Thanksgiving and Mealtime Precautions

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Thanksgiving is the day set aside in the United States and Canada as a day of pausing to reflect all that we are thankful for by connecting with friends and family over good food. It is also the day of taking special precautions when serving people with developmental disabilities.

Aspiration is a huge risk during the holiday season. Factors that place people at risk for aspiration includes the following:

  • Being fed by someone else
  • Poor chewing or swallowing skills
  • Weak or absent coughing/gagging reflexes which is common in people with cerebral palsy or muscular dystrophy
  • Eating to quickly
  • Inappropriate fluid consistency
  • Inappropriate food texture

For children and adults with autism, Thanksgiving may be a challenge for a variety of reasons:

  • Sensory and emotional overload with large groups
  • Picky eaters
  • Difficulty with various textures of food

To help you mange Thanksgiving with ease, click on the articles below:

5 simple steps to hosting an autism-friendly Thanksgiving

8 tips for managing Thanksgiving with children with autism

10 genius ways to help your autistic picky eater to eat this Thanksgiving

Autism and Picky Eating

Autism and Thanksgiving: How to cope with the feasting and hubbub

Feeding kids with sensory processing disorders

Preparing for Thanksgiving on the autism spectrum

Swallowing problems? What to do about Thanksgiving

Thanksgiving dinner ideas for speech therapy activities

Tips for Navigating Thanksgiving on the Spectrum

 

Updated 08/26/2020

Cerebral Palsy and Secondary Issues

Cerebral palsy affects people differently including; learning disabilities, intellectual disabilities, behavioral challenges, Attention Deficit Hyperactivity Disorder (ADHD), and Executive Function Disorder. People with cerebral palsy often have medical issues as well including, epilepsy, hydrocephalus, swallowing difficulties, vision problems, aspiration and constipation.

Seizures
  • a seizure is a sudden, out of control event that can cause involuntary movement.
  • It occurs when there are bursts of abnormal electrical activity in the brain which interferes with normal brain functioning.
  • The brain constantly sends unusual electrical messages very close together.
  • Inform the participants that seizures are the most common of associated problems.
  • Experts believe that seizures are the result of scarred tissue in the brain.
  • About 50% of people with cerebral palsy suffer from seizures.
  • Epilepsy is more common in the child with spastic quadriplegic
  • Complex partial seizures are the most common in people with cerebral palsy
  • in most cases, it is unknown the cause of seizures.

Cases which the cause is known include

  • Serious brain injury
  • Lack of oxygen
  • Bleeding in the brain
  • Infection in the brain including meningitis and encephalitis
  • Inflammation of the brain
  • Co-occurring conditions that involve an intellectual or developmental disabilities

Treating Seizures

  • Try to keep calm and make sure the person having the seizure is comfortable and safe from harm.
  • A seizure can last from a second or several minutes

Do Not:

  • Do not hold the person down or try to stop his or her movements.
  • Do not put anything in the person’s mouth. This can injure teeth or the jaw. A person having a seizure cannot swallow his or her tongue.
  • Do not try to give mouth-to-mouth breaths (CPR). People usually start breathing again on their own after a seizure.
  • Do not offer the person water or food until he or she is fully alert.

After the seizure:

  • After the seizure ends, the person will probably be groggy and tired. He or she also may have a headache and be confused or embarrassed. Try to help the person find a place to rest.
Vision Issues
  • The term blindness refers to complete impairment of vision
  • Visual impairment refers to diminished vison or low vision but not total blindness.
  • A person’s right side may include problems with muscles that control the right eye making it difficult for the affected eye to move from side to side.
  • People may appear to be crossed eyes.
  • Explain that people with cerebral palsy may have a condition called strabismus, where eyes do not line up and focus properly because of differences between the left and right eye muscles
  • May only impact one eye which happens to those whose cerebral palsy affect one side of the body.
Learning Disability
  • People with cerebral palsy may have a short attention span, motor difficulties, perceptual difficulties and language difficulties
  • This can impact literacy, numeracy and other important skills.
  • Learning disabilities may also affect fine and gross motor coordination
  • They may tire easily since they have to put more effort into concentrating on their movements and sequence of actions.
ADHD
  • A disorder of the executive function of the brain that allows a person to focus and organize
  • It is a developmental disability that occurs in approximately 3 to 5% of children
  • 19% of children with cerebral palsy will be diagnosed with ADHD
Hydrocephalus 
  • Enlargement of the fluid filled spaces in and around the brain known as ventricles
  • To correct the damaging effects, the fluid build-up is performed involving a shunt
Behavior Challenges
  • Children and adults with cerebral palsy may be more prone to having problems controlling their impulses as well as having difficulty with focus and attention
Hearing Loss
  • Birth injuries can cause partial or complete loss of vision and or hearing in many individuals
  • Possible result of physical damage to the ear due to inflammation of built-up
  • Senorineural hearing loss- nerves that transmit sound information from the outside world to the brain are damaged
Tube Feeding
  • Gastrostomy is used with children with significant eating, drinking and swallowing difficulties to ensure they received enough food and drink.
  • It is surgically placed through the abdominal wall to feed formula, liquids and medication directly to the stomach.
Intellectual Disability
  • Approximately 2/3 of people with cerebral palsy have an intellectual disability
  • 1/3 have Mild
  • 1/3- Moderate
  • 1/3- Normal IQ
  • Children with spastic quadriplegia are more likely to have an intellectual disability

