problems: Children with moderate-to-severe cerebral palsy often display
characteristics of failure to thrive. This is especially true with those children
with spastic quadriplegia. Babies with this disorder don't follow normal growth
curves, while young children can be quite short in comparison with their peers.
Older children with growth problems may be short in stature and have very delayed
sexual maturation. The muscles and limbs affected by the cerebral palsy tend
to be smaller, especially in the hand and foot. Nurses working with these families
can provide good nutritional counseling, teach adapted feeding techniques, and
make referrals to dietitians as needed.
Vision or hearing impairments: Strabismus, or cross-eyes, is common in children with cerebral palsy. This is primarily due to differences between muscles of the left and right eye. Children with CP seem to be particularly adept at adapting to strabismus, by ignoring the signals from the weaker eye. Unless strabismus is treated by eye-patching and/or surgery, the child may have significant visual impairments over time. Other children with CP have cortical vision impairment (CVI), secondary to damage to the visual cortex of the brain. Many children with CVI are considered to be legally blind, while others can learn to turn their heads to use undamaged portions of the visual cortex. Interestingly, a child with CVI has fluctuations in vision from day to day, and even from moment to moment. Nurses working with these children can provide family education and facilitate referrals to vision specialists.
sensation and perception: Some children with CP have impaired perceptions
of sensations such as touch, pain, hot, and cold. They may also have trouble
identifying objects using their sense of touch. Nurses working with these children
can highlight safety precautions for parents, teach parents about nonverbal
cues that may indicate pain in the child, and make referrals to occupational
therapists for appropriate training.