Cerebral palsy is a physical disability that affects movement and posture. It is a permanent condition that can affect many aspects of a person’s life.

CP is caused by a problem affecting the developing brain either during pregnancy or in the first few years of life. While the condition of the brain does not get worse over time, the way CP affects the rest of the body (particularly the bones, joints and muscles) can change as a person grows and develops.

Cerebral Palsy (CP) is the most common physical disability in childhood. In Australia, a child who will have CP is born every 18 hours. There are about 34,000 people in Australia with CP.

Cerebral Palsy is an umbrella term for a group of disorders affecting a person’s ability to move.

Cerebral means ‘of the brain’ and palsy refers to ‘a lack of muscle control’. CP affects body movement, muscle control, muscle coordination, muscle tone, reflex, posture and balance. People who have cerebral palsy may also have visual, learning, hearing, speech, epilepsy and intellectual impairments.

Cerebral palsy can be described by the way it affects people’s movement, the part of the body affected and by how severe the effects are.

Diagnosis of CP or high risk of CP should occur at the earliest possible age. This is important to allow early intervention to occur and the best functional outcome to be achieved.

Diagnosis will include assessment of risk factors for CP (link to below) and an examination for the signs of CP. Depending on the age of the child, different standardised assessments can be completed to determine the risk of CP. These include the General Movements Assessment and the Hammersmith Infant Neurological Assessment (HINE).

If the child is older than 20 weeks of age, an Allied Health (Physiotherapy, Occupational Therapy and Speech Pathology) assessment and medical specialist review by either a Paediatrician, Paediatric Neurologist or Paediatric Rehabilitation Specialist will be completed to determine diagnosis. If the Specialist thinks it is required, they will refer for further testing, this may include imaging such as an MRI or genetic testing.

The main types of cerebral palsy are:

• Quadriplegia - where both arms and legs are affected. The muscles of the trunk, face and mouth can also be affected.
• Diplegia - where both legs are more affected. The arms may be affected to a lesser extent.
• Hemiplegia - where one side of the body (one arm and one leg) are more affected. The other side is sometime affected to a lesser extent.

We also classify CP based on the type of movement disorder they have:

• Spastic CP – Which is the most common type, affecting 70-80% of people with CP. This is where muscles feel stiff and tight. It is caused by damage to the motor cortex in the brain.
• Dyskinetic CP – Which affects around 6% of people with CP. It causes involuntary movements that are out of a person’s control. It is usually caused by damage to the Basal Ganglia in the brain.
• Ataxic CP – Affects around 6% of with CP. This causes shaky movements and affects balance as well as a sense of positioning in space. It is caused by damage to the cerebellum in the brain
• Mixed type CP – Where a person with CP has more than 1 type of movement disorder. It is quite common to have more than 1 movement type.

We also use classification scales to demonstrate how much a person with CP can do. An example of this is the Gross Motor Functional Classification Score (GMFCS) – This is a one to five scale where 1 is least affected and 5 most affected.

There is also the Manual Ability Classification Score (MACS) for arm and hand use (picture) and the Communication Functional Classification Score (CFCS) (picture) for communication and the Eating and Drinking Ability Classification system (EDACS) (picture) which use the same one to five scale.

Cerebral palsy usually occurs due to a series of causal pathways, that is, a sequence of events that when combined cause or accelerate the injury to the developing brain. In most cases, risk factors and/or changes in the brain seen on MRI scan can help explain why a child has CP. In about 5% of cases, no risk factors or MRI changes are found, and the potential causes of the CP remain unknown.

In most cases of cerebral palsy, the brain injury leading to cerebral palsy occurs either while the mother is pregnant or before 1 month of age. Cerebral palsy can occur in babies born early (prematurely), or babies born on time (at term) or late (post-term).

Stroke is the most common cause in babies who acquire cerebral palsy after 1 month of age. The stroke may occur spontaneously or arise from surgical or heart complications.

Research has identified some risk factors which can lead to an increased chance of a child being born with cerebral palsy:

• Premature birth (less than 37 weeks)
• Low birth weight
• Blood clotting problems
• An inability of the placenta to provide the developing foetus with oxygen and nutrients
• RH or A-B-O blood type incompatibility between mother and baby
• Infection of the mother with German measles or other viral diseases in early pregnancy
• Bacterial infection of the mother or baby that directly or indirectly attacks the infant’s central nervous system
• Prolonged loss of oxygen during the pregnancy or birthing process, or severe jaundice shortly after birth.

Cerebral Palsy (CP) can affects a person’s ability to move, balance and control the position of the body, legs, arms, head and face. It can also affect the way they speak and communicate, eat, sleep and learn. The areas of the body affected and the severity of the effect is different for every person.

CP is primarily a physical disorder. People with CP can be severely physically affected, without being affected cognitively. People with severe CP may also have difficulties with swallowing, breathing, head and neck control, bladder and bowel control, eating and have dental and digestive problems.

The CPMD clinic accepts referrals for children with a diagnosis of cerebral palsy or high risk of cerebral palsy, as well as children with other diagnosed movement disorders. Referrals will also be accepted where there is a suspected diagnosis of cerebral palsy.

Referrals are accepted where there is an identified need for specialist medical and allied health review including tone and spasticity management, consultation regarding therapy programs, and specialist equipment review.

Please complete a referral form and send to HNELHD-HNEkidsrehab@health.nsw.gov.au

Clinics are held every Thursday (all day) and alternate Monday mornings.

All clinics are held at 621 Hunter St, Newcastle West.

When you arrive please alert staff in the waiting room.

Clinics are busy, and there will be 3-5 health professionals attending your child’s appointment. You may wish to prepare your child for this ahead of time. For some appointments, a member of our team will contact you before the appointment to answer any questions you may have before you meet the team.

We welcome feedback from children’s community therapists. Any reports or feedback can be sent to the team email address HNELHD-hnekidsrehab@health.nsw.gov.au

Address: 621 Hunter Street, Newcastle

Phone: 49257868

Email: HNELHD-HNEkidsRehab@health.nsw.gov.au

Cerebral Palsy Alliance Website

CanChild

Cerebral Palsy Foundation

Cerebral Palsy Fact Sheet