Specialized Hospital for Residential Treatment of Prolonged Therapy and Rehabilitation of Childrenwith Cerebral Palsy "SANTA SOFIA" Ltd.

Learning difficulties with children with ICP and developmental problems

Children with ICP are at higher risk of intellectual deficit, which may vary from profound mental retardation, to lighter or specific learning difficulties. The intellectual deficit is then reflected upon the child's future involvement in life.

Impacts affecting the development of the child's psyche:

neurological dysfunction
psycho-social factors such as actively learning about the environment which is especially important in the senso-motor period of the child's development - in their first two years of life children actively learn and form their understanding through active handling of objects that surround them. Their ability to move about is a way of learning, so any dysfunction within their ability to move and walk must be regarded as a factor related to their inability to acquire knowledge and skills.

Attention is an important factor contributing to the success in any activity. As it is through actively stimulating children to concentrate to a given task or game, that their ability to concentrate is increased.

The Attention Deficit Disease ( ADD ) is often combined with the hyperkinetic syndrome which means: being overactive, lack of attention, weak concentration and changing from one activity to another. Attention problems reflect on the ability of visual-motor coordination as well as on all the other cognitive processes ( perception, memory, thinking, imagination ) because there is no firm basis on which they could develop.

Many children with CP have the so-called perceptive impairments: damage of their sensations and perceptions concerning their own body and the world around them. From their infancy (from birth to his/her 2nd year ) the healthy child builds in its mind the so-called "body scheme". In children with CP however, and especially those with the ataxic or spastic form, this mental perception of the body is distorted to a certain degree and these children usually have difficulties orienting in space. In early childhood these problems are expressed in the inability to play constructive games, to separate the elements from the whole; they have difficulties in drawing elemental figures regardless of the fact that these children have already acquired the intelligence and movements to successfully perform these operations. These kinds of difficulties are later related to the existence of learning difficulties, often related to reading and writing. The lack of perception can be generalised, dividing them into: damage of several organs of perception at the same time, and damage of one perceptional function of perception only. One can often meet the so-called damages of the formation of the High Cortical structures, that is, gnosis and praxis impairments as a result of an organic impairment of those parts of the brain cortex, responsible for the synthesis of perceptions and for giving commands for performing consecutive purposeful motor acts.

When the CP is combined with intellectual deficit in some cases one can witness highly increased capacity for memorising which contrasts with the low intellect - here we have mechanical memory. Children with CP have problems with their auditory and visual memory as well as with building and keeping in mind the associative ties between the objects and events. If such a child has epileptic fits too, one can expect regression ( disintegration ) of the memory functions and of the intellect - the associative ties become poorer, the thinking process becomes slow, lazy, repetitive and too circumstantial.

In the early childhood thinking is inseparable of one's practical activities. And the appearance of the speech ability changes the way one thinks, for the two are united and thinking finds its immediate reflection in speech.

Children with CP have difficulties in forming their ability to analyse, to synthesise, to compare, to classify different events and objects from reality. Problems may arise related to their ability to find the cause-and-effect connections, and differentiating important features of the objects and events.

Manipulation with objects is basic in respect to all other activities; it is the foundation for development of the intellect and it is reflected in the formation and development of the child's intellect. Infants with CP have poor flexibility of mind, problems understanding the main thought, poor associative ties, difficulties comprehending complicated logical and grammatical structures and categories.

The early psychological and SL interventions are of considerable importance for future prevention and rehabilitation of the cognitive ( perception, attention, memory, thinking ) and SL deficits and is an important factor for the future social adaptation of children with CP, with CMD and developmental problems.