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CEREBRAL PALSY

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About Cerebral Palsy

Cerebral palsy (CP) is a term used to describe a group of chronic conditions affecting body movement and muscle coordination. It is caused by damage to one or more specific areas of the brain, usually occurring during fetal development; before, during, or shortly after birth; or during infancy. Thus, these disorders are not caused by problems in the muscles or nerves. Instead, faulty development or damage to motor areas in the brain disrupt the brain's ability to adequately control movement and posture.

 

 

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"Cerebral" refers to the brain and "palsy" to muscle weakness/poor control. CP itself is not progressive; however, secondary conditions, such as muscle spasticity, can develop, which may get better over time, get worse, or remain the same. CP is characterized by an inability to fully control motor function, particularly muscle control and coordination

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Other problems that may arise are difficulties in feeding, bladder and bowel control, problems with breathing because of postural difficulties, skin disorders because of pressure sores, and learning disabilities.

Other problems that may arise are difficulties in feeding, bladder and bowel control, problems with breathing because of postural difficulties, skin disorders because of pressure sores, and learning disabilities.

Note: Cerebral palsy is included under locomotor disabilities under RPwD ACT of 2016.

Birth asphyxia is one of the major causes of cerebral palsy.

 Cerebral palsy was found to be associated with premature births. Cerebral palsy and mental retardation may overlap however there are many children with cerebral palsy with normal intelligence. It is important for accurate early diagnosis by doctors to ensure they get need based interventions.

There are several types of Cerebral Palsy:

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  • Spastic Cerebral Palsy: People with spastic CP have stiff and jerky movements because their muscles are too tight. Mobility and handgrip are difficult to control. This is the most common type of CP and affects half of all people with CP.

 

  • Ataxic Cerebral Palsy: Low muscle tone and poor coordination of movements is described as ataxic. Shakiness or tremors make writing, page turning or using a keyboard difficult to perform. Poor balance and unsteady walking requires extra mental concentration or more time to complete the movements.

 

  • Athetoid Cerebral Palsy: Athetoid refers to a type of CP involving mixed muscle tone, too high or too low. Random, involuntary movements result in movements of the face, arms and upper body. Walking, sitting upright and maintaining posture control takes extra work and concentration. About one fourth of people with CP have athetoid CP.

 

  • Mixed Cerebral Palsy: When muscle tone is too low in some muscles and too high in other muscles, the type of CP is called mixed. About one fourth of all people with CP have this type.

 

​CP needs to be understood with a general definition of disability that each person must meet. A person has a disability if he/she has a physical or mental impairment that substantially limits one or more major life activities, a record of such an impairment, or is regarded as having an impairment. For more information on CP refer to RPD ACT.

Accommodating Students with Cerebral Palsy:

 

People with cerebral palsy may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with cerebral palsy will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.

 

Questions to Consider:

 

  1. What limitations is the student experiencing?

  2. How do these limitations affect the student and the student’s job performance?

  3. What specific job tasks are problematic as a result of these limitations?

  4. What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?

  5. Has the student been consulted regarding possible accommodations?

  6. Once accommodations are in place, would it be useful to meet with the student to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?

  7. Do supervisory personnel and students need training?

Accommodation Ideas
By Limitations

By Limitation of: Drooling

  • Drooling Aids

  • Flexible Schedule

  • Rest Area/Private Space

  • Telework, Work from Home, Working Remotely

By Limitation of: Handling / Fingering

Industrial

  • Anti-vibration Gloves

  • Anti-vibration Tool Wraps

  • Compact Material Handling

  • Ergonomic and Pneumatic Tools

  • Ergonomic Equipment

  • Extra Grip Gloves

  • Grip Aids

  • Vacuum Pickup Tools

Other

  • Aide/Assistant/Attendant

  • Money Handling Products

  • Periodic Rest Breaks

Office Equipment

  • Alternative Input Devices

  • Alternative Keyboards

  • Alternative Mice

  • Articulating Keyboard Trays

  • Book Holders

  • Compact Material Handling

  • Ergonomic Equipment

  • Expanded Keyboards

  • Forearm Supports

  • Grip Aids

  • Keyguards

  • Miniature Keyboards

  • On-Screen Keyboards

  • One-Handed Keyboards

  • Page Turners

  • Writing Aids

  • Typing / Keyboarding Aids

  • Scribe/Notetaker

  • Speech Recognition Software

  •  

  • Other

By Limitation of: Organizing / Planning/ Prioritizing

  • Applications (apps)

