Do they give disability with cerebral palsy? Children diagnosed with cerebral palsy - a sin of modern medicine? Fright in children with disabilities with the birth of cerebral palsy.

03.11.2019 -

Disability in cerebral palsy is given not on the basis of an existing diagnosis, but if the disease is accompanied by disability. In this case, limited ability to move, speech contact, self-service, learning is implied. It has different degrees severity, but in many cases it leads to disability. This disease is not considered genetic, but is congenital. This is what makes her unique.

What causes cerebral palsy in a child?

The main cause of this serious disease is considered to be damage to the parts of the brain that are responsible for the functioning of the whole body. Damage to the child's brain can begin already in the womb, from the first days of life or during childbirth.

The following factors can increase the likelihood of cerebral palsy:

intrauterine infections;
low hemoglobin in pregnant women;
infection of the nervous system in an infant;
difficult childbirth;
asphyxia during childbirth.

In addition, the abuse of alcoholic products by a woman during pregnancy significantly increases the likelihood of cerebral palsy. It is quite difficult to determine whether a child has this disease in early age. The fact is that the baby's motor activity is limited, and he sleeps for a long part of the day. Only the most severe forms of the disease can be detected on this early stage. With the development of the baby, some deviations may be observed, usually 2 months after birth.

To identify cerebral palsy in a child, a neurologist prescribes a list of medical examinations with which you can make the correct diagnosis. In infants, neurosonography is used for this (examination of parts of the brain through the fontanel). For older children, the procedure of electroencephalography and electroneuromyography is used, which determines the performance of the muscles. If the diagnosis is confirmed, a child with cerebral palsy is assigned a disability group.

How can you visually determine this disease?

Initially, you should observe how the child's arms and legs function correctly. Cerebral palsy can cause spasms motor activity both upper and lower limbs. In addition to this, the muscle fibers are under great tension, so that it is difficult to bend or unbend them. Symptoms of lethargy are also likely, in which there are difficulties in the implementation of movements of the arms and legs.

The other is hyperkinesis. With him in muscle structures involuntary movements are observed. When identifying the described symptoms of the child, it is urgent to show the doctor. These signs can lead to severe disability.

During the life of a child, other manifestations or complications may be noticeable. These include impaired speech abilities due to spasm speech apparatus. This leads to the fact that the child begins to stutter or pronounce slow speech. In addition, cerebral palsy can be accompanied by a mental disorder from the simplest to the most severe form. The final stage of this disorder is oligophrenia.

Today, modern equipment is used to identify children cerebral paralysis in a timely manner. Wherein rehabilitation period works best for children. In order to make a diagnosis, various examinations are prescribed depending on age.

Only an institution can recognize a child as disabled public service medical and social expertise. In this place, the state of health and the degree of restriction of the activity of the disabled person are assessed.

What gives a child a disability?

The main reason for calling for a disability for a child with cerebral palsy is the pension payments made by the state. These are funds intended for the purchase of necessary medicines and various means caring for a disabled child.

In addition to pension accruals, a disabled child is entitled to the following benefits:

free travel in city public transport (except for taxis);
benefits for travel in railway, air and river transport;
free treatment in a sanatorium;
providing a disabled person with the necessary medical equipment;
free receipt medicines in a pharmacy according to a doctor's prescription.

These rights are due not only to children with disabilities, but also to their mothers. This is a benefit in calculating the tax payment from the income received, the right to a reduced work schedule, additional leave, as well as an urgent retirement. Receipt of benefits will depend on which disability group is given to the child.

Group 1 is considered the most dangerous and is assigned to a child who does not have the ability to carry out independent care (move, eat, dress, etc.) without anyone's help. At the same time, a disabled person does not have the opportunity to fully communicate with people around him, therefore, he needs regular monitoring.

Group 2 disability implies some limitations in the above manipulations.

Also, a child who received group 2 does not have the ability to learn.

However, there is an opportunity to gain knowledge in institutions designated for these purposes for disabled children with disabilities.

Group 3 is assigned to a disabled person who is able to individually move, communicate, and learn. But at the same time, children have a slow reaction, therefore, they require additional control due to their state of health.

Disability in children with cerebral palsy

As mentioned above, children receive disability when diagnosing cerebral palsy. Mandatory assistance in documenting disability must be provided by a doctor at the site. In addition, he must give direction to the passage of the medical commission. At the next stage, a medical and sanitary examination (ITU) is carried out, with the help of which the diagnosis is confirmed. When preparing for its passage, it should be clarified how pronounced motor disorders are, the degree of damage to the hand, the degree of violation of support, speech, mental disorder and other factors.

Parents must prepare the required documents in order to issue a disability group for a child with cerebral palsy. The kit includes: a referral received at the clinic, with the results of the studies performed, a birth certificate, a passport of one of the parents, an application, a certificate of registration from the Housing Office, photocopies of all necessary documents. In addition to this, other documents may be required that are confirmation of the general state of health (the result of an examination or hospital extracts).

Within about a month, parents should be issued a certificate on the basis of which a certain disability group will be assigned. This document should be referred to Pension Fund for making pension payments.

Thus, childhood diseases can be quite serious, as in the case of cerebral palsy. If a child has this pathology, he must be assigned a disability group by a higher authority. Children with disabilities are entitled to free health care and life-sustaining medicines.

