During the diagnosis stage and immediately following a formal diagnosis, the child’s primary care physician, likely his or her pediatrician, will refer the child to any number of medical specialists in order to ascertain the extent, location and severity of the child’s condition. It is recommended that children are also tested for associative conditions that often exist alongside cerebral palsy. These can include seizure activity, cognitive impairment, vision impairment and hearing impairment.
The child will likely see a neurologist for the brain injury, and an orthopedic surgeon for the extent of physical impairment.
Treatment for cerebral palsy depends upon the severity. Likely, the child will require a multi-disciplinary team of medical experts to coordinate management of his or her health conditions. Ability evaluations are central in determining the child’s treatment plan. Therapy, assistive technology, medications, complementary medicines and surgery are commonly prescribed to those with cerebral palsy.
Beyond medical assessment, the public school system evaluates children through a process called the Independent Education Program (IEP) process. The process was designed by government representatives in order to establish criteria to uniformly evaluate abilities and identify areas where additional assistance may be required.
Evaluations for IEPs include assessing activities of daily living. These are activities an individual performs in the course of a normal day for self care and independence, including personal hygiene, feeding, toileting, dressing, cleaning and transportation.
The IEP will also assess family dynamics. A family’s access to health care, insurance, income, transportation and nutrition is valuable; the ability to provide care, sustenance and shelter plays a role in management of the child’s condition.
Further, the IEP will assess the child’s learning capacity by assessing his or her health status, mobility and communication skills. The focus on the education assessment is to identify barriers to the child’s ability to learn and develop. Vision, hearing, intelligence, and performance is evaluated in an attempt to identify areas where therapists and counselors can help the child, and learning opportunities, adaptive equipment or supportive interventions can be employed.
If the child is young enough, he or she may be considered for early education programs.
The child’s parent, medical team and education team will work together to form goals that when met will maximize the child’s academic and physical performance while minimizing barriers.
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The Evaluation includes:
Mobility/Motor Impairment Evaluation
- Abnormal muscle tone
- Movement coordination and control difficulties
- Reflex irregularity
- Abnormal posture
- Abnormal balance
- Gross motor dysfunction
- Fine motor dysfunction
- Oral motor dysfunction (Feeding, swallowing, respiratory, speech and vocal)
Associative Conditions and Co-Mitigating Factors Assessment
- Cognitive, psychological and behavioral
- Gastrointestinal, nutritional and dietary
- Oral health
- Skin health
Activities of Daily Living Evaluation
- Dressing and undressing
- Food preparation
- Personal hygiene
- Transferring (bed, chair, toiletry, etc)
Family Dynamics and Socio-Economic Status Assessment
- Access to health care
- Access to health insurance
- Socio-economic situation (financial, educational, parental status, language barriers)
- Caretaking capacity
- Support network
- Housing situation
- Transportation situation
- Extenuating circumstances
- Health and motor abilities
- Vision and hearing
- Social and emotional status
- General intelligence
- Academic performance
- Communication status
- Assistive technology needs
- Special accommodations requirements