Accommodations for Students with Physical Disabilities

 

Accommodations for physical disabilities 

Inclusive teaching; physical disability

Instructional strategies for students with physical disabilities 

Strategies in helping students with physical disabilities in the classroom using IDEA

Supporting students with physical disabilities

Teaching students with physical disabilities 

Tips for working with students with medical or physical disabilities

Teaching Strategies for Students with Cerebral Palsy

Cerebral palsy is a motor disorder which results from damage to the brain occurring before, during and after birth. Cerebral palsy is the most common motor disability in childhood and it is estimated that 1 in 323 individuals have been identified with cerebral palsy.

Since cerebral palsy is the result of damage to the brain, it impacts each person differently ranging from severe to mild symptoms. It is estimated that many children with cerebral palsy also have at least one co-occurring condition. For instance, 41% had co-occurring epilepsy and 40% of children were diagnosed with an intellectual disability.

Teaching strategies should focus on assistive technology, fine and gross motor skills, and personal care. Accommodations and modifications should include providing extra time for task completion.

The following links provide information on teaching strategies.

Accommodating a student with cerebral palsy

Cerebral palsy in the classroom

How to make your classroom inclusive for students with cerebral palsy

How to teach children with cerebral palsy

Inclusive teaching strategies for students with cerebral palsy

Students with mild cerebral palsy in the classroom: Information and guidelines for teachers

What teachers should know about children with cerebral palsy

What is a Multiple Disability?

According to the Individuals with Disabilities Act (IDEA), multiple disabilities refers to simultaneous impairments such as intellectual-blindness, intellectual disability-orthopedic impairment. The combination of which causes such severe educational needs that cannot be accommodated in a special education program solely for one of the impairments, meaning a student has more than one or multiple impairments. According to the U.S. Department of Education, 2.0 percent of students currently are diagnosed with multiple disabilities.

The term multiple disability is a broad term and can include a number of disabilities. For example, a person diagnosed with cerebral palsy may also have a diagnosed of epilepsy, intellectual disability  and ADHD. The Center for Parent Information and Resources explains that from the term, your cannot tell how many disabilities a child has, which disabilities are involved or how severe each disabilities are involved or how severe each disability is. It is important to know the following in orde to support the child:

  • which individual disabilities are involved;
  • how severe (or moderate or mild) each disability is; and
  • how each disability can affect learning and daily living.

Support should include the following areas:

  • caring for oneself;
  • performing manual tasks;
  • seeing, hearing, eating, and sleeping;
  • walking, standing, lifting, and bending;
  • speaking and communicating;
  • breathing;
  • learning;
  • reading;
  • concentrating and thinking; and
  • working.
Resources

Parent Center Hub

Teaching Strategies for Individuals with Multiple Disabilities

 

Evidence based practices for students with severe disabilities 

Instructional strategies for students with multiple disabilities

Multiple disabilities in your classroom: 10 tips for teachers

Severe and education of individuals with multiple disabilities

Strategies for inclusion of children with multiple disabilities including deaf-blindness

Students who are blind or visually impaired with multiple disabilities

Students with multiple disabilities

Supporting young children with multiple disabilities: What do we know and what do we still need to learn?

Teaching students with multiple disabilities

Teaching students with severe or multiple disabilities

What is Sepsis?

