Learning difficulties of children with cerebral palsy and developmental problems

Their intellectual development is of mosaical, uneven character, and this is caused by brain damage. As a result we have insufficiency in the psychological functions, established by various neuro-psychological tests, X-rays, EEG (brain scan), etc.

Other factors leading to learning difficulties in infants with CP can be added. These are the so-called psycho-social factors: parents being too over protective of their children, which hampers the child in its will power and developing all aspects of its attention. These are important conditions for the successful education. On the other hand, many children with CP are socially neglected (excluded)- their social contacts are reduced to the minimum leading to isolation and the impossibility to build models for social behaviour. Another factor explaining the lack of progress at school is the insufficient understanding of the possibility for prevention, diagnosis and identifying problematic children.

Attention is the basis on which all the cognitive functions are built. It is a hierarchical structure which develops gradually. It includes five elements: concentration, stability, scope, reconnection, and distribution.

The first feature of attention is concentration meaning that attention is being focused on the object.

Steadiness means concentrating the attention for a given period of time in order to execute a task.

Scope can exist only if concentration and steadiness are present. Scope represents steadiness in respect to more than one object.

Reconnection is the ability to shift concentration and steadiness from one object to another within the whole scope.

Distribution is possible only if all above-mentioned components are present. It is by the adequate shifting and fixing the attention on objects that influences it, adequate in time, duration, distribution of the concentration, steadiness and reconnection upon objects from the scope in respect to the final goal.

Children suffering from CP usually have impairments at the higher levels of the hierarchy i.e. reconnection and distribution of attention. These children have difficulties moving from one activity to another, especially if they are mentally retarded. With other children these two components are not developed. With other children the problem is even deeper, at the core of attention - at the level of concentration and stability. Often infants with CP do not possess sufficient levels of attention.

ADD often is combined with hyperkinetism which is represented by over activity, instability, quick change from one activity to another, impulsiveness. Attention problems reflect upon capability for visual-motor coordination, on the psychomotor speed and on the all other cognitive functions due to unstable basis on which they would develop.

The next important factor is memory. It encompasses, stores and reproduces past experiences. The memory components are: fixation, retention and reproduction.

If the traits in the memory are weak and the memory is mechanical and short-lived we can expect difficulties in the acquisition of knowledge by children with CP. Difficulties can be expected also with auditory and verbal memory. These children have problems generalising past experiences and projecting them onto new situations.

Another cognitive process that could be damaged is thinking. This is a process which reveals the important features and connections of objects and events in real-time. In the process of developing, children's ability to think goes through the following stages: concrete thinking, visual-active, visual-figurative and logical-abstract. This is a hierarchical process.

Children suffering from CP show impairments within the sphere of thinking, which is therefore expressed in poor flexibility of thinking, difficulty in understanding the main thought, poor associative ties, bradipsychism. Their thinking is usually visual-figurative; they rarely develop the logic and the abstract levels of thinking. In addition to that they have difficulties to analyse, synthesise, compare, classify, do analogies, especially complicated ones.

Intellect: the intellectual functioning of children with CP varies from different stages of mental retardation through detention in the psychic development, to normal intellect in respect to their biological age.

Space orientation also can be impaired in children with CP. They cannot follow descriptions, have difficulties in the consecutive stages of doing a motor activity; they mix up days of the week and months; they have problems telling the hour, etc.

The damaged orientation in space reflects on the time orientation of these children. Their perception of different aspects of time dimension is distorted, especially of the aspects connected with time continuity and periodicity.

The combination of poor co-ordination and inability to plan can lead to illegibility and poor spelling.

Often there are difficulties with the visual-motor coordination, expressed in problems with perception of those visual constructs which are drawn as a picture or a plan, or written. These difficulties are characterised by discrepancies between the stimulus and the reaction, lack of centralisation at the perceptional field of vision, preservations of different elements, simplification, distortion, etc. The fine visual-motor differentiation is especially problematic here, for these are important in acquisition of reading and writing skills.

The following learning difficulties are found with children with CP:

• Children with Spastic Diparesis: they have good verbal thinking which, as a whole, is within the norm for their biological age. Their attention has good concentration and stability. Their memory in most cases is normal for their age. These children however often have difficulties with understanding the perception for space, specifically with the space gnosis and praxis. Besides, their impaired fine motoric is as a consequence of their general motor skills impairments.
• Hyperkinetic Form of CP: difficulties at the visual-motor co-ordination, slow psychomotor speed and combinatory abilities, poor concentration and attention stability, impairments in SL development.
• Haemiparetic Form of CP: often there are difficulties at the figurative and verbal thinking, impairments at the time categorisation, space and constructive dispraxis, impaired fine motor skills.
• Atactic Form of CP: inability to estimate the power and direction of movements, dispraxis, lack of fine motor skills. Memory and attention vary in respect to the norm.
• The most considerable difficulties are with children with Quadiparesis. These children are heavily impaired in their motor abilities and because of that their possibilities for handwriting are restricted. With this group of children the following difficulties are common: slow psychomotor speed, tiredness, no body scheme, space orientation impairments, speech/language impairments, lack or impairment of the attention component.
• With the combined form of CP one can find difficulties or impairments in all the above mentioned spheres of the cognitive process, leading to learning problems.

The curved line of the psychological profile of children having CP is very diverse, uneven and different for each case; it depends on the place and the level of damage. Each case is individual as problematics and has its specifics and multiformity.

For the purposes of psychological diagnosis of a patient, many tests have been adopted. Some of them, test the learning abilities and school maturity. Conditions to learn to read and write, to count, the overall development as well as fine motor skills.

These tests are: the Goepingen test, the Bijkov tests and screening methodics. Other tests explore the High Cortical Functions (gnosis, praxis, speech ). Other groups of tests explore the intellect and help establish the psychological profile of the child. Raven and Wechsler tests are the standard ones belonging to this group.

Another category of tests exist, and are used to establish the personality peculiarities and family relationships.

The speed in the child's psycho-social development directly depends on the early diagnosis and the adequate therapy.

What is correctional therapy?

Correctional Therapy is a process of establishing an individual therapeutic programme which will help future education. The correctional programme includes: Psychological therapy, SL pathologist, SE therapist Montessori teacher, teachers and parents.

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The site is created in 2001. Last update - 20.06.2008