Handling the Child with Cerebral Palsy: Difference between revisions

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[[Category:Cerebral_Palsy]]
[[Category:Cerebral_Palsy]]
<div class="editorbox">'''Original Editor '''- [[User:Ines Musabyemariya|Ines Musabyemariya]]  '''Top Contributors''' - {{Special:Contributors/{{FULLPAGENAME}}}}
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== Introduction ==
== Introduction ==
[[File:Handling.jpg|thumb|This photo shows a dad trying to hold and position his son with cerebral Palsy in a way that will normalize the muscle tone.                                                                                                        Source: Author|alt=]]
[[File:Teach handling skills to parents.jpg|thumb|Teaching a parent, the handling skills                                                                                                  Source: Author|alt=]]
Children with cerebral palsy present with abnormal muscle tone and movement, resulting in an abnormal posture that makes it difficult to handle them <ref name=":0">Bower E., Milne A., Finnie's Handling the Young Child with Cerebral Palsy at Home Fourth Edition, Butterworth-Heinemann,2009, Page xiii.</ref>. Parents, caregivers, or therapists of Children with [[Cerebral Palsy Introduction|cerebral palsy]], need to have knowledge and [[Positioning the Child with Cerebral Palsy|handling skills, to be able to support them]]. Children with cerebral palsy show atypical movements that restrict their ability to develop naturally <ref name=":1">Hinchcliffe A., Children with cerebral palsy: A manual for therapists, parents and community workers, second edition. New Delhi, India,2007</ref>, and if the child remains atypical for a long time, deformities may occur, leading to a permanent disability<ref>S. Pérez-de la Cruz,


[[File:Handling .png|thumb|alt=|Source: [https://www.physiotools.com/products/handling-young-child-cerebral-palsy-home Handling the Young Child with Cerebral Palsy at Home] ]]
Parálisis cerebral infantil y el uso de sistemas de posicionamiento para el control postural: estado actual del arte,Neurología,Volume 32, Issue 9,2017, Pages 610-615, <nowiki>https://doi.org/10.1016/j.nrl.2015.05.008</nowiki>.</ref>. Handling skills are important in all [[Cerebral Palsy Interventions|interventions for cerebral palsy]]. Good handling facilitates more purposeful active movements for a child with cerebral palsy<ref name=":2">Miller F., Cerebral Palsy, Springer Science+Business Media, Inc., New York, USA. 2005 </ref>.
Children with cerebral palsy present with abnormal muscle tone and movement, resulting in abnormal posture that makes it difficult to handle them <ref name=":0">Nancy Finnie,Handling the Young Child with Cerebral Palsy at Home, 4th Edition edited by  Eva Bower, Annabel Milne, 2008</ref>. Parents, caregivers, or therapists of Children with [[Cerebral Palsy Introduction|cerebral palsy]], need to have knowledge and handling skills, to be able to support them. Children with cerebral palsy show atypical movements that restrict their ability to develop naturally <ref name=":1">Archie Hinchcliffe, Children with cerebral palsy: A manual for therapists, parents and community workers, second edition published in 2007.</ref>, and if the child remains in an atypical position for long time, deformities may occur, and lead to a permanent disability<ref>Pérez-de la Cruz S. Parálisis cerebral infantil y el uso de sistemas de posicionamiento para el control postural : estado actual delarte.Neurología.2017;32:610—615.</ref>. Handling skills are important in all [[Cerebral Palsy Interventions|interventions for cerebral palsy]]. Good handling facilitates more purposeful active movements for a child with cerebral palsy<ref name=":2">Freeman Miller, MD, Cerebral Palsy, 2005, ISBN 0-387-20437-7</ref>.


== What is Handling? ==
== What is Handling? ==
Handling is the ability of a person to position, carry/hold, and move a child with cerebral palsy <ref name=":0" />or other neurodevelopmental disability in such a way that his/her body achieves [[Positioning the Child with Cerebral Palsy|postural control]].  
Handling is the ability of a person to position, carry/hold, and move a child with cerebral palsy <ref name=":0" />or other neurodevelopmental disability in such a way that his/her body achieves [[Positioning the Child with Cerebral Palsy|postural control]].  
[[File:Handling a child.png|alt=|border|thumb|Source: [https://www.physiotools.com/products/handling-young-child-cerebral-palsy-home Handling the Young Child with Cerebral Palsy at Home]]]


It is necessary for both parents and caregivers, to have both the knowledge and handling skills, as they stay many hours per day with children. Proper handling will help a child to improve her / his physical abilities.<ref name=":1" />.
It is necessary for both parents and caregivers, to have both the knowledge and handling skills, as they stay many hours per day with children. Proper handling will help a child to improve her / his physical abilities.<ref name=":1" />.


