Opening the Door for Children with Cerebral Palsy - www.grandviewcc.ca - Disability Awareness Program
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Disability Awareness Program Proudly Supported by ... Opening the Door for Children with Cerebral Palsy www.grandviewcc.ca
This work is dedicated to the children and youth of Grandview Children’s Centre who show us the way! Introduction About Us When families first find out their child has Cerebral Grandview Children’s Centre offers programs and Palsy, they often feel overwhelmed. With information services for children with special needs, from infancy scattered in books and on the internet, locating to adolescent age. To find out more about these resources to help answer questions can be challenging. programs and services and what our staff may be That’s why Grandview Children’s Centre created this able to do to help you and your child, please visit booklet; to open the door to the world of Cerebral Palsy. our website at www.grandviewcc.ca Hopefully it answers some of your questions and sparks more questions for you to ask us. The bolded words can be found in the glossary at the back of this booklet. Our Mission Grandview Children’s Centre works with children The pictures are of children who attend Grandview and youth with special needs and their families to Children’s Centre. They are all learning about achieve their personal best. everything they are able to do. The photos say it all - these are happy children. Included in the booklet are Our Vision many comments from parents who write about the impact of having a child with Cerebral Palsy. These Grandview Children’s Centre... leading the way to heartfelt words were written for you… read them and excellence in services for children and youth with know that you are not alone. Enjoy reading this booklet special needs and their families. about the wonderful children of Grandview, and how together, we can help them achieve their personal best. 2 3
These heartfelt words were Table of Contents written for you… read them and know that you are not alone. 6 What is Cerebral Palsy? Acknowledgements 7 How is Cerebral Palsy Diagnosed? Wow… who knew that getting ‘Opening the Door for 8 Are there Different Types of Cerebral Palsy? Children with Cerebral Palsy’ off the ground was going to be so much work. It has been such a great experience for 10 What Causes Cerebral Palsy? Allyson and I to work together. She has brought such a 12 How Does Cerebral Palsy Affect my Child’s thoughtful perspective as she wrote, edited and organized Learning and Daily Activities? staff participation for this booklet. 14 How Healthy are Children who have Cerebral Palsy? It is wonderful to see such an insightful and talented young woman make such a great contribution, and for those of 16 Can Cerebral Palsy be Treated? How do we you who are wondering, yes she does have Cerebral Palsy! Manage Cerebral Palsy? We want to thank Grandview Children’s Foundation for 16 What Types of Therapy will my Child Need? their help organizing the photography and layout, and for 17 Cerebral Palsy and Botulinum Toxin A (Botox®) their generous financial support in making this booklet 18 What’s New in Research? come to life. 20 What Other Programs do Allyson Partridge Carolyn Hunt you Offer? Cerebral Palsy Booklet Project Developmental Pediatrician Coordinator Medical Director, 21 The Doors Open… Now What? Grandview Children’s Centre 22 Financial Resources Available for Families of Children with Disabilities 24 Additional Resources 4 26 Glossary 5
What is Cerebral Palsy? What was it like How is Cerebral Palsy Diagnosed? when your child was first diagnosed with Cerebral Palsy? At first, it was difficult and hard to accept What is Cerebral Palsy? How is Cerebral Palsy Diagnosed? that something was wrong with my son. When you have Cerebral Palsy, the part of the brain that controls Parents are usually the first ones to notice their child has difficulty with motor skills. Once I came to terms movement doesn’t work well. There are many causes, but the For example, your child may not sit up or walk as quickly as other children. They may with this, all the help underlying problem is that the signal the brain sends to the do things slightly differently, such as ‘commando crawl’ (crawl right on their belly) or and support from the muscles doesn’t work properly. Commonly, there is difficulty with walk on their toes. It is also common that your doctor or therapist is the first to notice Grandview staff made coordination, balance and tight muscles that make it hard to differences in motor function. Signs of Cerebral Palsy are present within the first 24 it