Apart from medical care children with cerebral palsy also need pedagogical assistance. To do this, parents, together with teachers, must draw up a comprehensive plan for influencing a disabled child. It should include classes on teaching the correct movements, physiotherapy, massage, work on simulators. the main role assigned to early speech therapy activities.

The result of physiotherapeutic and speech therapy effects is increased due to treatment medicines.

However, it is completely impossible. But with timely measures provided, the correct behavior of parents and teachers, a disabled child can achieve great success in self-service and acquiring skills.

We are glad to welcome regular and new visitors to our portal. In the current material, we will discuss the question of whether they give disability with cerebral palsy and whether it is always possible to get at least a third group. We will tell you what gives a child a special status, what advantages a person with disabilities and his parents get with him.

Cerebral palsy manifests itself from childhood, a sick child needs outside help and support from an adult. Assigned disability involves some concessions. It is important for the applicant, his representatives to know their rights in order to protect them if necessary. To do this, you should study the grounds and the order itself.

General concepts

What group in cerebral palsy is determined

Which disability group will be assigned to a disabled child upon reaching the age of 18 will depend on the degree of his disability. With minimal deviations, a person can successfully visit a team, find a job in simple work, and serve himself in everyday life. At the ITU, certain criteria, factors are evaluated.

First group

It is assigned to persons who are not able to serve themselves on their own. It's about about eating, changing clothes, going to the toilet, walking and other household needs. The patient's ability to communicate with other people, orientation in space is impaired. When you need care and control from the outside.

With a diagnosis of cerebral palsy (infantile cerebral palsy), I have been living since birth. More precisely, from the age of one (around then, the doctors finally determined the name of what is happening to me). I graduated from a special school for children with cerebral palsy, and after 11 years I came to work there. Since then, 20 years have already passed ... According to the most conservative estimates, I know more or less close, more than half a thousand cerebral palsy. I think this is enough to dispel the myths that those who are faced with this diagnosis for the first time tend to believe.

Myth one: cerebral palsy is a serious disease

It is no secret that many parents, having heard this diagnosis from a doctor, are shocked. Especially in recent years, when the media more and more often talk about people with severe cerebral palsy - about wheelchair users with damage to the arms and legs, slurred speech and constant violent movements (hyperkinesis). They are not aware that many people with cerebral palsy speak normally and walk confidently, and in mild forms they do not stand out among healthy people at all. Where does this myth come from?

Like many other diseases, cerebral palsy varies from mild to severe. In fact, it is not even a disease, but a common cause of a number of disorders. Its essence is that during pregnancy or childbirth, the infant is affected by certain parts of the cerebral cortex, mainly those that are responsible for motor functions and coordination of movements. This causes cerebral palsy - a violation of the proper functioning of individual muscles, up to the complete inability to control them. Doctors have more than 1000 factors that can trigger this process. Obviously, different factors cause different effects.

Traditionally, there are 5 main forms of cerebral palsy, plus mixed forms:

Spastic tetraplegia- the most severe form, when the patient, due to excessive muscle tension, is unable to control either his arms or legs and often experiences severe pain. Only 2% of people with cerebral palsy suffer from it (hereinafter, the statistics are taken from the Internet), but they are most often talked about in the media.

Spastic diplegia- a form in which either the upper or lower limbs. Legs suffer more often - a person walks with half-bent knees. Little's disease, on the contrary, is characterized by severe damage to the hands and speech with relatively healthy legs. Consequences of spastic diplegia have 40% of cerebral palsy.

At hemiplegic form motor functions of the arm and leg on one side of the body are affected. 32% have its signs.

In 10% of people with cerebral palsy, the main form is dyskinetic or hyperkinetic. It is characterized by strong involuntary movements - hyperkinesis - in all limbs, as well as in the muscles of the face and neck. Hyperkinesias are often found in other forms of cerebral palsy.

For ataxic form characterized by reduced muscle tone, sluggish slow movements, a strong imbalance. It is observed in 15% of patients.

So, the baby was born with one of the forms of cerebral palsy. And then other factors are included - the factors of life, which, as you know, everyone has their own. Therefore, what happens to him after a year, it is more correct to call the consequences of cerebral palsy. They can be completely different even within the same form. I know a person with spastic diplegia of the legs and rather strong hyperkinesis, who graduated from the Mechanics and Mathematics Department of Moscow State University, teaches at the institute and goes on hikes with healthy people.

According to various sources, 3-8 babies out of 1000 are born with cerebral palsy. Most (up to 85%) have mild and medium severity diseases. This means that many people simply do not associate the peculiarities of their gait or speech with a “terrible” diagnosis and believe that there are no cerebral palsy in their environment. Therefore, the only source of information for them is publications in the media, which by no means strive for objectivity ...

Myth two: cerebral palsy is curable

For most parents of children with cerebral palsy, this myth is extremely attractive. Not thinking about the fact that brain disorders today cannot be corrected by any means, they neglect the “ineffective” advice of ordinary doctors, spending all their savings and collecting huge sums with the help of charitable funds to pay for an expensive course at the next popular center. Meanwhile, the secret of alleviating the consequences of cerebral palsy is by no means so much in fashionable procedures as in constant work with the baby from the first weeks of life. Baths, ordinary massages, games with straightening the legs and arms, turning the head and developing the accuracy of movements, communication - this is the base that in most cases helps the child's body to partially compensate for violations. After all the main task early treatment consequences of cerebral palsy - not the correction of the defect itself, but the prevention of improper development of muscles and joints. And this can only be achieved daily work.

