Prevention through more thorough healthcare before, during and after pregnancy is the only real defence. Global prevalence of cerebral palsy is 3.3 per 1,000 births — rising to 40—100 per 1,000 live births among premature infants.
A Cognitive Sciences Specialist States: The Only Way to Prevent the Birth of Children with Cerebral Palsy / Signs at Birth
A specialist in cognitive and rehabilitative sciences said that the only way to confront the increasing number of children born with cerebral palsy is prevention—through more thorough healthcare before, during, and after pregnancy.
According to a report by Mehr News, Dr. Nader Alirezaloo also pointed out that reducing the risk factors for genetic abnormalities helps decrease these injuries, and added: “One of the most important factors is controlling consanguineous marriages.”
He explained that “cerebral palsy” refers to a non-progressive disorder of movement and posture that follows a neurological injury. In cerebral palsy, a group of chronic lesions impair an individual’s motor control.
Alirezaloo emphasized that the disorder appears in the early years of a child’s life and, usually, the brain damage does not worsen over time, although motor impairments may lead to new limitations depending on the level of the condition.
He noted that cerebral palsy is diagnosed through examining motor skills, developmental reflexes, medical history, and various tests, and said: “The global prevalence of cerebral palsy is 3.3 per 1,000 births; this figure increases to 40 to 100 per 1,000 live births for premature infants.”
He added that this prevalence is significant because the affected individual, their family, and a large segment of society become involved in protective and caregiving cycles. There are many psychological effects for the patient’s family, and the time and costs are high.
According to this specialist, the brain injuries in children and adults are irreversible, and although science has made progress, it has not yet been able to take an effective step toward the complete recovery of these patients; nonetheless, through the expansion of treatments such as rehabilitation and occupational therapy, attempts are made to compensate for the person’s motor and functional impairments in daily life activities.
Alirezaloo asked what occurs in the baby’s brain that results in birth with cerebral palsy, saying: in cerebral palsy, motor disorders are characterized by damage to voluntary movements resulting from developmental abnormalities before birth, during birth, or after birth. This damage involves the central nervous system (CNS) and occurs before the age of five—that is, while the child’s brain is still in development.
He added: in some cerebral palsy patients, reduced oxygen levels (hypoxia) cause damage in parts of the brain. Genetic abnormalities play an important role in this disease. Genetic problems are often observed in newborns from consanguineous marriages.
Alirezaloo clarified: preterm infants are at higher risk for developing cerebral palsy, but viral infections, lack of oxygen to the baby’s brain during delivery, and trauma to the fetus’s head are also important causes that can damage brain cells and subsequently lead to cerebral palsy.
He further added: in advanced countries, governments, fully aware of the social, cultural, and economic cost of having disabled individuals in society, allocate a portion of the national budget to prevention of births with cerebral palsy—such that pregnant mothers, from the moment of conception through birth, are covered by governmental health and public health services with full supervision over the pregnancy and birth process to reduce the likelihood of cerebral palsy births.
Is cerebral palsy detectable right from birth?
The cognitive and rehabilitative specialist, responding to whether cerebral palsy can be recognized immediately at birth, said: most cases of cerebral palsy, except mild ones, are identified within the first 18 months of life.
He explained: sometimes these infants show signs right after birth that distinguish them from others—for example, delayed head control. These signs appear as failure to reach motor milestones such as coarse and asymmetric motor performance, increased or decreased muscle tone. Gradually, cognitive and motor, behavioral disorders, sometimes seizures, and developmental delays also appear as the child ages. Occasionally, as the patient grows older, body shape may change.
Alirezaloo stressed that the symptoms vary greatly; they may be mild or severe, involve one half of the body or both halves. More limbs may be affected—arms or legs or all four limbs. Abnormal movements (such as torsional, jerky, or twisting motions) in the hands, legs, arms, calves occur, and these movements worsen under stress.
He continued: tremors, lack of coordination and balance, lax muscles especially at rest, overly flexible joints, reduced IQ, decreased learning capacity, speech impairment, hearing and vision problems, seizures, pain especially in adults, digestive symptoms (including difficulty sucking milk or food, chewing, swallowing, vomiting and constipation, drooling), slow growth, irregular breathing, urinary incontinence—these are among the other signs of cerebral palsy damage.
How does early diagnosis help in the child’s improvement?
Regarding how early diagnosis of cerebral palsy helps improvement, this specialist said: with early diagnosis, the patient’s recovery and lifespan depend on the severity of the disease. In severe cases, if cerebral palsy is accompanied by conditions such as heart disease, respiratory disorders, severe pulmonary infections, swallowing disorders, etc., it can lead to death. But in mild cases, by improving the physical-cognitive abilities of the affected individual through rehabilitation, a person’s natural life process can continue.
Alirezaloo emphasized: specialists in rehabilitation fields need training in developmental psychology and developmental disorders, including cerebral palsy, in infants and young children for early diagnosis and intervention.
He added: predictions regarding cerebral palsy show that while cerebral palsy is not curable, some key complications and consequences can be compensated. Generally, all children born with cerebral palsy require rehabilitation, and the rehabilitation process is long-term.
According to Alirezaloo, occupational therapy, speech therapy, and the fabrication of assistive mobility devices are among the most important rehabilitation programs needed for these children. Some will need orthopedic shoes, splints, and mobility aids like walkers or wheelchairs. Occupational therapy helps the child integrate into society. Those with mild cerebral palsy can be prepared for school admission and social participation.
He also said that unfortunately, there is no insurance coverage for these patients, and because rehabilitation is a long and expensive treatment for children with cerebral palsy, the high costs of therapy and frequent travel of families to rehabilitative and medical centers place a heavy burden on the family’s economic and psychological structure.
Alirezaloo added: of course, not to forget that the more families are involved in the material and emotional costs of this disorder, the greater the burden governments also face from the social damage caused by this disorder.
This cognitive and rehabilitative specialist, emphasizing that patient independence is very important because as the patient’s age increases, caring for them becomes harder, said: it would be better if in our country—as in developed countries—jobs appropriate to the disabilities of patients are planned. For example, if someone’s arms are paralyzed, a job should be identified that suits their motor impairment that does not require much use of arms.
He asserted: in recent years, organizations and institutions in our country have been established that create suitable employment opportunities for persons with disabilities so that, in addition to generating income for them, the quality of life of the patient and family improves, so that this golden principle of “community-based rehabilitation,” in line with reintegrating the disabled individual into social participation, is expanding.