Assistive Communication Devices and Applications for Children With Cerebral Palsy

Cerebral palsy can result in some or many of a wide array of impairments or developmental delays, some minor, others major. For many children with CP, the ability to communicate effectively can be a real challenge. This may be the result of cognitive impairments, where they struggle with vocabulary and idea processing, or it may be more about the motor skills that govern the mouth, lips and tongue. CP related hearing impairments can also have a profound effect on a child’s ability to communicate. Learning complex language and speech skills is uniquely human. So is the ability to invent and utilize adaptive devices to aid those who struggle with this process.

Children develop and use language at roughly their own pace, but a child who fails to meet certain developmental milestones for communication should be tested for speech and hearing issues. Babies should react to sound from birth and even look towards the source of a sound by 6 months. If a child isn’t hearing sound well enough to react to it, they will have a difficult time learning to speak. Hearing screenings are available to infants of any age.

In our highly technical world, many new techniques and devices have been developed aimed at assisting young people with hearing and speech impairments in their efforts to communicate. AAC (Augmented and Alternative Communication) strategies and devices exist in many formats from high-tech to low-tech. With the proliferation of highly sophisticated assistive devices comes the fear that children will lose their motivation to attempt speech.

Before choosing which specific method of intervention or technology will be of greatest benefit to your child with cerebral palsy, seek the nearest rehabilitation or teaching hospital that offers evaluation and assistance in choosing AAC systems. Many of them offer assistive technology clinics where teams of AAC specialists along with speech pathologists, occupational and physical therapists can work directly with AAC technology vendors to design a service plan customized for your child. Having all these professionals under one roof streamlines the process by facilitating effective communications between professionals you might otherwise have to visit individually in multiple cities. The result is an AAC system customized specifically to your child’s abilities and needs and the training that both you and your child will need.

Science has made mind-boggling advances over the past decade and there’s no end in sight. Laboratories have developed brain/computer interface systems that provide communication and control capabilities to individuals with severe motor disabilities.

VOCAs (voice output communication aids), such as those used by famous physicist Dr. Stephen Hawking, allow individuals with severe speech impairments to communicate verbally by using voice synthesizers filtered through computers, including laptops and hand-held devices.

It’s an undeniable fact that people with severe speech and motor impairments are having their lives changed for the better as a result of these amazing advancements in the field of assistive technology and augmentative communications. Some of the more impressive AAC devices and assistiveware applications on the market today include: Proloque, Proloque2Go, KeyStrokes, TouchChat, TouchStrokes, SwitchXS, LayoutKitchen, Minspeak, VisioVoice, GhostReader, Digit-Eyes, Pictello. Go to each products website to learn more about what systems the work on and other details.

4 Great Techniques To Help Your Baby Learn To Creep

Most babies typically begin creeping around the six- to seven-month mark. However, the range of age is wide in terms of when this may actually occur. Some babies begin to creep as early as five months, while others may take as long as eight or nine months. Creeping requires a considerable amount of trunk and upper/lower extremity strength, so have some patience and don’t rush your little one! We have provided a few techniques below to help you help baby get moving.

Please note: if you are worried that your baby is not as active as she should be, talk with your pediatrician. Trust your instincts!

Before we get to the techniques, let’s define the difference between two terms that are often used interchangeably: creeping and crawling.

Creeping isdefined as moving around on the floor with the stomach in direct contact with the ground. Some babies develop the ability to creep in a circle first; while others, whose arms are stronger than their legs, are able to creep backwards first.

Crawling is defined as moving on hands and knees with the stomach up off of the ground. One type of crawling, known as commando crawling, may be seen when an infant moves around on the floor on forearms while dragging his hips behind him.

The following are some strategies for initiating and developing creeping skills in your baby:

Tummy Time

One often overlooked aspect of developing the ability to creep is time spent on the floor. As long as your baby has adequate head control then she should be spending at least one hour each day, every day, on the floor. This activity has many benefits such as building strength of the arms and chest muscles as baby pushes her chest up off the floor. While in this position, baby will also have an opportunity to strengthen her neck muscles as she lifts her head to look around the room. Some babies may not like or be able to tolerate tummy time for extended periods. If this is your baby, start small and gradually increase the amount of time spent on the floor. Your baby will be able to tolerate being on her stomach if she sees you doing it with her, so lie down on your stomach face-to-face with your baby and show her how much fun tummy time is!

Once your baby is able to tolerate being on her stomach for an extended length of time, you are ready to help her to start moving.

Creeping in a Circle

  • Position baby on the floor propped on her forearms.
  • Place a small, brightly colored toy directly in front of her just out of reach.
  • Move the toy towards your baby’s side in a semi-circle so that she has to turn her head to continue looking at the toy.
  • Encourage her to shift her body weight from one hand to the other and try to reach the toy by pivoting on her stomach.
  • As she begins moving towards the toy, move it so that it is just out of her reach. Continue moving the toy until she has crept in a complete circle towards one side of her body. Allow her to play with the toy for a short amount of time and then repeat this process towards the opposite side of her body. Repeat this activity so that baby makes five complete circles to both the right and left sides of her body.

Practice creeping in a circle every day for about one week. Once baby is confident in her ability to complete this activity, she is then ready to attempt to creep forward.

Creeping Forward (Double Leg Assist)

  • Position baby on her stomach on the floor with a small toy just out of reach.
  • Once she is engaged with the toy, kneel behind her and slightly bend both of her knees.
  • Place your hands under the bottom of her feet and provide her with a firm surface from which to push off of.
  • Encourage her to reach forward to get the toy by dragging herself forward with her hands and pushing off of your hands with her feet.

