What is cerebral palsy? Explained

In the previous post we learned about Multiple disabilities In this article, the fundamental knowledge about people with cerebral palsy in India is introduced. Additionally covered in the module are cerebral palsy's definition, epidemiology, history, types, origin, severity, and prevalence.

At the end of this blog, the reader will:

Develop a thorough understanding of the meaning, aetiology, and history of cerebral palsy.
Recognize the many forms of cerebral palsy
Research the origins and signs of cerebral palsy.
Gain knowledge of cerebral palsy treatment.

Introduction
Definition of Cerebral Palsy
Epidemiology
History of Cerebral Palsy
Causes of Cerebral Palsy
Types of Cerebral Palsy:
Other conditions associated with cerebral palsy
Diagnosis of Cerebral Palsy
Management of Cerebral Palsy
Conclusion

Introduction

Cerebral Palsy (CP) is a diagnosis name for a set of motor syndromes caused by abnormalities in early brain development. A person's ability to complete daily tasks depends on his or her muscular strength. The development of muscle strength and power is a crucial developmental activity. CP is a diverse, persistent mobility and postural disease. It is a persistent, nonprogressive neurological disorder caused by immature brain abnormalities or laziness. Cerebral palsy affects the motor area of the outer layer of the brain (called the cerebral cortex), which controls muscular movement. Although CP affects muscle mobility, it is not caused by muscle or nerve dysfunction. Typically, the first signs of cerebral palsy show before a child reaches the age of three. The most prevalent symptoms are a lack of muscle coordination when performing voluntary movements (ataxia); stiff or tight muscles and exaggerated reflexes (spasticity); walking with one foot or leg dragging; walking on the toes, a crouched gait, or a "scissored" gait; and muscle tone that is either too rigid or too lax. A tiny proportion of children develop cerebral palsy as a result of brain damage in the first few months or years of life, brain diseases such as bacterial meningitis or viral encephalitis, or head trauma from a car accident, a fall, or child abuse. (Cerebral Palsy Information Page from NINDS)

Individuals with cerebral palsy are denied access to human rights, inclusion, communication, and basic services such as healthcare, education, and employment despite the international and state declarations of the rights of persons with disabilities. Due to the severity of the issue, it is crucial that cerebral palsy receives more socioeconomic and political attention. The inclusion of individuals with cerebral palsy necessitates that social workers having a role in bringing about change within the population be knowledgeable about the services accessible to them. Consequently, social work in the topic of disability gained prominence in India's Social Work Education.

Definition of Cerebral Palsy

Cerebral palsy is a group of disorders that affect how movement and posture develop and limit a person's ability to do things. These disorders are caused by nonprogressive changes in the developing brain of the foetus or infant. The motor problems that come with cerebral palsy are often accompanied by problems with feeling, thinking, communicating, perceiving, acting, and having seizures. (Martin Bax, et. al. 2005)

Mac Keith and Polani defind CP as “a persisting but not unchanging disorders of movement and posture, appearing in the early years of life and due to non-progressive disorders of the brain, the result of interference during its development. (Mac Keith, et. al., 1959)

According to the Rehabilitation Council of India, Cerebral Palsy is a group of conditions marked by long-term problems with movement or posture. It starts in the cortex, shows up early in life, and is not caused by a disease that gets worse over time. Cerebral Palsy is a syndrome, which means it is a group of symptoms that happen together:
(a) Disorder of Movement.
(b) Health problems.
(c) Problems with the senses.
(c) Hearing Disabilities.
e) Lack of attention.
(f) Language & Perceptual Deficits.
(g) Problems with behaviour.
(h) Retardation of the mind. (RCI, 2006)

Epidemiology

Developmental disabilities are a group of disorders that affect children and are caused by damage to their developing brains. In India, it affects a huge number of children. The condition has serious effects on the person, his or her family, and the community in terms of socioeconomics, emotions, and the quality of life for a large number of people who are affected. Mental Retardation, Cerebral Palsy (CP), Communication Disorders, Learning Disabilities, Attention Deficit Hyperactivity Disorder, and Childhood Autism are all types of developmental disabilities. These can happen on their own or together as multiple disabilities. A conservative estimate says that about 15% of children have one or more of these problems (RCI, 2006).

C.P. is found in between 1.5 and 2.5 of every 1000 live births. India doesn't have exact numbers, but it's safe to say that the total number of people living there at any given time may be staggering (RCI, 2006).