an easier road. walk. Most children’s muscles may feel tight or stiff, which is months of life and it is often suspected as early as 6 months. A firm diagnosis does referred to as spasticity. Some children have only minimal effects not usually take place until 1 - 2 years of age. We always knew from and can walk, while others use a walker or wheelchair. Most the day our son was young children with Cerebral Palsy make progress with their Your doctor is the one who diagnoses Cerebral Palsy. They listen to your child’s born there was a motor skills, but the amount of progress and the amount of time medical and developmental history, especially their motor skills, and review all problem. We went to it will take, depends on how severely the child is affected. aspects of health and development. A physical examination determines whether there many different doctors is tightness in the muscles (spasticity) or increased reflexes. Sometimes pictures of that had many your child’s brain are necessary to confirm a difference in one of the areas that different opinions. controls motor function and this is called Magnetic Resonance Imaging (MRI). The So when our son was decision to proceed with MRI can be discussed with your doctor and depends on your diagnosed, we were child’s symptoms. Putting all this together, along with information about risk factors relieved that finally and results from tests, allows for a diagnosis of Cerebral Palsy to be made. there was an answer. 6 7
Are there Different Types of Gross Motor Cerebral Palsy? Function & Determining the Level of Motor Function Classification System Levels Are there Different Types of Cerebral Palsy? LEVEL 1 Yes. Cerebral Palsy is often classified based on the body part that is Walks without affected and the type of movement problem that is present. restrictions; limitations in more advanced gross Spastic Cerebral Palsy Extra-pyramidal Cerebral Palsy Level of Motor Function (see sidebar) motor skills. Spastic Cerebral Palsy is the most common type Extra-pyramidal Cerebral Palsy is less common and At Grandview, we also classify Cerebral Palsy based on how and means the primary problem is tightness in the accounts for about 10% of all children with your child’s abilities affect their day-to-day life. This is done LEVEL 2 muscles. It involves primarily the legs (spastic Cerebral Palsy. Children with extra-pyramidal using the Gross Motor Function Classification System Walks without diplegia), one side (spastic hemiplegia), 3 Cerebral Palsy have extra movements, called (GMFCS); a research tool that was developed right here in assistive devices; limitations walking affected limbs (triplegia) or the whole body dystonia, or have unsteadiness, called ataxia. Ontario. The GMFCS shows us that children with Cerebral outdoors and in the (spastic quadriplegia). Some children have a combination of spasticity Palsy have symptoms that cluster in 5 Levels. Children with community. and extra-pyramidal Cerebral Palsy, which is then Level 1 have mild motor symptoms and are able to walk and called mixed Cerebral Palsy. Sometimes children’s run. They have differences in speed, quality of movement and LEVEL 3 symptoms don’t fit clearly into one category but the agility. Children with Level 5 have the most severe involvement. Walks with assistive findings on an imaging study, such as MRI, may They use a wheelchair for mobility and require help with most devices; limitations walking outdoors and help clarify the diagnosis. activities of daily living. in the community. Research shows that parents are very accurate in determining LEVEL 4 Cerebral Palsy the level at which their child is functioning. Talk to your team at Self-mobility with Cerebral = Of the Brain the Centre about which level your child is at and what limitations; children Palsy = Lack of Muscle Control are transported or expectations to have about your child’s future motor skills. Your use power mobility doctor or therapy team is usually able to begin to assess this Spastic Dystonic outdoors and in the Twisting movements / posture of limbs between your child’s second and third birthday. community. Hemiplegia Affects arm and leg on the same side Mixed and trunks Diplegia Mixed Cerebral Palsy may have specific features Ataxic LEVEL 5 Primarily affects both legs from both Spastic types and Disturbed sense of balance, involuntary Extrapyrmidal types of Cerebral Palsy movements Self-mobility is (in some there may be limited arm involvement) extremely limited Triplegia Athetoid Difficulty controlling and coordinating movement, even with the use of 3 Limbs involved involuntary movements assistive technology. Quadriplegia All 4 limbs are involved 8 9