While Sepsis is a severe life-threatening medical condition, it can also affect people with disabilities. According to the Centers for Diseases and Control (CDC), Sepsis is the body’s extreme response to an infection. It is a life-threatening medical emergency. Sepsis happens when an infection you already have —in your skin, lungs, urinary tract, or somewhere else—triggers a chain reaction throughout your body. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death. Sepsis kills more than 250,000 people a year with 1.5 million diagnosed each year.

Signs and Symptoms
  • An initial infection
  • Fever
  • High heart rate
  • heavy breathing

Severe sepsis occurs during organ failure. signs include:

  • decrease urination
  • breathing problems
  • body chills
  • extreme weakness

Sepsis is caused by:

  • Pneumonia
  • Kidney infection
  • Bloodstream infections.

if you work with an individual displaying any of these signs and symptoms, seek medical attention.

Resources

Recovering from Sepsis– NHS

Sepsis Overview– Science Direct

What is Sepsis?– Sepsis Alliance

Cerebral Palsy Resource Page

Definition: According to the Centers for Disease Control and Prevention (CDC), Cerebral Palsy (CP) is a group of disorders that affect a person’s ability to move and maintain balance and posture. It is the most common motor disability in childhood. It is estimated that an average of 1 in 345 children in the U.S. have cerebral palsy

Awareness Ribbon Green Ribbon

Awareness Month- March

Awareness Day-   October 6. World Cerebral Palsy Day

Prevalence

  • Around 764,000 people in the United states have at least one symptom of cerebral palsy
  • Around 10,000 babies are born each year with cerebral palsy
  • Boys are diagnosed more often than girls
  • Cerebral palsy is the mot commonly diagnosed childhood motor disability in the United States
  • Over 77% of children with cerebral palsy have the spastic form
  • More than 50% of all children with cerebral palsy can walk independently
  • African American children with cerebral palsy are 1.7 times more likely to need assistance with walking or be unable to walk at all
  • Around 41% of babies and children with cerebral palsy will have limited abilities in crawling, walking and running.
  • Around 41% children with cerebral palsy in the United states have some form of a cognitive disorder
  • Behavior problems are common in children with cerebral palsy including social skills and anger issues.
  • Seizures are a common associate disorder of cerebral palsy and can range from mild to extreme severe.
  • There is no known cure
Australia Facts and Statistics
  • 1 in 700 Australian babies is diagnosed each year
  • 1 in 2 is in chronic pain
  • 1 in 2 has an intellectual disability
  • 1 in 3 cannot walk
  • 1 in 4 also has epilepsy
  • 1 in 3 has hip displacement
  • 1 in 4 cannot talk
  • 1 in 4 has a behavior disorder
  • 1 in 5 is tube fed
  • 1 in 5 has a sleep disorder
  • 1 in 10 has a severe vision impairment
  • 1 in 25 has a severe hearing impairment
United Kingdom- Facts and Statistics
  • The current United Kingdom incidence rate is around 1 in 400 births
  • Approximately 1800 children are diagnosed with cerebral palsy each year
  • There are an estimated 30,000 children with cerebral palsy in the United Kingdom
  • For every 100 girls with cerebral palsy, there are 135 boys with cerebral palsy
  • just under half of children with cerebral palsy were born prematurely
  • One in three children with cerebral palsy is unable to walk
  • One in four children with cerebral palsy cannot feed or dress themselves
  • one in four children with cerebral palsy has a learning disability
  • one in fifty children with cerebral palsy has a hearing impairment

Facts

Is a group of neurological disorders that affects body movement and muscle coordination.

Is caused by damage to the brain which controls movement and balance

Affects the motor area of the brain that directs muscle movement.

The symptoms of cerebral palsy differ in type and severity in each person.

Is the leading cause of childhood disabilities.

Cerebral Palsy is not progressive meaning it does not get worse overtime.

Cerebral Palsy prevalence is 3.3 children per 1000.

There is no cure for cerebral palsy

Cerebral Palsy is not contagious

Risk factors for cerebral palsy include pre-mature birth, infections during pregnancy, exposure to toxic substances and mothers with excess protein in the urine or a history of having seizures.

Cerebral Palsy can also be caused by complicated labor and delivery due to disruption of blood and oxygen to the brain(hypoxia) and babies in a breech position (feet first).Spastic cerebral palsy is the most common type affecting 80% of people with cerebral palsy.

