Treatment of Cerebral Palsy and Motor Delay is a highly practical, easy-to-read resource for all paediatric practitioners and students working with the developmental abilities and difficulties of children, providing a thorough overview of cerebral palsy and its treatment.
The sixth edition has been thoroughly revised and updated to integrate the latest evidence-base on motor control and motor learning, whilst still retaining Sophie Levitt's eclectic, holistic and functional approach. It includes greater detail on paediatric occupational therapy, classification systems, the latest systematic reviews of research, as well as an expanded chapter on adolescents and adults with cerebral palsy. The chapter on equipment has also been increased so as to be of further relevance to occupational therapists.
Supported by clear diagrams and photographs, as well as summaries to consolidate learning, it outlines therapeutic approaches and suggests treatment and management options, providing a wealth of practical information. The book promotes positive relationships between therapists, people with cerebral palsy and their families.
Table of Contents
Foreword ix
Preface xi
Acknowledgements xvii
1 The clinical picture for therapy and management 1
Incidence of cerebral palsy 1
Motor dysfunction 1
Associated impairments and disabilities 3
Broad framework for therapy and management 4
Aetiology of cerebral palsy 7
Genetic causes 7
Causes in later childhood 7
Neuroimaging 7
Clinical picture and development 8
Change at different ages 9
Classification systems 11
Topographical classifications 14
Classification of motor types of cerebral palsies 15
Common features observed in all presenting types of cerebral palsies 21
Motor delay 22
Summary 23
2 A collaborative learning approach 25
Working with parents within a family framework 25
Emotional support 26
Parents vary 27
Other adults 28
Family‐centred services 28
Research on home and school visits 30
Collaborative learning approach 30
Opportunities to discover what the parents and child want to achieve 31
Opportunities to clarify what is needed for these achievements, to recognize what parents and children already know and can do, and to find out what they still need to learn and do 32
Involvement in the selection and use of methods 34
Involvement in the evaluation of progress 37
Parent-child interaction 38
Helping a child to learn motor control (body function) and motor function (activity) 39
Observation of parent and child interaction 40
Social needs 41
Parents’ health 41
Teamwork with parents 42
Siblings 43
Alternative and complementary treatments 44
Summary 46
3 Learning motor function 49
Learning methods 50
Development of a child’s attention and learning 52
Practical ideas to promote attention and learning 53
A child’s own strategies for a chosen goal 54
Task analysis 55
Cues for learning 56
Verbal guidance 58
Rewards 58
Practice and experience 59
Summary 60
4 Adolescents and adults 61
Studies of function in adolescents and adults 62
Activity goals 63
Issues of concern for adolescents and adults 64
Adolescents 65
Adults 66
Healthy lifestyle 67
Develop appropriate community mobility 68
Training of self‐care and cosmetic appearance 69
Knowledge about the condition 69
Therapeutic activities 70
Measures 70
Summary 70
5 Outline of treatment approaches 71
History 71
Muscle education and braces 71
Progressive pattern movements 73
Proprioceptive neuromuscular facilitations (PNF) 74
Neuromotor development 75
Neurodevelopmental treatment (NDT) (Bobath approach) 75
Sensory stimulation for activation and inhibition 77
Reflex creeping and other reflex reactions 78
Conductive education 79
Sensory integration 81
Context therapy 82
Strength training 82
Systems‐based task‐oriented approach 87
Mobility Opportunities via Education (MOVE) 88
Contemporary theories 89
6 Evidence‐based practice 93
Research and clinical studies 93
Research on treatment approaches 93
Theoretical grounds 94
Research studies 94
Reviews of research studies 94
Research on specific procedures 95
Other research 95
Clinical experience with evidence‐based practice 96
Definitions 97
The appraisal of research studies for therapy 98
Examples of qualitative research methods (Greenhalgh and Taylor 1997) 102
7 Synthesis of treatment approaches 103
The eclectic viewpoint in therapy 103
Synthesis of treatment systems 104
The postural mechanisms 105
Trunk control 108
Voluntary motion 108
Perceptual-motor function 110
Principles for a synthesis of therapy and management 110
Developmental training 111
Some advantages and disadvantages of modifications of developmental sequences 114
Treatment of atypical tone 116
Training of movement patterns 117
Use of afferent stimuli 118
Management of deformity 120
8 Assessment for therapy and management 121
Approach to assessment 121
Assessment and measurements 125
Examples of atypically persistent postures, movements, and functions 132
Functional measures 133
Specific functional items 135
Measures of upper extremity and hand function 137
Measures of daily activity and participation 138
Quality of life and health‐related quality of life measures 142
Norm‐referenced measures of stages of child development 143
Neonatal assessments 144
Methods of observation of gait 145
Additional assessment required 154
Records 155
Summary 156
9 Treatment procedures and management 157
Motor training 157
Development of the child with severe visual impairment 161
Developmental Training 168
Prone development 168
Supine development 193
Development of sitting 208
Development of standing and walking 230
Lower limb orthoses for standing and walking 263
Development of hand function 277
Techniques for carrying the child correctly 307
10 Function and the child’s daily life 309
Motor function in communication 310
Motor function in self‐care activities 313
Motor function for leisure 326
11 Therapeutic group work 329
General management of groups 331
Selection of children 332
The programme 333
Summary 335
12 Management of deformities 337
Causes of deformities 338
Therapy goals 343
Deformities and gait 344
General considerations related to surgery 348
Therapy and daily care 351
Dynamic arm deformity 365
Deformities of trunk and neck 365
13 Assessment, prescription, and provision of equipment 367
Equipment for self‐care tasks 368
Postural management equipment 370
Sleep systems 381
Other equipment for positioning 383
Mobility equipment 383
Adaptations and the built environment 391
Appendix 1 Developmental levels 393
Physical ability assessment guide 393
Wheelchair use 397
Appendix 2 Useful organisations 399
References 401
Index 429
