In addition to problems controlling their muscle movement, children with CP may have some other problems too. Most of these are caused by the same brain injury that caused the CP.

Just as CP can affect the way a person moves their arms and legs, it can also affect the way they move their mouth, face and head. This can make it hard for the person to talk clearly and to bite, chew and swallow food. If you meet a girl with CP you may notice that her speech is hard to understand or that she seems to work very hard just to get out a few words. This is because she is not able to make her lips, jaw and tongue move as quickly as you can. She may also have trouble controlling her breath flow to make her voice work. All of these parts of your body are very important in talking.

Try this: Make a "g" sound (say "guh"). To do that, you must pull your tongue back and touch the back of your tongue to the back part of the roof of your mouth (your palate). Then, you must breathe out a little but not let the breath through until you are ready to make the sound. When you say "guh," you let your tongue drop while letting the breath out and turning on your voice. Whew! That's a lot of stuff to do just to make one sound. Just think of all the movements you must put together to say a whole word, or a sentence. Now imagine what it would be like to make sounds and words if you had trouble controlling your tongue, lips, and breathing!

The speech problem most children with CP have is called dysarthria (dis-are-three-a). Meaning it is hard for them to control and coordinate the muscles needed to talk. Their speech may sound very slow and slurred and their faces may look a little funny when they are trying to talk. Some kids voices may sound different too. If too much air comes through your nose when you talk you sound hypernasal (hyper - means too much), like Erkel from the TV show "Family Matters". If not enough air comes through your nose you sound hyponasal (hypo - means not enough), like when you have a bad cold and can't breathe through your nose. If you meet someone with CP who has speech problems, try hard to listen carefully when they are talking, and don't be afraid to tell them when you can't understand something they've said. Most people would rather say it again or find a different way to communicate (maybe writing or pointing) than have you pretend you understood them when you did not.

Many of the same muscles involved in talking are also used when you eat. Some kids with CP might not be able to bite and chew foods like a hotdog or a peanut butter sandwich. They may also have trouble sucking through a straw or licking an ice cream cone.

About one-fourth to one-half of children with CP also have some type of learning problem. It may be a learning disability so that they have trouble with one or two subjects in school but learn other things pretty well, or may be a more severe learning problem like mental retardation in which they learn everything at a slower rate. There are many different levels of mental retardation so that people with mild mental retardation may learn to read and write and do math, but people with more severe mental retardation probably will not. This does not mean that children with severe mental retardation can't learn. It means that they learn at a slower pace than most other kids, and that they will need some special learning help in school.

About half of all children wih CP have seizures. This means that they have times when there is some abnormal activity in their brains that interrupts what they are doing. Often, the abnormal brain activity happens in the same place as the brain injury which caused the CP. Your brain is constantly sending messages out to your body - to breathe, to move, to keep your heart pumping. A seizure is a series of abnormal messages being sent out very close together. These abnormal messages may cause someone to stare and stop moving during a seizure, or may cause them to loose control of their body and fall down. Some people show shaking movements all over when they are having a seizure. Seizures usually last a few seconds to a few minutes, and in most case are not dangerous. Many children take special medicine to help prevent seizures or reduce the number of seizures they have.

You may already know that seizures also occur in many people who do not have CP.

Therapy is the treatment that is the basis for most success with cerebral palsy patients. It takes the form of movement, speech, vocational practical tasks, and others. Physical therapy usually begins in the first years of life, soon after the diagnosis is made. Physical therapy programs use specific sets of exercises to work toward two important goals: preventing the weakening or deterioration of muscles that can follow lack of use (called disuse atrophy) and avoiding contracture, in which muscles become fixed in a rigid, abnormal position. Contracture is a serious complication of cerebral palsy. Normally, children whose bones are growing stretch the body's muscles and tendons through daily activities like walking and playing. This makes the muscles grow at the same rate. However, children with cerebral palsy, spasticity prevents this stretching and, as a result, muscles do not grow fast enough to keep up with lengthening bones. The resulting contracture can disrupt balance and trigger loss of previous abilities. Physical therapy alone, or in combination with special braces works to prevent this complication by stretching spastic muscles. Children with CP often go to different kinds of therapy to help them improve their motor skills for things like walking, talking and using their hands. Some kids get therapy at school and some kids go to a special clinic to see their therapists. Therapists are special teachers who are trained to work with people on learning better or easier ways to do things. Just like a coach who helps you learn and practice new skills to make you a better soccer or basketball player, therapists "coach" people to help them learn and practice new skills.