Different research has highlighted the importance of different handling techniques that are used in handling children with cerebral palsy and their effect on muscle activation<ref>Paludo, T., Zardo, F., de Mattos, B. T. P., Frata, B., Ling, C. C., de Castro Barroso, G., & Cechetti, F. (2022). Measuring muscle activation using electromyography during neurodevelopmental treatment in individuals with severe cerebral palsy. ''Journal of back and musculoskeletal rehabilitation'', 10.3233/BMR-220113. Advance online publication. <nowiki>https://doi.org/10.3233/BMR-220113</nowiki></ref>, and promoting postural control <ref>Bain K, Chapparo C. The impact of neurodevelopmental treatment on the performance of daily living tasks by children with cerebral palsy. Developmental medicine and child neurology, 2012, 54, 51 | added to CENTRAL: 31 October 2014 | 2014 Issue 10
Handling skills are important to positively normalize the tone <ref>Paludo, T., Zardo, F., de Mattos, B. T. P., Frata, B., Ling, C. C., de Castro Barroso, G., & Cechetti, F. . Measuring muscle activation using electromyography during neurodevelopmental treatment in individuals with severe cerebral palsy.2022. Available from <nowiki>https://doi.org/10.3233/BMR-220113</nowiki></ref>, and promote postural control <ref>Bain K, Chapparo C. The impact of neurodevelopmental treatment on the performance of daily living tasks by children with cerebral palsy. Developmental medicine and child neurology, 2012, 54, 51 | added to CENTRAL: 31 October 2014 | 2014 Issue 10


<nowiki>https://doi.org/10.1111/j.1469-8749.2012.04289.x</nowiki></ref><ref>Acar, G., Ejraei, N., Turkdoğan, D., Enver, N., Öztürk, G., & Aktaş, G. (2022). The Effects of Neurodevelopmental Therapy on Feeding and Swallowing Activities in Children with Cerebral Palsy. ''Dysphagia'', ''37''(4), 800–811. <nowiki>https://doi.org/10.1007/s00455-021-10329-w</nowiki></ref><ref>Ejraei, N., Ozer, A. Y., Aydogdu, O., Turkdogan, D., & Polat, M. G. (2021). The effect of neck-trunk stabilization exercises in cerebral palsy: randomized controlled trial. ''Minerva pediatrics'', 10.23736/S2724-5276.21.06206-6. Advance online publication. <nowiki>https://doi.org/10.23736/S2724-5276.21.06206-6</nowiki></ref>.  
<nowiki>https://doi.org/10.1111/j.1469-8749.2012.04289.x</nowiki></ref><ref>Acar, G., Ejraei, N., Turkdoğan, D., Enver, N., Öztürk, G., & Aktaş, G. The Effects of Neurodevelopmental Therapy on Feeding and Swallowing Activities in Children with Cerebral Palsy. 2022, ''37''(4), 800–811. <nowiki>https://doi.org/10.1007/s00455-021-10329-w</nowiki></ref><ref>Ejraei, N., Ozer, A. Y., Aydogdu, O., Turkdogan, D., & Polat, M. G.. The effect of neck-trunk stabilization exercises in cerebral palsy: a randomized controlled trial. Minerva pediatrics, 2021. Available from <nowiki>https://doi.org/10.23736/S2724-5276.21.06206-6</nowiki></ref>.  
{{#ev:youtube|c9LyCzhvFPE}}
{{#ev:youtube|c9LyCzhvFPE}}This video shows how good handling can promote good posture in a cerebral palsy child.
=='''Sensory stimulus/ Inputs through handling the child with Cerebral Palsy'''==
 