Myth three: cerebral palsy does not progress

This is how those who are faced with mild consequences of the disease console themselves. Formally, this is true - the state of the brain does not really change. However, even mild form hemiplegia, almost invisible to others, by the age of 18 inevitably causes a curvature of the spine, which, if not dealt with, is a direct path to early osteochondrosis or intervertebral hernias. And this is severe pain and limited mobility up to the inability to walk. Each form of cerebral palsy has similar typical consequences. The only trouble is that in Russia these data are practically not generalized, and therefore no one warns growing cerebral palsy and their relatives about the dangers that lie in wait in the future.

Parents know much better that the affected areas of the brain become sensitive to the general state of the body. A temporary increase in spasticity or hyperkinesia can cause even a banal flu or a pressure surge. In rare cases jar of Hearts or serious illness cause a sharp long-term increase in all the consequences of cerebral palsy and even the appearance of new ones.

Of course, this does not mean that people with cerebral palsy should be kept in greenhouse conditions. On the contrary: the stronger the human body, the easier it adapts to adverse factors. However, if a procedure or physical exercise regularly causes, for example, an increase in spasticity, they should be abandoned. In no case should you do anything through "I can not"!

Parents should pay special attention to the condition of the child from 12 to 18 years old. At this time, even healthy children experience serious overload due to the peculiarities of the restructuring of the body. (One of the problems of this age is the growth of the skeleton, which is ahead of the development of muscle tissues.) I know several cases when walking children due to problems with knee and hip joints at this age they sat on a stroller, and forever. That is why Western doctors do not recommend putting children of 12-18 years old on their feet if they have not walked before.

Myth four: everything from cerebral palsy

The consequences of cerebral palsy are very different, and yet their list is limited. However, relatives of people with this diagnosis sometimes consider cerebral palsy to be the cause of not only disorders motor functions, as well as vision and hearing, but also such phenomena as autism or hyperactivity syndrome. And most importantly, they believe: it is worth curing cerebral palsy - and all other problems will be solved by themselves. Meanwhile, even if cerebral palsy really became the cause of the disease, it is necessary to treat not only it, but also a specific disease.

During childbirth, Sylvester Stallone's facial nerve endings were partially damaged - part of the actor's cheeks, lips and tongue remained paralyzed, however, slurred speech, a smirk and big sad eyes later became a hallmark.

Especially funny is the phrase “You have cerebral palsy, what do you want!” sounds in the mouths of doctors. More than once or twice I heard it from doctors of various specialties. In this case, I have to patiently and persistently explain that I want the same thing as any other person - to alleviate my own condition. As a rule, the doctor gives up and prescribes the procedures that I need. In extreme cases, a trip to the manager helps. But in any case, when faced with a particular disease, a person with cerebral palsy has to be especially attentive to himself and sometimes prompt doctors the right treatment to minimize negative impact procedures.

Myth 5: People with cerebral palsy are not taken anywhere

Here it is extremely difficult to assert anything based on statistics, because there are simply no reliable data. However, judging by the graduates of the mass classes of the special boarding school No. 17 in Moscow, where I work, only a few stay at home after school. Approximately half enter specialized colleges or departments of universities, a third go to ordinary universities and colleges, some immediately go to work. In the future, at least half of the graduates are employed. Sometimes girls quickly get married after graduation and start “working” as a mother. With graduates of classes for children with mental retardation the situation is more complicated, however, even there, about half of the graduates continue their studies in specialized colleges.

This myth is spread mainly by those who are not able to soberly assess their abilities and want to study or work where they are unlikely to be able to meet the requirements. Receiving a refusal, such people and their parents often turn to the media, trying to get their way by force. If a person knows how to measure desires with opportunities, he finds his way without showdowns and scandals.

An illustrative example is our graduate Ekaterina K., a girl with a severe form of Little's disease. Katya walks, but can work on the computer with just one finger of her left hand, and only very close people understand her speech. The first attempt to enter a university as a psychologist failed - after looking at an unusual applicant, several teachers said they refused to teach her. A year later, the girl entered the Academy of Printing at the editorial department, where there was a distance learning. The study went so well that Katya began to earn extra money by passing tests for her classmates. Get a job after graduation permanent job it failed (one of the reasons is the lack of an ITU labor recommendation). However, from time to time she works as a moderator of educational sites in a number of universities in the capital ( labor contract issued to another person). And in his free time he writes poetry and prose, posting works on his own website.

Dry residue

What can I advise parents who found out that their baby has cerebral palsy?

First of all, calm down and try to give him as much attention as possible, surrounding him (especially at an early age!) with only positive emotions. At the same time, try to live as if an ordinary child is growing in your family - walk with him in the yard, dig in the sandbox, helping your child to establish contact with peers. There is no need to once again remind him of the disease - the child himself must come to an understanding of his own characteristics.

Second - do not rely on the fact that sooner or later your child will be healthy. Accept him for who he is. It should not be thought that in the first years of life all forces should be devoted to treatment, leaving the development of the intellect “for later”. The development of the mind, soul and body are interconnected. A lot in overcoming the consequences of cerebral palsy depends on the desire of the child to overcome them, and without the development of intelligence, it simply will not arise. If the baby does not understand why it is necessary to endure the discomfort and difficulties associated with treatment, there will be little benefit from such procedures.

Third, be lenient with those who ask tactless questions and give “stupid” advice. Remember: recently you yourself knew no more about cerebral palsy than they did. Try to calmly conduct such conversations, because how you communicate with others depends on their attitude towards your child.

