Young Adult Living With Cerebral Palsy Functions

¶ … young adult living with cerebral palsy functions in the world today and provides a transition plan for either college or work after high school. There are sixteen references used for this paper.

People living with cerebral palsy face many challenges, however, with the right resources, they can become productive members of society. Whether a young adult chooses to attend college or enter the job force upon completion of high school, he needs to research all of the options available to him in order to format a transition plan into adulthood.

Defining Cerebral Palsy

Before determining what is the best course for someone with cerebral palsy to take in life, it is important to understand cerebral palsy. Cerebral palsy is a medical condition that affects a person's control of his muscles. The word cerebral pertains to the head and brain while the word palsy refers to a person's inability to use some of his muscles or joints normally (http://www.people.virginia.edu/~smb4v/tutorials/cp/cp.htm).

A person with cerebral palsy has had an injury to their brain and can not use their muscles in the customary way. This person may have trouble walking, talking, eating or playing in the same methods as many other people.

Cerebral palsy is not a disease or an illness, nor is it contagious. Cerebral palsy is a lifelong disability.

While it won't get worse, a child with cerebral palsy will never "grow out of it (http://www.people.virginia.edu/~smb4v/tutorials/cp/cp.htm)."

Causes of Cerebral Palsy

Cerebral palsy is caused by "an injury to the brain before, during, or shortly after birth (http://www.people.virginia.edu/~smb4v/tutorials/cp/cp.htm)." In most cases, it is uncertain what caused the brain injury, or how the injury could have been prevented.

A baby's brain can sometimes be injured before birth, while it is still in the mother's womb. An injury may occur from an infection or if the mother is hurt in an accident. The health of the mother may also cause injury to baby's brain. If the mother has high blood pressure or diabetes during pregnancy, the baby may develop problems in the womb.

During birth, the baby may not receive enough oxygen due to the umbilical cord being compressed. A difficult delivery can also cause injury a baby's brain.

There may be problems if a baby is born prematurely and "his body is not ready to live outside the mother's womb (http://www.people.virginia.edu/~smb4v/tutorials/cp/cp.htm)."

Babies that are born full-term may also develop cerebral palsy due to an infection or bleeding in their brain. These factors can lead to a brain injury since the human brain still continues to develop after birth. An important fact about cerebral palsy is a person generally can not develop it later in life. The rare exception is an abrupt accident that affects the brain and muscle's movement. It is almost always caused "by an injury to the brain near the time of birth (http://www.people.virginia.edu/~smb4v/tutorials/cp/cp.htm)."

Characteristics of Cerebral Palsy

Individuals with cerebral palsy often exhibit distinguishing characteristics. These include convulsive muscle contractions that may be intermittent known as tonic or continuous, which is clonic.

A person can develop contractures and abnormal spinal curves. The person may exhibit rigid, primitive reflexes and distorted deep tendon reflexes (Dzienkowski, 1996). Exaggerated posturing, fragmented motor movements, and lack of balance may also be observed in an individual with cerebral palsy.

Classifications of Cerebral Palsy

The Swedish created a system which divided cerebral palsy into four primary classifications. These classifications are broad and based on disorders in postural tone and reciprocal stimulation of nerves (Dzienkowski, 1996).

Spastic cerebral palsy is the most common form and is often caused by injury to the cerebral cortex or pyramidal tract (Dzienkowski, 1996).

Those with spastic cerebral palsy may have their muscles convulse or develop contractures of their limbs.

Spastic cerebral palsy is subdivided into three distinct groups: spastic quadriplegia, spastic diplegia, and spastic hemiplega (Dzienkowski, 1996). Though all of the subtypes involve manifestations of spasticity, the individual will attempt to make up for particular motor deficits as he develops and display certain behaviors and malformations that are specific to a particular subtype (Dzienkowski, 1996).

Dyskinetic cerebral palsy involves loss of voluntary control that is caused by an injury to extrapyramidal basal ganglia structures. Some signs of this disorder include incomplete movements, tremors, and bizarre twisting motions (Dzienkowski, 1996). An individual with dyskinetic cerebral palsy may be at greater risk for hand, wrist and elbow deformities, as well as hip dislocations. Since it is easier to prevent kernicterus, a condition where there is a dysfunction of the basal ganglia due to high levels of bilirubin, dyskinetic cerebral palsy is becoming rarer.

An extremely rare type of cerebral palsy that is a result of injury to the cerebellum is known as ataxic cerebral palsy.

A baby who has this type of cerebral palsy has irregular muscle coordination, and may look like an infant with "floppy infant syndrome (Dzienkowski, 1996). The child will eventually develop stiff trunk muscles and his muscle tone will slowly increase. The person may have become unstable and have difficulty walking, especially during the developmental years (Dzienkowski, 1996).

If an individual has a combination of any of the other three types, they will be classified as having mixed cerebral palsy. The most frequent combination is of spastic and dyskinetic cerebral palsy.

