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Cerebral palsy can’t be cured, but treatment will often improve a child's capabilities. Many children go on to enjoy near‑normal adult lives if their disabilities are properly managed. In general, the earlier treatment begins the better chance children have of overcoming developmental disabilities or learning new ways to accomplish the tasks that challenge them.
Treatment may include physical and occupational therapy, speech therapy, drugs to control seizures, relax muscle spasms, and alleviate pain; surgery to correct anatomical abnormalities or release tight muscles; braces and other orthotic devices; wheelchairs and rolling walkers; and communication aids such as computers with attached voice synthesizers.
Its important to develop a compressive plan. A team of health care professionals should construct an individualized treatment plan based on the patient's needs and problems. It is imperative to involve patients, families, teachers, and care givers in all phases of planning, decision making, and treatment. A pediatrician, pediatric neurologist, or pediatric physiatrist (physician who specializes in physical medicine) provides primary care for children with CP.
Physical therapy: This is one of the most important therapies for children with cerebral palsy. Muscle training and exercises may improve strength, balance and mobility and lead to greater independence. Stretching is one component of a program that may help slow the formation of contractures (limitation of joint range of motion). Physical therapy should begin as soon as a muscle tone abnormality or developmental delay is detected and may continue for years. Specialists assist with recommendations regarding wheelchairs and other mobility devices when needed.
To prepare a child for school, the focus of therapy gradually shifts toward activities associated with daily living and communication. Exercises are designed to improve the child's ability to sit, move independently, and perform tasks such as dressing, writing, and using the bathroom.
Medications: Medications may relax tight muscles and reduce tremors and muscle spasms. Injectable medications such as Botox or phenol may be used to reduce areas of muscle spasticity. People who have seizures also may need antiseizure (anticonvulsant) medications. If other medical conditions are present, additional medications may be necessary.
Orthotic devices: For children with cerebral palsy, muscles do not grow fast enough to keep pace with lengthening bones. The resulting contracture can disrupt balance and trigger loss of abilities. Special braces (orthotic devices) combined with physical therapy and other interventions may prevent this complication by stretching spastic muscles.
Surgery: Surgery may help loosen tight or stiff muscles or correct problems such as curvature of the spine or uneven leg growth. To decrease spasticity, a surgeon can implant a pump to deliver medications to the spinal cord or sever nerve roots (rhizotomy) that contribute to increased muscle tone.
A child may need surgery on muscles, tendons, nerves or joints to place his or her arms and legs in their correct positions. Surgery can help facilitate sitting or walking, improving a child's ability to use the hands, decreasing pain, easing care issues for families and avoiding future surgeries.
Surgery may also be used to place feeding tubes and to control gastroesophageal reflux. Recently, botulinum toxin injections have been used to reduce or delay the need for surgery.
Occupational therapy: This therapy often focuses on developing a child's hand function, hand skills and self‑care skills. Feeding and swallowing problems may be addressed. Occupational therapists also have expertise regarding special equipment that can benefit a child in daily living, school and mobility.
Speech therapy: Speech therapists can help children improve their speech and language skills or use of alternative means of communication.
Play Therapy: Play is an essential activity for all children. This is where real learning begins. Because some children with cerebral palsy are more limited in their physical ability, it may not be easy for them to engage in spontaneous play, so be ready to give your child any assistance they may need to help them enjoy playing. It not only helps to release stress, it can also aid their development, and in some cases speed it up. Playing also increases hand-eye coordination, can aid in developing fine motor skills, and as they get older, can aid in developing their gross motor skills. This is an area where friends and family can be fully involved in the therapy of your child’s development.
Behavior/Psychological therapy: Behavioral therapy can complement physical therapy, employing psychological techniques that encourage the mastery of tasks that promote muscular and motor development. Praise, positive reinforcement, and small rewards can encourage a child to learn to use weak limbs, overcome speech deficits, and stop negative behaviors like hair pulling and biting.
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