When Your Child Has Cerebral Palsy (CP)

Cerebral palsy (CP) causes a child to have problems with certain motor skills. This means that they may have trouble with muscle control, movement, or coordination. These problems are caused by damage or abnormal development of certain areas in the brain. Intelligence can be affected in children with CP, but many children with cerebral palsy have normal intelligence. The severity of symptoms from CP can vary. It doesn’t get better or worse over time. With diagnosis and treatment, children can learn how to manage their CP.

What are the causes of CP?

Most children with CP are born with it. CP is caused by problems with brain development before birth. Or it is caused by injury to the brain during birth. CP is slightly more common in boys than girls. Babies with low birth weight or who are born before their due date (preterm) are more likely to have CP. Often there is no clear cause of CP. 

What are the different types of CP?

CP has different types. These include:

• Spastic CP. A child has more muscle tone than normal in the arms, torso, or legs. This means the muscles are too stiff and firm. They may jerk or spasm. In some cases, only one side of the body is affected.

• Dyskinetic CP. A child has poor muscle control. This causes uncontrolled or sudden movements of the arms, legs, hands, or feet. In some cases, the muscles in the face or the tongue are also affected.

• Ataxic CP. A child has less muscle tone than normal. This means the muscles are too weak and relaxed. They have more trouble coordinating their movement. This can lead to problems walking or doing tasks such as dressing.

What are the symptoms of CP?

CP affects each child differently. Symptoms can range from mild to severe. CP doesn’t get worse. But symptoms can change as the nervous system develops. Most children are diagnosed between 18 to 24 months of age. It is important to watch for symptoms if your child is at risk. Your child may have CP with one or more of these symptoms:

• Overly passive or grouchy

• Poor feeding as a baby

• Weak muscles in the face, tongue (which can cause slurred speech), arms, legs, hands, or feet

• Poor head control

• Frequent clenching of fists

• Delayed motor skills

• Trouble swallowing that causes drooling

• Poor posture

• Unbalanced walk

• Legs spread far apart when walking (wide gait)

CP and other health problems

Children with CP are more likely to have certain other health problems. These can include:

• Vision, hearing, or speech problems

• Convulsions or seizures

• Learning or reasoning problems, including intellectual disability

• Behavior problems

• Trouble with feeding

• Bladder or bowel control problems

• Abnormal bone development

• Poor growth

• Psychiatric disorders, including anxiety and ADHD

• Gastrointestinal disorders, such as constipation

• Drooling

• Breathing fluids or food into the lungs (aspiration)

• Bedwetting and other urinary symptoms

Your child’s healthcare provider will talk with you about these. They will give you more information about any other health problems your child has.

How is CP diagnosed?

CP often can't be diagnosed until your child is about 2 years old. It takes time for a healthcare provider to track your child's physical and mental development. Babies with CP are slower to develop certain skills. For example, a child may take longer to learn how to roll over, sit up, crawl, or walk. Based on your child's progress by age 2, your child's healthcare provider can then confirm the diagnosis. Often by age 3 or 4, there is enough information to predict how your child will function in the years to come.

Your child will likely see a pediatric neurologist for diagnosis and treatment. This is a healthcare provider who treats nervous system problems. No single test can diagnose CP. It takes time to figure out this diagnosis. During the diagnosis process: 

• The healthcare provider gives your child a physical exam. They also ask about your child’s symptoms and health history. This is to check for the timing of possible brain damage or injury to your child.

• The provider may order blood tests or imaging tests for your child. These may help the provider learn more about your child’s condition.

• Your child will be screened for developmental milestones. Failing to meet motor milestones is a sign of CP.

How is CP treated?

CP is permanent and can't be cured. The goals of treating CP are to reduce pain, make it easier to move, and prevent complications from the movement problems. Treatment of CP varies depending on your child's needs. Your child will likely work with a team of people to learn how to manage their condition. This will include teachers, healthcare providers, nurses, and therapists. Treatment may include:

• Supportive services. These can include special learning facilities. It can include physical, occupational, or speech therapy.

• Medicines. These may be prescribed to help manage symptoms, such as muscle spasms. One is the medicine baclofen. This can help manage the spasticity that comes with cerebral palsy. Baclofen can be given by mouth or through a small pump into the spinal canal (intrathecal pump). Another is botulinum toxin. This is a muscle-relaxing medicine. It can help relieve the toe-walking that is linked to muscle tightening or other abnormal movements. Other medicines can be used to decrease uncontrollable movements.

• Mobility aids. Your child may need aids such as a walker or leg braces. These are to help maintain balance and help with walking. Some children may not walk at all and need a wheelchair.

• Surgery. Many children with cerebral palsy will need tendon release surgery later in life. This is done to improve severe spasticity and reduce pain.

What are the long-term concerns?

CP is an ongoing condition that needs to be managed. With regular medical care and supportive services, your child can learn how to be as active and independent as possible.

Life expectancy depends on many factors. But most people with CP have a normal lifespan. It is important that life-threatening conditions linked to CP are managed. Make sure that your child has healthcare and lifestyle support.

Coping with your child’s condition

A positive outlook helps while supporting your child. Encourage your child to be active and to try new things. Think about talk therapy (counseling). This can help you and your child deal with any worries or concerns. And get help from friends, community resources, and support groups. The more you learn about your child’s condition, the more control you may feel.