Our body changes its position according to external sensory feedback<ref name=":2" />, and this is called [[Positioning the Child with Cerebral Palsy|system sensory feedback/ feed-forward control]]. It is necessary to observe the child, prior to handling, because any sensory feedback from hands, or equipment will result in typical or atypical movement. Knowledge of [[Postural Control|neurologic control of the musculoskeletal system]] is necessary to master appropriate handling<ref name=":1" />. Appropriate handling of a child with cerebral Palsy leads to [[Positioning the Child with Cerebral Palsy|postural control]] and other benefits<ref>Warutkar, V. B., & Krishna Kovela, R. (2022). Review of Sensory Integration Therapy for Children With Cerebral Palsy. ''Cureus'', ''14''(10), e30714. <nowiki>https://doi.org/10.7759/cureus.30714</nowiki></ref> such as:
=='''Sensory stimulus/ Inputs through handling''' ==
The human body naturally reacts to external sensory feedback<ref name=":2" />, and this is called [[Positioning the Child with Cerebral Palsy|system sensory feedback/ feed-forward control]]. It is necessary to evaluate any child's reaction (positive or negative) while trying to position him/her while using our hands, or equipment will. Knowledge of [[Postural Control|neurologic control of the musculoskeletal system]] is necessary to improve your handling skills <ref name=":1" />. Appropriate handling of a child with cerebral Palsy leads to [[Positioning the Child with Cerebral Palsy|postural control]] and other benefits<ref>Warutkar, V. B., & Krishna Kovela, R. Review of Sensory Integration Therapy for Children With Cerebral Palsy. Cureus, ''14''(10), e30714. <nowiki>https://doi.org/10.7759/cureus.30714</nowiki></ref> such as:
# Normalization/reduction/ increase of tone.
# Normalization/reduction/ increase of tone.
# Maintenance of skeletal alignment and prevent future deformities.
# Maintenance of skeletal alignment and prevent future deformities.
Line 31: Line 31:
# Facilitation of maximum function with minimal pathology
# Facilitation of maximum function with minimal pathology


==''' Points to Consider while Handling a Child with Cerebral Palsy.'''==
=='''Points to Consider while Handling a Child with Cerebral Palsy.'''==
Handling a child with Cerebral Palsy needs to take into consideration the followings:
Handling a child with Cerebral Palsy needs to take into consideration the followings:


===='''1. Observing the child first'''====
===='''Observing the child first'''====
Through Observation, the person has information on atypical movement patterns and the presentation of the child in general.  
Through Observation, the person has information on atypical movement patterns and the presentation of the child in general.  


===='''2. Have Knowledge about the Physiopathology of Cerebral Palsy'''====
===='''Have Knowledge about the Physiopathology of Cerebral Palsy'''====
It is very important to know why abnormal movement patterns occur in a child with cerebral palsy and what you can do to influence the near-normal movement pattern. This knowledge will also help you make sense of what you observe and where to start while placing your hands through handling. It is also good to understand that you will not take away Cerebral palsy, but you can help the child to learn and develop to their full potential and continue to leave and enjoy life like other children without cerebral Palsy.  
It is very important to know why abnormal movement patterns occur in a child with cerebral palsy and what you can do to influence the near-normal movement pattern. This knowledge will also help you make sense of what you observe and where to start while placing your hands through handling. It is also good to understand that you will not take away Cerebral palsy, but you can help the child to learn and develop to their full potential and continue to leave and enjoy life like other children without cerebral Palsy.  


===='''3. Feel the movement using your hands'''====
===='''Feel the movement using your hands'''====
After observing a child, the person places the hands cautiously to feel the movement and see the reaction of the child.  
After observing a child, the person places the hands cautiously to feel the movement and see the reaction of the child.  


==== 4. Talk to the Child while handling him/Her ====
==== Talk to the Child while handling him/Her ====
It is necessary to talk to the child while handling him/her because physical, communicative, and intellectual skills cannot be learned in isolation.  
Talking to the child while handling him/her is necessary because physical, communicative, and intellectual skills cannot be learned in isolation.  
 
===='''Help the child practice!'''====
It is important to allow the child to practice the skill learned through playing and [[Activities of Daily Living in Cerebral Palsy|activities of daily living]] such as bathing, combing, dressing, eating, toileting, etc.
 
===='''Don't Remove support if the child has not yet mastered the skills'''====
Even if the child can maintain good posture for a while, you must realize that what you have accomplished in one session will not necessarily continue if you take your hands away. It takes time and must be practised over and over in the child's daily life.
 
