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A number of professionals work with children with cerebral palsy and their families. Depending on needs, some children may be seen by all of these people, others only by one or two. Different professionals will be helpful at various stages of the child’s development. Some of the people involved are:
1. The parents
Parents are the most important people of all as they know most about their child. All children need the love and security parents provide. In day to day family life parents will incorporate many of the suggestions made by therapists and teachers into the
daily routine.
2. The family
doctor/general practitioner. Children with cerebral palsy have the same health problems as other children of a similar age. They are just as likely to develop coughs and colds and other common childhood illnesses such as chicken pox. The family
doctor will help with these problems. General practitioners may also know the whole family and be able to provide support and encouragement.
3. The paediatrician.
This is the doctor who specialises in children’s health and development. Paediatricians can provide advice regarding the special health problems that occur in children with cerebral palsy, such as epilepsy. The paediatrician works closely
with all the people who are involved in helping children with cerebral palsy, and can make referrals to other specialists as necessary.
4. Nurses:
provide assistance in various ways. Maternal and child health nurses monitor children’s early development and provide support to parents. School nurses, either in mainstream or special schools, are able to address everyday health issues such as bowel and bladder management. Community nurses, whether in hospitals or community health centres, may provide advice in areas such as epilepsy management and constipation. The Royal District Nursing Service supports families at home following orthopaedic procedures or where other ongoing medical or nursing interventions are required. Nurses may also be helpful in liaising with and obtaining appropriate health care services.
5. Paediatric therapists are skilled in working with
children with cerebral palsy and provide assessment, advice and/or treatment. They may work with childrenand their parents either individually or in small groups. Those most commonly assisting children with cerebral palsy are physiotherapists, occupational therapists, and speech pathologists. Not every child needs to have assistance from all of these people. However, they often work together in planning or providing treatment. Therapists aim to teach parents how best to help their children learn to move and acquire all the practical skills needed for living. All young children learn through play and this principle is used when advising parents about the best way to encourage their child’s development. The special areas in which each therapist works are as follows.
a) The physiotherapist advises parents on ways to encourage children to move, and to develop skills such as sitting, crawling and walking. Practical advice on ways to lift and carry children, and on positioning children for play and eating, can also be given. The physiotherapist may also give advice on suitable footwear, splints to improve children’s foot posture and gait, and equipment such as supportive chairs and standing and walking frames.
b) The occupational therapist specialises in hand skills and activities of daily living, and advises about play and appropriate toys. Occupational therapists also suggest easier ways of bathing, feeding, dressing and toileting. As children become older, occupational therapists help them to become more independent in these self-care tasks. They also assist children to acquire skills needed for kindergarten and school (such as handwriting).
c) The speech pathologist gives advice on how to encourage speech and language development. Some children may need to learn an extra or alternative means of communication. This may be in the form of gestures and hand signs, or a communication book that uses words or pictures. Children with cerebral palsy may have problems with eating and drinking because of poor control of the muscles of the mouth and face. They may dribble excessively at times. The speech
pathologist can help with these problems
6. The social worker can provide information about services and entitlements and can help find appropriate
early childhood intervention programs, kindergartens and schools. The social worker can also provide information for parents who wish to meet others with similar experiences. Most importantly, social workers can provide counselling and advocacy support. You can talk to social workers about your child and discuss any problems or worries that you and your family are
experiencing.
7. The psychologist is concerned with progress in learning and emotional and social development. The psychologist may be available to help if there is concern about a child’s emotional well-being and behaviour or difficulties within the family.
8. Special education teachers work in a variety of settings, including family homes, early intervention
programs, preschool settings (kindergarten and child care centres), playgroups and special schools. Special education teachers provide support to families by:
• Helping families understand more about their child’s disability and the impact it may have on learning and development.
• Establishing individual therapy/education program
plans.
• Supporting the child and staff in the child’s participation in local kindergarten and child care programs.
• Assisting with the child’s successful transition to school and post-school options.
9. The orthopaedic surgeon. Orthopaedic surgery may
be helpful for some children (particularly those with spasticity). Very careful assessment is necessary before operations are recommended.
10. The orthotist works closely with the
physiotherapist to determine appropriate bracing for those children that need it. The orthotist makes
the braces for the children and is also involved in the modification of equipment.
11. The dentist. Dental care is very important for your
child. Regular check ups and help with toothbrushing and preventing dental decay can be sought from either your local family dentist or the School Dental Service through Dental Health Services Victoria; depending on where you live there are experienced dentists who visit local schools. Alternatively, you can ask your paedia- trician to refer you to the Dental Department at the Royal Children’s Hospital. While the Dental Department may not be able to provide your child
with ongoing regular care it will be able to refer you on to the most appropriate place to seek care.
12. The audiologist tests
children’s hearing to make sure they can hear well enough to learn to speak and understand language. Some children with physical disabilities, and very young infants, cannot respond consistently to sound. They sometimes cannot show us
how much they hear. Audiologists have special tests to measure the hearing of such children. If deafness is detected the audiologist works with the ear specialist (otolaryngologist) to improve children’s hearing. If that is not possible the audiologist will arrange for hearing aids to be fitted and advise parents in their use. All of these professionals may assist families to develop advocacy skills. However, parents may choose their own advocate to accompany them to meetings and
appointments to provide support
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