Cerebral Palsy: How can a multidisciplinary approach help?

Cerebral palsy is caused by a general brain injury that typically happens prior to three years of age. It is most commonly caused by a lack of oxygen or blood flow during pregnancy or birth. A person with cerebral palsy can clinically have a wide range in presentation including but not limited to: low tone (hypotonia), high tone (hypertonia), abnormal reflexes, involuntary movements, weakness, poor balance, and decreased independence with mobility. Rehabilitative services are imperative to assist a child with cerebral palsy to improve quality of life and live the most independent life possible.  

How does PT help? 
Physical therapy is in important part of a child with cerebral palsy’s life, and the earlier the child begins the better the outcome will be. A physical therapy evaluation will include birth and medical history including any surgeries or procedures, range of motion assessments, strength assessments, and functional mobility. In addition to assisting with strengthening, improving balance, and working toward independent transfers and mobility, a physical therapist can help with equipment and orthotic management and referrals. Equipment may play a pivotal role in increasing the independence of the child. Examples of potential equipment that a physical therapist may recommend are: gait trainers, walkers, bath chairs, and/or wheelchairs. A home exercise program will be important to ensure optimal carry over with all progress made during physical therapy sessions.  

How does OT help? 
An OT will assess your child’s overall movement and coordination needed for participation in daily activities. This may include gross motor skills, fine motor skills, visual-perceptual skills and oral-motor development. Using a sensory profile, they may also assess how your child responds to certain sensory inputs like touch and movement. The therapist will also assess functional independence when performing daily activities and pinpoint the specific goals for your child to work toward to reach functional independence at home, in school and in the community. 

How does ST/feeding help? 
Speech Therapy plays an important role in a child with cerebral palsy’s life. An assessment will include birth and medical history.  Furthermore, an assessment of the child’s ability to produce sounds and ability to be understood, assessment of language skills, and voice may be completed.  The use of another mode of communication, such as an AAC (Augmentative Assistive Communication) device may be utilized to increase the child’s ability to use language and be understood. The speech therapist would work closely with his/her OT and PT to make the most appropriate device, if needed, best fits your child’s needs.  
Feeding therapy may also be recommended. Depending on the degree of motor impairment, the child’s ability to chew and swallow food may be impacted, which could lead to a limited diet. A feeding evaluation will include a birth and medical history, an assessment of oral motor skills, and a presentation of a variety of textured foods from different food groups.  Therapy could focus on expanding a child’s diet to include a variety of fruits, vegetables, proteins, and starches, as well as different textures (hard, soft, puree, mixed textured, etc). It may also include exercises to improve coordination and strength of their lips, tongue and jaw so they chew foods more safely. Specific utensils and/or cups may be recommended to help the child improve eating and drinking skills.