Cerebral Palsy

What is cerebral palsy?

Cerebral palsy describes a group of disorders that affects the way a person moves. Cerebral palsy occurs when there is damage to the brain when it is developing, and it affects a child’s ability to control their muscles. It is the most common form of physical disability in childhood. A child with cerebral palsy may face challenges with muscle weakness, stiffness, slowness and/or shakiness of movement. Balance, coordination and walking can be challenging.

Every child with cerebral palsy will show different strengths and challenges. For example, some kids may only have limitations with motor control on one side of their body, while others will have challenges controlling both sides. If muscles in the face, mouth, and throat are impacted by cerebral palsy, kids can experience challenges with talking, eating and drinking. They may find speech challenging, which means they might have different ways of communicating through augmentative alternative communication (AAC; e.g. using computer technology, speech generating devices, iPads or pictures).

Kids with cerebral palsy may have challenges across other areas, for example, they may have hearing or vision difficulties. Children may have difficulties with their vision and it may impact their ability to see things clearly, their eye movements may be slow or less controlled, and they may not pick up moving objects as quickly as other children. Some kids with cerebral palsy may have intellectual disability or learning disorders, which impact the way they think, learn and understand. Some kids may have spasms where their arm/leg/hand might suddenly ”fly” in a direction or in response to a startle. It is important to get to know each child with cerebral palsy, so you know how best to include them in dance.

About 1/3 of kids with cerebral palsy also have epilepsy, which means that they have re-occurring seizures. Just like cerebral palsy, epilepsy includes many different types and it affects people in different ways. For some kids, a seizure will mean that they stare blankly or look as if they are daydreaming for a period of time; for other kids, a seizure may involve stiffness or jerking movements. Some kids will benefit from medication, which means that seizures may be rare. Parents know their children best – if a child in your class has epilepsy, ask the parents about how you can recognise a seizure and what to do if this happens in class. The About Me medical summary can be completed by parents and the child’s doctor to ensure you are aware of any medical problems and what you need to do to ensure the child is safely included in your dance class.

What might be some challenges in the dance class?

  • Kids with cerebral palsy will differ in how much their movement is impacted. Some kids will walk independently, while other kids will use mobility aids (e.g. a walking frame or a wheelchair).
  • Coordination of movement for an activity like dance may be very challenging for some kids.
  • Kids with cerebral palsy who have challenges with talking may have different ways of communicating, such as by using computer technology (e.g. iPads), pictures or gestures.

Quick tips

Each child with cerebral palsy will show different areas of strengths and challenges. The most common area of challenge involves motor skills and mobility. See the Dance Teacher Resources for Mobility and Motor. Kids with cerebral palsy may also have challenges in the areas of Hearing, Vision, Cognition, Communication, Attention, Learning and Memory, and Behaviour. See the Dance Teacher Resources for these areas.

General principles

  • Parents know their child best: No matter how much you know about a particular disability, parents know their child the best. Talk to parents to find out the best way to communicate and work with their child. Parents can help you understand a child’s unique strengths and areas they need more help.
    Before starting to teach the child you could ask questions like: What activities does your child enjoy the most? Are there any things they find particularly challenging? Are there things I can do to support his/her participation as much as possible? Are there situations that he/she finds stressful? Are there things that I can do to help your child understand or learn a new skill? What is the best way to communicate?
  • Change the activity, not the child: If a child is struggling with an activity don’t attribute the problem to the child, instead attribute it to the strategy. E.g. ‘You seem to have difficulty doing this movement. Let’s slow the action down and try it together’.
  • Allow alternate ways to play: For example, if a child with coordination difficulties can’t do a full turn, try a side step or quarter turn.
  • Allow more time to learn skills: Some kids might not pick up steps quickly and may need more time than others to learn these skills.
  • Modify the dance movements so everyone can join in: Focus on teaching the basic form of a dance movement. For example, a ‘sitting ballerina’ can perform the same or similar movements as their standing ballerina peer while sitting in a wheelchair or on a furniture cube.
  • Make eye contact at the kid’s level: Think about how to have good eye contact for kids who may sit at a lower height (e.g. in a wheelchair). You can kneel down or sit on a bench. Check that you have the child’s attention before giving instructions.
  • Let parents or siblings help: Parents and siblings know the child best. They might be able to help get them more involved and feel safe to dance.
  • Consider different roles: Dance exercises may sometimes be difficult for some kids. They might prefer to do another role (e.g. help teacher with music or even keep the beat with a simple percussion instrument).
  • Give kids time: Allow time to let kids reply or comment as language production can be halting. Don’t rush them as they may take more time to get going and complete a dance activity. Hearing and processing may need more time. Remember to praise and reward every effort!
  • Allow dance students to use technology or assistive devices: Just like dancers use footwear technology (e.g. ballet or tap shoes), some students will have technology or assistive devices that they use to help them. Encourage students to use technology that best supports the goals of dance and best fits their bodily needs.

Consider the environment

  • Consider the surface for kids who use wheelchair: Check the surface of the dance floor to see if it is too slippery or sticky for a child to move around in his/her wheelchair. Consider another area to teach the class or what adaptations you might be able to make to the surface. Wooden floors are best and vinyl is good too. Avoid carpet. Plenty of open space is good too!

Consider the activity and equipment

  • Be aware of physical movements that put some children at risk: Each student will have a different range of motion and level of strength. This information is especially important for students who use wheelchairs, crutches, scooters, or braces to support their mobility. If you are unsure, ask the student or their parents and remember to get parents to complete the About Me Medical Summary form.
  • Use props to enhance the tactile and visual pleasure of the movement: Use props to add tactile or visual pleasure and to support movement qualities, rhythm, and freedom of expression. Common props include scarves, coloured plastic “scarves,” ribbon wands, stretchy bands, rhythm instruments, lightweight balls, wooden rods, leaves, cones and balloons.
  • Be aware and recognise the signs of fatigue: Some children will get tired more quickly. Signs that kids need a break include them slowing down, looking tired, having difficulty catching their breath, or showing signs of frustration.
  • Shorten activities: Shortening activities can help limit fatigue. The length of an activity may need to be tailored to the individual child.
  • Break the steps down: Break the moves down. Teach one step at a time.

Things to consider

Sometimes people may assume that kids with physical disabilities have difficulties with thinking and understanding. This is often not the case. Similarly, just because a child faces challenges with talking or communicating does not mean they are not smart or that they have difficulties with thinking or learning. As a teacher, learning how to communicate most effectively with a child with talking or communication challenges is important so that they have every opportunity to participate and have fun. Teachers should speak with the child’s parents or guardians if they are unsure about how much they say is being understood. Giving time is key. When using a communication device kids need thinking time, processing time, typing time and so on.

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