===='''Make handling Fun and engaging!'''====
All children master [[Child Development|milestones]] while playing and exploring the environment around them in a natural way! it is necessary for making the handling playful to help the child maximize their learning through active engagement. The following video shows a physiotherapist trying to engage with the child as active as she can through handling.
{{#ev:youtube|9UVvWsN5d84}}


===='''5. Help the child to practice!'''====
== Role of the Multidisciplinary team in managing the Child with Cerebral Palsy ==
It is important to allow the child to practice the skill learned through playing and while doing all their activities of daily living such as bathing, combing, dressing, eating, toileting, etc. to master appropriate movement and posture.
Caring for a child with cerebral palsy is a long-term task involving a strong [[Multidisciplinary and Interdisciplinary Management in Cerebral Palsy|multidisciplinary team]] that helps the child maximize his potential and abilities, but also improve his [[Quality of Life|quality of life]] and that of his family<ref>Bulekbayeva, S.,Daribayev, Z.,Ospanova, S.,Vento, S.Cerebral palsy: a multidisciplinary, integrated approach is essential.The Lancet Global Health,Volume 5, Issue 4, 1 April 2017, Page e401. DOI:<nowiki>https://doi.org/10.1016/S2214-109X(17)30082-7</nowiki></ref> <ref>Trabacca, A., Vespino, T., Di Liddo, A., & Russo, L. . Multidisciplinary rehabilitation for patients with cerebral palsy: improving long-term care.2016. Journal of multidisciplinary healthcare, ''9'', 455–462. <nowiki>https://doi.org/10.2147/JMDH.S88782</nowiki></ref>. Every team member has a role to play as described in the table below:
{| class="wikitable"
|+
!Member of a Multidisciplinary Team
!Role
|-
|Doctors (Physician, Pediatrician, Rehabilitation Doctor, Surgeon)
|Assessment, Diagnosis, Prescription of Medication, Surgery, Referrals.
|-
|Physiotherapist
|The physiotherapist evaluates and treats muscle tone, strength and gait (walking)
|-
|Occupational Therapist
|The occupational therapist checks and train the child's ability to perform tasks of self-help and care - from food intake to manual dexterity.
|-
|Speech Therpist
|The speech therapist deal with the evaluation of the child's ability to eat, speak, understand language, and communicate. Once the main problems are identified, he sets treatment goals and implements the intervention.
|-
|Orthotist
|Involved in the Fabrication of assistive devices. 
|-
|Social worker
|Involved in a community follow-up, livelihood and social assistance programs.
|-
|Psychologist
|Involved in psychosocial support and parent counselling.  
|-
|Nutritionist
|Involved when there is issue of malnutrition
|}


===='''6. Don't Remove support if the child has not yet mastered the skills'''====
== Lessons learned from low-resource settings ==
Even if the child can maintain a good posture for some time, you must understand that what you have accomplished in one session will not necessarily continue when you take your hands away. It takes time and needs to be practiced in the child's daily life.
Low and Middle -income countries (LMICs) face different challenges in supporting children with Cerebral Palsy  <ref>Bizzego, A., Lim, M., Schiavon, G., & Esposito, G. . Children with Developmental Disabilities in Low- and Middle-Income Countries: More Neglected and Physically Punished.2020 International Journal of environmental research and public health, 17(19), 7009. Available from <nowiki>https://doi.org/10.3390/ijerph17197009</nowiki></ref>. They are confronted with family conflict and discrimination, poverty, lack of qualified human resources for rehabilitation, Cultural and religious beliefs, etc.


===='''7. Make handling Fun and Active!'''====
In such context, skills are transferred to parents and caregivers to improve the quality of life of children with cerebral palsy and their Families.
In a natural way, children learn while they are playing, it is necessary for making the handling playful to help the child maximize their learning and be actively engaged throughout the session.
{{#ev:youtube|9UVvWsN5d84}}This video has been released into the public domain by its author.
== Lessons learned from low resource settings ==
Children with cerebral Palsy from Low and Middle -income countries (LMICs) face different challenges compared to peers from developed countries <ref>Bizzego, A., Lim, M., Schiavon, G., & Esposito, G. (2020). Children with Developmental Disabilities in Low- and Middle-Income Countries: More Neglected and Physically Punished. ''International journal of environmental research and public health'', ''17''(19), 7009. <nowiki>https://doi.org/10.3390/ijerph17197009</nowiki></ref>. They are confronted with family conflict and discrimination, poverty, lack of qualified human resources for rehabilitation, Cultural and religious beliefs, etc.