And most importantly - believe: your child will be fine if he grows up an open and friendly person.

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Anastasia

I read the article. My theme:)
32 years old, right-sided hemiparesis (mild cerebral palsy). Normal Kindergarten, an ordinary school, a university, independent job searches (in fact, I am currently on it), travel, friends, ordinary life ....
And through the "lame-footed" she went through, and through the "clubfoot", and through God knows what. And there will be many more, I'm sure!
BUT! The main thing is positive attitude and strength of character, optimism!!

Nana

Does it really get worse with age? I have mild degree, spasticity in the legs

Angela

And me attitude people don't favorable conditions lives were broken. At 36, I have no education, no job, no family, although a mild form (right-sided hemiparesis).

Natasha

After vaccinations, a lot of "dtsp" appeared. Although the children are not cerebral palsy at all. There is nothing congenital and intrauterine. But they attribute to cerebral palsy and, accordingly, incorrectly "heal". As a result, they really get a kind of paralysis.
Often the cause of "congenital" cerebral palsy is not an injury at all, but an intrauterine infection.

Elena

A wonderful article that raises a huge problem - how to live with it. It is well shown that it is equally bad to ignore the presence of disease-related limitations and give them excessive importance. Don't focus on what you can't, but focus on what is available.
And it is really very important to pay attention to intellectual development. We even injected Cerebrocurin, it gave us a huge boost in development, after all, embryonic neuropeptides really help to use the available capabilities of the brain. My opinion is that you don’t need to wait for a miracle, but you shouldn’t give up either. The author is right: “this can only be achieved by the daily work” of the parents themselves, and the sooner they do this, the more productive. It’s too late to start “prevention of abnormal development of muscles and joints” after a year and a half of age - “the locomotive is gone.” I know on personal experience and the experiences of other parents.
Ekaterina, all the best to you.

* Kinaesthesia (ancient Greek κινέω - “I move, touch” + αἴσθησις - “feeling, sensation”) - the so-called “muscular feeling”, a sense of the position and movement of both individual members and everything human body. (Wikipedia)

Olga

I completely disagree with the author. firstly, why, when considering the forms of cerebral palsy, did they say nothing about double hemiplegia? it differs from ordinary hemiplegia and from spastic tetraparesis. secondly, cerebral palsy is really curable. if we mean the development of the compensatory capabilities of the brain and the improvement of the patient's condition. thirdly, did the author see heavy children in the eyes ??? those about which there is no question of making play in the sandbox. when you almost look at the child and he is shaking from convulsions. and the screaming doesn't stop. and he arches in such a way that the bruises on the hands of my mother when she tries to hold him. when not only to sit - the child cannot lie down. fourthly. the form of cerebral palsy is nothing at all. the main thing is the severity of the disease. I saw spastic diplegia in two children - one almost does not differ from his peers, the other is all crooked and with convulsions, of course, he cannot even sit upright in a stroller. there is only one diagnosis.

Elena

I do not quite agree with the article as the mother of a child with cerebral palsy - spastic diplegia, medium degree gravity. As a mother, it is easier for me to live and fight, thinking that if it is incurable, then it is fixable, it is possible to bring the child as close as possible to "norms." social life. for 5 years we managed to hear enough that it’s better to send your son to a boarding school, and give birth to a healthy one yourself ... and this is from two different orthopedic doctors! it was said in front of a child who has a preserved intellect and he heard everything ... of course, he closed himself, began to shun strangers .... but we have a huge leap - our son walks on his own, though it’s bad with balance and his knees are bent ... but we fight. we started quite late, from 10 months , before that they treated other consequences of premature birth and indifference of doctors ...

Effective rehabilitation of children with cerebral palsy includes a set of measures. Attention is paid not only to the physical, but also to the mental development of the child, the acquisition of skills of independence and social adaptation. For children with disabilities, free observation, provision of vouchers for treatment in sanatoriums, provision of medicines and means are also possible. technical rehabilitation.

Causes of the disease and risk factors

The causes of cerebral palsy are divided into intrauterine provoking factors and postpartum. The first type includes:

severe pregnancy;
unhealthy lifestyle of the mother;
hereditary predisposition;
difficult childbirth, during which fetal asphyxia occurred;
sharp or some chronic diseases mothers;
children born prematurely and with low birth weight;
infectious processes occurring in a latent form in the mother's body;
toxic poisoning of the brain of a child due to incompatibility between mother and fetus in terms of blood group and Rh factor, or liver failure child.

Postpartum triggers include:

baby weight up to 1 kg at birth;
the birth of twins or triplets;
head trauma at an early age.

In every third case, however, to identify specific reason pathology fails. And as a rule, the rehabilitation of children with cerebral palsy does not depend on the causes of the development of the disease. may be revised except in the case of premature and low birth weight children - such patients often require more careful care and medical supervision.

The main phases of the course of the disease

Rehabilitation of children with cerebral palsy depends on the phase of the disease, the severity of the course of the disease and the age of the patient. There are three phases of the course of the disease:

Early (up to 5 months). Cerebral palsy is manifested by developmental delay, preservation of unconditioned reflexes.
Primary (up to 3 years). The child often chokes on food, does not seek to speak, asymmetry, hypertonicity or excessive muscle relaxation is noticeable.
Late (over three years). It is manifested by the shortening of one limb compared to the other, swallowing, hearing, vision, speech disorders, convulsions, urination and defecation disorders, mental retardation.