What Causes Cerebral Palsy? How is Cerebral Palsy Diagnosed? What advice would you give to parents whose What Causes Cerebral Palsy? child has just There are many different causes of Cerebral Palsy. Sometimes been diagnosed? doctors can pinpoint why a child has Cerebral Palsy, other times it is very difficult to tell. Cerebral Palsy is caused by injury to the Ask, ask, ask questions! developing brain. This injury affects the parts of the brain that control movement: the motor cortex, the cerebellum and the Don't be afraid of the basal ganglia. This can occur before, during or just after birth. diagnosis and take advantage of all One common cause of Cerebral Palsy is prematurity. Infants born information offered. at less than 32 weeks gestational age are more prone to bleeding Don't be afraid to ask in the areas of the brain that control motor function. Bleeding questions of any medical occurs because the blood vessels are not fully developed. If this people. Remember you happens, premature infants will then develop peri-ventricular Common Causes of Cerebral Palsy are in control and you leukomalacia (PVL) which affects the brain’s motor area. PVL will be the best advocate usually leads to a diagnosis of Cerebral Palsy later on. Prenatal (Before Birth) Perinatal (During Birth) Postnatal (After Birth) for your child. • Congenital Malformations • Placental Abruption • Asphyxia e.g. Schizencephaly Another common cause of Cerebral Palsy is stroke. Just like adults, • Hypoxic-Ischemic • Head Injury Breath and research... children can also have strokes and are particularly vulnerable • Congenital Infections Encephalopathy when in utero. No one knows yet how to detect or prevent this, e.g. Rubella, • Brain Infections look for ways you can Cytomegalovirus • Cord Prolapse e.g. Meningitis, assist in your child's although research is ongoing. Children who have Cerebral Palsy Encephalitis progression. caused by a cerebral artery stroke should have screening blood • Shoulder Dystocia • Prematurity / work done to make sure they don’t have any other risk factors for Low Birth Weight Every child is different. bleeding and stroke. • Inflammation of Placenta Have faith, your child may surprise everyone! One common misconception is that Cerebral Palsy is caused by a • Twins / Multiple Births difficult birth. In fact, only a small fraction of Cerebral Palsy is related to specific birth events and in almost all of these cases, even • Clotting Abnormalities e.g. Factor V Leiden the best pre-natal, obstetric and pediatric care could not have Deficiency prevented the difficulties or the development of Cerebral Palsy. 10 11
How does Cerebral Palsy Affect my Child’s Learning and Daily Activities? The Term Cerebral Palsy Refers Only Learning Disabilities to Motor Difficulties There is also a much higher incidence of learning disabilities The term Cerebral Palsy refers only to motor difficulties. and differences, including attention problems, in children with This includes large movements, such as walking and running Cerebral Palsy. Sometimes, the injury to the brain affects other (gross motor skills), and can include movements of the hands areas which control thinking and learning, resulting in an and arms, such as eating and printing (fine motor skills). intellectual delay or a learning disability. The muscles used for speech and language can also be Learning can also be affected because the child has difficulty affected. Speech problems can range from slowed speech, to interacting with the environment due to their movement difficulty being understood, to not being able to speak at all. If difficulties. For example, they may not be able to experience the speech and language difficulty is severe, your child may be the thrill of exploring the ‘pots and pans’ cupboard because able to use an assistive device such as a Picture Exchange they can not get to it and thus lose out on experimenting with Communication System (PECS) or a specialized computer to some sounds, places and objects. This is just one reason why help with their communication. it is important to provide stimulating learning experiences and to bring the environment to them as much as possible. However, most learning issues relate to underlying changes and differences in the brain. The team at Sometimes consultation with a Psychologist is recommended to Grandview can complete a formal evaluation of your child’s skills. The team at help you Grandview can help you understand your child’s strengths and understand your challenges and help you plan appropriate goals. child’s strengths and challenges and help you plan appropriate goals. 12 13
