Cognitive Impairment in Cerebral Palsy

Cognitive ability refers to the ability to use intellectual capacity to perceive, learn, and understand what is happening around us. While cognitive impairment is not a diagnostic criterion for Cerebral Palsy, up to half of all children with Cerebral Palsy will be cognitively challenged to some degree. With suitable intervention and support, patients can learn the cognitive skills they need to function effectively at home, school, and elsewhere. Here, we offer a brief introduction to what cognitive impairment in Cerebral Palsy looks like.

Understanding Cerebral Palsy

Cerebral Palsy refers to a group of non-progressive neurological disorders that affect movement, muscle tone, coordination, and gait. It occurs due to damage to the brain on account of an injury or infection before, during, or shortly after birth. Children with Cerebral Palsy struggle with symptoms like unsteady gait, poor balance, lack of coordination, extreme muscle tone (hypertonia/hypotonia), and cognitive delays. Treatment for Cerebral Palsy such as Stem Cell Therapy, Physical Therapy, Occupational Therapy, and Cognitive Rehabilitation can manage the symptoms and help the child be as functional as possible.

Causes of cognitive impairment in Cerebral Palsy

Around 30-50% of children with Cerebral Palsy have some level of cognitive impairment. The more severe the Cerebral Palsy, the higher the degree of impairment.

Cerebral Palsy occurs because of damage sustained by the child’s brain as a consequence of injury or infection. This damage can also affect the centers of the brain that transmit accurate information from the inputs received from outside. As a result, the patient may experience problems with attention span, comprehension, language skills, memory, decision-making, recognition, and so on.

The nature and extent of the cognitive impairment will depend on where the injury occurred and how severe it was. In some cases, the exact causal factor may be unknown. Some of the conditions that can cause brain damage before, during, or shortly after birth include:

  • Chromosomal abnormalities
  • Genetic abnormalities
  • Congenital hypothyroidism
  • Prenatal infections
  • Lack of oxygen to the brain
  • Complications during birth
  • Head trauma during or shortly after birth
  • Maternal stroke

Signs of cognitive impairment

While cognitive impairment can be difficult to detect at an early age, parents should watch the way their child interacts with the external environment. Typically, children with cognitive impairment will hit developmental milestones much later than normal, or may miss them altogether. 

Signs of cognitive impairment in babies include:

  • Not responding to parents’ voices
  • Not recognizing parents’ faces
  • Not responding to external stimuli like loud noises or bright lights
  • Not smiling or showing affection
  • Not responding to or shying away from touch

Signs in older children include:

  • Delays in language development
  • Trouble processing what is being said to them
  • Poor attention span
  • Poor memory
  • Inability to recognize sounds, lights, or names
  • Trouble interacting with others
  • Temper tantrums
  • Speech delays
  • Sensory processing disorders

In addition, the child may have co-occurring conditions like:

  • Anxiety
  • Depression
  • ADHD
  • Sleep disturbances
  • Behavioral disorders
  • Difficulty processing emotions

Treatment for cognitive impairment

While there is no cure for the brain damage that caused the cognitive impairment, treatment can teach children the skills they need to achieve learning goals, interact with the environment around them, and communicate effectively with others. Parents who suspect that their child with Cerebral Palsy may have cognitive impairment should consult the child’s doctor without delay. A typical treatment program may include:

  • Special education: Special educators may work in conjunction with the child’s school teachers to help them with classroom learning. Some of the techniques they might use include pictures with words to develop picture-word association, flash cards to help them remember concepts like colors or animal names, using short sentences to communicate verbally, and reading aloud to children.
  • Speech Therapy: Speech therapists will teach children various exercises to articulate words clearly and intelligibly. 
  • Occupational Therapy: Children with cognitive impairment may not know how to use their body correctly to perform everyday tasks. Occupational therapists break down each task into short, simple steps that are easier to pick up.
  • Behavior Therapy: Children with cognitive impairments frequently act out, either as a symptom or as a result of frustration about their condition. Behavioral therapists can teach children healthy ways of expressing their feelings while showing them how to conduct themselves at home and in public settings. 
  • Psychologists: Psychological counseling can help children work through their emotions and deal with problems like anxiety or depression. 

Living with a cognitive impairment can be hard, but a tailored treatment plan can ensure that the child picks up the cognitive skills they need to perform academically and fit in with their peers. Parents can support their child by ensuring that they always praise their child’s progress and listen to them when they express feelings. With enough love and care, children can be healthy and happy no matter what their cognitive abilities are.

Dr Na'eem Sadiq is a respected stem cell specialist at Plexus, and a prominent neurologist in Bangalore. He studied neurology and clinical neurophysiology in London, and worked with some of the most prestigious medical institutions in England, and the Middle East. He completed his MBBS at Bellary Government Medical College, and a postgraduate degree in psychiatry from NIMHANS in Bangalore.

Dr Na'eem has perfected his knowledge and expertise in Continuing medical education (CME), and training in tissue culture, Stem Cell Therapy, and neurology. Dr Na'eem Sadiq possesses an undying passion to improve people’s lives. This led to the creation of Plexus, a neuro and Stem Cell Research centre in Bangalore in neurosurgery, and neurorehabilitation.