Cerebral palsy takes many forms – in fact no two children with cerebral palsy are precisely alike, Some are so lightly affected that they have no obvious disability. Others may be much more seriously handicapped, They may be clumsy in their walk, or they may have difficulty using their hands or with their speech, and they may well be dependent on others. If the damage involves certain parts of the brain it may cause hearing loss, poor vision, disturbances of the sensation of touch or difficulties of perception, that is to say, the ability to give meaning to what the child hears, sees or touches. Consequently many children also have specific learning difficulties which make them slow to learn. These children will require special teaching techniques.

Quite a large proportion of cerebral palsied children are backward because of their handicaps, On the other hand children with cerebral palsy may have higher than average (or "normal") intelligence, but their intelligence may be disguised by their handicaps. Some have involuntary facial movements which give the impression that they are retarded, but some of those who seem to be severely handicapped are in fact least affected in their intellect.

What causes cerebral palsy?

Cerebral palsy is not a disease and it is unusual for two cases to occur in the same family. Broadly speaking a child with cerebral palsy is born once in every 400 live births.

Another cause of cerebral palsy that is becoming more and more common is damage to the brain caused by accidental injury. This may occur should a child sustain a head injury in a fall, a road accident or at play.

The nature of the problem

Inherited defects do not play a large part in cerebral palsy; the problem is mainly one of brain damage or lack of development of an area of the brain.

In the diagram, important sections of the brain are illustrated. The cortex, or outer layer, has to do with movements, thought and sensation. Within the brain the basal ganglia help to make movement well organised, graceful and economical. The cerebellum at the base of the brain governs functions of the body such as posture and balancing. It is linked to the brain stem which connects the spinal cord with the upper brain.

Are there several kinds of cerebral palsy?

Yes; there are three main forms of cerebral palsy: spasticity, athetosis and ataxia. Sufferers from all three types are commonly called by the general term "cerebral palsied".

The spastic child has increased tone in affected muscles, disordered movement and often disturbance of growth and development. Damage to the cortex of the brain appears to be the cause of the spastic condition. It may affect the arm and leg on one side of the body (hemiplegia), both arms to a lesser extent and both legs to a greater extent (diplegia) or all four limbs equally (quadriplegia).

The main feature of the athetoid cerebral palsied child is lack of muscular control with frequent involuntary movements which interfere with the normal movements of the whole body. Athetosis results when the basal ganglia of the brain are damaged.

The child with ataxia has an unsteady gait and difficulty in balancing. This form of cerebral palsy is linked to injury to the cerebellum.

Can cerebral palsy be cured?

The source of the problem is not in the affected limbs but in the cells of the brain, Correct treatment given early enough in life can often bring great benefit, though not a cure. No way has yet been found to repair the damage done to the brain cells themselves, The damage does not spread, but the effect of that damage may increase as the child grows older.

Early recognition of the condition is very important. Diagnosis must be followed by speedy and skillful assessment by specialists. A comprehensive treatment programme can then be drawn up and the parents shown how to carry out part of it at home as they have an essential part to play in the programme. Children with cerebral palsy are in need of the best standard of care that love and modern knowledge can give: every child deserves this, In reaent years there has been considerable progress in providing the special services which can bring the greatest possible benefit to this group of the handicapped, and help them to make the most of what they have.

Our hope of diminishing the world-wide tragedy of cerebral palsy is to master its causes and so eliminate it as far as possible at its origin – through intensive research.

The National Cerebral Palsy Division

The National Cerebral Palsy Division was inaugurated in 1955 by the National Council for the Physically Disabled in South Africa. The Division caters for the needs of the cerebral palsied on a country-wide basis.

Since 1948, tremendous progress has been made in South Africa in the field of cerebral palsy habilitation. Thanks to State subsidies, voluntary associations have been able to establish schools equal to the best in the world in various parts of the Republic and for all population groups. Provision is now also being made for retarded cerebral palsied children.

Diagnostic and assessment clinics operate in many schools and centres throughout the Republic, Provincial hospitals are also expanding clinical services for the cerebral palsied.

Every person with cerebral palsy has an impairment, but an impairment does not necessarily mean a disablement. In other words, the fact that an individual has an anatomical or psychological problem does not necessarily mean that he is dependent on other people for the performance of his activities of daily living or that he is not capable of productive activity. The aim of treatment is to improve the quality of his life and to enable him to earn a living.

Attention is being given to the needs of cerebral palsied school leavers. The number of protective workshops for those who are unsuited for placement in the open labour market is expanding, aided by improved subsidies and the forward-thinking policies of the responsible State departments.

What remains to be done?

A great deal remains to be done.

• Special clinics and treatment facilities must be available for all those who require help – wherever they may live.
• Homes are needed for cerebral palsied children and adults requiring long term total care
• Accommodation, vocational training and sheltered employment opportunities must be provided for those who require them.

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