Treatment Approaches and Therapies
For almost all children affected by cerebral palsy, physical therapy will play an important role in their treatment. The goal of a physical therapist is to help children affected by cerebral palsy develop the large muscles of the body, and in particular those located in the legs, arms, and abdomen.
He or she also helps a person with cerebral palsy develop exercises designed to avoid contractures, bone deformities, and unwanted movements.
Physical therapy typically has three core components, and in some cases, many more:
- Stretching – A slow steady pull is placed on all major muscle groups. Daily stretching is critical to the proper functioning of large muscle masses.
- Strengthening – These exercises help the body develop stronger muscles in order to increase its functioning.
- Positioning – Positioning involves placing the body in different, but very specific, positions in order to attain long stretches. Some of these positions help to reduce unwanted muscle tone.
The Bobath Approach
The Bobath method of treatment improves posture and movement for people with cerebral palsy by providing specialized ways of handling. This method may target the way parents and care providers pick up, carry, and put down child so that his or her physical functioning is greatly increased.
This method uses different positions so that many different muscles receive regular exercise. The therapy evolves as the child continues to grow developmentally.
Therapists follow a family-centered approach to therapy and focus on lifetime needs of communication, mobility and self-care. When consistently followed through on by families and schools, this therapy is very effective and greatly increase the functioning of individuals affected by cerebral palsy.
Play therapy is designed to accommodate the specific needs of each child. It often refers to modifying behavior to:
- Enhance emotional development
- Social development
- Reduce aggression
- Improve cooperation
- Assist in coping with a traumatic event
- Help children physically develop
Play for children with cerebral palsy does not come as easily as it does to typical children. At home, be sure to make play easily accessible for your child.
Be sure to do the bare minimum possible to assist them so they learn the skills on their own. One struggle many parents have is being a little too helpful, which slows the child’s growth towards independence.
Allow your child to have choices. Don’t structure his or her play area so he or she must accept whatever choices you want.
Here are a few ideas for children age 0-2 years:
- Making lots of babbling and cooing noises
- Tickling games
- Building and knocking down building bricks
- Picture books
- Imitating actions and sounds
- Basic turn taking
For children age 2-4 years, try:
- Obstacle courses
- Spotting differences
- Pretend play
- “Simon says” types of games
- Matching colors and shapes
These are just a few of the ideas you or your play therapist may try. Be sure to consult with a play therapist on a regular basis so your child’s growth is maximized.
The job of an occupational therapist is to assist children with cerebral palsy in developing fine motor skills and small muscles. Activities target your child’s mouth and extremities.
If an occupational therapist is working within your local social service department, he or she will also assist you in determining what major adaptations need to be made to your home in order to increase your child’s independence.
If your child needs specialized equipment to assist with various daily living activities, an occupational therapist helps him or her by identifying modified spoons, cups, toys, scissors, writing utensils, wheelchairs, or anything else your child might need.
An occupational therapist also evaluates your child to determine whether a sensory deficit is present, or whether your child simply has difficult processing sensory information.
In all cases, an occupational therapist helps you identify reasonable and realistic goals for your child and is absolutely essential to the healthy development of your child.
Music & Dance Therapy
The term “therapy” typically brings up many concerns in your mind. Many of those thoughts revolve around fear and worry. Will your child like it? Will it help your child? How much does it cost?
Fortunately, while therapy helps address essential needs for children with cerebral palsy, it always revolves around doing so in a fun away.
One particular fun method of therapy that helps children with cerebral palsy is music and dance therapy.
Music and dance therapy helps your child to:
- Express his or her emotions
- Develop a sense of rhythm, which supports physical development
- Enhance communication skills
- Increase auditory and tactile sensory perception
Dancing is particularly helpful for children with cerebral palsy, as it involves effective coordination of almost every part of their body.
You don’t necessarily need to wait to see a specialist to learn how to do this effectively, although his or her advice could be quite helpful. In fact, you can simply play different types of music and encourage your child to move around as best as he or she can.
You can also target your child’s auditory perception by having him or her play musical instruments in rhythm with music. Have fun and dance with your child if you want!
Speech and language therapists typically work out of clinics, hospitals, and health centers. They help your child develop more effective communication skills, and if needed, will recommend augmentative devices.
They will also assist with any feeding, drinking, or swallowing problems your child may have. He or she also helps parents and teachers understand the child’s attempts at communication and identify appropriate activities for helping your child learn more complex communication skills.
The speech therapist will also help you understand how your child interprets communication attempts from others.
Being in water reduces pressure on bones and joints. Because children have so much fun in the water, this form of therapy tends to be fairly effective for many children. Not only do children with cerebral palsy have the opportunity to improve their overall muscle coordination, but they can work on their muscle tone and cardiac health while reducing their stress levels.
Hippotherapy (Horseback Riding)
Hippotherapy offers children a chance to have fun while also improving muscular strength and coordination, balance, posture, and lowering blood pressure. Children also have the opportunity to experience new sights, situations, and feelings. Children become more accustomed to a typical gait, as a horse’s stride is similar to that of a human. Therapists will sit directly behind your child, or if he or she can sit independently, a therapist walks alongside the horse.
Vocational counseling helps people with cerebral palsy integrate successfully into the workforce. As in the general population, people with cerebral palsy have different skills and levels of talent.
In the short-term, vocational counseling helps people with cerebral palsy function at their highest levels. They will process through real-world work scenarios in a sheltered workshop setting with other people who have various disabilities.
They will also work jobs similar to those they would work in mainstream society, so they can develop the necessary skills to be successful on their own.
The long-term goal of vocational counseling is to help your child with cerebral palsy become completely independent at work. The road often has many obstacles along the way, but there are experienced professionals available to help your child.
Unfortunately, many symptoms of cerebral palsy cannot be treated by any form of therapy. Medication can also be another helpful component of a successful treatment plan.
Types of medication your child may need include:
- Anticonvulsants, which reduce the frequency and duration of seizures
- Injectable antispasmodics, which are directly injected into spastic muscles to help them relax
- Botulinum Toxin (Botox), which also helps with muscles in a spasm or contracting uncontrollably
- Anticholinergics, which help a small percentage of people with cerebral palsy reduce drooling and uncontrollable body movements
While medication can help, it often does so only a limited basis. And, many medications also come along with serious side effects.
Your doctor will help you identify any medications that may be of benefit to your child.
Unfortunately, surgery is a necessity for many children affected by cerebral palsy. In most cases, doctors attempt to delay or postpone surgery, if possible. Very often, a symptom can be successfully treated with less invasive procedures.
Some reasons doctors may recommend your child should have surgery include:
- Spine curvature
- Uneven leg length
- Hip dislocation
- To reduce muscle spasticity
- Addition of a small medicine pump near the spine
- To increase the range of motion
Doctors do not widely agree on the best age for a child to have surgery. In general, surgery is recommended more often for the legs than the arms, and it is also more effective for the arms.