Treatment for cerebral palsy

Interventions for movement difficulties

Medication

Medical specialists may prescribe medications that assist movement issues. Some medications are taken orally (e.g. diazepam) and others are injected or delivered through surgically implanted pumps (e.g. Baclofen). Many children with cerebral palsy benefit from Botulinum toxin type A injections into muscles affected by spasticity. This intervention is used from about two years of age and is most effective when used in conjunction with therapy.

See:

• Botulinum Toxin-A injections for supporting pain and comfort
• Occupational therapy following botulinum toxin-A injections

Surgical procedures

Selective Dorsal Rhizotomy (SDR) is a neurosurgical procedure that is used in a small percentage of children with cerebral palsy to permanently reduce spasticity in their legs.

Physiotherapy and occupational therapy

Physiotherapists and occupational therapists focus on encouraging a person’s day-to-day movement skills such as sitting, walking, playing, dressing and toileting. They will use a range of specialist interventions such as movement training and equipment, e.g. walking frames, wheelchairs, supportive seating, footwear and orthotics.

See:

• Ankle Foot Orthoses
• Bimanual upper limb therapy
• Conductive education
• Constraint-induced movement therapy for the leg (CIMT-Leg)
• Goal directed training
• Home programs
• Hydrotherapy for adolescents and adults
• Massage for pain and movement
• Powered mobility
• Treadmill training for people with cerebral palsy

Interventions for muscle, bone and joint difficulties

Surgical procedures

Orthopaedic surgeons correct joint deformities and lengthen muscles. Surgery usually takes place in a child’s late primary years or early adolescence to improve walking quality and reduce pain. Paediatric rehabilitation specialists support the management of some of the conditions associated with cerebral palsy, such as spasticity, musculoskeletal issues and growth.

Casts, splints and muscle strengthening

Physiotherapists and occupational therapists may also focus on preventing impairments that might affect movement. They use casts, orthotics and muscle strengthening exercises.

See:

• Hydrotherapy for adolescents and adults
• Strength training of the arm
• Treadmill training for people with cerebral palsy

Interventions for communication issues

Speech pathology

Communication includes understanding what is being said and learning to use words and sentences. Speech pathologists assess and provide intervention to assist communication skills.
Treatment (intervention) for communication often involves the use of augmentative or alternative communication systems, such as signing, communication boards and speech generating devices.

See:

• Communication Partner Training
• Conductive education
• Eye-gaze technology
• Speech generating devices
• Speech therapy for children with dysarthria

Interventions for intellectual disability and learning difficulties

Assessments, special education and learning strategies

Psychologists can provide assessment of a child’s learning and development. Special educators work with families to develop a program of interventions to address each child’s learning needs. Occupational therapists can facilitate a child’s active participation in these learning activities.

Psychologists and occupational therapists can provide assessment and recommend learning strategies to compensate for perceptual difficulties.

Interventions for epilepsy

Medication

Medical specialists may prescribe antiepileptic medication to minimise the number of seizures. They will also guide families on the management of seizures when they do occur.

Interventions for pain management

Medication

Pain may be treated through medication and by addressing the underlying cause of the pain, e.g. by treating muscle contractures or gastro-oesophageal reflux.

Cognitive-behavioural therapy

Psychologists may offer cognitive-behavioural therapy for chronic pain. This process works to help a person change the way they think about pain and, in turn, how they feel and behave about pain.

See:

• Cognitive behaviour therapy for chronic pain

Massage therapy and hydrotherapy

Temporary relief of pain may be assisted through massage or hydrotherapy.

See:

• Hydrotherapy for adolescents and adults
• Massage for pain and movement

Interventions for sleep disorders

Medication

Medical specialists may prescribe medication or treat the associated issues that impact on sleep.

Behaviour therapy

Psychologists may assist with behaviour therapy or help families to establish routines to help resolve children’s sleep issues.

Sleep systems

For children with postural issues that make sleep difficult, occupational therapists and physiotherapists may prescribe special sleep systems to help children feel more comfortable in bed.

See:

• Behavioural interventions for children’s sleep problems
• Sleep positioning systems

Interventions for behaviour and emotional issues

Behaviour therapy and counselling

Psychologists can offer assessment and support for emotional and behavioural challenges, which may include behaviour therapy and cognitive behaviour therapy. Social workers support people with cerebral palsy and their families in many ways, including strengths-based counselling and mutual aid group work.

See:

• Counselling at the Time of Diagnosis
• Solution focused brief therapy

Interventions for issues with eating, digestion and nutrition

Medication and surgery

Treatment (intervention) for severe difficulties with digestion, such as gastroesophageal reflux (GOR) includes medications or sometimes surgery. Non-oral feeding may be recommended if the individual has severely limited eating skills or experiences an unsafe swallow. This involves a surgically inserted feeding tube to the stomach or the small intestine.

See:

• Gastrostomy feeding

Medical interventions are performed by medical specialists in hospitals.

Speech Pathology

Speech pathologists provide assessment and treatment (intervention) for eating, drinking and swallowing difficulties. Examples of these are learning to use the muscles of the mouth better, using specially designed utensils and sitting in an optimal position.

See:

• Modified foods and thickened fluids

Dietary Advice

Dietitians provide advice on improved and balanced nutrition.

Interventions for issues with saliva control (DRIBBLING AND DROOLING)

Speech pathology

Speech pathologists may suggest various strategies to help people manage saliva loss. These include remembering to wipe their mouth and wearing age-appropriate clothing protection.
They may also recommend special exercises for the face and mouth, which may lead to better ability to control saliva.

Medication

Medical specialists may prescribe medication for saliva control. This is not usually considered a long term treatment option, but can be useful to dry up saliva temporarily. Botulinum Toxin Type A, injected into the salivary glands can reduce the secretion of saliva. In severe cases of drooling, surgery may be suggested to permanently manage saliva.

Interventions for hearing and vision impairment

Hearing and vision impairment are managed as they are for the general population by Ophthalmologists, Optometrists, Audiologists, Ear, Nose and Throat Specialists and General practitioners. Interventions include corrective eye wear (glasses), contact lenses, hearing aids and in some cases medication or surgery.