How Healthy are Children What is the best who have Cerebral Palsy? thing about having a child with Cerebral Palsy? How Healthy are Children who have Cerebral Palsy? She is an amazing child; Most children with Cerebral Palsy are quite healthy. However, there are some she makes me laugh medical issues that are more common in children with Cerebral Palsy. everyday. Bones and Muscles Vision and Hearing I think one of the main If a child has difficulty weight bearing, their bone density can be decreased and calcium and vitamin D Some children with Cerebral Palsy have differences in the things is that it put our supplements may be needed. When a child is not able to walk on their own, tight muscles can pull on their muscles that control eye movements. This is called strabismus lives into perspective and joints, particularly the hips. Very tight muscles can cause the hips to slide (sublux) within the socket. Your and can cause one eye to ‘turn in’ or give a ‘cross-eyed’ we don't sweat the small doctor will monitor your child’s hip joints and spine to determine if x-rays are needed. If there are differences appearance. It is important to treat strabismus as soon as things. Our daughter is on the x-ray, or if your child is having pain in their hips, they will be referred to see a Pediatric Orthopedic possible because glasses, patching and/or surgery may be Surgeon who run clinics at the Centre. Sometimes other muscles become very tight and surgery can help helpful to restore the muscle balance and prevent further vision and always has been lengthen these muscles. difficulties. A referral to an Ophthalmologist may be required to such a happy girl with a monitor your child’s progress. A list of Optometrists equipped to smile that melts your Feeding, Growth and Nutrition see children with Cerebral Palsy is also available at the Centre. heart. We have also When a child’s motor system and movement is severely affected, the muscles that control feeding and learned not to under In Ontario, all children have their hearing screened at birth. swallowing are also affected. Occasionally a child will have a gastrostomy tube (g-tube) inserted to help estimate her abilities. However, if your child spent a long time in the Neonatal Intensive with feeding. This is a special tube that goes directly into their stomach and provides either all their nutrition Care Unit (NICU), been on multiple medications, has had a lot I didn't think she could or a ‘top-up’ of calories to help with growth. Your doctor can help you determine if your child is growing of difficulties with ear infections, or there are concerns about their do certain things only to adequately and whether they need more calories to keep up with weight gain. Your child may also be more hearing, the Centre’s Audiologist can retest their hearing. be pleasantly surprised. prone to gastro-esophageal reflux (GERD), constipation, drooling and dental cavities. Usually a community pediatrician will help you manage these issues. Sleep It teaches me about All small children can have sleep challenges. However, a child people with special Seizures with Cerebral Palsy is particularly prone to having them. It is often needs. I'm more aware Children with Cerebral Palsy have an increased risk of seizures; however, many kids never have seizures. harder for parents to let their child ‘cry it out’ as there are so that we can overlook the Epilepsy refers to a pattern of repeated seizures. Children with spastic diplegia have a decreased likelihood many other challenges facing them on any given day. Sometimes negative and think about of seizures compared to children with hemiplegia. Children with spastic quadriplegia have the highest parents worry their child may hurt themselves by crying. All what people with incidence. Children with extra-pyramidal Cerebral Palsy may have unusual movements easily confused with children need a good night’s rest and so do their tired parents! disabilities can do. seizures. Some children will need to take medication to help control their seizures and will be followed by So, if your child is not sleeping through the night by 9 months of a Neurologist. age, talk to your doctor. 14 15