In such context, skills are transferred to parents and caregivers to improve the quality of life of children with cerebral palsy and that of their Families. Different successful interventions such as [[Hambisela Project: Cerebral Palsy|Hambisela]] project, and [https://www.ubuntu-hub.org/resources/babyubuntu/ Baby Ubuntu project] have nice resources for handling children with Cerebral Palsy<ref>Benfer, K. A., Novak, I., Morgan, C., Whittingham, K., Khan, N. Z., Ware, R. S., Bell, K. L., Bandaranayake, S., Salt, A., Ghosh, A. K., Bhattacharya, A., Samanta, S., Moula, G., Bose, D., Tripathi, S., & Boyd, R. N. (2018). Community-based parent-delivered early detection and intervention programme for infants at high risk of cerebral palsy in a low-resource country (Learning through Everyday Activities with Parents (LEAP-CP): protocol for a randomised controlled trial. ''BMJ open'', ''8''(6), e021186. <nowiki>https://doi.org/10.1136/bmjopen-2017-021186</nowiki></ref><ref>Tann, Cally J; Kohli-Lynch, Maya; Nalugya, Ruth; Sadoo, Samantha; Martin, Karen; Lassman, Rachel; Nanyunja, Carol; Musoke, Margaret; Sewagaba, Margaret; Nampijja, Margaret; Seeley, Janet; Webb, Emily L; (2020) Surviving and Thriving: Early Intervention for Neonatal Survivors With Developmental Disability in Uganda. Infants & Young Children, 34 (1). pp. 17-32. ISSN 0896-3746 DOI: <nowiki>https://doi.org/10.1097/IYC.0000000000000182</nowiki> </ref>.  
For more information on handling children with Cerebral palsy, different documents were developed resulting in different interventions such as the [[Hambisela Project: Cerebral Palsy|Hambisela]] project, and [https://www.ubuntu-hub.org/resources/babyubuntu/ Baby Ubuntu project] <ref>Benfer, K. A., Novak, I., Morgan, C., Whittingham, K., Khan, N. Z., Ware, R. S., Bell, K. L., Bandaranayake, S., Salt, A., Ghosh, A. K., Bhattacharya, A., Samanta, S., Moula, G., Bose, D., Tripathi, S., & Boyd, R. N. Community-based parent-delivered early detection and intervention programme for infants at high risk of cerebral palsy in a low-resource country (Learning through Everyday Activities with Parents (LEAP-CP): protocol for a randomized controlled trial.2018, BMJ open, ''8''(6), e021186. Available from <nowiki>https://doi.org/10.1136/bmjopen-2017-021186</nowiki></ref><ref>Tann, Cally J; Kohli-Lynch, Maya; Nalugya, Ruth; Sadoo, Samantha; Martin, Karen; Lassman, Rachel; Nanyunja, Carol; Musoke, Margaret; Sewagaba, Margaret; Nampijja, Margaret; Seeley, Janet; Webb, Emily L; Surviving and Thriving: Early Intervention for Neonatal Survivors with Developmental Disability in Uganda. 2020, 34 (1). pp. 17-32. Available from: DOI: <nowiki>https://doi.org/10.1097/IYC.0000000000000182</nowiki> </ref>.  


== References ==
== References ==

Revision as of 16:14, 26 September 2023

Original Editor - Ines Musabyemariya Top Contributors - Ines Musabyemariya, Naomi O'Reilly, Kim Jackson and Vidya Acharya

Introduction

This photo shows a dad trying to hold and position his son with cerebral Palsy in a way that will normalize the muscle tone. Source: Author
Teaching a parent, the handling skills Source: Author

Children with cerebral palsy present with abnormal muscle tone and movement, resulting in an abnormal posture that makes it difficult to handle them [1]. Parents, caregivers, or therapists of Children with cerebral palsy, need to have knowledge and handling skills, to be able to support them. Children with cerebral palsy show atypical movements that restrict their ability to develop naturally [2], and if the child remains atypical for a long time, deformities may occur, leading to a permanent disability[3]. Handling skills are important in all interventions for cerebral palsy. Good handling facilitates more purposeful active movements for a child with cerebral palsy[4].

What is Handling?

Handling is the ability of a person to position, carry/hold, and move a child with cerebral palsy [1]or other neurodevelopmental disability in such a way that his/her body achieves postural control.

It is necessary for both parents and caregivers, to have both the knowledge and handling skills, as they stay many hours per day with children. Proper handling will help a child to improve her / his physical abilities.[2].

Handling skills are important to positively normalize the tone [5], and promote postural control [6][7][8].

