CEREBRAL PALSY - PDF document

CEREBRAL PALSY 39 identified Cerebral Palsy then called‘Cerebral Paralysis’. He raised the possibility ofbirth asphyxia as a chief cause of the disorder.Sigmund Freud, in 1897, suggested thatshown that 75% of the cases were not due to birthasphyxia. This supported Freud’s view, eventhough through the 19th and 20th Century, Little’sIn India, services to the Cerebral Palsy (C.P.)Cerebral Palsy (C.P.) was set up in 1973. It wasin Kolkata, Bangalore, Chennai and New Delhi.Spastics Society of Northern India in 1977, SpasticsTamil Nadu in 1980 and Spastics Society of IndiaHistorical PerspectiveInclusive Education at Bandra, Mumbai. Similarly,Open School facility. It also runs a vocationalTrust. The community based programmes, bothFundamental ideology is effective inclusion in the 41 first identified Cerebral Palsy then known as‘Cerebral Paralysis’. He raised the possibilitydisorder.Sigmund Freud in 1897 suggested thatasphyxia supporting Freud’s view even though2.Give the updated version of definition.Cerebral Palsy is a group of conditions thatCerebral Palsy is a syndrome as the following(a)Motor Disorder.(b)Medical Conditions.(c)Sensory Impairments.(d)Hearing Disabilities.(e)Attention Deficits.(f)Language & Perceptual Deficits.(g)Behavioral Problems.(h)Mental Retardation.3.(a)What are the congenital causes of CerebralPalsy ?–Malformation of the brain & blood–Neurological damage as a result of(1)Intrauterine viral infections(2)Pollution (affect of(3)Poor oxygenation of brain as a(4)Vascular factors (Congenital(b)What are the peri-natal causes of CerebralPalsy ?(1)Birth asphyxia.(2)Damage to the white master of the(3)Severe untreated jaundice,(4)Sepsis (Meningitis, encephalitis).(5)Premature infant with(6)Intracranial bleeding.(7)Multiple births.(c)What are the causes after the birth of the child(Post-natal causes) which are about 10 to 15%of Cerebral Palsy?(1)Infections (bacterial of viral).(2)Post-surgical vascular(3)Asphyxia due to aspiration.(4)Traumatic brain injury.4.What are the different types of Cerebral Palsy(1)Spastic (increased muscle tone) 60 to(2)Ataxic (balance and coordination) 10 to(3)Athetoid (involuntary, uncontrolled) 10(4)Mixed type. 43 (2)Sensory impairments (loss of vision/(3)Growth.(4)Gastro-enterological Tract problems(5)Respiratory problems (common in(6)Orthopedic problems (contractures and(7)Osteoporosis due to poor nutrition,13.Are there any Neurological problems associated withCerebral Palsy?(1)Seizure Disorders (fits)33% - 50%(2)Mental Retardation50% - 70%(3)Learning Disorder60% - 70%(4)Attention Deficit Hyperactive Disorders/(5)Speech deficits/ shallow breath(6)Dysarthria - 50%(7)Feeding difficulties – swallowing(8)Sleep disturbances.14.Do children with Cerebral Palsy have other medical(1)Growth retardation occurs frequently incerebral palsy.(2)30% due to poor nutrition.(3)Gastro – Enterological – Regurgitation15.When there is a feeding problem, what are the areas(1)Complete nutritional history, intake(2)Oral and oral pharyngeal function.(3)Involuntry movements of the tongue(4)Position of the head and neck and(5)Gastro – Enterological – Regurgitation16.Do children with Cerebral Palsy need to have DentalYes, they have:(1)Caustics in both milk teeth & permanent(2)Gingivitis(3)GER causes food to remain in oralcaviling causing decay.(4)Difficulty in providing oral care.(5)Inability to close or open mouth totally.(6)Teeth grinding.17.What are the common associated orthopeadicproblems in Cerebral Palsy?(1)Dislocated/Sub-located hips.(2)Scoliosis.(3)Contractures at joints.(4)Discrepancy of Skeletal Growth.(5)Deformities of hand and feet.(6)Deformity of the Pelvis.18.What are the sensory deficits usually seen in CerebralPalsy?(1)Visual Impairments 40% to 50%(2)Auditory Impairments 25% to 40%(3)Sensory Motor Difficulties.