Cerebral palsy is a term used to refer to a group of complicated conditions that affect movement and posture because of damage to or failure in the development of the part of the brain that controls movement. This happens before birth, during birth or during early childhood before the brain’s growth has reached a certain level of maturity. The condition itself does not normally change but individuals with cerebral palsy can become increasingly better at managing their difficulties as they get older. Generally speaking cerebral palsy is characterised by involuntary jerking movements, a poor sense of balance, spastic muscles and speech impairment. Many forms of cerebral palsy are now recognised and it is described either:
(a) in terms of the part of the body affected:
- Hemiplegia: affecting one side of the body.
- Diplegia: affecting the whole body.
- Quadriplegia: affecting both arms and legs.
(b) in terms of how the body is affected:
- Spasticity: difficulty moving limbs and problems with posture and general movements.
- Athetosis: involuntary movements such as twitches or spasms.
- Ataxia: difficultly co-ordinating muscle groups and problems with balance, walking, etc.
It is sometimes the case that students present with a mixture of these conditions, as well as other associated difficulties, so the term embraces a wide spectrum. The associated difficulties include difficulties with constipation, epilepsy, general/specific learning disabilities, sleeping, speech and understanding the spoken word, and visual perception.
It is estimated that 1 in 400 students are affected by cerebral palsy and it is important to note that there is a huge variation in the manner in which cerebral palsy affects each individual. Some but not all students will have communication difficulties (including social mixing difficulties), movement and control difficulties, difficulties in processing and in ordering information, and spatial and perceptual difficulties.
Strategies for Learning and Teaching
- Encourage independence.
- Remove obstacles so that the student can move freely from lesson to lesson.
- Encourage support for the student from classmates.
- Consider physical access issues such as ramps, toilets, lifts and classroom layout.
- Incorporate advice from the occupational therapist in the student’s programme.
- Use computers and audio-visual aids in the student’s learning and teaching programme.
- Specialised equipment may also be necessary such as adapted keyboards, page turners, word boards or special desks.
- If writing is difficult consider using a tape recorder.
- Encourage communication to prevent isolation.
- Teach social skills if necessary.
- Allow students extra time to complete tasks.
- If teaching Physical Education, note that slower-paced activities are better than those requiring a fast response. Students will do better catching a bounced ball than a thrown one; kicking a stationary ball than a moving one.
- Students may have a low self-image, therefore it is important to ensure that the student feels included and is encouraged and praised.
- As students tend to become distracted quite easily minimise distractions in the classroom environment.
- If students use wheelchairs, where possible place yourself at their eyelevel when talking to them.
- Table-type desks with adequate leg space will need to be considered if the student has a wheelchair.
- The board in the classroom may have to be lowered if the student is in a wheelchair.
To facilitate students’ reading, use easels, portable reading racks or adjustable desks.