Can Cerebral Palsy be Treated? How do we Manage Cerebral Palsy? Can Cerebral Palsy be Treated? How do we Manage Cerebral Palsy? There is no ‘cure’ for Cerebral Palsy. The focus of treatment is on promoting health, wellness and Speech and Language Therapy participation in the community. Children and families may face challenges because of the disability, Speech-Language Pathologists (SLPs) help children with but this should not stop them from becoming active members of society. Grandview’s goal is to help communication and feeding. They also teach parents ways to children achieve their personal best through therapy, prevention of secondary problems and help their child develop language, speech and other participation in school and community life. communication skills. Sometimes other methods of communication will be introduced such as signing, pictures or electronic devices. Alternative and Augmentative Communication (AAC) is used when communication is very difficult for a child. What is the biggest Physiotherapy Cerebral Palsy and Botulinum challenge? Most children with Cerebral Palsy will see a Physiotherapist (PT) to help develop gross motor skills such as Toxin A (Botox®) rolling, crawling, standing and walking. Physiotherapists use a variety of methods to help with this including an active ‘hands on’ approach, and home programs consisting of stretches, exercises and participation in What is Botox®? The biggest challenge is physical activities. Physiotherapy will be based on specific goals identified by you, your child and their Most children with Cerebral Palsy have stiffness in their muscles and continues to be therapist. Specialized equipment may be suggested, such as a walker or stander. Your child may also benefit referred to as spasticity. When spasticity is severe, sometimes advocating for our from using braces such as ankle-foot orthotics (AFOs). There is an Orthotics Clinic at Grandview where medications can be used to decrease it. Some children may daughter's needs in all your child can be fitted with orthotics made especially for them. benefit from injections of Botulinum Toxin A (also known as areas of her life. Having Botox®) to help reduce this tightness in their affected muscles. to have faith and trust in Occupational Therapy (OT) Botox® temporarily paralyses the spastic muscles so there is less pressure on the joints. The spastic muscles will then grow better so many people dealing An Occupational Therapist (OT) will assess your child’s fine motor skills and determine how their fine motor and the other muscles can be strengthened. The decision to use with your child who is abilities are impacting their participation in daily activities such as dressing, feeding, bathing, printing and ® Botox is made very carefully and is based on the amount of unable to verbally play. Sometimes group therapy will be recommended, other times it will be individual therapy. The OT can spasticity, the child’s medical history, their skills, and input from communicate has and also look at your child’s environment and make suggestions about equipment needs like bath chairs, home parent and child. The Centre has a specialized muscle tone clinic probably always will be modifications and seating options, such as use of a wheelchair. where children are seen by a Physiatrist who will help you decide a challenge for me, if Botox® is right for your child. her mum. 16 17
New Programs & Alternative Therapies Family Support Workers What’s New in Research? Here to Help What barriers exist in society There are many exciting areas of research in Family Support Workers will help you adjust to the news and in the Cerebral Palsy. Virtual reality games may be a that your child has Cerebral Palsy and will provide way to improve hand function in children with opportunities for you to talk with other parents who have community? Cerebral Palsy. Some researchers are looking children with special needs. They will provide information How can families at how the function of an affected hand about specialized community supports, resources and overcome this? improves if the stronger arm is temporarily available financial sources. They can also provide access constrained. There is ongoing research in the to individual and family counseling, educational dosing and scheduling of Botox® injections workshops and support groups. Families who have just We face many physical and scientists are also looking at risk factors for learned their child has Cerebral Palsy have a lot of barriers in the community Cerebral Palsy and ways to prevent injury to questions, not to mention stressors such as multiple and accessibility is still motor areas of the brain. A lot of research is medical appointments. Our family support team is skilled an issue that needs to be undertaken at Bloorview Kids Rehab in Toronto at talking with families, acknowledging their experiences, an ongoing fight. and at Sick Kids. From time to time, Grandview connecting them with other families and helping them Families need to get becomes involved in research and you may be cope with all the new information. involved