Cerebral Palsy (CP) is an umbrella term for a broad group of movement disorders that affect movement and posture due to damage to the developing brain. While it is a life-long physical disability, the way it presents in you or your child can change over time.
There are 34,000 in Australia, 17 million world wide and one in 700 Australian babies is diagnosed with Cerebral Palsy.
The causes of Cerebral Palsy are complex and not fully understood. Cerebral Palsy is often but not always the result of a brain injury. The brain injury can occur during pregnancy, at birth or shortly after birth.
Risk factors for Cerebral Palsy are numerous, and include genetics, pre-term delivery and low birthweight, and pregnancy infection. There is growing research linking Cerebral Palsy to genetics.
Cerebral Palsy is not hereditary (passed down between family members) however it can be the result of a Genetic change in the individual.
While there is no cure for Cerebral Palsy, there is plenty of early intervention and prevention research and practices available here.
How does Cerebral Palsy (CP) affect what people can do?
Cerebral Palsy (CP) affects people differently, with one in three unable to walk, one in three unable to manipulate objects with their hands, and one in four unable to talk. Cerebral Palsy may affect how a person moves (gross motor skills), manipulates objects (fine motor skills), communicates and impact other areas of their health.
Some of the health conditions that can be associated with Cerebral Palsy are Epilepsy, Hearing or Visual impairments, Respiratory (breathing) impairments, difficulty with swallowing food and/ or liquids, pain and sensory processing difficulties.
While the cause of CP (brain injury, genetic change etc) does not change the way CP impacts an individual it is likely to vary at different ages, with changing needs across the lifespan.
How Cerebral Palsy is measured
Cerebral Palsy can be classified in several ways. The most common classification system is the Gross Motor Function Clasification Scale (GMFCS). Impacts on other areas of function such as eating and drinking and fine motor skills can be classified however measuring these impacts does not give a holistic picture of an individuals functioning and quality of life.
GMFCS
GMFCS (Gross Motor Function Classification System) is used to categorise the severity of a person's Cerebral Palsy. This type of assessment looks at a number of different ways of moving including the way the person sits and walks.
The Gross Motor Function Classification System categorises this ability according to 5 different levels, starting from 1 (least severe) through to 5 (most severe).
Level I
Walks without crutches or limitations but has decreased speed, balance and co-ordination.
Level II
Walks Independently, can climb stairs with a railing, may struggle on uneven surfaces or in crowds, cannot run or jump very well.
Level III
Walks using a hand-held mobility device, may be able to climb stairs using a railing.
Level IV
Severely limited, may use powered mobility.
Level V
No self-mobility, must be transported in a manual wheelchair, cannot sit or stand independently even with equipment. Once a child turns 5, it is highly unlikely that they will move between GMFCS level. For example, a 7-year-old that requires a wheelchair will most likely need one for life.
MACS
MACS (Manual Ability Classification System) is used to measure a child’s ability to handle objects in everyday life.
The MAC system examines a child’s ability to handle objects in everyday activities. Similarly to the GMFCS, the MACS also looks at five separate categories. Knowing a child’s MACS level can help parents, teachers and others to understand in which situations a child is independent and the extent to which they need support or adaptations.
Level I
Handles objects easily, some limitations in speed and accuracy when doing manual tasks.
Level II
Some reduced speed and accuracy in object handling, may avoid certain tasks or look for alternatives.
Level III
Experiences difficulty, needs assistance for activities.
Level IV
Needs continuous support, handles only a limited selection of easily managed objects.
Level V
Does not handle objects, needs total assistance.
CFCS
The Communication Function Classification System (CFCS) assesses everyday Communication, focusing on how information is expressed and how it is received. All methods of Communication can be examined using this measurement, including speech, sign language, eye gaze, images, Communication books or boards, and speech generating devices. Familiar and unfamiliar communication partners are also considered with the CFCS.
Level I
Effective sender and receiver with unfamiliar and familiar partners.
Level II
Effective but slower paced sender and/or receiver with unfamiliar and/or familiar partner.
Level III
Effective sender and receiver with familiar partners.
Level IV
Inconsistent sender and/or receiver with familiar partners
Level V
Seldom effective sender or receiver even with familiar partners.
EDACs
Eating and Drinking Ability Classification System (EDACS) is used to measure a child’s eating and drinking ability. This includes safety (aspiration and choking) when eating and drinking, efficiency (food loss and speed of finishing meal) and the amount of assistance a person needs.
Level I
Can independently eat and drink safely and efficiently.
Level II
Eats and drinks safely but with some limitations to efficiency.
Level III
Eats and drinks with some limitations to safety and there may also be limitations to efficiency. Solids may be difficult to swallow and choking may be a risk.
Level IV
Eats and drinks with significant limitations to safety and cannot swallow food and drink without risk of aspiration. Smooth purees and mashed foods can be given through oral feeding.
Level V
Unable to eat or drink safely, relies on tube feeding and is at high risk for aspiration. Levels of assistance Independent – can bring food and drink to mouth without assistance. Requiring assistance – can bring food and drink to mouth using adaptive equipment or requires another individual to assist them using adaptive equipment. Totally dependent - another individual brings food and drink to mouth.
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