The Impacts of Cerebral Palsy on Youngsters in Old Westbury, USA

1.0 Background (Introduction) 

Cerebral palsy is a risky cerebrum condition because of hindered muscle coordination for the most part because of the mind deformity/injury previously or during childbirth. The injury to the growing brain usually happens during the antenatal, perinatal, and post-natal sessions ( Neurological, 2001). Cerebral palsy has no researched cure and is often associated with other co-morbid neurological disorders such as intellectual disability, epilepsy, speech problems, and hearing and visual disorders. Cerebral palsy is a brain disorder condition found in children with incidence varying across geographical areas. According to the world database, the prevalence is approximately 2.5-3 per 1000 live births ( Parkin, 2016) . In the year 2003, through the subsidizing of the West Australian government, a proof-based clinical program for the kids with cerebral palsy was established. The program was officially known as the cerebral paralysis Mobility Service (CPMS). Because of the subsidizing database, there was the presentation of the Pediatric Rehabilitation Information System (PRIS), with a review of information passage for children with CP. In any case, the present review shows that CPMS controls the state-wide populace of kids with cerebral paralysis in this manner, giving the exact following of mediations. 

Cerebral palsy has been identified as one of the major causes of childhood disabilities in the world. The global records indicate that between 2-3 per 1000 live birth are diagnosed with cerebral palsy ( Silver, McAllister & Arciniegas, 2018). In developing countries (mostly from Africa), it is attributed to poor obstetric care, which includes severe neonatal jaundice and central nervous system. This impacts negative effects on the present child hence the need to assess its implication to the society. Initial diagnosis is significant to improve long-term results through early identification of the affected children with early intervention. 

The main purpose of this investigation is to contribute to the knowledge base on the long-term outcome/effects associated with cerebral palsy in children across the world. This research, tries to investigate partial and permanent effects of cerebral palsy on the children in Old Westbury, USA. Furthermore, the study aims at to examining its risk factors as well as impacts to the present society. It also highlights some important reasons why the government needs to fund more research concerning these neurological disorders in the future. 

2.0 Psychological Considerations 

2.1 DSM-V Classification 

The study adopted a cohort approach where 420 children with diagnosed CP and whose parents gave consent were observed in a clinical setting. In this cohort study child aged between 6 to 14 years were observed and tested in different areas of literacy. From the initial point, DSM as undergone various revisions as the APA and general public’s understanding of mental pathology ( Burda, Bernstein & Sofroniew, 2016) . DSM adheres to specific guidelines to categorize it's described mental disorders. This greatly assists the mental health fraternity to stay on the page. From the study, it was observed that children with cerebral palsy had psychological, behavioral, and other related disorders. 

2.2 Psychological symptoms 

Cerebral palsy is characterized by several symptoms ranging from psychological to other disorders. The disease can affect the child's motivation and make them disassociated with others. However, regardless of a growing awareness of this, the main focus of assessment and management remains to be the motor impairment ( Burda, Bernstein & Sofroniew, 2016) . The presence of communication or cognitive difficulties can develop the identification of mental health disorders in the child be challenging. 

2.3 Behavioral symptoms 

Although there are many mental health assessment tools employed in general clinical practice, however, not all of these are efficient for use in children and young adults with cerebral. It is imperative that assessment seems to be sensitive to the symptoms of mental disorders in this age group with CP are critically evaluated before the practice for reliable outcome. Behavioral symptoms of CP can vary greatly but the common symptoms that include: 

stiff muscles 

difficulty in walking 

delayed motor skills milestones 

difficulty in speech and hearing 

difficulties in swallowing 

2.4 Related Disorders 

Apart from the above-mentioned cerebral palsy disorders, there are other related difficulties such as seizures, learning problems, slow movements, variations in muscle tone, deformity, and intellectual problems. To a greater extent, cerebral can be witnessed by Epilepsy, deafness, and blindness. 

3.0 Neuropsychological Considerations 

The primary causes and nature of the brain injury usually vary considerably, thus rendering children and young people with CP, a heterogeneous group (Jain, 2019). It is all in recent days with the help of technological advancement in the field of science that the research has started to determine the nature of brain damages and the relation to clinical observations. As a group, children suffering from CP are at risk of both identified cognitive impairments and intellectual problems such as literacy, mathematics, and visual-spatial reasoning (Jain, 2019). The risk of cognitive impairment is real and acknowledged. Unfortunately, considering the pervasive impacts like impairment may have on the child's life, limited studies are investigating this severe issue. Neurological abnormalities connected with cerebral palsy cause problems relating to difficulty in seeing and hearing, intellectual disability, seizures, urinary incontinence, oral diseases, and mental health problems. 

Diagnosing cerebral palsy at a young age is critical to the future prosperity of the youngster and the family on the loose. The diagnosing procedure can make many strides, including formative checking, screening, and clinical assessments. Formative observing generally alluded to as reconnaissance involves following a child's development and improvement over some time ( Kalkman et al., 2019) . It is indispensable for doctors to screen the advancement of the youngster, particularly the individuals who are encountering higher hazard for improvement due to preterm birth or low weight. Formative screening is finished with the point of evaluating if the kid has explicit formative deferrals. This might be through surveys or meetings completed by guardians. The fundamental target of a formative assessment is to analyze the distinguished kind of turmoil that influences a youngster. 

Notwithstanding the formative assessment, there are additional tests that should be possible to discover the wellspring of CP. As per the specialists, mind imaging tests, as X-beam figured tomography (CT filter) and attractive reverberation imaging, could be directed (Lerner, Damiano, and Bulea, 2017). Different tests, for example, an electroencephalogram (EEG), hereditary testing, metabolic testing, or a mix of both, should be done. 