Ataxic cerebral palsy affects balance and depth perception

There are more boys born with cerebral palsy than girls.

Stroke in a baby or child less than the age of 3 results in cerebral palsy.

One in nine with cerebral palsy have features of autism

One in three children with cerebral palsy cannot walk

One in four children with cerebral palsy cannot feed themselves

There are 17 million people with cerebral palsy worldwide.

58.2% of children with cerebral palsy can walk independently, 11.3 walk using a hand-held mobility device and 30.6% have limited or no walking ability

Speech and language disorders are common in people with cerebral palsy

Pain is common among children with cerebral palsy

Harry Jennings, an engineer built the first modern folding wheelchair

Sir William Osler wrote the first book on cerebral palsy

Dr. Sigmund Freud was the first to state that cerebral palsy might be caused by abnormal development before birth.

Cerebral palsy doesn’t necessary mean learning difficulties.

Cerebral Palsy History Timeline

1810- Dr. William John Little is credited with first identifying spastic diplegia is born.

1836- Louis Stromeyer corrects John Little’s club foot. This discovery begins a career in understanding and treating childhood impairments.

1843- Dr. William John Little begins lecturing on spastic ridgity.

1853. Dr. William John Little publishes On the Nature and Treatment of the Deformities of the Human Frame.

1861- Dr. William John Little establishes the classic definition of spastic cerebral palsy.

1889- William Osler, one of the founding professors of John Hopkins Hospital, wrote the book, Cerebral Palsies of Children

1937- Herbert A. Everest and Harry Jennings Sr., built a lightweight collapsible wheelchair.

1937- The Children’s Rehabilitation Insitute is founded by Dr. Winthrope Phelps specializing in children with cerebral palsy.

1897- Dr. Freud states cerebral palsy may be caused by fetal development

1946- Cerebral Palsy of New York State founded by parents of children with cerebral palsy.

1948- United Cerebral Palsy is incorporated.

1949- United Cerebral Palsy founded by Leonard Goldenson, his wife Isabel, Nina Eaton and Jack and Ethel Hausman.

2002-  Centers for Disease Control and Prevention (CDC) conducts first U.S. multi-state study on the prevalence.

Secondary Issues

  • Epilepsy
  • ADHD
  • Hydrocephaly
  • Executive Function
  • Learning Disability
  • Speech Impairment

Classifications

Hemiplegia- The inability to move the arm and leg on one side of the body.

Diplegia-The inability to move either both arms or both legs.

Quadriplegia- A type of cerebral palsy that affects all limbs on both sides of the body

Monoplegia- A type of cerebral palsy that affects only one limb.

Types of Cerebral Palsy

Athetoid- A type of cerebral palsy in which affected muscles move involuntarily.

Ataxic- A type of cerebral palsy affecting balance and coordination.

Spastic– A type of cerebral palsy causing stiff and severely cramped muscles.

Co-existing Disorders

Assistive Devices

Organizations

The following organizations provide resources on their websites including fact sheets, resources and information:

Cerebral Palsy Foundation

Funds cerebral palsy research in the United States, (CPF) promotes the delivery of current research, best practices and technology to people with cerebral palsy and their support system. The mission includes transforming lives through research, innovation and collaboration.

Children’s Hemiplegia and Stroke Association

Helps children who have survived an early brain injury that results in hemiplegia (weakness on one side of the body).

Make LemonAide Foundation

The Make Lemon Aide Foundation is a non-profit organization designed to improve the lives of people with cerebral palsy by raising awareness, funding research and training therapist.

Reaching For The Stars

Founded in 2005, RFTS is the largest pediatric cerebral palsy non-profit foundation in the world led by parents with a focus on the prevention, treatment and cure of cerebral palsy

United Cerebral Palsy

UCP educates, advocates and provides support services to ensure a life without limits for people with a spectrum of disabilities. UCP provides services and support to more than 176,000 children and adults through its 68 affiliates around the country.

CP Daily Living

An educational resource website and Facebook page designed to give families and caregivers a central place for practical information and resources.

Cerebral Palsy Alliance

A non-profit organization based in Australia. Provides services to help children and adults living with neurological and physical disabilities.

National Institute of Neurological Disorders and Stroke

NIDS mission is to seek fundamental knowledge about the brain and nervous system and to use that knowledge to reduce the burden of neurological disorder. The website provides patient and caregiver education on cerebral palsy including an informational page.

