Our colleagues in the UK, the birth injury attorneys at Irwin Mitchell Solicitors, have created an incredible program to encourage inventions that help people with disabilities such as cerebral palsy live independently and have a better quality of life. The program is called “Design for Life,” and winners of the competition receive funding so they can develop their inventions. The inventions that win help those living with cerebral palsy and other disabilities overcome day-to-day problems, such as difficulty with personal care, household chores and hobbies.
This year’s winner was Simon Lyon, who designed a device called the Nimble. The Nimble is a tool that helps those with limited mobility in their hands open packages. It is especially useful for people who can’t grip strongly between their finger and thumb; it allows a user to simply swipe her finder to open a difficult package.
The birth injury attorneys at Reiter & Walsh ABC Law Centers have helped dozens of families affected by cerebral palsy. Jesse Reiter, president of ABC Law Centers, has been focusing solely on birth injury cases for over 28 years, and most of his cases involve hypoxic ischemic encephalopathy (HIE) and cerebral palsy. Partners Jesse Reiter and Rebecca Walsh are currently recognized as being two of the best medical malpractice lawyers in America by U.S. News and World Report 2015, which also recognized ABC Law Centers as being one of the best medical malpractice law firms in the nation. Email or call Reiter & Walsh ABC Law Centers at 888-419-2229 for a free case evaluation. Our firm’s award winning birth injury attorneys are available 24 / 7 to speak with you.
CHILDREN WITH CEREBRAL PALSY OFTEN HAVE DIFFICULTY WITH EVERYDAY TASKS
Cerebral palsy (CP) is a group of syndromes characterized by difficulty with movement and posture. Children who have cerebral palsy often struggle to move and they frequently have difficulty with fine motor skills, such as picking up a crayon or small piece of cereal. Simple actions that are performed unconsciously by unaffected children require a lot of effort and concentration in children with cerebral palsy, and attempts at simple actions often fail.
Spastic cerebral palsy is the most common type of CP, affecting approximately 80% of all children who have cerebral palsy. Although the brain injury that causes spastic cerebral palsy does not get worse over time, a child’s muscle, bone, joint and tendon problems can worsen and become very painful, especially without adequate therapy and treatment.
Normally, muscles coordinate in pairs; when one muscle contracts, the other relaxes. This allows the muscles to do what the child wants them to do. When a child has spastic cerebral palsy, there is dysfunction in brain-to-nerve-to-muscle communication, which causes muscles to work against each other. This leads to a tightening or shortening of the joint. When the muscle fibers become short, the joints nearby can end up and remain in a fixed position. This can further hinder a child’s ability to move around. Indeed, without proper therapy and treatment, spastic muscles can cause damage to the child’s body: muscles, bones, joints and tendons can get shorter and become painful.
Ataxic cerebral palsy occurs in about 10% of all children who have CP. Some children with ataxic CP have hypotonia (reduced muscle tone) and tremors. Motor skills involving the hands, such as writing, typing or using scissors, are often affected. Children with ataxic cerebral palsy usually have a difficult time keeping balance, especially while walking.
Athetoid or dyskinetic cerebral palsy involves mixed muscle tone (hypertonia and hypotonia) and involuntary muscle movements. Children with athetoid CP have difficulty holding themselves in an upright position for sitting and walking. For some children with athetoid cerebral palsy, it takes a lot of work and concentration to get their hands to a certain spot (like scratching their nose or reaching for something). Because of their mixed tone and trouble maintaining a position, they may not be able to hold onto objects, especially small ones requiring fine motor control (such as using a pencil).
Indeed, cerebral palsy can make everyday tasks very difficult for children. The sooner therapy and treatment for cerebral palsy begins, the better. However, many children aren’t diagnosed with CP until they are 4 or 5 years old, when certain developmental milestones are missed.
WHAT ARE SOME TREATMENTS & ASSISTIVE DEVICES FOR CHILDREN WHO HAVE CEREBRAL PALSY?
Occupational therapy (OT) is a very important part of any cerebral palsy treatment program. The goal of OT is to promote a child’s ability to perform daily activities in a way that will enhance her quality of life and help her be as independent as possible.
During occupational therapy, a therapist will guide the child in adapting, compensating, and achieving maximum function levels. Therapists take into account physical functioning abilities and limitations, cognitive functioning levels (reasoning and processing skills), and the ability and willingness to adapt and compensate.