and speak to asked to participate, if interested. Caring for a child with a special need can local government about be very stressful. There are community these issues. resources that can help with respite Do Alternative Therapies Work? care. Family Support Services can help you find what you need. Many families use alternative and complementary therapies with their children. We understand you may want to try anything to improve your child’s health and abilities. However, it is important to carefully look at the medical evidence for any alternative therapy. We strongly encourage you to discuss your questions with us first, as some therapies may interfere with other treatments, such as seizure medication. There are some complementary therapies that have been shown to be helpful such as therapeutic horseback riding and hydrotherapy (therapeutic swim time). 18 19
What Other Programs do you Offer? Educational, Recreational and Leisure Programs Preschool Programs Recreation and The Door’s Open… Leisure Programs Now What? Children with Cerebral Palsy greatly benefit from a structured preschool environment to enhance The Centre has fabulous recreation, leisure It can often be an overwhelming and their development. Durham Region has many and summer day camp programs, which stressful time when your child is excellent childcare programs available that are made possible by Grandview Children’s diagnosed with Cerebral Palsy. As provide such care. Information about these Foundation. Activities like swimming your child grows and develops, new programs can be found at lessons, creative dance, yoga, martial arts, questions are certain to arise. We www.region.durham.on.ca/childrensservices. sports night and bowling are also offered. encourage you to ask your team at The Centre’s Preschool Outreach Program Some programs are offered at the main the Centre a lot of questions. We (POP) provides consultation to the licensed site, and some elsewhere in Durham such have listed additional resources at preschools and daycares in Durham. There is as at Legends Sports Centre, Ajax the back of this booklet - visit our also a daycare for children with special needs Community Centre, Lakeside Community Resource Centre for more available at Resources for Exceptional Children School and Sinclair High School. The information. In our experience, and Youth. A subsidy can be applied for through activities are not only fun, but give despite the initial sadness that many the Children’s Services Division of The Regional participants a chance to get physical and Municipality of Durham, although the wait list for Campbell Children’s School show off their abilities. parents feel after a diagnosis of Cerebral Palsy is made, most go on this subsidy can be long. Your family support Campbell Children’s School is a small, to find parenting a child with team can help you explore these options. Programs encourage social interaction with specialized school located at the Centre. It is Cerebral Palsy a very rewarding peers and provide the opportunity to designed for children with physical disabilities experience. The children who come explore without parents. Programs are and/or severe speech needs who require active to the Centre are wonderful changing all the time so keep an eye out for therapy. All potential students must be able to blossoming individuals who will the ones that are right for your child. The participate in the daily school program, group achieve AMAZING things! We most recent Rec Guide is always available activities and therapy sessions. Spots are welcome you to the Grandview at Grandview and on our website at available for JK, SK and occasionally Grade family and are confident that we will www.grandviewcc.ca One. Short term placements after surgery may become a positive part of your also be available. Spaces are limited, so discuss family’s life. this option with your child’s therapy team. 20 21
Financial Resources Available for Families of Children with Disabilities Financial Resources Available for Families of Children with Disabilities Jennifer Ashleigh Children’s Charity Special Services at Home (SSAH) Here are some of the financial resources available to families of children with disabilities. This provides financial assistance for children Helps families purchase respite services or You will probably need help to navigate ‘the system’, so talk to one of our Family Support Workers, with disabilities such as treatment needs and allows them to pay a worker to help their child they will be happy to help. medical expenses. develop skills and participate in activities in the 905.852.1799 community. Assistance for Children