Cerebral palsy affects posture, balance, and ability to move. It can also affect someone’s abilities to communicate, eat, and sleep.
The parts of the body affected by cerebral palsy, the level of involvement, and combination of symptoms can differ for each person. For example, one person may have a weakness in one hand and find tasks like writing or tying shoelaces challenging. While another person may have little or no control over their movements or speech and require 24 hour assistance.
People with cerebral palsy may experience uncontrolled or unpredictable movements, muscles can be stiff, weak or tight and in some cases people have shaky movements or tremors. People with severe cerebral palsy may also have difficulties with swallowing, breathing, head and neck control, bladder and bowel control, eating and have dental and digestive problems.
People with cerebral palsy may also have a range of co-occurring issues.
Mobility Issues
1 in 3 people with cerebral palsy will be unable to walk. At greatest risk are those who have spastic quadriplegia, intellectual disability, epilepsy, vision impairment and an inability to sit independently at 2 years of age.
Communication Issues
Cerebral palsy can affect someone’s ability to coordinate the muscles around their mouth and tongue, which are needed for speech. The respiratory coordination that is needed to support speech can also be affected, which can make some people sound like they’re running out of breath when they speak. Some people with cerebral palsy may not be able to produce any sounds. Others may be able to produce sounds but have difficulty controlling their movement enough to produce speech that is clear and understood by others. 1 in 4 people with cerebral palsy cannot talk.
Pain
3 in 4 people with cerebral palsy experience pain. Pain is often a result of impairments associated with cerebral palsy, like contractures, abnormal postures, dystonia, skin breakdown, partial hip dislocation, and scoliosis. This pain can affect a person’s behavior, their ability to do things for themselves, and their social relationships. Pain may cause people to avoid day-to-day tasks that are important for independence. Pain can often be relieved, so please consult your medical practitioner.
Eating and Drinking Issues
Cerebral palsy can affect the muscles that open and close the mouth and move the lips and the tongue. Some people with cerebral palsy may have difficulties in chewing and swallowing food and drink – a condition known as dysphagia.Because cerebral palsy often impacts fine motor skills, many people are unable to easily use cutlery, hold a cup, or transfer food from a plate to their mouth using their hands. Others may experience gastroesophageal reflux, which causes acid from the stomach to rise into the esophagus, making eating uncomfortable or painful. This can sometimes be controlled by medication. 1 in 15 people with cerebral palsy are unable to take food through their mouth and need to be fed through a feeding tube.
Saliva Control
Because cerebral palsy can affect the muscles around the mouth, 1 in 5 people with cerebral palsy experience drooling. This may be more noticeable when they are concentrating on a fine motor task.
Intellectual Disabilities
1 in 2 people with cerebral palsy have an intellectual disability. Of those people, approximately 20% have a more involved intellectual disability. The level of physical impairment someone experiences from cerebral palsy does not necessarily correlate to the level of intellectual disability. Someone can have lots of physical impairments with no intellectual disability and vice versa.
Learning Difficulties
People with cerebral palsy may experience specific learning difficulties. These may include a short attention span, motor planning difficulties, perceptual challenges, and language challenges. This can impact literacy, numeracy and other skills. Learning may also be affected by difficulties in fine motor and gross motor coordination and communication. Students with cerebral palsy require more effort to move and sequence their actions than nondisabled people, so they may also tire more easily.
Hearing Impairment
1 in 20 people with cerebral palsy also have some level of hearing impairment. 1 in 50 children with cerebral palsy are deaf.
Visual Impairment
Impaired vision is common in people with cerebral palsy. Children with the more involved forms of cerebral palsy are more likely to experience high myopia, absence of binocular fusion, dyskinetic strabismus, severe gaze dysfunction, and optic neuropathy or cerebral visual impairment (CVI). 1 in 10 children with cerebral palsy are blind.
Behavior and Emotional Well-Being
Behavioral problems occur in 1 in 4 children with cerebral palsy. People most likely to experience this issue include children and adults with intellectual disability, epilepsy, severe pain, or a milder level of physical disability. Problem behaviors include dependency, being headstrong, hyperactive, anxious, prone to conflict with their peer group, or exhibiting antisocial behaviors.
Children with cerebral palsy may also have strong emotional responses to new challenges. Teenagers and adults with cerebral palsy may be more prone to depression and anxiety disorders.
Epilepsy
1 in 4 people with cerebral palsy have epilepsy. People with cerebral palsy and an intellectual disability experience a higher incidence of epilepsy is high.
Seizures can affect speech, intellectual functioning, and physical functioning. Medication is the most effective intervention for epilepsy.Some medications have side effects which cause drowsiness or irritability. Both epilepsy and the related medication can affect a person’s behavior and attention span. For children with cerebral palsy, doctors or therapists may recommend modifications to school supports and equipment.
Sleep Issues
1 in 5 people with cerebral palsy have a sleep disorder. There are a range of contributing factors, including the muscle spasms associated with cerebral palsy, other forms of musculoskeletal pain, and a decreased ability to change body position during the night. Epilepsy is also known to disturb sleep and is likely to predispose people to sleep disorders. Blindness or severe visual impairment can affect sleep timing and maintenance because of their effects on light perception and melatonin secretion.
Spinal and Hip Abnormalities
Spine and hip abnormalities are associated with cerebral palsy and can make sitting, standing, and walking difficult. They can also cause chronic pain.
1 in 3 people with cerebral palsy have hip displacement. Children and adults who have a more involved physical disability or those whose body is affected on both sides are at greater risk of hip problems. People who use wheelchairs most of the time are more at risk for hip problems than people who walk independently or with assistive devices.
Bladder and Bowel Control
Continence and constipation are issues for many people with cerebral palsy. 1 in 4 people with cerebral palsy have bladder control problems. People with intellectual disability and/or a more involved form of cerebral palsy are most at risk. Lack of mobility and difficulty eating can predispose people with cerebral palsy to constipation.