OT for cerebral palsy focuses on specific tasks, such as feeding, dressing, toileting, grooming, and transfers. The goal is for the child to function as independently as possible with or without the use of adaptive equipment. To accomplish this, therapists focus on:
- Determining adaptive methods a child can learn to complete tasks
- Breaking down essential tasks into smaller steps that are often modified
- Developing in a child a sense of place in her environment, at school, and in the community
- Capitalizing on the need for accomplishment, pride, enjoyment and independence
Children with cerebral palsy benefit from therapy because it teaches them how to develop and maintain a daily routine – which contributes to independence and quality of life. As children grow, they want to handle tasks to the best of their abilities without interference. Children want to be accepted by their peers and participate socially with others.
Children with cerebral palsy can use specialized adaptive equipment and assistive technologies. In these circumstances, an occupational therapist will modify and then teach children how to use specialized equipment, including:
- Computers with pre-programmed language
- Computers that use eye-tracking technology, such as the Tobii, so that children who are unable to speak and/or use their limbs can “write” and communicate
- Equipment to navigate transfers from a laying to seated position
- Computerized environmental control systems
- Specialized chairs that help maintain proper position for eating and breathing
- Desks that rotate
Some children with cerebral palsy have involvement of the face and upper airway, causing drooling and difficulty swallowing and speaking. Speech therapy can be used to help improve swallowing and communication.
Augmentative alternative communication (AAC) devices give children who have speech problems the ability to communicate in different ways, using signs, letters, pictures and even a voice. There are dozens of apps that help children with cerebral palsy communicate. Some of the most popular are listed below.
- Proloquo2Go. This AAC program is highly customizable and can be adjusted to a wide range of users. The text to speech program generates speech by tapping buttons with symbols or typing on-screen. It features a range children’s voices to choose from and it can be personalized with a combination of icons and photos.
- TapToTalk. This is a free ACC and it can meet basic text-to-speech needs, but it does not have quite the vocabulary or flexibility of the Proloquo2Go. However, the customizable version can be purchased and more words and images (including your own photos) can be added.
- Yes-No, Smarty Ears. This easy application only offers a choice between yes and no, but is a great program for non-verbal children with cerebral palsy to quickly get across an answer. The two choices can be configured with pictures, audio and text as needed.
- iComm. This is an AAC application for quick choice-making. iComm comes with a number of pictures and voice recordings of colors, shapes, letters and body parts, with the option of customizing with your own photos and recordings. All the child has to do is select the images that correspond with the point they wish to communicate and create a short sentence.
- First Then Visual Schedule. This is a tool that helps children with cerebral palsy better understand their daily schedule. Knowledge and understanding of next steps can help decrease frustration and anxiety in children, especially with those with limited communication skills or understanding of sequences. A selection of photos and voice prompts (you can record your own) allows creation of custom schedules that walk children through their routines.
- SpeechBox for Speech Therapy – iPad Edition. This app is designed for word practice, and it uses simple picture-for-word “flashcards” to help children increase their vocabulary. Not only does the app have over 700 pictures/words, but it can be customized by adding pictures (including friends and family members) for practice.
- Dance Party Zoo. Used as a fun way to practice balance, coordination, and rhythm, this app is a dancing game that provides children feedback about how well they did at keeping rhythm via a simple graph. Children able to pick their own zoo animal as an avatar and then they can watch their avatar replay the dance.
- Dexteria for Fine Motor Skill Development. This app gives children with cerebral palsy a set of therapeutic hand exercises. Used on a regular basis, the program can build strength, control, and dexterity, which can help with handwriting and other activities that involve fine motor skill. Dexteria has an automatic tracking and reporting feature that allows progress to be monitored.
- Injini – Child Development Game Suite. This app has a collection of learning games that targets toddlers and preschoolers with cognitive, language, and fine motor delays. The app engages children with features such as 10 feature games, 90 puzzles and over 100 illustrations. Injini helps children practice their fine motor and language skills and improve spatial awareness, memory and visual processing.
Physical therapy (PT) is one of the most important treatments for cerebral palsy, and there are many types of PT that can be given to a child. PT is aimed at promoting the motor and developmental skills of a child with cerebral palsy. Parents and other caregivers should be taught the exercises or activities that are necessary to help the child reach her full potential.