4.0 Neurobiological, Neuroanatomical, and Neurochemical considerations. 

4.1 Neurobiological considerations 

Cerebral palsy is a risky neurological condition, meaning that the disorder causes damage or injuries to the brain. In the end, this results in the brain becoming malformed in one way or another (Morgan & Ricker, 2016). A portion of the neurological cerebrum contaminations, for example, bacterial meningitis or viral encephalitis, issues with bloodstream to the mind might be recognized at beginning times of cerebrum harm. The most contaminated piece of the influenced by the cerebral paralysis is the engine zone of the mind's external layer (cortex). The symptoms of motor cortex brain disorders include drooling, tetraplegia, and dysphagia. 

Neuroanatomical structures Even though the anatomical structure of the cerebrum harm in cerebral palsy kids is efficient, there is a restricted comprehension of utilitarian changes in engine control. The advancement of understanding these progressions is generally hampered by inadequate perinatal creatures with obvious engine deficiency ( Burda, Bernstein & Sofroniew, 2016) . 45% of the kids watched had neurological disarranges in the thalamus and basal ganglia. The harm of basal ganglia or thalamus sores can create somatosensory issues. 

Neurochemical consideration 

Overall, as the activity of Prefrontal Cortex (PFC) continues, it forms the increased levels of synaptic glutamate within the brain. The increase in glutamate in turn will result in the stimulated hypothalamic nucleus of the arcuate which in turn releases the b-endorphin. The result product is considered and opioid that is generated through the arcuate nucleus in the hypothalamus. It is then spread towards the subcortical areas of the brain. 

5.0 Discussion 

The study, like other studies before, confirmed that cerebral palsy had negative impacts on the growth of the child. Children with CP had both psychological, social, and behavioral difficulties ( Myrhaug et al., 2018) . Among 254 children with CP seen, 38.5% had difficulties in learning ( Meehan et al., 2016) . This implies that the majority of people with CP or brain injuries have difficulties in literacy, mathematics, and executive discussions. The research also shows cerebral palsy causes delays in motor skills milestones in children. Some children find it challenging to move, crawl, walking as well as problems in hearing and speech. CP should be monitored from early stages and evaluation profiles documented to enable the doctor to handle children with brain disorders carefully. 

The findings also indicate that CP, if it fails to be treated in early stages, can lead to intellectual disabilities, involuntary movements, and deformities. It was also noticed that children suffering from CP are at risk of both identified cognitive impairments and intellectual problems such as literacy, mathematics, and visual-spatial reasoning. The risk of cognitive impairment is real and acknowledged. Unfortunately, considering the pervasive impacts like impairment may have on the child's life, limited studies are investigating this severe issue. Neurological abnormalities connected with cerebral palsy cause problems relating to difficulty in seeing and hearing, intellectual disability, seizures, urinary incontinence, oral diseases, and mental health problems. 

6.0 Conclusion 

This research has confirmed that CP has negative implications for the children and society at large. CP causes depression and anxiety to the victim hence leading to poor association with peers. Therefore, it is vital to diagnose the children at an early age through developmental monitoring, screening, and medical evaluation. The government should also step in and finance research concerning cerebral palsy to enable people to understand its implications to society and victims clearly. 

References 

Burda, J. E., Bernstein, A. M., & Sofroniew, M. V. (2016). Astrocyte roles in traumatic brain injury.  Experimental neurology ,  275 , 305-315. 

Jain, K. K. (2019). Neuroprotection in traumatic brain injury. In  The Handbook of Neuroprotection  (pp. 281-336). Humana, New York, NY. 

Kalkman, B. M., Maganaris, C. N., Bar-On, L., & O'Brien, T. D. (2019). Letter to the editor regarding the Effects of cerebral palsy on Achilles tendon moment arm length-Do children with CP have larger or smaller moment arms than typically developing children? Commentary on: Alexander et al. Journal of biomechanics ,  92 , 175 

Lerner, Z. F., Damiano, D. L., & Bulea, T. C. (2017). The effects of exoskeleton assisted knee extension on lower-extremity gait kinematics, kinetics, and muscle activity in children with cerebral palsy.  Scientific reports ,  7 (1), 1-12. 

Meehan, E., Harvey, A., Reid, S. M., Reddihough, D. S., Williams, K., Crompton, K. E., ... & Scheinberg, A. (2016). Therapy service use in children and adolescents with cerebral palsy: An A ustralian perspective. Journal of paediatrics and child health, 52(3), 308-314. 

Morgan, J. E., & Ricker, J. H. (Eds.). (2016).  Textbook of clinical neuropsychology . Taylor & Francis. 

Myrhaug, H. T., Odgaard-Jensen, J., Østensjø, S., Vøllestad, N. K., & Jahnsen, R. (2018). Effects of a conductive education course in young children with cerebral palsy: a randomized controlled trial.  Developmental neurorehabilitation ,  21 (8), 481-489. 

Neurological, P. (2001). Developmental Disorders: Meeting the Challenge in the Developing World. Institute of Medicine (US) Committee on Nervous System Disorders in Developing Countries. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK223473/ 

Parkin, A. (2016).  Explorations in cognitive neuropsychology . Psychology Press. 

Silver, J. M., McAllister, T. W., & Arciniegas, D. B. (Eds.). (2018).  Textbook of traumatic brain injury . American Psychiatric Pub.