This video shows how good handling can promote good posture in a cerebral palsy child.

Sensory stimulus/ Inputs through handling

The human body naturally reacts to external sensory feedback[4], and this is called system sensory feedback/ feed-forward control. It is necessary to evaluate any child's reaction (positive or negative) while trying to position him/her while using our hands, or equipment will. Knowledge of neurologic control of the musculoskeletal system is necessary to improve your handling skills [2]. Appropriate handling of a child with cerebral Palsy leads to postural control and other benefits[9] such as:

  1. Normalization/reduction/ increase of tone.
  2. Maintenance of skeletal alignment and prevent future deformities.
  3. Providing a stable base of support to promote maximum functioning.
  4. Promoting tolerance to the desired position
  5. Promoting comfort and relaxation
  6. Facilitation of normal movement patterns or control of abnormal movement patterns
  7. Regulating pressure or preventing the development of pressure sores
  8. Reduction of fatigue
  9. Improving autonomic nervous system function (cardiac, digestive, and respiratory)
  10. Facilitation of maximum function with minimal pathology

Points to Consider while Handling a Child with Cerebral Palsy.

Handling a child with Cerebral Palsy needs to take into consideration the followings:

Observing the child first

Through Observation, the person has information on atypical movement patterns and the presentation of the child in general.

Have Knowledge about the Physiopathology of Cerebral Palsy

It is very important to know why abnormal movement patterns occur in a child with cerebral palsy and what you can do to influence the near-normal movement pattern. This knowledge will also help you make sense of what you observe and where to start while placing your hands through handling. It is also good to understand that you will not take away Cerebral palsy, but you can help the child to learn and develop to their full potential and continue to leave and enjoy life like other children without cerebral Palsy.

Feel the movement using your hands

After observing a child, the person places the hands cautiously to feel the movement and see the reaction of the child.

Talk to the Child while handling him/Her

Talking to the child while handling him/her is necessary because physical, communicative, and intellectual skills cannot be learned in isolation.

Help the child practice!

It is important to allow the child to practice the skill learned through playing and activities of daily living such as bathing, combing, dressing, eating, toileting, etc.

Don't Remove support if the child has not yet mastered the skills

Even if the child can maintain good posture for a while, you must realize that what you have accomplished in one session will not necessarily continue if you take your hands away. It takes time and must be practised over and over in the child's daily life.

Make handling Fun and engaging!

All children master milestones while playing and exploring the environment around them in a natural way! it is necessary for making the handling playful to help the child maximize their learning through active engagement. The following video shows a physiotherapist trying to engage with the child as active as she can through handling.

Role of the Multidisciplinary team in managing the Child with Cerebral Palsy

Caring for a child with cerebral palsy is a long-term task involving a strong multidisciplinary team that helps the child maximize his potential and abilities, but also improve his quality of life and that of his family[10] [11]. Every team member has a role to play as described in the table below:

Member of a Multidisciplinary Team Role
Doctors (Physician, Pediatrician, Rehabilitation Doctor, Surgeon) Assessment, Diagnosis, Prescription of Medication, Surgery, Referrals.
Physiotherapist The physiotherapist evaluates and treats muscle tone, strength and gait (walking)
Occupational Therapist The occupational therapist checks and train the child's ability to perform tasks of self-help and care - from food intake to manual dexterity.
Speech Therpist The speech therapist deal with the evaluation of the child's ability to eat, speak, understand language, and communicate. Once the main problems are identified, he sets treatment goals and implements the intervention.
Orthotist Involved in the Fabrication of assistive devices.
Social worker Involved in a community follow-up, livelihood and social assistance programs.
Psychologist Involved in psychosocial support and parent counselling.
Nutritionist Involved when there is issue of malnutrition

Lessons learned from low-resource settings

Low and Middle -income countries (LMICs) face different challenges in supporting children with Cerebral Palsy [12]. They are confronted with family conflict and discrimination, poverty, lack of qualified human resources for rehabilitation, Cultural and religious beliefs, etc.

In such context, skills are transferred to parents and caregivers to improve the quality of life of children with cerebral palsy and their Families.

For more information on handling children with Cerebral palsy, different documents were developed resulting in different interventions such as the Hambisela project, and Baby Ubuntu project [13][14].

