October 6, 2020 9:10:57 am
By Dr Sheba Sam
As we go green for World Cerebral Palsy Day 2020 — amid the globally-hit COVID-19 pandemic — let us learn about the uniqueness and the power of people living with cerebral palsy, and what helps in their way to independence and success. Many people with this disability have been using their wings to fly, fighting stigmas and limitations. All it takes to reach great heights is having a heart for it, along with strong faith and confidence.
Cerebral palsy (CP) is a lifelong condition that is caused by non-progressive damage to the infant brain, impacting the developmental trajectory of children, as well as their families. It is the most common physical disability in childhood and has a prevalence of approximately one in 500 live births; it is estimated that globally, 17 million people have CP.
The clinical presentation of CP varies depending on the location and extent of the brain insult. Its symptoms go beyond what is commonly observed in the musculoskeletal system. Individuals with CP may present associated challenges in communication, learning, sensory, cognition, and behaviour, as well as seizure disorder. Due to the complex clinical presentation, individuals with CP and their families with significant economic burden, require coordinated support from health, education, and social services. Regardless of the diagnosis, let them acknowledge that they have many abilities, and that with the right adaptations and modifications of the environment, they can fully participate in activities of daily living.
With both cerebral palsy and occupational therapy sharing the same celebratory month — with just a difference of 21 days — there seems a strong connect. Occupational therapy is an integral part of a cerebral palsy patient’s overall treatment program. Right from the neonatal intensive care unit (NICU), occupational therapy takes on its role of adapting and modifying the stimuli that the premature or the newborn baby is exposed to, providing treatment in areas of eating and feeding (sucking, swallowing skills), maintaining adaptive positions that support the child, encouraging development including methods of handling adaptive-assistive devices, and so on. NICU patients are at high-risk for developmental disabilities including CP. Early identification of CP is essential for effective rehabilitation.
Occupational therapy for cerebral palsy is to promote a child’s ability to perform daily rituals and activities in a way that will enhance their quality of life and make possible the enjoyment of independent living. Occupational therapists focus on assessing and developing an individual’s ability to function to their highest level in daily activities at home, in school, out in public, and at work. They work on improving several core areas including hand functions, gross and fine motor functions, cognitive, perceptual, social and emotional skills, and also home and environment modifications, splints (cock-up splint), adaptive devices (universal cuff for those who struggle with their fine motor skills to assist them in holding objects), leisure and recreation, and so on. Additionally, it enables a child to respond to life’s demands, setting the stage for them to develop relationships, care for themselves, provide for their own physical needs, pursue education, maintain employment, and achieve economic parity with their peers.
Battling against COVID-19, we have a great opportunity to learn from people living with cerebral palsy. Around the globe, people are searching for ways and innovations that would help them adapt to the big change. People who have cerebral palsy have mastered dealing with change, breaking down barriers, and coming up with creative solutions their whole lives. Reading about their success stories and knowing more about life will certainly fill your heart and keep you going up the ladder.
(Dr Sam is an occupational therapist with Prayatna, a private child development centre in Kochi, Kerala)
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