  • Apps for Organization/ Time Management

  • Color-coded Manuals, Outlines, and Maps

  • Electronic Organizers

  • Ergonomic Equipment

  • Job Coaches

  • Job Restructuring

  • On-site Mentoring

  • Organization Software

  • Personal On-Site Paging Devices

  • Professional Organizers

  • Reminders

  • Supervisory Methods

  • Task Identification

  • Task Separation

  • Timers and Watches

  • Wall Calendars and Planners

  • Written Instructions

By Limitation of: Toileting / Grooming Issue

  • Accessible Toilets and Toilet Seats

  • Aide/Assistant/Attendant

  • Flexible Schedule

  • Grab Bars - Toilet Hinged Arm Support

  • Grooming and Dressing Aids

  • Independent Living Aids

  • Modified Break Schedule

  • Swing Away Grab Bars

  • Telework, Work from Home, Working Remotely

  • Toileting Aids

  • Transfer Aids

  • Transfer Sheets

  • Worksite Redesign / Modified Workspace

By Limitation of: Walking

  • Scooters

  • Walkers

  • Wheelchairs

By Work-Related Function

Access Information

  • Accessible Mobile Phones

  • Accessible Telephones

  • Adjustable Desk Top Workstations for Office Settings

  • Aide/Assistant/Attendant

  • Alternative Input Devices

  • Alternative Keyboards

  • Alternative Mice - Limiting Tremors

  • Alternative Mice

  • Breath and Mouth Controlled Alternative Computer Input Devices

  • Eye Controlled Alternative Computer Input Devices

  • Head Controlled Alternative Computer Input Devices

  • Keyguards

  • Large Button Phones

  • On-Screen Keyboards

  • One-Handed Keyboards

  • Prism Glasses/Bed Spectacles

  • Speech Recognition Software

By Limitations of Commute
1. Drool
2. H/F
3. o/p/p
4. Toilet
5. Walk
6. Access
Accommodation Ideas
7. Commute

  • Flexible Schedule

  • Ridesharing/Carpooling

  • Telework, Work from Home, Working Remotely

  • Transportation Assistance

  • Van Conversion

  • Walkers

8. Off Site
By Limitations of Off-Site Access

  • Accessible Vehicles

  • Accessories for Scooters

  • All-Terrain Scooters

  • All-Terrain Wheelchairs

  • Examination and Procedures Chair

  • Flexible Schedule

  • Head Support for Wheelchairs

  • Low Task Chair

  • Personal Transportation and Mobility Products

  • Scooters

  • Stair Assists

  • Telework, Work from Home, Working Remotely

  • Transportation Assistance

  • Van Conversion

  • Wheelchair Accessible Scales

  • Wheelchair Carts/Trailers

  • Wheelchair Mounts

By Limitation of: Parking
9. Parking

  • Accessible Parking Space

  • Flexible Schedule

  • Telework, Work from Home, Working Remotely

  • Wheelchairs

By Limitation of: Work Site Access
10. Work Site

  • Accessible Toilets and Toilet Seats

  • Accessories for Scooters

  • Adjustable Workstations for Industrial Settings

  • Adjustable Workstations for Office Settings

  • All-Terrain Scooters

  • Anti-fatigue Matting

  • Automatic Door Openers

  • Boat Access

  • Braille and/or ADA Signage

  • Door Knob Grips and Handles

  • Examination and Procedures Chair

  • Flexible Schedule 

  • Head Support for Wheelchairs

  • High Visibility Floor Tape and Paint 

  • Low Task Chair 

  • Portable Ramps 

  • Service Animal

  • Smart Locks/Keyless Entry Locks 

  • Stair Assists

  • Stair Tread/Textured Tape 

  • Support Animal

  • Telework, Work from Home, Working Remotely 

  • Van Conversion 

  • Wearable Anti-fatigue Matting

  • Wheelchair Accessible Scales 

  • Wheelchair Carts/Trailers

  • Wheelchair Lifts 

  • Wheelchair Mounts 

  • Worksite Redesign / Modified Workspace

By Limitations of Workstation Access
11. Workstaton access

  • Accessories for Scooters

  • Adjustable and Ergonomic School Desks and Equipment

  • Adjustable Desk Top Workstations for Office Settings 

  • Adjustable Workstations for Industrial Settings 

  • All-Terrain Scooters 

  • Anti-fatigue Matting 

  • Articulating Keyboard Trays 

  • Assist Lift Cushions 

  • Chair Mats 

  • Chairs for Little People 

  • Chairs for People who are Tall

  • Dual Monitors

  • Elevating Lift and Office Chairs

  • Ergonomic and Adjustable Office Chairs

  • Ergonomic Equipment

  • Examination and Procedures Chair

  • Expanded Keyboards

  • Forearm Supports

  • Forward Leaning Chairs

  • Head Support for Wheelchairs

  • Large-Rated Chairs

  • Low Task Chair

  • Monitor Mirrors

  • Monitor Risers

  • Mousing Surfaces

  • Stair Assists

  • Stand-lean Stools

  • Supine Workstations

  • Van Conversion

  • Wheelchair Accessible Scales

  • Wheelchair Carts/Trailers

  • Wheelchair Mounts

  • Work Platforms

  • Zero Gravity (reclining) Chairs

Situations & Solutions
Situations and Solutions

  1. A student with cerebral palsy could not walk long distances.His college provided him with motorized scooter and arranged peer support .

  2. A student with cerebral palsy had difficulty using key board due to mild spasticity in her upper extremities. Her employer purchased a keyguard to go over her keyboard to help her hit the right keys and forearm supports to help stabilize her arms.

  3. A student with CP had difficulty walking to classrooms from gate in a school on hill top in Uttarakhand. We suggested to use a rope way basket from home gate to classrooms using local bamboo baskets which are used in hilly areas.

  4. A university student with cerebral palsy used a speech generating communication device to meet her communication needs at work and elsewhere. Her device worked well with her personal cellphone, but she needed a speakerphone in order to take calls on the office phone line. Due to workplace changes, she needed to start sharing an office with two coworkers. Her employer purchased an adapter for the device so that she could use her device with the telephone more discreetly. 

  5. A student with cerebral palsy needed assistance with lunch, including getting food from the cafeteria and eating. His college provided a peer assistant for the student’s entire lunch hour.

  6. A teacher with cerebral palsy had difficulty manipulating papers and writing on the chalkboard. She was provided a teacher’s aide to pick up and pass out student papers and an overhead projector to replace the chalkboard.

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