Cerebral Palsy

OT Dude Academy’s Free NBCOT® Exam Prep Course Pediatric Conditions Cerebral Palsy

  • Nonprogressive disorder of the CNS
  • Known as static encephalopathy
  • Symptoms may change even though the disease itself does not progress.
  • Affects posture, motor function, movement, and cognition.
  • Associated symptoms: epilepsy, language, speech, sensory, psychosocial, bowel and bladder.
  • Pathophysiology: Due to a lesion in the developing brain.
  • Types:
    • Congenital: trauma, environmental toxins, low birth weight, premature birth, infertility treatments, medical complications
    • Acquired: injuries and infections; falls, child abuse
  • Affects coordination, speech, and development1 
  • Gait presentations: toe walking, crouched, scissored, widened, asymmetric
  • Sensory impact: vision, hearing, smell, touch, pain
  • Behavioral problems and family stressors
  • Terminology to review: hemiplegia, quadriplegia, diplegia, spasticity, rigidity, flaccidity, athetosis, choreoathestosis, dyskinesia (see video)
  • Types:
    • Spastic (70-80%) – Motor cortex
    • Athetoid-dyskinetic (10-20%) – Basal ganglia
    • Ataxic (5-10%) – Cerebellum
    • Mixed (<5%)
  • Early signs of CP
    • Stiffness
    • Floppiness
    • Atypical reach
    • Difficulty with rolling
    • Atypical crawling
  • Treatment team: MD, specialists, PT, OT, SLP, psychologist, RN, SW
  • Serviced by IDEA Parts B and C, Early Intervention (EI)
  • Outcome measures
    • COPM
    • Goal Attainment Scaling
    • Activity Card Sort (Adult and Pediatric Versions)
    • Sensory Profile
    • Modified Ashworth Scale
    • WeeFIM
    • PEDI
    • Child Health Questionnaire (CHQ)
    • ABILHAND Kids
    • Erhardt Developmental Prehension Assessment
    • Box and Blocks
    • Peabody Developmental Motor Scale (PDMS)
    • Bayley Scales of Infant and Toddler Development
    • Bruininks-Oseretsky Test of Motor Proficiency (BOT)
  • OT Interventions most supported by EBP2 
    • Constraint-Induced Movement Therapy (CIMT)
    • Orthotics and Casting (Lower limb casting)
    • Goal-directed training
    • Bimanual training
    • Context-focused therapy
    • Home programs
  • Use with caution: NDT, SI3 
  1. CDC. (2022). Cerebral Palsy (CP). Retrieved from https://www.cdc.gov/ncbddd/cp/index.html[↩]
  2. Steultjens, E. M., Dekker, J., Bouter, L. M., Van De Nes, J. C., Lambregts, B. L., & Van Den Ende, C. H. (2004). Occupational therapy for children with cerebral palsy: a systematic review. Clinical rehabilitation, 18(1), 1-14.[↩]
  3. Novak, I., Mcintyre, S., Morgan, C., Campbell, L., Dark, L., Morton, N., … & Goldsmith, S. (2013). A systematic review of interventions for children with cerebral palsy: state of the evidence. Developmental medicine & child neurology, 55(10), 885-910.[↩]
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