Early signs of cerebral palsy

To early signs of cerebral palsy include the following deviations:

delayed physical development: head control, turning over, sitting without support, crawling or walking;
preservation of "children's" reflexes upon reaching 3-6 months of age;
predominance of one hand by 18 months;
any symptoms that indicate hypertonicity or excessive relaxation (weakness) of the muscles.

Clinical manifestations of the disease can be both pronounced and almost imperceptible - it all depends on the degree of damage to the central nervous system and the brain. Apply for medical care follows if:

the child's movements are unnatural;
the child has convulsions;
muscles appear excessively relaxed or tense;
baby does not blink in response to loud noise in one month;
at 4 months, the child does not turn his head to a loud sound;
does not sit without support at 7 months;
does not speak single words at 12 months;
the baby does not walk or walks unnaturally;
the child has strabismus.

Comprehensive rehabilitation of children with cerebral palsy gives the best results if it starts at an early age. At severe forms disease, delayed recovery physical activity or late development of social skills, the child may remain completely unadapted to life.

Is it possible to cure the disease

Cerebral palsy refers to diseases that are almost impossible to cure completely. However, comprehensive and timely rehabilitation allows children with such a diagnosis to be trained on an equal footing with healthy children and lead a full-fledged lifestyle. Significant progress can be considered the preservation of individual symptoms of the disease in the child.

Modern methods of treatment of cerebral palsy

The main task for children with paralysis is the gradual development of skills and abilities, physical and social adaptation. Methods that are developed individually for each child gradually correct motor defects, improve motor activity, develop the patient emotionally, personally and socially, develop independence skills in Everyday life. As a result of systematic rehabilitation, the child can integrate into society and adapt to later life independently.

The rehabilitation program for children with cerebral palsy includes the following approaches:

treatment water procedures: swimming, balneo or hydrotherapy;
PET therapy, or animal treatment: hippotherapy psychophysical rehabilitation in the process of communicating with dolphins and swimming;
the use of orthopedic devices, exercise equipment, gymnastic balls, ladders;
increasing the bioelectric activity of muscles;
therapeutic massage to reduce the degree of lethargy and muscle spasm;
drug treatment: Botox, botulinum toxin, xeomin, dysport are used;
Vojta therapy, which allows you to restore natural patterns of behavior;
physiotherapy treatment: myoton, ultrasound, magnetotherapy, darsonvalization;
Montessori therapy, which allows you to form the ability to concentrate and develop independence;
classes with a psychologist;
speech therapy classes that correct speech disorders (program "Logorhythmics");
special pedagogy;
shiatsu therapy - massage of biologically active points;
classes according to the Bobath method - special gymnastics using certain equipment;
laser effect on reflex zones, tip of the nose, joints, reflex-segmental zones, area of paretic muscles;
art therapy aimed at preparing the child for learning;
Peto's technique - division of movements into individual acts and their learning;
surgical orthopedic interventions;
Spa treatment;
alternative methods of treatment: osteopathy, manual therapy, catgut therapy, vacuum therapy, electroreflexotherapy.

Of course, not all methods of rehabilitation of children with cerebral palsy are listed above. There are many ready-made programs developed and currently being developed by rehabilitation centers, alternative approaches and techniques.

Physical rehabilitation of children with cerebral palsy

The physical recovery of a sick child should begin as early as possible. Leading experts in the world have recognized that the rehabilitation of a disabled child (CP) brings the best results up to three years, but in Russia many centers refuse to accept children under one or three years old, and doctors are in no hurry to establish a diagnosis and formalize disability. But still, physical rehabilitation is the most important stage in the adaptation of a special child to later life, and you should start working with a small patient immediately after the diagnosis of "cerebral palsy" is established.

Rehabilitation of children with cerebral palsy is necessary in order to prevent muscle weakness and atrophy, to avoid the development of complications, and it is also resorted to in order to promote the motor development of the child. Therapeutic massage, physical education and exercises on special simulators are used. In general, any motor activity is useful, and the supervision of a specialist will help to form motor stereotypes, to correctly develop physical form and prevent addiction to pathological positions.

Rehabilitation Bobath Therapy

The most common form of rehabilitation is Bobath therapy in combination with other, no less effective methods. The essence of therapy is to give the limb a position opposite to that which, due to hypertonicity, it seeks to accept. Classes should be held in a calm environment, three times a day or a week, each movement is repeated 3 to 5 times. The movements themselves are carried out slowly, because the main goal of treatment is to relax the muscles. Complexes of exercises are developed individually. Treatment according to the Bobath therapy method can also be carried out at home - a parent or guardian is trained to perform techniques with the help of a specialist in a rehabilitation center.

Means of technical rehabilitation

In the physical restoration of the motor activity of a child with cerebral palsy, the means of technical rehabilitation of children are also used. Severe cerebral palsy requires mobility aids (walkers, wheelchairs), development (exercise bikes, special tables and chairs) and hygiene (bath seats, toilet seats) of the child. Also, rehabilitation means for children with cerebral palsy involve the use of orthopedic devices and exercise equipment. For example, the Adele suit is used, which redistributes the load, develops motor skills, Veloton, which stimulates muscles, the Spiral suit, which allows you to form new movement stereotypes, and so on.