When baby is able to creep forward using the above technique, she is ready to move forward and attempt to creep with assistance provided to one leg at a time.

Creeping Forward (Single Leg Assist)

  • Place baby on her stomach with a brightly colored toy in front of her just out of reach.
  • Once she is interested in and focused on the toy, bend one of her knees.
  • Place your hand under the foot of the leg with the bent knee and encourage her to push off from your hand as she reaches for the toy by extending or straightening that leg.
  • When baby has moved forward, switch to her other leg and bend that knee and repeat the above process.
  • Continue forward alternating between her right and left legs.

After about a month or two of practice on the floor creeping in a circle and creeping forward, baby should be ready to start learning how to crawl. Stay tuned for future articles on techniques for helping your baby through this next stage of development.

The Ataxic Cerebral Palsy Nightmare

Although the occurrence of ataxic cerebral palsy is quite rare (such type is only accounted for about 5 to 10 percent of the entire cases), keep in mind that it is still cerebral palsy, and it can cause bothering problems not only on your affected child but also to you as well. The following are some of the facts which you need to be aware of:

o The cerebellum is the part of the human brain that is damaged, causing the ataxic type of disorder. It is responsible for the coordination and balance of body movements.

o Once damaged, it could result on the following:

o Hypotonia disorder or poor muscle tone;

o Having hard time maintaining balance;

o Depth perception disorders;

o Various tremors; and

o Disability in controlling the motion and range of voluntary movements.

o Children affected may show the following signs:

o Demonstrating unsteady gait;

o Intention tremors while attempting to perform any voluntary movements;

o Clumsiness and difficulty in performing such voluntary movements;

o Writing task is severely affected;

o Depth perception disorder results to coarser movements like reaching for any object;

o Involuntary and rapid eyeball movements; and

o Other related conditions such as visual and hearing disabilities, seizures, and possibly mental retardation.

In most cases, a doctor diagnoses a child for any possible presence through a combination of meticulous physical examination and findings from medical imaging methods like MRI and CT scans. Such findings along with the result of the physical examination are used to evaluate and identify if the brain is developing normally or not. Moreover, if not diagnosed at an early age, it may worse as the affected child ages.

Sad to say, the cure has to be formulated. However, it can be treated by the help of therapies and medical substances. One of the popular treatments used to combat is by undergoing a process called chronic cerebella. It starts by placing any stimulation medium such as electrode at the surface of the damaged cerebellum. This is believed to restore the muscle tone and balance.

It is important that you are aware of the signs of ataxic cerebral palsy for it will be your cue if your child is suffering from it, thus you can brought him/her to your physician for further evaluation. Your child’s life as well as his/her future is at stake here, so it is imperative that you are not negligent. Be alert and be aware of ataxic cerebral palsy.

Infant Development – Teach Your Baby How To Crawl

Crawling is the term used to describe moving around the floor on hands and knees with the stomach up off of the ground. This type of mature movement is different from creeping, which is defined as baby dragging her body around with her stomach in direct contact with the ground.

Crawling typically appears after a baby has learned to creep on the floor. Don’t be surprised though if your baby skips creeping and pushes herself up onto her hands and knees and begins to attempt to crawl first. Most babies will acquire the ability to crawl around the nine to ten month mark. However, some babies begin to crawl as early as six or seven months. Others may take as long as twelve to thirteen months before crawling. If you are worried that your baby is not crawling, a conversation with your baby’s pediatrician would be in order. As an alternative, you may contact your local Early Intervention program and request a physical therapy evaluation to determine if some type of intervention is necessary. In the meantime try these simple techniques for immediate results.

Rocking front to back on hands and knees

  • Place your baby on her stomach.
  • Kneel behind your baby and gently but firmly grasp her around her trunk, with one of your hands on either side of her body.
  • Gently use your fingers to raise her hips up off the ground and bring her knees under her trunk so that she is on her hands and knees.
  • Use one of your hands for support under her trunk, if necessary.
  • Gently rock her front to back while maintaining the hands and knees position.
  • Once she is stable on her hands and knees, kneel on the floor in front of her and show her how much fun rocking on hands and knees is.

Reaching while on hands and knees

  • Position your baby on her hands and knees as described above and support her under her trunk with one hand.
  • Place a toy in front of the baby and tell her to reach for the toy with one hand.
  • Increase the support under her trunk as needed to help her maintain her balance on both knees and one hand while she plays with the toy using the other hand.
  • Allow her to play with the toy in this position for about one minute.
  • Move the toy close to her other hand and encourage her to switch hands and play with the toy with her other hand while you provide support under her trunk as needed.

Crawling forward with assistance at hips

  • Position your baby on hands and knees as described above, but this time place her favorite toy in front of her, just out of reach.
  • Kneel on the ground behind her and gently move her right knee forward about 2″, then move her left hand forward 2″.
  • Move her left knee forward 2″, then move her right hand forward 2″.
  • Keep alternating her hands and knees for her until she reaches the toy.
  • Move the toy out of reach and encourage her to move forward on hands and knees to get the toy once again.
  • Provide assistance to her knees as needed to help her move forward.
  • Practice crawling on the floor daily until your baby is able to crawl on her own.

In the next module of this training series I will discuss some simple tips and tricks to help improve your baby’s sitting balance.