Jane Walters is a five year old girl and has a diagnosis of left sided spastic hemiplegia, a form of Cerebral Palsy. Jane has two older sisters who attend horse riding lessons at their local stables. Jane has recently expressed an interest in joining them to her parents. However her parents are worried that because of her diagnosis she will not be able to keep up with her siblings. Jane is very aware of her condition, and has recently lost confidence, asking her parents why she is different from other children her age.
Diagnosis – Cerebral Palsy (CP) refers to non-progressive conditions characterised by impaired voluntary movement or posture, and resulting from prenatal developmental malformations or postnatal CNS damage (Reed, 2013, pp. 38-47).
According to the National Institute of Neurological Disorders and Stroke (2008), it is highly likely that a child with CP will have other medical disorders such as; cognitive impairments, seizures, delayed growth and development. Spastic syndromes such as Jane’s occur in more than 70 percent of CP cases.
Spastic hemiplegia is a type of CP that typically affects the body down one side. The spasticity creates a state of resistance against any range of motion; this resistance ultimately increases with increasing speed of that movement (Reed, 2013, pp. 38-47). Children like Jane with spastic hemiplegia will generally walk later than other children and will tend to walk on their tiptoes because often they will suffer from high heel tendons. Often the arm and leg on the child’s affected side are shorter and thinner (National Institute of Neurological Disorders and Stroke 2008).
Impact of Right Hemisphere Brain Damage- Jane has left sided spastic hemiplegia, indicating that damage to the brain has occurred in the right hemisphere. The primary cause of CP is damage to white matter of the brain this is often caused by abnormal brain development. This can be caused by a bleed on the brain, or by a lack of oxygen to the brain, generally caused by a difficult birth (NINDS 2008).
It was important to consider additional complications related to right sided brain damage to ensure an awareness of Jane’s level of functional ability be it; physically, cognitively or behaviourally. Those that may relate to Jane’s case are listed below in table one.