Social rehabilitation of disabled children with cerebral palsy

Closer to school age, more attention is paid to the social adaptation of the child. Efforts are directed to the formation of independence skills, mental development preparing the child for collective learning and communication. In addition, the patient is taught to dress himself, serve himself, exercise hygiene, move around, and so on. All this will reduce the burden on those caring for a disabled child, and the smallest patient will be able to adapt to life.

Psychologists, speech therapists and teachers work with special children. The role of parents or guardians who will deal with the child at home is extremely important. Social rehabilitation of children (ICP) pursues the following goals:

expansion of vocabulary and horizons;
development of memory, attention and thinking;
education of personal hygiene skills;
education of self-service skills;
speech development, culture formation.

Children with this diagnosis can study in experimental classes, which are more often formed in private schools, but with significant restrictions, it is better to think about boarding or homeschooling. In the boarding school, the child can communicate with peers, receive special skills and participate in career guidance activities. Homeschooling requires more active parental involvement and daily medical supervision.

In many cases, further labor activity person diagnosed with cerebral palsy. Such people can master the professions of mental labor (teachers, but not elementary grades, economists, architects, junior medical staff), work at home as programmers, freelancers, and even (with the preservation of hand movements) as seamstresses. Employment is impossible only in severe cases.

Disability with cerebral palsy

It has several forms and degrees of severity. Disability in cerebral palsy is issued if the disease is accompanied by restrictions in relation to normal life, learning, self-service, speech contact. Disability registration is possible only after medical examination. A mother with a child will have to undergo a neurologist, surgeon, psychiatrist, pediatrician, orthopedist, ophthalmologist and ENT specialist. This "adventure" does not end there. Followed by:

issue a final conclusion from the head of the medical institution;
go through the procedure of reconciliation of documents already in an adult polyclinic;
give a package of documents to the point of acceptance of papers for medical and social examination.

Depending on the term for establishing disability, it is necessary to conduct a medical and social examination (and, consequently, to re-pass all doctors) again after a certain period of time. It is also necessary to obtain conclusions again if the issued individual program rehabilitation is undergoing changes - for example, if a child, as prescribed by a specialist, needs a new means of rehabilitation.

Benefits for disabled children with cerebral palsy

Registration of disability for some families is a vital issue, because it makes it possible to receive cash payments for rehabilitation and benefits.

So, families with disabled children with cerebral palsy are entitled to the following benefits:

free rehabilitation in federal and regional centers and sanatoriums;
a discount of at least 50% on the payment of municipal or public housing, as well as housing and communal services;
right to receive priority land plots for individual construction, gardening and housekeeping;
provision of medicines (as prescribed by a doctor), medical nutrition products;
free travel to the place of sanatorium treatment and back, as well as in public transport (the benefit is for a disabled child and one accompanying person);
compensation for the services of a psychologist, teacher and speech therapist, determined by an individual rehabilitation program (in the amount of no more than 11.2 thousand rubles per year);
exemption from payment in kindergartens;
compensation payments to unemployed persons caring for a disabled child (a parent, adoptive parent or guardian can receive 5.5 thousand rubles, another person - 1.2 thousand rubles);
pension for a disabled child and additional payments (in total 14.6 thousand rubles as of 2017);
the period of caring for a child with a disability is included in the mother's seniority;
the mother of a disabled child with cerebral palsy has a number of benefits under labor law: she cannot be involved in overtime work, business trips, has the right to work part-time, retire earlier, and so on;
a single mother raising a disabled child cannot be dismissed, except in cases of complete liquidation of the enterprise.

Rehabilitation centers in Russia

In special centers, the rehabilitation of children with cerebral palsy is carried out comprehensively and under the supervision of relevant specialists. As a rule, systematic classes, an individual program and professional medical support for both children and parents can achieve significant results in a relatively short period of time. Of course, to consolidate the result, you need to continue to engage in the proposed program at home.

Russian Scientific and Practical Center for Physical Rehabilitation and Sports (Grossko Center)

There are several rehabilitation centers in Russia. The Grossko Center in Moscow operates on integrated program: upon admission, diagnostics are carried out, then with special child Specialists-instructors in physical recovery are engaged. Physical rehabilitation children with cerebral palsy in the Grossko Center provides for physiotherapy exercises, swimming, exercises with special simulators that allow developing coordination of movements and fixing motor stereotypes, classes on a treadmill, roller skating. Based on the results of pedagogical testing, programs are adjusted so that recovery meets the needs and condition of a particular small patient.

The cost of rehabilitation of a child (cerebral palsy) in the Grossko Center, of course, is not small. For example, for initial appointment you will have to pay 1,700 rubles, and the cost of 10 physical therapy sessions (45-50 minutes each) is 30 thousand rubles. One lesson with a speech therapist (lasting 30 minutes), as well as a massage session (30-40 minutes according to the doctor's testimony) will cost 1000 rubles. However, the results of the classes really are, and the Grossko Center itself is a prominent institution.

Russian Research Institute of Traumatology and Orthopedics. R. R. Vredena

The Rehabilitation Center for Children with ICP named after R. R. Vreden (RNIITO - Russian Research Institute of Traumatology and Orthopedics) in St. Petersburg provides its clients with a full range of services: from diagnostics to surgical intervention including, of course, treatment and recovery. More than twenty fully equipped departments are at the disposal of highly professional specialists of the center with many years of practical experience.

