed epilepsy as a result of having a brain injury, which can become debilitating if medications do not work the way they're supposed to.
Because the injury is a onetime thing and isn't progressive, there is nothing that can be done to reverse the outcome and the changes suspicious for cerebral palsy develop rather quickly over a period of weeks to months. The end result is a child confined to a wheelchair or a child who needs assistants to walk.
Shortly after the diagnosis of cerebral palsy is made, the child enters a rehabilitative phase that can last a few years or a lifetime. In rehabilitation therapy, the child learns how to use assistive devices like braces and walkers, learns how to speak and swallow with some degree of efficiency, and learns how to use his or her arms and hands so that he or she can eventually learn to color or draw with their affected or unaffected hands.
Getting these things maximized takes time because, not only is the child dealing with a disability, he or she is developing just like other kids so that it takes time to maximize self sufficiency. A normal toddler doesn't have self sufficiency so it cannot be expected of a child with cerebral palsy. Therefore, the goal is to bring the child as much as possible to their age level within the constraints of their inabilities.
Many kids with cerebral palsy have epilepsy diagnosed before or shortly after the actual diagnosis of cerebral palsy. They must deal with the possibility of seizures for the rest of their lives. This means medications to control seizures, some of which have side effects that, in and of themselves, have side effects. The same is true of antispasmodic medication, which is used to reduce stiffness and spasm of the muscles. These medications also have side effects that can be lifelong. They can reduce the ability of the individual to do a good job in school and later in the workplace.
There's no question that the most physical and occupational therapy is done as the child grows and develops. Along with speech therapy, these therapies develop a baseline level of functioning that can take the child from being extremely debilitated to being functional members of society. When the correct braces are used and there is teaching in speech and the use of the hands, the child can become ambulatory with assistance (at times) and can begin to grow as a student in a public or private school system.
With cerebral palsy, some children need special education because of intellectual delays associated with having a brain injury. This means they get an educational plan and work with teachers to teach them those things they can assimilate and that which will be helpful to them as adults. If the child has normal mentation and has intelligible speech, integration into a regular classroom can happen and the child can learn the same things at the same time as other students. They sometimes need a classroom aide to help them get by when it comes to getting assignments done or getting around the classroom. The point, however, is to give these children the best education they can get, given their disability.
At some point, the child grows up and must decide on a vocation. What vocation they choose depends on what intellectual skills they have and on what physical skills they have. Either intellectual or physical impairments can affect the child's choice of vocation. They need some kind of direction to help them find a vocation that best fits what they can do and what they can't do.
This is where vocational training comes in. It can begin in high school, which is a time when the child may have little or no involvement with other therapies. They have learned what they can regarding physical limitations, have maximized their speech abilities and have a degree of intellectual capabilities that won't likely change for the worse or for the better.
In vocational training, the student is matched with their interests and with their abilities. If the child is wheelchair-bound, for example, this limits jobs requiring a lot of walking or standing. If the child has function of only one hand, they may need to be taught computer typing skills appropriate for a person who can type with only one hand. When they learn this skill, this opens up the world of many clerical jobs or jobs in business.
Can the child with cerebral palsy attend college? If the child has not had a significant drop in intellectual capabilities as a result of their brain injury and can maneuver their way through a college campus, the child may certainly attend college. Graduating from college means the person can nearly completely enter the workforce as a valued member of society, even if they are wheelchair bound or have mild impairments in speech and physical functioning. They may have some difficulty getting a job because of prejudices on the part of the employers but most of them will become employed members of society.
They may also find companionship and love as adults with cerebral palsy. It may occur with another person with a similar disability but it can certainly be a rewarding experience for the child who started life out with a serious diagnosis. Kids with cerebral palsy can grow up to be married and have children just like anyone else, especially if their disease is mild to moderate. There are no restrictions on fertility and these people have as good a chance as anyone to have normal children.
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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here