with www.jenniferashleighfoundation.ca 905.665.1030 www.cfcs.gov.on.ca Disability Tax Credit (DTC) Severe Disabilities (ACSD) Reduces the amount of tax you have to pay if Assists with expenses related to your child’s Ontario Federation for Trillium Drug Plan (TDP) you qualify. A Disability Tax Credit Certificate disability and is based on income. If you Cerebral Palsy (OFCP) This helps families who spend a large portion T2201, signed by your doctor, needs to be sent qualify, your child may receive a drug and This provides some financial support for of their income on prescription drugs. to the Canada Revenue Agency. dental card. equipment. OFCP also offers a variety of 416.326.1558 or 1.800.575.5386 1.800.959.8281 www.ccra-adrc.gc.ca 905.665.1030 www.cfcs.gov.on.ca programs including educational services and www.health.gov.on.ca individualized planning. Easter Seal Society - Durham Region Assistive Devices Program (ADP) 416.244.9868 or 1.877.244.9686 Access 2 Entertainment This helps with some equipment costs such as www.ofcp.on.ca Depending on your child’s abilities, you may This covers approximately 75% of the cost of wheelchairs, orthotics and ramps. Easter Seals certain equipment (i.e. wheelchair, feeding be able to purchase an Access 2 Entertainment also run summer camps and may provide pump, ankle-foot-orthotics). Your child’s Respite Services Card, which provides discounts for financial assistance toward local camp therapist or dietitian can help you apply. Helps families with in-home and out-of-home entertainment activates, such as movies and programs. Look on the National Programs 416.327.8804 or 1.800.268.6021 respite needs and can register you for the other attractions. www.access2.ca page for Access 2 Entertainment Card www.health.gov.on.ca Community Helpers for Active Participation information regarding free admission for (CHAP) Program. CHAP helps families find President’s Choice Children’s Charity support persons. Diaper Grant people interested in working with children with This charity is dedicated to helping children 416.421.8146 or 1.866.6303336 Incontinence Supplies Grant disabilities. Special Services at Home (SSAH) who are physically or developmentally www.easterseals.ca www.easterseals.org funding can be used to pay a CHAP worker. challenged, including children with Cerebral Available from Easter Seal Society for children 416.322.6317 www.respiteservices.com Palsy. They are committed to helping remove over age 3 that use diapers. Your doctor must sign the application. barriers to independence and may help fund 1.888.377.5437 www.easterseals.org mobility equipment and environmental modifications. www.presidentschoice.ca/Childrenscharity 22 23
Additional Resources Additional Resources Please visit our Resource Centre for more information! Grandview Children’s Centre Disability Taking Cerebral Palsy to School American Academy for Cerebral Palsy and Awareness Program Developmental Medicine Elizabeth Anderson, Valley Park, MO: 2000. Other resources for school age children and their JayJo Books, L.C. www.aacpdm.org classmates 905.728.1673 ext 2560. I’m Wendy Blair, Not a Chair! Need a family doctor? Children with Cerebral Palsy Try The College of Physicians and Surgeons of Carolyn MacDiarmid. 2002. Canadian A Parents’ Guide - Second Edition Ontario’s doctor search. www.cpso.on.ca Council on Rehabilitation and Work. Edited by Elaine Geralis.Woodbine House 1998. Wendy doesn’t have Cerebral Palsy, she has a spinal cord injury, but this is such a great book Ontario Federation for Cerebral Palsy to send to school for the SK to Grade 3 classes www.ofcp.on.ca to read. Ontario Paralympics Sports Association Grandview Children’s Centre Website www.paralympicsontario.ca/ocpsa.shtml www.grandviewcc.ca Parentbooks.com Cerebral Palsy: What Parents and A bookstore in Toronto that has great resources Doctors Want to Know for families of children with special needs. Peter Rosenbaum. British Medical Journal, Volume 326, pg.970-974, May 3, 2003. A Comprehensive Guide to Intellectual & Developmental Disabilities CanChild Centre for Childhood Brown & Percy 2007. Disability Research Chapter on Cerebral Palsy written by www.canchild.ca Drs. Hunt & Fehlings. 24 25