(4)Tactile defensiveness, hyper sensitivity(5)High Thus hold for pain due to in Childhyposensivity. 45 terms of calorie and protein is a major factor,common type is acquired C.P., occurring beforeevidently, logical given the conditions of pregnancy,childbirth and childrearing, the problem of C.P. in 47 Parental and Social Attitudes Towards Disability D isability of the individual with C.P. in thisboth as a family and social issue. Problems of C.P.family, school, community, work place and also inperspective, whether the C.P. person is a male or aallocation of resources, it is gratifying, thanks tofocused and committed leadership provided by theincluded) and society. Parents often experiencebringing to this world of a C.P. child. Thesedisables a person with a condition like C.P. is theattitude of his or her family and friends. Poor orquality of life for the C.P. population, from birththerapy, education, vocational training, jobs, living to see their “abilities”, and eschewParent SupportFollowing Questions and Answers areI.(Q)How would the parent know you arePalsy?(A)Only by showing respect and beingII.(Q)When the parent is talking, what are you(A)Listen with full attention, listen for thecauses of the problem, give enough timeIII.(Q)How should one talk to the parent?(A)(1)Think before you talk and learn to 49 Able Disabled All People Together(ADAPT)ADAPT. ADAPT stands for Able Disabled AllPeople Together. Many barriers exist that limitinvisibility in public policy, negative attitudes, inThrough its activities ADAPT will attempt toObjectives of ADAPT•Raise awareness on disability issues.•Advocate and lobby on issues and concernsof people with a disability.•Provide a forum for sharing information and•Organize seminars, workshops, social events.•Network with individuals and other similarAttitudes of Society towards people withand ignorance. ADAPT endeavors to bring aboutInaccessible Facilities and Transportation Systemsexhibitions, shopping centers, etc. An ongoingproject of ADAPT is to survey various public placesplaces like the Bombay High Court, IMAX Cinemaof ADAPT is to move the organization from aaround the world. The slogan of ADAPT is:Nothing for the Disabled Without the Disabled”. 51 Directory of Institutions for Persons with Cerebral Palsy in IndiaStateInstitute’s addressNature of persons admittedAndhra PradeshAkshaya Kshetram Adj. to North Post Office,All typesR.S. Gardens, Tirupathi - 517507Centre for Disabled Children, Lenin Nagar, PeddaCPCheruvu, Narsarap Pet, Guntur - 522601.AssamManovikas Kendra, Vikaspur, Kahilpara,CPPrerona Pratibandi Shishu Bikash Kendra,CPHaryanaBlessings Centre for Mentally Hadicapped,SpasticsKeralaAdarsh Rehabilitation Institute for SpasticsCP21/322, Chonmaya Road, Ford, Tripunithura,Jyothi Special School, Francis Road, Near AKG,CPMaharashtraDyanganga, M.R. & C.P. Special School,CPMokde Nagar, Tumsar, Dist. Bhandara - 441912.New DelhiKrishna Bikalang Kalyan Sanstha,Guidance to allH. No. 6, Ranghat Colony, Wazirabad, New Delhi - 110054.handicappedOrissaChetana Institute for the Mentally Handicapped,CPAt. Bahadir Bagochapada, Kalahandi,Jiban Jyothi Welfare Association for Mentally & PhysicallyCPHandicapped, At. Rathagada, Dhenkanal - 759001.Manpower Institute of Tact Research Action (MITRA),CPAt. New Balabhadrapur, P. O. Korian, Dhenavanar - 759013RajasthanPrayas, 343, Lane No. 2, Raja Park, Jaipur - 302004CPTamil NaduBethshan Special School,CP with2/19, Koodal Nagar, Madurai-625018normal I.Q. 53 to educational needs to this kind. With such facility,(a) Direct Services to Childrendisability. This should be followed by preparationprocedures. After this the most suitable learningchallenged child should be provided. Finally, all(b) Support ServicesThere is need to generate awareness andcommunity as a whole. Parents of CWSN also needchildren and helping