Moscow Scientific and Practical Center for the Rehabilitation of the Disabled Due to Cerebral Palsy

The Moscow Scientific and Practical Center for the Rehabilitation of Persons with Disabilities Due to Cerebral Palsy is considered one of the most accessible and well-known. The doctors of the center work on the basis of several dozen rehabilitation programs, use all modern domestic developments and find an individual approach to each patient. The center accepts children from three years of age. Apart from directly physical recovery, psychologists-defectologists, speech therapists, professional massage therapists and conductologists - teachers who work with children and adults who have disorders of the central nervous system, deal with young patients.

Institute for Conductive Pedagogy and Rehabilitative Movement Therapy in Budapest, Hungary

Rehabilitation of a disabled child (CP) at the Institute. A. Petyo in Budapest - the capital of Hungary - is the center where hundreds of families aspire to get. The institution is famous for its excellent specialists, the use of the most modern developments in the treatment of young patients, as well as the visible results achieved by children with cerebral palsy who have completed a rehabilitation course.

There are many other rehabilitation centers and sanatoriums that accept children with cerebral palsy for rehabilitation. Only in Moscow, for example, the Center for the Rehabilitation of Children with Cerebral Palsy "Movement" operates, Rehabilitation center"Spark", Rehabilitation Center "Overcoming" and others. In some institutions, free rehabilitation of children with cerebral palsy is also possible. Families with disabled children are also supported by charitable organizations and social centers.

Cerebral palsy - this abbreviation scares all parents and often sounds like a sentence. However, when receiving such a diagnosis, the parents of the child should not give up, but are simply obliged to sound the alarm. This terrible diagnosis should be questioned and the true causes leading to a violation of the child's motor functions should be identified. The fact is that pediatric neuropathologists tend to make this diagnosis, which is familiar to them, from the first year of a child's life - when the first signs of paralysis and paresis appear. However, with deep scientific and practical research It turned out that the diagnosis of cerebral palsy is a very conditional, inaccurate diagnosis. According to Anatoly Petrovich Efimov, traumatologist-orthopedist-neurorehabilitologist, doctor of medical sciences, professor, general director of the Interregional Center restorative medicine and rehabilitation in Nizhny Novgorod, “ICP is not yet a sentence, since 80% of cases can be cured until the child fully recovers. If this is done in a timely manner, as my medical practice shows, children under 5 years old are cured in 90% of cases and go to school along with ordinary children.

Cerebral palsy does not happen without a cause. When any conversation appears on the part of doctors about the threat of cerebral palsy or about cerebral palsy parents should do the following.
Firstly, parents need to find out the causes of cerebral palsy together with the doctor, if the doctor insists on this diagnosis. And these reasons are few, and in any hospital they can be established in one or two weeks. There are only six causes leading to cerebral palsy.

First reason are inherited genetic factors. All the disorders that are in the genetic apparatus of the parents can really manifest themselves in the form of cerebral palsy in a child.

The second reason- this is ischemia (impaired blood supply) or hypoxia (lack of oxygen) of the fetal brain. This is the oxygen factor, the lack of oxygen to the child's brain. Both can occur during pregnancy or during childbirth as a result of various vascular disorders and hemorrhages.

Third reason- This is an infectious factor, that is, a microbial one. The presence in a child in the first days and first weeks or months of life of diseases such as meningitis, encephalitis, meningoencephalitis, arachnoiditis, occurring with high temperature, heavy general condition a child with bad blood tests or cerebrospinal fluid, with the detection of specific microbes - the causative agents of an infectious disease.

Fourth reason- these are the actions of toxic (poisonous) factors, poisonous drugs on the body of a future person. This is most often the intake by a woman of potent drugs during pregnancy, the work of a pregnant woman in hazardous working conditions, in chemical industries, in contact with radiation or chemicals.

Fifth reason – physical factor. Impact on the fetus of high-frequency electromagnetic fields. Irradiation, including X-ray, radiation and other physical adverse factors.

Sixth reason- this is a mechanical factor - birth trauma, trauma before childbirth or shortly after them.

In each polyclinic, in one to two weeks, one can fully assess the root causes of paralysis of brain functions. Practice shows that pediatric neuropathologists are fond of diagnosing and searching for only infectious or ischemic causes of brain damage in a child. A viral or infectious brain lesion is often diagnosed. Doctors also pay attention to the lack of oxygen due to vascular disorders, although most vascular disorders and hemorrhages are precisely traumatic, because young blood vessels in newborns cannot burst on their own, like in old people 80-90 years old, so there is no typical stroke in children. Vessels in newborns and children are soft, elastic, supple, adaptive, therefore, it is deeply wrong to explain the causes of cerebral palsy with vascular disorders. Most often, they are caused by traumatic causes. The importance of identifying the root cause of the disease is that the entire program of further treatment and the life prognosis for the child depend on it.

Cerebral palsy is of three groups.

First group- True cerebral palsy, not acquired. The disease is hereditary, congenital, primary, when at the time of the birth of a child, his brain is really deeply affected genetic disorders or disorders of embryonic development. It is underdeveloped, smaller in size and volume, the convolutions of the brain are less pronounced, the cerebral cortex is underdeveloped, there is no clear differentiation of gray and white matter, there are a number of other anatomical and functional disorders of the brain. This is the primary one, i.e. true infantile cerebral palsy. The brain at the time of birth is biologically and intellectually defective, paralyzed.

Primary cerebral palsy is formed due to:
1) hereditary causes;
2) the action of various adverse factors during the embryonic (intrauterine) development of the child;
3) severe birth trauma, often incompatible with life.
But if such a child was miraculously revived and saved, the state of the head or head remains incompatible with normal development. spinal cord.
There are about 10% of such children.

