Let's start with this: kids that miss milestones often group up to lead normal, happy, and healthy lives. Some kids just need more time than others. Still, as your toddler begins to miss important developmental milestones, you may wonder if cerebral palsy or another birth injury is to blame. It is true that delays in meeting developmental milestones can be the first indicator that something is not right. In some cases, cerebral palsy may indeed be contributing to a child's delay in meeting developmental milestones, particularly those related to coordination and movement.
This article is to gain a better understanding of what cerebral palsy is, what may cause cerebral palsy, and what signs to look for in a toddler who may have been born with CP. We also talk honestly about whether someone is to at-fault for the problems your child is having and what you can do about it.What is Cerebral Palsy? (and what it is not)
What is your image of cerebral palsy? Some imagine walking aids or wheelchairs, while others picture perfectly mobile individuals who may suffer from occasional involuntary muscle spasms. Still, others might envision individuals with intellectual or developmental disabilities.
The reason for the discrepancy in the way people think of cerebral palsy is that cerebral palsy is unique to each individual with CP. So there is no singular description of cerebral palsy - it can manifest itself in different ways depending on a number of factors, and nobody experiences cerebral palsy in quite the same way.
In order to understand what cerebral palsy is, it may be helpful to first understand what it is not. Cerebral palsy is non-progressive, meaning that it does not get worse over time. Unfortunately, cerebral palsy will not get better over time either; however, there are many resources available to help individuals cope with this condition over the course of their lives.
Cerebral palsy is not a disease, and it is not contagious.
So, what is cerebral palsy? It is a series of conditions resulting from physical damage to the brain - specifically the cerebral cortex - while it is still developing, either in the womb, during the birthing process, or as a newborn. Cerebral palsy is the most common motor disability in childhood.
The cerebral cortex is the outermost area of the brain. It is responsible for the motor function and touch sensation, among other things, which is why cerebral palsy is first and foremost a motor disability. As the child continues to grow, their brain is unable to meet the motor function demands being asked of it. While nothing is physically wrong with their body, their brain is unable to properly control their muscles, resulting in movement and coordination problems.
There are four recognized types of cerebral palsy, some more debilitating than others. Types of cerebral palsy (CP) include spastic CP, dyskinetic CP, ataxic CP, and mixed CP (which a combination of the other form of cerebral palsy. Spastic cerebral palsy can be further separated into spastic diplegia, spastic hemiplegia, and spastic quadriplegia depending on what parts of the body are affected. Spastic cerebral palsy is the most common form.Related Maladies
Sometimes, toddlers who have been diagnosed with cerebral palsy are further diagnosed with additional conditions that occur alongside the cerebral palsy. When two or more medical conditions are present at the same time, they are referred to as "co-morbid" (which is an awful sounding name). Common instances of comorbidity in toddlers with cerebral palsy include difficulty with vision and hearing, intellectual disabilities, seizures, abnormal touch or pain perceptions, oral diseases, psychiatric conditions, and urinary incontinence.Causes of Cerebral Palsy
Cerebral palsy is the result of physical damage to the cerebral cortex area of the brain while it is still developing. This damage can occur during pregnancy, during childbirth, or during the neonatal period. There are many possible causes for damage resulting in cerebral palsy.
A significant portion of cases occur during pregnancy. Possible causes at this stage include environmental or genetic abnormalities, maternal and placental infection, chorioamnionitis, or prenatal asphyxiation.
During childbirth, possible causes include oxygen deprivation or head trauma. These could be a result of umbilical cord problems, excessive force, improper use of tools, and waiting too long to perform an emergency C-section.
After childbirth, possible causes include trauma, infections, or asphyxia.
- Deeper dive into the causes of cerebral palsy
Cerebral palsy is rarely diagnosed at the time of the brain injury because you do not usually see signs of spasticity or high tone in infants. So while the symptoms evolve over time, the baby has already suffered the underlying brain injury. So a child can have cerebral palsy from an injury during childbirth but the lack of symptoms may result in any delayed diagnosis until you may not be diagnosed as having cerebral palsy until you are older.
In some cases, signs of cerebral palsy can appear mild to non-existent in infants. You may not realize anything is different about your child until he or she is considered a toddler, especially if their manifestation of cerebral palsy is mild. By age 2, most children have been diagnosed if they have cerebral palsy.
So we sometimes get the question of whether cerebral palsy can develop later in life? The answer is yes and no. The symptoms can come later but the injury that caused the cerebral palsy happened during the birthing process (or just before).
Some possible symptoms to watch for in toddlers include:
- If able to walk: Abnormal walking (walking on toes, walking while hunched over, walking with knees crossing like scissors, walking with a wide or asymmetrical gait)
- Crawling awkwardly by using jerky movements or displaying limpness on one side
- Failure to meet the milestone of speaking short sentences by 24 months
- Avoiding crawling altogether by scooting or hopping on knees
- Failure to meet the milestone of walking by 12-18 months
- Muscle spasms or keeping body parts stiff and rigid
- Overly relaxed muscles, or overly tight muscles
- Favoring one side of the body over the other
- Trouble standing up without support
- Trouble with fine motor movements
- Shaking in arms, legs, or both
- Awkward or unusual posture
- Communication problems
- Inability to focus visually
- Limited range of motion
At the beginning of this article, we identified what cerebral palsy is, and what it is not. Now that you have a better understanding of what cerebral palsy is and isn't, there is one final "isn't" that should be discussed. Cerebral palsy is NOT a defining factor of who your child is as an individual. There are numerous resources and support systems available to make life more navigable for children - and parents of children - with cerebral palsy.
As a parent, however, you are certainly entitled to understand how and why this condition developed. Diagnosing cerebral palsy requires a team effort between you, your child's physician, and other medical specialists (such as neurologists, genetic specialists, and orthopedic surgeons) depending on your child's symptoms and needs.Additional Informational Sources
- Arya, A., & Punia, A. (2018). Cerebral palsy: General motor disability in childhood. International Journal of Pharmaceutical Sciences and Research, 3579-3588.
- Bax M, Goldstein M and Rosenbaum P: Proposed definition and classification of cerebral palsy. Dev Med Child Neurol 2005; 47: 571-6.
- Stanley F, Blair E and Alberman E: Cerebral Palsies: Epidemiology and causal pathways. London, United Kingdom: MacKeith Press 2000.
If you believe your child has cerebral palsy, what you want to know is why. Is a doctor, nurse or hospital responsible or is it just something that happens?
The only way to know is to find a cerebral palsy lawyer who will, for free, collect the medical records and tell you whether you have a potential claim. Because you have no way of knowing what happened. The doctors and nurses are certainly not going to let you know that they might have made a mistake. Instead, they are going to tell you this is something that happens sometimes and it is no one's fault. Sometimes, no one is to blame. But far too often in birth injury cases, and particularly cerebral palsy cases, the child suffers livelong injuries and the parents just believe the doctor that there was nothing that could be done.
Our lawyers regularly handle cerebral palsy malpractice cases. We are based in Maryland but we handle cerebral palsy claims throughout the country. Do you want to know if your child and your family have claims that could make the economic picture of cerebral palsy a lot more manageable? Call our lawyers at 800-553-8082 or select here for a free consultation.