Cerebral palsy can start before, during, or after birth. Some of the cases are caused by infections inside the uterus or problems with the brain's development. Eight to ten percent of the cases are caused by damage during pregnancy, and two percent are caused by genes. Asphyxia during birth, especially if it lasts for a long time, raises the risk of C.P., which happens in about 10% of cases. Premature birth and underlying pathological conditions like periventicular haemorrhage and venous infarcts also play a role. Most of the time, the causes of C.P. are not known. C.P. is caused by things like CNS infections, meningo-encephalitis, hyperbilirubinemia, CVS accidents, and head injuries (RCI, 2006).

History of Cerebral Palsy

William Little, a British surgeon, was the first person to find out what is now called Cerebral Palsy. He said that birth asphyxia could be a major cause of the disorder. In 1897, Sigmund Freud said that a hard birth was not the only cause, but rather a sign of other effects on the development of the foetus. Research done in the 21st century has shown that birth asphyxia was not the cause in 75% of the cases. Even though Freud's view was the traditional one in the 19th and 20th centuries, this showed that Freud was right.

In India, services for people with Cerebral Palsy (C.P.) have mostly been run by parents, mostly in hospitals. These services have been at best incomplete and grossly insufficient. In 1973, the first school for people with Cerebral Palsy (C.P.) opened. After that, schools opened quickly in Kolkata, Bangalore, Chennai, and New Delhi. Spastics Society of Northern India was started in 1977, Spastics Society of Karnataka in 1980, Spastics Society of Tamil Nadu in 1980, and Spastics Society of India (Chennai), now called Vidyasagar in 1985.

As a starting point, the Spastics Society of India in Mumbai began training teachers and therapists and building skills. With the opening of the National Resource Centre for Inclusive Education in Bandra, Mumbai, there has been a lot of work done to spread the word about inclusive education. In the same way, the Spastics Societies in the Eastern, Southern, and Northern regions have been very active in training, providing technical support, and networking.

The Spastics Society of Karnataka has set up places for early diagnosis, the right kind of help, and special education, including a place for the National Open School. In all of these areas, it also runs a vocational polytechnic and a training programme that goes on all the time. It serves as a hub for the National Trust. The programmes that the Spastics Society of Karnataka runs in both rural and urban areas of the state help a lot of people. Fundamental ideology is effective inclusion in about two to three decades.

Causes of Cerebral Palsy

Cerebral palsy happens when part of the brain develops wrong or when parts of the brain that control movement are hurt. This kind of harm can happen before, during, or right after birth. Most children are born with congenital cerebral palsy, which means they have it from birth. However, it may not be found until a few months or years later. A small number of children get cerebral palsy after they are born. This means that the disorder started after birth. Brain damage in the first few months or years of life, brain infections like bacterial meningitis or viral encephalitis, problems with blood flow to the brain, or a head injury from a car accident, a fall, or child abuse are some of the things that can cause acquired cerebral palsy.

Most of the time, no one knows what caused cerebral palsy. Possible causes include genetic problems, birth defects in the brain, infections or fevers in the mother, or an injury to the foetus. These symptoms can be caused by the following types of brain damage:

Damage to the white matter of the brain or Periventricular Leukomalacia: The brain's white matter is in charge of sending signals both inside the brain and to the rest of the body. Periventricular Leukomalacia causes damage to the white matter of an infant's brain that looks like tiny holes. Signals can't get through normally because of these holes in the brain tissue. Researchers have found a time when the periventricular white matter of the developing foetal brain is especially sensitive to insults and injuries. This time is between 26 and 34 weeks of pregnancy.
Abnormal development of the brain or Cerebral Dysgenesis: Any change to the normal way the brain grows in a foetus can cause brain malformations that make it hard for brain signals to get where they need to go. If the genes that control how the brain grows and develops during this time are changed, the brain may not grow and develop normally. The nervous system of an unborn baby can be hurt by infections, fevers, trauma, or other things that make the mother's body unhealthy.
Bleeding in the brain or Intracranial Hemorrhage: Often, foetal stroke is caused by blocked or broken blood vessels in the brain that leak blood into the brain. Some babies have a stroke while they are still in the womb. This happens when blood clots in the placenta block the flow of blood to the brain. Other types of foetal stroke are caused by blood vessels in the brain that are not right or are weak, or by problems with how the blood clots. Hypertension, or high blood pressure, in the mother is a common health problem during pregnancy, and it happens more often in babies who have had a foetal stroke. It has also been shown that a mother's infection, especially pelvic inflammatory disease, can make a baby more likely to have a stroke.
Severe lack of oxygen in the brain: Due to the stress of labour and delivery, asphyxia, a loss of oxygen in the brain caused by a halt in breathing or inadequate oxygen flow, is frequent in newborns for a brief duration. An infant can develop hypoxic-ischemic encephalopathy, a form of brain injury that damages tissue in the cerebral motor cortex and other regions of the brain, if its oxygen supply is interrupted or lowered for extended periods. This type of injury can also be caused by severe maternal hypotension, uterine rupture, placental detachment, issues with the umbilical chord, and significant head trauma during labour and delivery.