Second group- True cerebral palsy, but acquired. Children with such a diagnosis are also about 10%. These are children with acquired disabilities. Among the causes are severe birth trauma, for example, deep hemorrhage during childbirth with the death of parts of the brain, or the traumatic effect of toxic substances, especially anesthesia, as well as severe infectious brain damage with purulent meningoencephalitis, etc. such serious causes, affecting the brain and nervous system of the child, form a severe picture of cerebral palsy, but they are no longer hereditary and embryonic in nature, in contrast to the first group of patients with cerebral palsy, but acquired. Despite the severity of the lesion, children can be adapted to independent movement and independent walking so that later they can serve themselves. Their everyday rehabilitation is possible so that their movement is independent, so that they do not need to be carried on their hands, since aging parents cannot do this, and the body of a child grows to a significant weight of a man or woman.

Third group- ICP is not true acquired. This is a false, pseudo-cerebral palsy, or secondary, acquired cerebral palsy syndrome, a much larger group. At the time of birth, in this case, the children's brain was biologically and intellectually complete, but as a result of the action, first of all, birth injuries, disturbances appeared in various parts of the brain, leading to subsequent paralysis of individual functions. 80% of children suffer from acquired cerebral palsy. Outwardly, such children differ little from children with true cerebral palsy, except for one thing - their intellect is preserved. Therefore, it can be argued that all children with a smart head, with a intact intellect, are never children with true cerebral palsy. That is why all these children are very promising for recovery, since the cause of cerebral palsy-like syndrome in them was mainly a birth injury - severe or moderate.
In addition to birth injuries, the cause of secondary (acquired) cerebral palsy is oxygen starvation of the brain during pregnancy, mild hemorrhages in the brain, exposure to toxic substances, and physical adverse factors.

In addition to the diagnosis of cerebral palsy, it is worth dwelling on the diagnosis of “threat of cerebral palsy”. It is placed mainly in the first year of a child's life. At the same time, it is necessary to take into account: until the main causes of paralysis of the nervous system, the musculoskeletal system have not been identified, until a modern comprehensive examination of the child has been carried out, and until normal, natural terms for the appearance of walking have come, it is impossible to prematurely diagnose "the threat of cerebral palsy". For such children under one year old, it is necessary to bother a lot, first of all, to parents, to advise them in the best centers, with the best doctors in order to finally understand the prospects for the development of such a disease in a child.

An important and numerous group of patients diagnosed with cerebral palsy are children with the so-called secondary cerebral palsy, that is, initially at the time of birth, these children had no reason to diagnose cerebral palsy. The nature of such diseases does not create. Where do they come from? It turns out that all these children only have cerebral palsy-like diseases, with the consequences of birth injuries or exposure to other pathological factors. But due to improper treatment by the age of 7-10 they become children with secondary cerebral palsy - absolutely unpromising, with irreversible functional disorders, with medical and biological consequences, that is, profoundly disabled. This group of children lies entirely on the conscience of doctors. By virtue of different reasons they were treated for years with a treatment regimen for cerebral palsy, without finding out true reasons development movement disorders and other disorders. As for the treatment of cerebral palsy, they used potent drugs that affect the brain, prescribed inadequate physiotherapy, primarily electrical procedures, used manual therapy without justification, they prescribed active massage of those parts of the body where it is undesirable, used the methods of chipping, as in the treatment of true cerebral palsy, methods of electrical stimulation, prescribed hormonal drugs, etc. Thus, incorrect treatment carried out for years (5, 7, 10 years) forms large group disabled people with secondary infantile paralysis. This group of children is a great sin modern medicine. First of all, child neurology. Parents need to know about this in order to prevent the further formation of such a group of patients in our society as children with cerebral palsy of an untrue, acquired, secondary nature. With the right modern diagnostics, with proper rehabilitation treatment, all these children can recover to a normal state, i.e. they can master a certain working specialty, depending on the age and the timing of the start of adequate rehabilitation.

How should the parents of a child behave when diagnosed with "threat of cerebral palsy" or "cerebral palsy"?

First of all, don't give up. They should know that in addition to traditional neurological treatment regimens for cerebral palsy, in Russia there is an opportunity to accurately diagnose the true causes of cerebral palsy. And also to distinguish true cerebral palsy from acquired, true causes leading to paralysis of the brain, from causes paralyzing temporarily, i.e. so that the paralyzing disturbances are reversible. Particularly effective is the group of children who have developed cerebral palsy as a result of birth trauma, since many of the consequences of trauma are reversible. And reversibility means curability. Therefore, cerebral palsy caused by birth trauma is treated in such a way that further the child has prospects for recovery at any age. Although it should be noted that the earlier treatment is started, the more effective it is. The best curability is observed in children under 5 years old - in 90% of cases, up to 10 years old - about 60%. After 10 years, due to the fact that children are neglected, that is, many physiological disorders appear in their bodies by this time, and not only in the brain, but also in bones, joints, muscles and other organs, they are already recovering worse. But they are sure to be restored to the level of independent movement and self-service. These patients should apply and actively engage in all methods of family rehabilitation at home until a positive end result appears. Of course, the older the child, the more time it takes to recover. But in any case, you can not stop and to achieve the desired results, you need to practice at home. Rehabilitation is for all ages.

Ekaterina SERGEEVA