Why My Child?

Cerebral palsy is one of the more common congenital problems: of every 2000 infants born, 5 are born with cerebral palsy. Medical experts are unable to agree about what causes cerebral palsy in children who have congenital CP. We do know that the child who is at highest risk for developing CP is the premature baby who does not cry in the first five minutes after delivery, who needs to be on a ventilator for over four weeks, and who has bleeding in the brain. Babies who have congenital malformations in systems such as heart, kidneys, or bones are also more likely to develop CP, probably because they also have malformations in the brain. A newborn who has seizures also has an increased risk of developing CP.

There is no combination of factors that always results in an abnormally functioning child. That is, even the small premature infant has a better than 90 percent chance of not having cerebral palsy. There are surprising numbers of babies who have a very stormy course after birth and go on to do very well. In contrast some infants who have a rather benign and uneventful beginning are eventually found to have severe mental retardation or learning disabilities.

Many children with cerebral palsy have a congenital malformation of the brain, a malformation that existed at birth and was not caused by factors occurring during the birthing process. Even with today's most sophisticated scans, not all of these malformations can be seen by the physician, but when CP is recognized in a newborn, a congenital malformation is suspected

When a physician diagnoses a baby with CP, the mother and father often feel guilty and wonder what they did to contribute to their child's disorder. While it is certainly true that good prenatal care is an essential part of preventing congenital problems, these "birth defects" often occur even when the mother has strictly followed her physicians advice in caring for herself and the developing infant.

There are no specific events that, if they occur during pregnancy, delivery, or infancy, always cause cerebral palsy. One large study, for example, indicates that more than 60 percent of all pregnancies have at least one complication, and that most of these complications cause no problems. For instance, 25 percent of all the newborns in the study had the umbilical cord wrapped around their neck, and 16 percent past meconium (had the first bowl movement)  at the time of birth. Fortunately, these common "birth events" and the development of CP have only a small correlation.

On the other hand, newborns in this study who had very low Apgar scores ( less than 3 at 20 minutes) had a risk of developing cerebral palsy that was 250 times greater than infants with normal Apgar scores. ( an Apgar score is a system for assessing the condition of a newborn baby by scoring reparation effort, heart rate, color, muscle tone, and motor reactions at 1 and 5 minutes after birth.) An Apgar score of less than 3 at 20 minutes after birth suggests that the infant suffered severe asphyxia during birth ( asphyxia is a lack of sufficient oxygen to the brain). Half of the infants who suffered severe asphyxia during birth did not develop cerebral palsy, however.  

Some things you should consider:

Cerebral palsy is the term used to describe  the motor impairment resulting from brain damage in the young child, regardless of the cause of the damage or its effect on the child. Impairment is the correct term to use to define a deviation from normal, such as not being able to make a muscle move or not being able to control an unwanted movement. Disability is the term used to define a restriction in the ability to perform a normal daily activity that some one of the same age is able to perform (for example, a 3 yr old child who is not able to walk has a disability because normal 3 yr olds can walk independently). Handicapped is the term used to describe the condition of a child or adult who, because of the disability, is unable to achieve a normal role in society appropriate to his or her age and environment.

 A 16 yr old who is unable to prepare his own lunch or brush his teeth is handicapped. But a 16 yr old who walks with the assistance of crutches, attends a regular school, and is fully independent in daily activities is disabled, not handicapped. Thus, a person can be impaired and not necessarily be disabled, and a person can be disabled without being handicapped.