Articles

Aging

5 common challenges for adults with cerebral palsy- Made For Movement Blog

Adults and cerebral palsy– Cerebral Palsy Organization

Adults with Cerebral Palsy- Cerebral Palsy Foundation

Aging with Cerebral Palsy and Chronic Pain– The Mighty

Care of adults with cerebral palsy-American Academy for Cerebral Palsy and Developmental Medicine

Cerebral Palsy and aging– Developmental Medicine and Child Neurology

Cerebral palsy and transitioning to adulthood-Cerebral Palsy Alliance

Cerebral Palsy effects through lifespan-Physiopedia

Cerebral Palsy in Adulthood– Everyday Health

Cerebral Palsy patients provide rare insight into aging– Cerebral Palsy News Today

Cerebral palsy symptoms in Adulthood- Healthfully

Living as an adult with cerebral palsy– Healthline

Living with cerebral palsy as an adult– WebMD

Progression and Correction of Deformities in Adult with Cerebral Palsy-ACNR

The good, the bad, and the ugly facts about adult cerebral palsy-Karen Pape

Co-occurring Disorders

Cerebral Palsy and Epilepsy– Cerebral Palsy Guidance

Cerebral Palsy and Seizures– Cerebral Palsy Guidance

Cerebral Palsy and Speech Therapy– Cerebral Palsy Group

Children with spastic cerebral palsy experience lower leg fatigue when walking study shows- Cerebral Palsy News Today

Common health problems associated with cerebral palsy- My Child Without Limits

Communication and swallowing issues for adults with cerebral palsy-EPI

Difficulties in swallowing and coughing in spastic cerebral palsy focus of study– Cerebral Palsy News Today

Digestive health tips for kids with cerebral palsy-Sarah Halstead

Gastrointestinal and nutritional issues in cerebral palsy-practicalgastro.ocom

How does cerebral palsy affect people?-Cerebral Palsy Alliance

Prevalence of cerebral palsy and intellectual disability among children- NCBI

Sleep disorders in kids with cerebral palsy often remain untreated study suggest– Cerebral Palsy News today

Sleep issues among children with cerebral palsy-CP-NET

Seizures in children with cerebral palsy and white matter injuries-Pediatrics

Understanding more about cerebral palsy and seizures– Murdoch Children’s Research Institute

 

The grief in knowing you’ll one day outlive your primary caregiver as a person with a physical disability

Published by: CBC News
Written by: Sam Juric

“They’re like a charley horse,” says Rebecca Wilchynski, explaining the involuntary spasms that take hold of her legs — breathtaking and sudden.

“It’s not just in one muscle, it can be in all the muscles or a few,” she said. “Cerebral palsy, every case is individualized, and there are definitely more severe cases and some that are less severe. I have the less severe.”

Cerebral palsy is a neurological condition affecting body movement and muscle co-ordination, resulting from an injury to the brain. It does not get worse over time, though the exact symptoms can change over a person’s lifetime.

As a result of an injury to the brain, cerebral palsy interferes with messages from the brain to the body, and from the body to the brain.

“It’s very painful. I have spastic … and athetoid [cerebral palsy], which means they move without me wanting them to, so it can make life a little bit interesting.”  Click here to read the rest of the story

We are alone in this together

Published by: Cerebral Palsy News
Written by: Briana Beaver

“This pandemic is really working for you,” my mom said, half-jokingly. She nor I never could have imagined that over the course of only weeks, society would rearrange itself into a more Briana-friendly place. The “awkward” social necessities characteristic of my interactions with others have now become the norm.

For years, I have received critical looks upon entering a public space wearing a mask. When I would ask people not to stand close to me, to refrain from touching me because of my immunocompromised state, people would look at me strangely. Trying to explain to others that I have been isolated in my home because of environmental health triggers has been met with skepticism. Suddenly, social distancing and quarantining have become the rule, not the exception.

The ability of society to reorganize with warp speed is something to behold. The countless years during which I attempted to legitimize my health needs and requisite social arrangements have felt fruitless. I’ve lost friends and watched sprouting relationships fade into the background because others could not understand my life. The cultural repercussions of the pandemic are providing us with a unique opportunity not only to legitimize the various needs of those with chronic health conditions and disabilities, but also to increase awareness about the flexibility of humanity. Click here to read the rest of the story.