Symptoms of Children with CP

Cerebral palsy refers to a collection of neurological conditions that manifest in infancy or early childhood and impact permanently the mobility and coordination of the body. Cerebral palsy (CP) is caused by injury or anomalies in the growing brain that interfere with the brain's capacity to control movement, maintain posture, and maintain balance. The term 'cerebral' relates to the brain, whereas 'palsy' describes a loss or impairment of motor function.

Cerebral palsy affects the motor area of the outer layer of the brain (called the cerebral cortex), which controls muscular movement.

In several instances, the cerebral motor cortex did not develop normally throughout foetal development. In certain cases, the impairment is caused by a brain injury before, during, or after delivery. In both instances, the damage is irreparable and the resulting disabilities are permanent.

Children with CP exhibit a wide variety of symptoms, including:

Lack of muscle coordination when performing voluntary movements (ataxia)
Stiff or tight muscles and exaggerated reflexes (spasticity)
Weakness in one or more arm or leg
Walking on the toes, a crouched gait, or a “scissored” gait
Variations in muscle tone, either too stiff or too floppy
Excessive drooling or difficulties swallowing or speaking
Shaking (tremor) or random involuntary movements
Delays in reaching motor skill milestones and
Difficulty with precise movements such as writing or buttoning a shirt

The symptoms of cerebral palsy vary in form and intensity from person to person, and can even alter over time. Depending on whether areas of the brain have been damaged, a person's symptoms may differ significantly. Some individuals with cerebral palsy may have intellectual incapacity, seizures, and aberrant bodily feelings or perceptions, in addition to other medical conditions. People with CP may also experience decreased vision or hearing, as well as language and speaking difficulties.

CP is the most common cause of childhood disability, yet it does not necessarily result in serious impairments. A kid with severe cerebral palsy may be unable to walk and require significant, lifelong care, whereas a child with mild cerebral palsy may be only slightly awkward and require no particular assistance. The condition is not progressive, which means it does not worsen over time. Nevertheless, as the child ages, certain symptoms may become more or less noticeable. There is no cure for cerebral palsy, however supportive therapy, drugs, and surgery can assist many individuals in improving their motor skills and communication abilities.

There are some medical problems and events that might occur during pregnancy and delivery that may raise the risk of cerebral palsy in newborns. These dangers consist of:

Low birth weight and early delivery: Premature infants (those born prior to 37 weeks of gestation) and infants weighing less than 3 kilogrammes at birth have a significantly higher chance of having cerebral palsy than full-term, larger infants. Tiny infants born at a very early gestational age are particularly vulnerable.
Multiple births: Multiple births, including twins, triplets, and others, are associated with an increased incidence of cerebral palsy. The death of a twin or triplet increases the chances considerably.
Infectious diseases in pregnancy: The womb and placenta are susceptible to infections such as toxoplasmosis, rubella (German measles), CMV, and herpes. Infection-induced inflammation may cause damage to an unborn child's developing nervous system. This type of inflammatory response is also triggered by maternal fever during pregnancy or delivery.
Incompatibility of blood types between mother and child: Rh incompatibility is a condition that occurs when the Rh blood type of the mother (either positive or negative) is incompatible with that of the infant. The mother's body will begin to produce antibodies that will fight and kill her infant's blood cells, which can result in brain damage.
Exposure to hazardous substances: During pregnancy, mothers who have been exposed to harmful compounds, such as methyl mercury, have an increased risk of having a child with cerebral palsy. Mothers with thyroid problems, intellectual disability, excessive protein in the urine, or seizures are marginally more likely to have a child with cerebral palsy.
There are other medical issues during labour and delivery and immediately after birth that serve as early warning indications for CP. The majority of these youngsters, however, will not acquire CP. Signs of danger include: At the start of labour, infants with cerebral palsy are more likely to be in a breech position (feet first) than in a vertex position (head first). Babies born in the breech position are more likely to be exceptionally flaccid as foetuses.
Complicated pregnancy and childbirth: A newborn with vascular or pulmonary complications during labour and delivery may have already sustained brain damage or abnormalities.
Underweight for gestational age: Due to conditions that prevented them from growing normally in the womb, cerebral palsy is a concern for infants born smaller than average for their gestational age.
Low Apgar rating: The Apgar score is a numerical rating that indicates the physical health of a baby. During the first few minutes after birth, doctors assess the newborn's heart rate, respiration, muscle tone, reflexes, and skin colour periodically. A low score 10 to 20 minutes after delivery is frequently regarded as a crucial indicator of future complications such as CP.
Jaundice: More than fifty percent of newborns develop jaundice (yellowing of the skin or whites of the eyes) when bilirubin, a chemical normally found in bile, accumulates faster than their livers can break it down and eliminate it from the body. Untreated jaundice can destroy brain cells and lead to deafness and cerebral palsy.
seizures: An infant who has seizures faces a higher risk of being diagnosed later in childhood with CP.

Types of Cerebral Palsy:

The severity, kind, and location of a child's anomalies determine the cerebral palsy subtypes. Doctors classify cerebral palsy based on the kind of movement issue present spastic (tight muscles), athetoid (writhing motions), or ataxic (bad balance and coordination) plus any additional symptoms, such as weakness (paresis) or paralysis (plegia). For instance, hemiparesis (hemi means half) signifies weakness on only one side of the body. Quadriplegia (quad meaning four) signifies all four limbs are impaired.

Spastic cerebral palsy is the most common type of the disorder. People have stiff muscles and awkward movements. Forms of spastic cerebral palsy include:

Spastic hemiplegia / hemiparesis normally affects the arm and hand on one side of the body, although the leg may also be affected. Due to tight heel tendons, children with spastic hemiplegia often walk later and on their toes. The affected side's arm and leg are often shorter and thinner. Some children will acquire an abnormal spine curvature (scoliosis). An infant with spastic hemiplegia may also experience seizures. Speech will be delayed and may be competent at best, but intelligence is typically normal.
Spastic diplegia / diparesis is characterised by major muscle rigidity in the legs, with less severe effects on the arms and face; however, the hands may be clumsy. Leg tendon reflexes are very active. When the bottom of the foot is stimulated, the toes point upward. Certain leg muscles that are taut cause the legs to move like the arms of a pair of scissors. Children may need a walker or braces for their legs. Typically, intelligence and language skills are average.
The most severe form of cerebral palsy, spastic quadriplegia / quadriparesis, is frequently accompanied by moderate-to-severe intellectual disability. It is the result of extensive brain injury or major brain abnormalities. Frequently, children have severe limb stiffness but a loose neck. Rarely are they capable of walking. Speaking and being understood is challenging. Frequent seizures can be difficult to control.

Dyskinetic cerebral palsy (which also includes athetoid, choreoathetoid, and dystonic cerebral palsies) is characterised by sluggish, involuntary writhing or jerking of the hands, feet, arms, or legs. Some children grimace or drool because of hyperactivity in the facial and tongue muscles. They have difficulty sitting upright and walking. Some youngsters have difficulty hearing, regulating their breathing, or coordinating the necessary muscle movements for speech. Infrequently is intelligence impacted in certain types of cerebral palsy.

Ataxic cerebral palsy impacts both equilibrium and depth perception. Children with ataxic cerebral palsy frequently have poor coordination and an unsteady, wide-based gait. They struggle with rapid or precise movements, such as writing or buttoning a shirt, or with voluntary movement control, such as reaching for a book.

Mixed forms of cerebral palsy relate to symptoms that do not match to a single type of CP, but instead represent a combination of sorts. A child with mixed CP, for instance, may have certain muscles that are excessively tight and others that are too relaxed, resulting in a combination of stiffness and flaccidity.