Glossary Alternative Therapy Constipation Gastro-Esophageal Reflux Disease (GERD) Picture Exchange Communication Therapy that is outside the scope of traditional A child is not having regular, soft bowel Liquid and/or food that is in the stomach and System (PECS) medical practice. movements. Frequency of normal bowel moves back up to into the esophagus. Many A series of cards, which can be used in place of movements can vary from child to child but young children experience this, but when a spoken language, to request items and activities. Ankle-Foot-Orthotic (AFO) most typically developing children will have child has Cerebral Palsy and their muscles Physiotherapist (PT) A plastic brace that is molded to the shape of at least one bowel movement per day. don’t function normally, the reflux can be A professional trained to help achieve your child’s foot. It helps maintain a stretch on severe. Some symptoms include pain, maximum mobility. tight muscles and a normal foot position. Developmental Pediatrician irritability and vomiting. A Pediatrician who has completed specialized Prematurity Ataxia training in child development. They will collect Gross Motor Function Classification Infants who are born before 37 weeks gestational A disorder of movement that results in detailed information and do a physical System (GMFCS) age. instability while walking. examination to make a diagnosis. Sometimes Describes the severity of Cerebral Palsy. Audiologist they will complete additional tests to assess Psychologist Gross Motor Skills A professional trained in assessing thinking A professional who assesses hearing. specific aspects of development. Large movements such as rolling, sitting, or cognitive skills. Basal Ganglia Diplegia crawling, standing and walking. Specialized structures in the brain that help When primarily the legs are affected. Quadriplegia Gastrostomy Tube (G-Tube) When both arms and both legs are affected. control movement. Dystonia A tube inserted by a surgeon or radiologist into Botulinum Toxin A (Botox®) Muscles that have variability in tone. Children the stomach by making a small incision in the Seizure Medication used to treat muscle tightness. It is usually have some uncontrolled movements. skin and stomach lining. It is used for children An electrical discharge in the brain that causes the derived from a toxin produced by a bacteria that who are unable to manage pureed food or nerve cells to fire too quickly resulting in a loss of Epilepsy consciousness and shaking of the arms and legs. causes temporary muscle weakness. who are having trouble taking in enough A condition where an individual has seizures Sometimes seizures are subtle and will result in calories to maintain their weight. Cerebellum regularly. loss of control of only certain muscles, staring A structure at the back of the brain that is often Hemiplegia spells or changes in heart rate. Extra-Pyramidal Cerebral Palsy considered to be the “control centre” When one side of the body is affected. Cerebral Palsy that is predominately a Spasticity for movement. movement disorder as opposed to spasticity. Magnetic Resonance Imaging (MRI) ‘Tightness’ in the muscles. Cerebral Artery Stroke A large magnetic tube machine. The child goes Family Support Worker Speech-Language Pathologist (SLP) A blockage or bleed of one of the main blood inside the tube and the magnetic forces in their A social work professional with a broad range A professional trained to assist in verbal or vessels of the brain. brain are measured and turned into a picture. of skills who can help you and your family cope non-verbal (pictures, computers, signs) speech Commando Crawl with the challenges of having a child with a Motor Cortex production and language skills. When a child moves on their stomach by disability and provide links to financial and The area in the brain that controls basic motor pulling along with their arms, without much community programs. function. Strabismus movement in the legs. (i.e. an army A visual disorder where the eyes are misaligned Fine Motor Skills Occupational Therapist (OT) and point in different directions. commando crawling under a wire.) Movements of the hand and arm, such as A professional trained to help achieve maximum Complementary Therapy eating, dressing and printing. functional independence and often focuses on Sublux Used in conjunction with traditional medical hand function and equipment needs. Gradual movement of the head of the femur bone therapy. It may include such things as (top of the leg) within the hip socket. When a child has Periventricular Leukomalacia (PVL) very tight muscles and is not weight bearing, this therapeutic horseback riding or sensory Injury to the white matter surrounding the movement can change the forces at work on the hip, integration therapy. ventricles (spaces) in the brain. causing the hip to gradually move out. 26 27
600 Townline Road South, Oshawa, Ontario L1H 7K6 Tel: 905.728.1673 or 1.800.304.6180 Fax: 905.728.2961 Email: info@grtc.ca www.grandviewcc.ca
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