Daily range-of-motion (ROM) exercises are important to prevent or delay contractures that are caused by spasticity and to maintain the mobility of joints and soft tissues. Stretching exercises should be performed to increase range of motion, and progressive resistance exercises are necessary in order to increase strength. The use of age-appropriate play and of adaptive toys and games are important so that therapy is fun and the child cooperates. Strengthening knee extensor muscles helps improve crouching and stride length. Postural and motor control training is important and should follow the developmental sequence of normal children; head and neck control should be achieved, if possible, before advancing to lower body (trunk) control.
The use of Kinesio taping (elastic therapeutic tape) can help educate muscles for stretching and strengthening, and aquatic therapy can also be beneficial for strengthening. Vibration and short-term use of heat and cold over the child’s tendons may help decrease spasticity.
Electrical stimulation of weakened muscles is usually tolerated well in older children and can help strengthen muscles and maintain muscle size. In a child with weak dorsiflexors (muscles in the lower leg that act on the foot) that are causing foot drop or tripping, for example, electrical stimulation to the anterior tibialis (shin muscle) could be beneficial.
Physical therapy is crucial when a child has had surgery to help correct spasticity; it helps the child obtain maximum benefit from surgery such as selective dorsal rhizotomy (SDR).
Conductive education (CE) is a system of teaching and learning for children with motor disorders such as cerebral palsy. CE was created in the 1940s to help children with motor dysfunction participate and function in society. One of the treatment’s main goals is to avoid learned helplessness by having students identify new achievable goals. In the program, the “conductor” acts as teacher and therapist, and independent functioning using repetition and verbalization by the child is promoted.
The exercises are broken down into basic functional movements and are performed intensively (5 hours per day, 5 days per week) in small groups. This promotes interactivity and fun. The use of adaptive equipment such as splints, walkers and wheelchairs in the classroom is discouraged.
The main theory behind this treatment is that problems with motor skills are problems of learning; new abilities are created out of teaching.
Key components of conductive education for children with cerebral palsy include:
- Activity and intention
- Continuity and consistency
- The child is a unified whole
- CE targets the whole personality
- CE is an interdisciplinary model
AWARD WINNING CEREBRAL PALSY & BIRTH INJURY ATTORNEYS HELPING CHILDREN FOR ALMOST 3 DECADES
If you are seeking the help of a birth injury attorney, it is very important to choose a lawyer and firm that focus solely on birth injury cases. Reiter & Walsh ABC Law Centers is a national birth injury law firm that has been helping children with birth injuries for almost 3 decades.
Birth injury attorney Jesse Reiter, president of ABC Law Centers, has been focusing solely on birth injury cases for over 28 years, and most of his cases involve hypoxic ischemic encephalopathy (HIE) and cerebral palsy. Partners Jesse Reiter and Rebecca Walsh are currently recognized as being two of the best medical malpractice lawyers in America by U.S. News and World Report 2015, which also recognized ABC Law Centers as being one of the best medical malpractice law firms in the nation. The lawyers at ABC Law Centers have won numerous awards for their advocacy of children and are members of the Birth Trauma Litigation Group (BTLG) and the Michigan Association for Justice (MAJ).
If your child was diagnosed with a birth injury, such as periventricular leukomalacia (PVL), cerebral palsy, a seizure disorder or hypoxic ischemic encephalopathy (HIE), the award winning birth injury lawyers at ABC Law Centers can help. We have helped children throughout the country obtain compensation for lifelong treatment, therapy and a secure future, and we give personal attention to each child and family we represent. Our nationally recognized birth injury firm has numerous multi-million dollar verdicts and settlements that attest to our success and no fees are ever paid to our firm until we win your case. Email or call Reiter & Walsh ABC Law Centers at 888-419-2229 for a free case evaluation. Our firm’s award winning birth injury attorneys are available 24 / 7 to speak with you.
VIDEO: BIRTH INJURY ATTORNEYS DISCUSS BIRTH ASPHYXIA & CEREBRAL PALSY
Watch a video of birth injury attorneys Jesse Reiter and Rebecca Walsh discussing how birth asphyxia can cause brain damage and cerebral palsy in a baby.