Other conditions associated with cerebral palsy

30 to 50 percent of those with cerebral palsy will have intellectual impairment. People with spastic quadriplegia are more likely than those with other forms of cerebral palsy to suffer from mental impairment.
Up to half of all children with cerebral palsy experience one or more seizures. Intellectual disability is more prevalent in children with both cerebral palsy and epilepsy.
Children with moderate to severe CP, particularly those with spastic quadriparesis, may experience delayed growth and development. In infants, this typically manifests as inadequate weight gain. In young children, it can manifest as abnormal shortness, and in adolescents, as a combination of abnormal shortness and lack of sexual development. The muscles and limbs affected by cerebral palsy tend to be smaller than usual, especially in children with spastic hemiplegia, whose damaged limbs may not grow as swiftly or as long as those on the unaffected sid.
Deformities of the spine curvature (scoliosis), humpback (kyphosis), and saddle back (lordosis) are connected to CP. Spinal abnormalities can impede sitting, standing, and walking and produce persistent back pain. Osteoporosis may be caused by joint compression and malalignment (a breakdown of cartilage in the joints and bone enlargement).
Vision impairment: Many children with cerebral palsy have strabismus, sometimes known as "cross eyes," which, if left untreated, can cause impaired vision in one eye and hinder the ability to assess distance. Some children with cerebral palsy struggle to comprehend and organise visual information. Other youngsters may have vision impairments or be blind, obscuring their usual range of vision in one or both eyes.
Hearing impairment is also more prevalent in individuals with CP than in the general population. Some children suffer from partial or total hearing loss, often as a result of jaundice or oxygen deprivation to the developing brain.
Speech and language difficulties: More than a third of people with CP have speech and language disorders, such as difficulty forming words and speaking clearly. Poor speech inhibits communication and is frequently regarded as a sign of cognitive impairment, which may be extremely frustrating for children with CP, particularly the majority who have average to above-average intellect.
Some patients with cerebral palsy drool due to a lack of control over the muscles of the throat, mouth, and tongue.
Incontinence: Incontinence is a potential complication of cerebral palsy, caused by a lack of control over the muscles that keep the bladder close
Some patients with cerebral palsy suffer pain or have difficulties detecting simple sensations, such as touch.
Children with cerebral palsy may have trouble processing specific types of spatial and auditory information. Brain injury may hinder the development of language and cognitive abilities.
Many adults with CP have a higher risk of heart and lung problems, as well as pneumonia (typically caused by breathing food particles into the lungs), than those without the ailment.
Contractures Muscles can become painfully stuck in aberrant positions, a condition known as contractures, which can worsen muscle stiffness and joint abnormalities in CP patients.
Malnutrition: Difficulties with swallowing, sucking, or eating can make it difficult for many individuals with CP, especially newborns, to receive adequate nutrition and acquire or maintain weight.
Oral problems: Due to poor dental hygiene, many children with CP are at risk for acquiring gum disease and cavities. Certain medications, including anticonvulsants, can exacerbate these issues.
Lethargy: Motor areas of the brain that produce and control voluntary movement are impaired in children with cerebral palsy, which exacerbates childhood inactivity. While children with cerebral palsy may use more energy during daily activities, mobility deficits make it difficult for them to engage in sports and other activities with adequate intensity to build and maintain strength and fitness. Inactive adults with disabilities indicate a rise in illness severity and a decline in general health and well-being.

Diagnosis of Cerebral Palsy

The majority of children are diagnosed with cerebral palsy within the first two years of life. However, if a child's symptoms are modest, it might be challenging for a physician to make an accurate diagnosis before the age of 4 or 5.

The doctors will arrange a battery of tests to evaluate the motor skills of the child. The doctor will examine the child's development, growth, muscle tone, age-appropriate motor control, hearing and vision, posture, and coordination during routine checkups in order to rule out other conditions that could produce similar symptoms. Although symptoms may alter over time, cerebral palsy does not progress. If a kid consistently loses motor abilities, it is more likely that he or she has a condition other than cerebral palsy, such as a genetic or muscular disease, metabolic disorder, or tumors in the nervous system. Other illnesses that may cause symptoms similar to those of CP can be identified through laboratory testing.

