How children with cerebral palsy can be helped to learn

Rebecca Effiong, a mother of two was surprised that Jonah, her second son was not willing to relate with others. He was always keeping to himself, and was not able to maintain eye contact at about 30 months of age.

The boy could not speak well, just mumbling words. She thought the situation was going to improve with time but that was not to be, and this got her worried.

All the signs called to mind something she had read in passing in a magazine several years earlier. So she went on Google to research the symptoms and possible solutions.

Everything she read confirmed her suspicions; cerebral palsy. “I just knew it,” says Rebecca, gazing at the wall in front of her as she recalls that day.

Cerebral palsy also called CP refers to a group of disorders caused by abnormal brain development or damage to the developing brain that affects a person’s ability to control his or her muscles resulting in an inability to move and maintain balance and posture.

Children with cerebral palsy may experience specific learning difficulties including short attention span, organisation and sequencing of movement, perceptual difficulties and language difficulties

Cerebral Palsy’s symptoms vary from person to person. While a person with severe cerebral palsy might not be able to walk at all or need to use special equipment to be able to walk, a person with mild CP might walk a little awkwardly.

Experts are of the view that early detection of the disorder helps the child to settle down in life as professionals and the parents can work out a disorder management course for the child, including the schooling options that will help the child to interact with others and cope better for the activities required of him/her.

To help a child to cope better the efforts should be in the areas of speech, occupational, behavioural therapy. However, cerebral palsy does not get worse over time, even though the exact symptoms may change as the person gets older.

Even though all people with CP have problems with movement and posture, many also develop related conditions as a result of the uncoordinated movement of the muscles.

These conditions include epilepsy, problems with vision, hearing, or speech, intellectual disability; changes in the spine (scoliosis and others); joint problems (such as contractures); and seizures.

There are four main types of cerebral palsy. They are Spastic Cerebral Palsy. Dyskinetic Cerebral Palsy, Ataxic Cerebral Palsy, and Mixed Cerebral Palsy.

These are categorised according to types of movement disorders experienced by the persons as caused by the areas of the brain that are affected.

People with cerebral palsy experience uncontrolled or unpredictable muscle movements resulting in shaky movements or tremors while those with severe disorders have difficulties with head and neck control, bladder and bowel control, swallowing, breathing, eating and have dental and digestive problems.

According to Mercy Nnokam, an educationist with a school in Port Harcourt, “One of the ways to help children with cerebral palsy is to place the child near the teacher or caregiver. If the child has a visual disability, placing him/her near or at the front of the classroom can help him/her see better and be more engaged in lessons.

“This can also help the teacher keep a close eye on the child, supervise his behaviour and spot any emotional issues.”

Nnokam also reiterated that the classroom should be made as navigable as possible.

“Some students with CP use braces, crutches, or wheelchairs to get around. Making sure that children with CP can access all parts of the classroom as independently as possible is very important in helping them to learn. If needed, provide extra time to navigate between activities and areas of the class/school,” she said.

Due to their difficulties with movement and posture, children with cerebral palsy have limited ability to explore the world. This does not mean that they are not willing to explore; just that they may need more stimulation and an environment that facilitates play.

Almost half of the people with cerebral palsy have an intellectual disability from a moderate to severe level. The intellectual disability is affected by the level of the person’s physical impairment.

Experts believe that variety is especially important for a child with cerebral palsy who may struggle in ways other children do not.

To help a child learn, they suggest that teachers use direct instruction, small group discussions, hands-on experimentation, quiet reading, videos and computer learning, and all types of strategies to reach each child.

Children with cerebral palsy may experience specific learning difficulties including short attention span, organisation and sequencing of movement, perceptual difficulties and language difficulties.

These will greatly impact literacy, numeracy and other classroom skills and activities. To make learning more effective children with cerebral palsy need to be encouraged to put more effort into concentrating on their movements and sequence of actions to avoid tiring more easily.

To overcome these challenges, Omobola Odetoyibo, a UK-based paediatrician counselled that teachers should embrace technology in their knowledge impartation exercise.

“Children with disabilities can really benefit from appropriate devices in the classroom, such as personal response devices. Such technological devices can massively help in ensuring that all the children in the room respond to the teacher’s questions, and participate in discussions.

This way, each student is armed with a device and can input an answer that will appear anonymously and/or not on a screen. A child with cerebral palsy may have speech and language challenges that make it difficult to speak up, but this technology allows him to participate,” she said.

Patrick Obi, a parent with a cerebral palsy child shared his experience in getting his boy to learn.

“One of the things we did was to get a special assigned seating for our boy. Children will sit with their friends and those they are comfortable and familiar with if allowed to choose their own seats.

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To encourage more engagement between students, make assigned seating charts and change them regularly. A child with cerebral palsy may be shy and tempted to hide in the corner. Pairing this student with a friendly, talkative child can make a big difference,” he said.

In addition, he said; “Schools should give no tolerance for bullying. Children with disabilities are far more likely than their peers to be victims of bullying.

Teachers can promote a safer environment by having a firm, no-tolerance policy for any kind of bullying behaviours. It helps of course if the school has a policy that teachers can follow, but if not, each classroom can be proactive about this damaging problem.”

A teacher with a Dawn Syndrome centre in Surulere-Lagos believes that there is a great need for inclusiveness in managing these children with special needs.

“Every child with cerebral palsy is truly an individual with unique needs, limitations, and abilities. Teachers need to get to know every child as an individual, and this way inclusion gets easier,” she said.

Besides, she pointed out that being in communication with parents of children with cerebral palsy is so important in knowing what a child needs.

“Symptoms and complications can change, getting better or worse, and teachers need to know about them to provide the best inclusion. Parents can also provide advice on how to better reach or engage their children, as they know them best,” she added.