Developmental Disorder: Cerebral Palsy a common cause.

A normal child will follow a more or less typical pattern of development both mentally and physically. A common refrain that might be heard amongst parents is my child is not catching up, that might  be in terms of mental development, academically, physically. It might be a benign concern coming from a parent who expects children to win all the possible ways in this big race called life. But when should we suspect that there is actually wrong with my child. We commonly use milestones that should be reached for particular age groups. Skills such as taking a first step, smiling for the first time, and waving “bye-bye” are called developmental milestones. Children reach milestones in how they play, learn, speak, behave, and move (for example, crawling and walking). A brief overview of the common milestones that are monitored is given below. A pediatrician or a neurologist should examine any child who is lagging behind in these milestones.

 

                 image courtesy : www.cdc.gov 

When do we know that is not keeping up and when does the parents should meet their healthcare provider. There are few red flags that indicate child is not developing well:

1.      If child is lagging on milestone chart
2.      If is unable to attend to task given
3.      If child is hyperactive
4.      If child has any seizure
5.      Has difficulty in sensory perception, progressive decreased vision and decreased hearing.

If there is any of the above symptoms, we should suspect Developmental disorder in the child and take medical help as soon as possible.  

What cause developmental disorders? Most of developmental disorders are caused by a mix of factors genetics; parental health and behaviors (such as smoking and drinking) during pregnancy; complications during birth; infections the mother might have during pregnancy or the baby might have very early in life; and exposure of the mother or child to high levels of environmental toxins, such as lead. For some developmental disabilities, such as fetal alcohol syndrome, which is caused by drinking alcohol during pregnancy, we know the cause. But for most, we don’t.
  

Can my child be affected? 

Developmental disabilities occur among all racial, ethnic, and socioeconomic groups. 

What are the common Developmental disorders? 

Common developmental disorders include:
1. Cerebral Palsy
2. Autism and austic spectrum disorder
3. ADHD
4. Hearing Loss
5. Vision Loss
6. Miscellaneous – including specific genetic syndromes.
  

What is cerebral palsy (CP)? 

Cerebral palsy is a group of disorders that affect a person’s ability to move and keep their balance and posture which may occur because of brain injury or abnormal brain development. The cause of the palsy may begin before or as is more common during and immediately post birth. Cerebral palsy causes different types of disabilities in each child. A child may simply be a little clumsy or awkward, or unable to walk at all. 

How does CP present ? 

Presenatation of CP vary greatly because there are many different types and levels of disability. The main sign that your child might have cerebral palsy is a delay reaching the motor or movement milestones. CP might be suspected if child do not attain the below mentioned milestoenes at the ages mentioned aside them.A child at: 

2 months cannot control head or has stiff legs that cross or “scissor”.
6 months continues to have a hard time controlling head when picked up or reach with only one hand while keeping the other in a fist.
10 months crawls by pushing off with one hand and leg while dragging the opposite hand and leg and not sit by himself or herself.
12 months not crawl and not be able to stand with support.
24 months not be able to walk or to push a toy with wheels. 

Are there any other symptoms that the child with CP have? 

Apart from motor symptoms, child might have associated seizures, speech problems, ,  clumsiness in doing work, eating problems, skeletal problems, sensory impairments, intellectual disability, learning disabilities, urinary incontinence, fecal incontinence, and/or behavioural disorders. Pain because of stiffness in the muscles is another disabling complaint in these children. 

What causes CP? 

CP is caused by damage to the motor centers of the developing brain which may occur during pregnancy, during childbirth, or after birth up to about age three. Upto 2% of all cerebral palsy cases are believed to be due to a genetic cause. 

In a case of suspected cerebral palsy, Please seek the help of a specialist such as a developmental pediatrician or child neurologist, who might after evaluating the child might guide on the path to its management.  

Contributed by:
Dr Sweta Singla
MD, DM Neurology 

Consultant Neurology & Sleep Disorder.