them. Teacher training shouldservices in the form of physiotherapy, occupationaltherapy, speech therapy, counseling, etc., should beprovided in the resource room. SSA missions mayalso plan for Vocational Education of DisabledChildren at Upper Primary Level. The planninglow cost/no cost, Teaching and Learning Aids using(c) Monitoring and Evaluationthe process. Therefore, an adequate and efficient 55 Document Preparation ClerkKey Punch OperatorSmall /Petty ShopkeeperCanteen Management Services, Cashier,Production of Hand Made Paper itemsBakery items–Production, packing, maintaining ofProduction of Tailoring items 57 Teachers’ Training T courses around the country. As can be seen fromgreater number of C.P. population countrywide.List of Training Institutions/Universities/National Institutes ImpartingRCI’s Approved Rehabilitation Training Courses in Cerebral PalsyAssamShishu Sarothi, Centre for Rehabilitaion and Training forDSE(CP)Multiple Disability, off Ramakrishna Mission Road,DelhiAction for Ability Development and Inlcusion (AADI),PG Dip.inFormerly The Spastics Society of Northern India,DevelopmentalBalbir Saxena Marg, Hauz Khas, New Delhi-110016TherapyGujaratSmt. Parsanben Narandas Ramji Shah (Talajwala) SocietyDSE(CP)for Relief & Rehabilitation of the Disabled, 51, Vidyanagar,Bhavanagar-364002.KarnatakaThe Spastics Society of Karnataka, 31, 5th Cross,DSE(ASD)Off-5th Main, Indiranagar, Ist Stage, Bangalore-560038.DSE(CP)KeralaRaksha Society for the Care of Children with MultipleDSE(CP)Handicaps,“Yasmin Manzil”, VII/370, Darragh-es-SalaamRoad, Kochangadi, Cochin - 682002.Madhya PradeshShiv Kalyan Shikshan Samiti, LIG-26, 2nd Floor,DSE(CP)Harshwardhan Nagar, Bhopal-462003. 59 Emerging Technologies - Concept1.Systematic application of technology to helpindividuals with disabilities(C.P. in thismeans the “engineer” fabricate devices,and enhance those abilities. Example, if a C.P.forearm becomes the porthole for the C.P.comfort at work.2.The R.E. interfaces with the physicaltherapist, employment specialist and the C.P.C.P. individual operates in, to ensureand style. Mobility, seating, adaptive3.Experience in the West indicates that RE mayof the disabled in general and C.P. inparticular.4.Evaluation/Assessment(i)Based on observation, interview and(teachers included), R.E. evaluates aC.P. person’s individual strengths and R.E. visits the work site(iii)Commercially available aids and deviceseffectiveness. After implementation,productivity, success and failure shouldsuccess and productivity, to be widely available. Alland its value for the C.P. populations’ productiveemployment and economic security. 61 Chapter 10Conclusions programmes for the persons with C.P.We need to go a long way in terms ofEducational and Vocational Training Programmes.We need to do more scientific studies andWe need to reach the rural population within mind the problems of C.P and the ruralEvery child with C.P. should be our concernirrespective of socio-economic profile, geographic 63 For Information On the Newly FormedIndian Academy of Cerebral PalsyFounder & Executive Members of Indian Academy of Cerebraly PalsyJoint General SecretaryDr. P. Hanumantha RaoUpkaar & Sweekar Rahab. Instt. for Handicapped, Associate General SecretaryDr. Sashikala24 A, Chinmay, Baji Prabhunagar,Ujwal Housing Co-op Society, TreasurerSpecial Educator,Dept of Neurosurgery, NIMS,Panjagutta, Hyderabad Joint TreasurerDr. S. PrakashPresidentDr. S. MahadevaiahDevelopment Paediatrician518, Rajmahal Vilas Extension,Sadashiv Nagar, Bangalore. Vice-PresidentDr. Mrs. Mithu AlurChair Person,Spastics Society of India, Afghan Church Road, Joint Vice–PresidentDr. A. K. Johari Joint Vice–PresidentDirector, Spastics Society of Karnataka, Main, Indiranagar, General SecretaryDr. A. K. PurohitProfessor & HODDept of Neurosurgery, NIMSPanjagutta, Hyderabad