Neuroimaging procedures (such as an MRI scan) that allow doctors to examine the brain can uncover abnormalities that signal a possibly curable movement issue. Methods for neuroimaging include:

Using high-frequency sound waves, cranial ultrasonography produces images of the brains of infants. It is used for preterm newborns at high risk since it is the least invasive imaging technology. However, it is not as effective as computed tomography or magnetic resonance imaging at detecting small abnormalities in white matter, the type of brain tissue that is destroyed in cerebral palsy.
Computed tomography (CT) employs x-rays to generate images of the brain's structure and damaged regions.
Using a computer, a magnetic field, and radio waves, magnetic resonance imaging (MRI) creates an image of the brain's tissues and architecture. MRI can identify the location and nature of damage and provides greater precision than CT.

An electroencephalogram uses taped or temporarily pasted electrodes to measure brain electrical activity. Epilepsy may be diagnosed by abnormal electrical patterns. Metabolic diseases can mimic CP. Most childhood metabolic diseases have MRI-visible brain abnormalities. Other conditions can cause or be confused for CP. coagulation abnormalities can cause prenatal or perinatal strokes that damage the brain and cause CP symptoms, most often hemiparetic CP. Referrals to a child neurologist, developmental pediatricians, ophthalmologist, or otologist aid in diagnosis and treatment.

Management of Cerebral Palsy

Although cerebral palsy cannot be cured, treatment can typically improve a child's abilities. If their disabilities are adequately treated, many children grow on to live near-normal adult lives. In general, the sooner treatment begins, the better the chances of children overcoming developmental problems or learning new ways to do tasks that are difficult for them. There is no one-size-fits-all therapy for those with cerebral palsy. A team of health care specialists will collaborate with a kid and his or her parents to identify specific impairments and requirements, and then build an appropriate plan to address the main disabilities that influence the child's quality of life.

Physical therapy, which is usually started in the first few years of life or soon after the diagnosis, is an important part of CP treatment. Specific exercises and activities (such as resistive or strength training programmes) can help to maintain or develop muscle strength, balance, and motor abilities, as well as prevent contractures. To enhance mobility and stretch spastic muscles, orthotic devices (special braces) may be employed.

Occupational therapy focuses on improving upper body function, posture, and maximising a child's mobility. Occupational therapists assist people in addressing new ways to meet daily activities such as dressing, going to school, and participating in daily activities.

Participation in art and cultural activities, athletics, and other events that help an individual grow physical and cognitive skills and capacities is encouraged through recreation therapy. When children participate in recreational therapy, their parents frequently see an increase in their child's speech, self-esteem, and emotional well-being.

Speech and language therapy can help a child speak more clearly, improve swallowing disorders, and learn new ways to communicate using sign language and or special communication devices such as a computer with a voice synthesiser or a special board covered with symbols of everyday objects and activities to which a child can point to indicate his or her wishes.

Treatments for eating and drooling problems are frequently required when children with CP have trouble eating and drinking due to a lack of control over the muscles that move their mouth, jaw, and tongue. They are also vulnerable to inhaling food or fluid into the lungs, as well as starvation, recurring lung infections, and progressive lung disease.

Assistive technology Computers, computer software, voice synthesisers, and picture books can all help some people with CP improve their communication skills. Other technologies in the home or business assist people with CP in adapting to daily routines.

Orthotic devices aid in compensating for muscle imbalance and increasing independence. External force is used in braces and splints to address muscular irregularities and improve function, such as sitting or walking. Other orthotics aid in muscle stretching or joint placement. Braces, wedges, special chairs, and other equipment can help people sit more comfortably and do everyday tasks more easily. Individuals who are unable to move independently can benefit from the use of wheelchairs, rolling walkers, and powered scooters. Glasses, magnifiers, large-print publications, and computer font are examples of vision aids. Some people with CP may require surgery to repair eyesight impairments. Hearing aids and phone amplifiers can help individuals hear better.

Conclusion

This article covers the definition, causes, and treatment of cerebral palsy. Here Cerebral palsy is the result of brain injury. Brain injury or aberrant brain growth that occurs while a child's brain is still forming before birth, during birth, or immediately after delivery causes brain damage.

Cerebral palsy is a functional impairment or limitation. A condition that limits a person to some extent is referred to as impairment. Individuals with disabilities all have impairment. Cerebral palsy is a disability, although in some situations, a person might be impaired without being disabled if his handicap does not prevent him from doing a life activity. It is not a sickness; rather, it is a catch-all phrase for a variety of disorders that often produce physical impairment. A cerebral palsy cause of handicap is a temporary situational barrier or hindrance that inhibits activity or participation. Individuals with CP who may require additional resources, assistance, or technology are considered to have special needs.