The physical, mental and psychosocial development of the each person will vary depending on the extent of the disability.

The child often displays unique compensatory movements and posturing to maintain the greatest control over his/her specific neuromotor deficits (Dzienkowski, 1996)."

Meet John Smith

In order to understand the limitations and opportunities available for an individual with cerebral palsy, it is important to devise a transitional plan for that person.

John Smith is an eighteen-year-old who has recently graduated from high school.

He and his family had to make decisions concerning his future, and after doing research, decided he would attend a nearby college. By maintaining the close proximately, his family would be available if any problems arose that John could not handle.

John's Diagnosis

When John was born, his mother was concerned because he was stiff, irritable and cried all of the time. Though John's mother constantly called the pediatrician and frequently took him to the doctor, the physician would say "He's just a little bit chubby and colicky. He looks normal (Howard, 2001)."

His mother was referred to a support group for nervous mothers by one of doctors who saw John.

John was diagnosed with spastic cerebral palsy when he was 9 months old. His parents were referred to a neurologist when John couldn't sit up, control his head or hold an object (Howard, 2001).

John's Post-Secondary Outcome survey conducted in 1995 polled two separated groups of individuals to determine how many people pursue a secondary education. The first group "identified themselves as not having a disability or chronic physical condition (Becker, 1995)." The second group were members of a disability advocacy group, most of whom had cerebral palsy. Of those in the first group, 80% had attended or graduated from college compared to 83% of those in the second group (Becker, 1995). This study indicates that individuals with cerebral palsy are able to successfully attend and graduate college.

The Individuals with Disabilities Education Act (IDEA) "specifies that Individualized Transition Plans (ITPs) be developed for adolescents with disabilities between 14 and 16 years of age (Betz, 1998)." The main reason for ITPs is to help the individual become a productive member of his community. The ITP includes "the recommendation for provision of services and supports that are necessary to achieve successful outcomes in post-secondary education (Betz, 1998)."

John and his family met with his counselor to work out the best plan for him. Together, they went over John's ITP and decided John would be able to help others who also suffer from cerebral palsy by pursuing a career in physical therapy at a local college.

With the help of a federally funded program, Vocational and Educational Services for Individuals with Disabilities (VESID), John was provided with a computer designed to meet his educational needs (Duggan, 2001).

John's Residential Needs

John and his family decided he would try living in a residential house, as a means to prepare him to live independently one day. They found there were waiting lists for many of the residences they inquired about. John and his family contacted The Division of Developmental Disabilities for assistance in placing John in the appropriate housing needed for his disability. This organization "tailors services to clients' individual needs through a process known as "person-centered planning" (unknown, 1996)."

Although person-centered planning can sometimes take a while to place the person in the appropriate home, most people feel it is beneficial for providing for the needs of the individual (unknown, 1996).

The organization was able to remove John from a waiting list and place him in a group home for men with cerebral palsy. This home caters to the specific needs of men living with cerebral palsy and gives them a chance to interact with others who share their disability.

John's Financial Income person living with a disability often finds he is faced with a tremendous financial burden.

Many will have to spend "20% more than the average person on daily living expenses (McDonnell, 1994)."

They have to buy services that most people are able to do for themselves. Having a personal aid help with bathing, dressing or fixing meals can cost over $30,000 a year, but the American Disabled for Attendant Care Programs Today (ADAPT) states a nursing home can cost twice as much (McDonnell, 1994).

However, in a recent survey of people with cerebral palsy, "fifty-four percent indicated they had adequate financial resources (Becker, 1995)."

Most disabled individuals qualify for Supplemental Security Income (SSI).

This federally funded assistance program is overseen by the Social Security Administration.

For many disabled Americans, SSI is the only source of income they receive. In 1994, a disabled person only received $377 a month (McDonnell, 1994).

John will use his monthly income from SSI to help pay for his living expenses. The counselors at his group home will assist him in making a budget. John also receives help from the United Cerebral Palsy Association in obtaining funds for his educational needs (Dzienkonski, 1996). He relies on assistance from VESID to provide additional equipment that may be needed and that is too costly for him to obtain otherwise.

Enjoying Life

Just because a person suffers from a disability, it does not mean they can't participate in many of the leisure activities enjoyed by most individuals. Professionals believe allowing those who are handicapped to participate in recreational activities boosts the self-esteem of the individual.

Groups such as Therapeutic Recreation Program "provides people with disabilities the opportunity to participate leisure activities (Acord, 1996)." For a small fee, they tailor group programs to meet the individual needs of the client, such as "skiing, whitewater rafting, water sports, hiking and camping, and rock climbing (Acord, 1996)."

New methods of participating in sports are constantly being devised. John Castellano, a bike designer who became a paraplegic after a car accident in 1989, "invented a hybrid wheelchair/mountain bike (Acord, 1996)" as a means to get back outdoors. Today, there are also special programs which help those in wheelchairs ride horses.

