Care & Maintenance of Cerebral Palsy: Bathing, Toilet Training, Dressing, Feeding &
Nutrition, Play, Fitness, Seizures, Sleep, Suctioning, Hearing, Vision and Teeth
Play & Fitness
Play is an essential activity for all children. This is where real learning begins. It may not be easy to some children who have CP to engage in spontaneous play in the same way as children without disabilities. Family and friends will have an important role, giving whatever assistance is needed to help them enjoy playing, helping the child to develop; practicing social skills, exploring and expanding physically, and having additional stimulation mentally. Exploring opportunities to bridge from play to exercise can be even more important for a child that has cerebral palsy than for children without disabilities. Exercise and movement are important to health and in many cases, for children with CP, exercise and stretching decreases the severity of their spasms and help children with lack of tone to gain strength.
For young children with cerebral palsy, one of the best ways to encourage movement is through the roughhouse play that other children instinctively make a part of their regular exercise. The touch and movement input that is so much a part of this type of play is essential to the normalizing a childs reactions to touch and her response to movement. Furthermore, children enjoy roughhousing, so long as you keep in mind the principles of good handling and pay attention to the childs body. For example, if throwing a child up in the air makes him stiff as a board, think of another, slower activity, involving some trunk rotation and leg dissociation (separation) to reduce his tone. A good alternative might be the human merry-go-round, in which the child is held face-to-face with his legs straddling your waist and twirled around. Try to remember that low-tone children generally respond well to fast movements, while high-tone children respond better to a slower pace. Also remember that children wont break, so dont be afraid to handle them.
Ideally, you will be able to make your childs exercise a part of your daily routine by incorporating it into such activities as diapering, dressing, and feeding. Your childs occupational and physical therapists can give you specific tips on how to do this, but here are two general guidelines: 1) Place objects far enough away from your child that he needs to reach for them or crawl to them. For example, if you are working a puzzle with your child, dont simply hand him the pieces. Let him pick them up (or try to pick them up) from the table or tray. 2) Encourage your child to do all the physical activities he is capable of, even if it sometimes seems easier for you to do them. For example, if y our child has the movement skills to put his blocks away in his toy chest but takes a very long time to do it, try not to get impatient and do it for him
Another avenue to explore in the realm of exercise for children with Cerebral Palsy is yoga. The following quote from http://www.specialyoga.com/ explains some of the potential benefits: (click on the link for CP on the home page.
The practice of yoga poses (asanas), followed by deep relaxation, can help to significantly reduce high muscle tone, which is characteristic of most children with cerebral palsy. Holding an asana gives the muscles and tendons a relaxing stretch, releasing overall stress and tightness throughout the musculature and around the joints. At the same time that asanas are relaxing the body, they also provide just enough resistance to exercise low muscle tone areas of the body. In this way asanas actually improve both high and low muscle tone problems in children with cerebral palsy.
Perhaps the most important aspect of asana practice for children with cerebral palsy is its ability to stretch and realign the spine. Asanas flex and twist the spine in all directions. This scientifically designed series of stretches and counter-stretches helps to create more space between the vertebrae and reduce pressure on the disks and nerves that radiate out of the spine. Reducing the pressure on these radial nerves facilitates the release of muscular tension throughout the body and enhances overall nerve function. As a result, the child is able to develop a greater range of movement and coordination, as well as greater independence.
As with many aspects of raising a child with cerebral palsy, much trial and error is involved in finding enjoyable exercises that are right for your child. Like any child, your child will have likes and dislikes when it comes to certain types of exercises. It is important to respect these feelings as much as possible so that your child comes to see exercise as a natural, enjoyable part of life, not a chore. Remember, fresh air and exercise are important for everyone, and if your child values them when he is young, he will likely value them for a lifetime.
While it is good to incorporate exercise into play when possible, sometimes play should just be the opportunity to have fun. Almost all toys and playthings contain within them an opportunity for a child to learn something new. With the best toys, the beauty is that the child is learning without knowing it while having a good time.
The following list of play ideas graded from the very young upwards from The Cerebral Palsy Handbook: p 107 108.
0 2 Years
Play mat and frame with dangling toys
Rocking and bouncing games
Making lots of babbling and cooing noises
Building bricks begin with building them up for her to knock down, later on help her to build her own towers to knock down
Picture books you can also get picture books which have the complement of sounds and raised textures to stimulate hearing and touch
Hide and seek toys and people behind curtains/under towels etc.
Hitting things wooden spoons on saucepans, for example
Imitation and turn-taking
Playing with mirrors
Unwrapping toys (dont put tape on wrapping paper)
Water and sand
Lentils, rice and pasta in tubs to sit in, put your hands in or just throw about
You need to be careful to watch that she doesnt put small objects in her mouth that she might choke on.
Posting box games
Surprise bags full of toys and interesting objects for your child to find
Pulling and pushing
Picking correct object from a selection (for example you can ask your child to find the cow from a selection of farmyard animals)
Pretend games with dollies and teddies
Painting, using fingers or brushes
Cars and trains
Helping round the house
Making cakes and other food
Messy play with a purpose (i.e. sculptures in sand, boats on water)
Sticking textures on paper with non-toxic glue
Printing (potato prints etc.)
Spot the difference
Shape and color matching
Simon says-type copying games
Turning boxes into toys (such as castles, cars or space ships)
Making music with home-made instruments
There are different schools of thought on whether all of a childs toys and playthings should be readily available and easy to get at or should be kept in cupboards so as not to over stimulate the child or have the child become bored with the toys by having them around all the time. There is no right answer. Like with exercise trial and error will tell you which way works best for your child. You can consult with his therapists to get their insights. Children who have trouble maintaining focus on a specific activity would probably benefit from a less cluttered atmosphere.
Play is just as important, though much more challenging to achieve, for those children who have more physical limitations as a result of CP and its related conditions. If the child has the cognitive and social-emotional skills, he should have help bypassing or making adaptations for lagging motor skills. There have been tremendous advances in the past decade with improved devices, computers, and CDs that have truly expanded the possibilities for play and learning opportunities for children with cerebral palsy. Computers with touch screens or modified tracking balls combined with the right computer programs can enable a child with limited mobility in their hands to draw a picture even though they cant hold a pencil, crayon or brush.
Computers can also be a tremendous aid for children who can not speak but who have with normal cognitive abilities. They can now interact with their families and classmates during play and conversation, participating to the extent that their disabilities will allow.
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Nutrition, Play, Fitness, Seizures, Sleep, Suctioning, Hearing, Vision and Teeth