References

  1. ↑ 1.0 1.1 Bower E., Milne A., Finnie's Handling the Young Child with Cerebral Palsy at Home Fourth Edition, Butterworth-Heinemann,2009, Page xiii.
  2. ↑ 2.0 2.1 2.2 Hinchcliffe A., Children with cerebral palsy: A manual for therapists, parents and community workers, second edition. New Delhi, India,2007
  3. ↑ S. Pérez-de la Cruz, Parálisis cerebral infantil y el uso de sistemas de posicionamiento para el control postural: estado actual del arte,Neurología,Volume 32, Issue 9,2017, Pages 610-615, https://doi.org/10.1016/j.nrl.2015.05.008.
  4. ↑ 4.0 4.1 Miller F., Cerebral Palsy, Springer Science+Business Media, Inc., New York, USA. 2005
  5. ↑ Paludo, T., Zardo, F., de Mattos, B. T. P., Frata, B., Ling, C. C., de Castro Barroso, G., & Cechetti, F. . Measuring muscle activation using electromyography during neurodevelopmental treatment in individuals with severe cerebral palsy.2022. Available from https://doi.org/10.3233/BMR-220113
  6. ↑ Bain K, Chapparo C. The impact of neurodevelopmental treatment on the performance of daily living tasks by children with cerebral palsy. Developmental medicine and child neurology, 2012, 54, 51 | added to CENTRAL: 31 October 2014 | 2014 Issue 10 https://doi.org/10.1111/j.1469-8749.2012.04289.x
  7. ↑ Acar, G., Ejraei, N., Turkdoğan, D., Enver, N., Öztürk, G., & Aktaş, G. The Effects of Neurodevelopmental Therapy on Feeding and Swallowing Activities in Children with Cerebral Palsy. 2022, 37(4), 800–811. https://doi.org/10.1007/s00455-021-10329-w
  8. ↑ Ejraei, N., Ozer, A. Y., Aydogdu, O., Turkdogan, D., & Polat, M. G.. The effect of neck-trunk stabilization exercises in cerebral palsy: a randomized controlled trial. Minerva pediatrics, 2021. Available from https://doi.org/10.23736/S2724-5276.21.06206-6
  9. ↑ Warutkar, V. B., & Krishna Kovela, R. Review of Sensory Integration Therapy for Children With Cerebral Palsy. Cureus, 14(10), e30714. https://doi.org/10.7759/cureus.30714
  10. ↑ Bulekbayeva, S.,Daribayev, Z.,Ospanova, S.,Vento, S.Cerebral palsy: a multidisciplinary, integrated approach is essential.The Lancet Global Health,Volume 5, Issue 4, 1 April 2017, Page e401. DOI:https://doi.org/10.1016/S2214-109X(17)30082-7
  11. ↑ Trabacca, A., Vespino, T., Di Liddo, A., & Russo, L. . Multidisciplinary rehabilitation for patients with cerebral palsy: improving long-term care.2016. Journal of multidisciplinary healthcare, 9, 455–462. https://doi.org/10.2147/JMDH.S88782
  12. ↑ Bizzego, A., Lim, M., Schiavon, G., & Esposito, G. . Children with Developmental Disabilities in Low- and Middle-Income Countries: More Neglected and Physically Punished.2020 International Journal of environmental research and public health, 17(19), 7009. Available from https://doi.org/10.3390/ijerph17197009
  13. ↑ Benfer, K. A., Novak, I., Morgan, C., Whittingham, K., Khan, N. Z., Ware, R. S., Bell, K. L., Bandaranayake, S., Salt, A., Ghosh, A. K., Bhattacharya, A., Samanta, S., Moula, G., Bose, D., Tripathi, S., & Boyd, R. N. Community-based parent-delivered early detection and intervention programme for infants at high risk of cerebral palsy in a low-resource country (Learning through Everyday Activities with Parents (LEAP-CP): protocol for a randomized controlled trial.2018, BMJ open, 8(6), e021186. Available from https://doi.org/10.1136/bmjopen-2017-021186
  14. ↑ Tann, Cally J; Kohli-Lynch, Maya; Nalugya, Ruth; Sadoo, Samantha; Martin, Karen; Lassman, Rachel; Nanyunja, Carol; Musoke, Margaret; Sewagaba, Margaret; Nampijja, Margaret; Seeley, Janet; Webb, Emily L; Surviving and Thriving: Early Intervention for Neonatal Survivors with Developmental Disability in Uganda. 2020, 34 (1). pp. 17-32. Available from: DOI: https://doi.org/10.1097/IYC.0000000000000182
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