With all of the opportunities available, John needs to mainly choose what activities interest him. He has discovered he enjoys the challenge of climbing walls, always making sure there is an instructor available to assist him. Climbing walls are a wonderful way for a person with cerebral palsy to utilize specific affected muscle groups. John also finds by using special saddles designed for people with disabilities, he is able to enjoy nature by taking long horseback rides along park trails.

Because John enjoys all outdoor activities, he has expressed a desire to try whitewater rafting in the near future.

Health Care Needs

People with cerebral palsy will have specific medical needs for their entire lives. Many times, the person will need to have major orthopedic surgery to release tightly curled muscles (unknown, 2001). They have their hamstrings cut surgically to prevent "spasticity-plagued muscles from interfering with bone growth (Vergano, 2001)." Many will need physical therapy for the rest of their lives to exercise their muscles and prevent additional contractures, while some find electrical treatments for back muscles beneficial. Only one-third of people with cerebral palsy suffer from "serious intellectual impairment, and can lead full lives if they don't allow muscles to atrophy (Vergano, 2001).

There are new treatments constantly being discovered to aid those with cerebral palsy. One such treatment is injections of deadly botulinum toxin (unknown, 2001). These injections are providing individuals with cerebral palsy "new-found mobility and a chance to develop essential skills without the need for surgery (unknown, 2001)." The toxin works by relaxing the spastic muscles in the person's arms and legs allowing the individual to dress and feed themselves and walk without assistance. The person needs to receive the shots every six to twelve months and will not forget the skills they have perfected. These shots not only increase the individual's confidence and independence level, but family members have many burdens removed from them in terms of caring for the person (unknown, 2001).

Many people who originally thought their only relief from cerebral palsy was surgery, are now surprised to discover the benefits of martial-arts. Doctors are finding those who were originally sentenced to life in a wheelchair, are able to "reconnected to their bodies (Vergano, 2001)" using this form of physical therapy. Not only is it beneficial for the person's body, but since they actually enjoy the exercise, they are more likely to attend the classes and obtain a boost in their confidence level.

Martial arts not only increase a person's strength, but also gives them better control of their body. Martial arts are totally opposite of cerebral palsy. It centers on control of movement and control of power, and improves the individual's focus and self-discipline (Vergano, 2001).

John currently uses a walker, which he will continue utilizing to assist him in getting around campus and his group home. It may prove beneficial for John to check with the local hospital for the availability of karate classes for individuals with cerebral palsy. John needs to practice motor skills for the parts of his body that are most affected by cerebral palsy (Vergano, 2001).

He needs to continue physical therapy to prevent his muscles from atrophying. John's family and physician are currently looking into the availability of the botulinum injections in an effort to increase John's independence and mobility.

Creating a Social Life

Although a person has decreased mobility, he stills needs to interact with others. John has been referred to several support groups for individuals with cerebral palsy.

One group is Very Specials Arts (VSA), which is "an international organization and educational affiliate of the John F. Kennedy Center for the Performing Arts in Washington, D.C. (Torkelson, 1996)."

This program is a "non-profit, volunteer-based organization (Torkelson, 1996)" that gives people with disabilities a chance to interact with those without disabilities in an enjoyable and creative environment (Torkelson, 1996). The activities, which are tailored to the individuals interests and ability, include music, dance, drama, and visual arts.

Some people with cerebral palsy describe "art activity as having an even more basic educational value, since it teaches people to work towards something... To have a goal (Torkelson, 1996)." Others find the freedom of moving to the rhythm of music gives them another way to express themselves.

Most professionals believe that participation in group-oriented community-based expressive art programming enhances a disabled individual's social and communication skills (Torkelson, 1996). Since John's social skills will increase significantly by attending group art programs, his parents have already made inquiries about the local VSA programs. John will also be attending social activities at his group home, allowing him a chance to interact with his peers.

Just because a person has physical disabilities, it does not mean he doesn't have sexual needs. "Cerebral palsy has no physical effect on sexual desire (sexualhealth.com)" and erectile function is not usually affected. The main problem a person with cerebral palsy experiences is the negative attitude socially. If a person feels he is not sexually attractive, he will sometimes psychologically lose his sexual desires. Individuals sometimes have trouble finding someone to have a relationship with, since most of society asexualizes them (sexualhealth.com). However, a recent study of men with cerebral palsy found most of them had either had sexual relationships or were currently in a relationship.

It is important for John to realize that communication is essential in a relationship since there may be difficulties in some of the physical aspects, such as kissing, holding hands, or sexual positioning. Since there can be limitations on sexual positions, John may have to be creative during lovemaking, which many women look upon as a positive aspect of the relationship (sexualhealth.com). John must remember to protect himself and his partner by using appropriate birth control. If necessary, he should be counseled by his physician on possible sexually transmitted diseases, such as AIDS.