Physical therapists help children learn better ways to move and balance. They may help children with CP learn to walk, use their wheelchair, stand by themselves, or go up and down stairs safely. Kids may also work on fun skills in physical therapy like running, kicking and throwing a ball, or learning to ride a bike. Physical therapy is usually called "PT" for short.

Speech therapists work with children on communication skills. Communication skills may mean talking, using sign language, or using a communication aid. Helps identify specific difficulties and overcome them through a program of exercises involving the mouth and tongue. Children who are able to talk may work with a speech therapist on making their speech clearer (easier to understand) or on building their language skills by learning new words, learning to speak in sentences, or improving their listening skills. Children who are not able to talk because of their difficulty controlling the muscles needed for speech may learn sign language or use some kind of communication aid. A communication aid might be a book or poster with pictures that show things the person might want, or an alphabet board that the person can use to spell out their message. There are also computers that are used as communication aids that actually talk for the person with voice synthesizers.

The therapist works with the child to develop the skills needed in daily life such as feeding, dressing, or using the bathroom. This can help reduce demands on the parents and aid with self-reliance and self-esteem. Occupational therapists usually work with children on better ways to use their arms, hands, and upper body. They may teach children better or easier ways to write, draw, cut with scissors, brush their teeth, dress and feed themselves, or control their wheelchair.

Recreational therapists help kids with CP have fun! They work with children on sports skills or other leisure activities. In recreational therapy kids may work on dance, swimming or horseback riding. They may also work on art or horticulture (growing and taking care of plants) or almost any other hobby they are interested in.

Doctors usually prescribe drugs for those who have seizures associated with cerebral palsy, and these medications are very effective in preventing seizures in many patients. In general, the drugs given to individual patients are chosen based on the type of seizures, since no one drug controls all types. People act differently to each drug. Some people need a combination of two or more drugs to achieve good seizure control.

The drugs most prescribed are diazepam, baclofen and dantrolene. Baclofen acts as a general relaxant of the brain and body. Baclofen blocks signals sent from the spinal cord to contract the muscles. And dantrolene interferes with the process of muscle contraction. These drugs are usually given orally and can reduce spasticity for short periods, but their value for long-term control of spasticity has not been clearly demonstrated.

Surgery is often recommended when contractures are severe enough to cause movement problems. In the operating room, surgeons can lengthen muscles and tendons that are proportionately too short. Because lengthening a muscle makes it weaker, surgery for contractures is usually followed by months of recovery. For this reason, doctors try to fix all of the affected muscles at once when it is possible or, if more than one surgical procedure is unavoidable, they may try to schedule operations closer together.

A second surgical technique, known as selective dorsal root rhizotomy, aims to reduce spasticity in the legs by reducing the amount of stimulation that reaches leg muscles via nerves. In the procedure, doctors try to locate and selectively sever overactivated nerves controlling leg muscles. Although there is scientific controversy over how selective this technique actually is, recent research results suggest it can reduce spasticity in some patients, particularly those who have spastic diplegia. Ongoing research is evaluating this surgery's effectiveness.

Because of the muscle problems kids with CP have, you may see them using some special things to help them get around or do their work at school.

Wheelchairs let kids who cannot walk, or have a lot of trouble walking, move from one place to another. Many kids with CP can use their arms to roll the wheels of their wheelchair themselves, and can move around school or the playground without much trouble. You may also see a motorized wheelchair. This is a chair that has a motor attached to it that pushes the wheels around. Usually a motorized wheelchair has a handle or joystick (like on video games) that lets the person in the chair start, stop, and steer it.

Some children with CP can walk, but have poor balance and fall a lot. They use a walker to help them balance and get around without a wheelchair. A walker is a light metal frame with four legs that the person moves in front of them as they walk. You might also see a walker with wheels on it, and sometimes kids put a bike basket on their walker to hold their stuff.

Special handles or grips can be very helpful to someone who has difficulty holding on to small things. Grips or handles are often used on spoons and forks or on pencils and pens to make them easier for the person with CP to hold and use.

When a child's speech is very hard to understand, it is easier for them to use a communication aid to talk with others. A communication aid might be a book or poster with pictures that show things the person might want, or an alphabet board that the person can use to spell out their message. There are also computers that are used as communication aids that actually talk for the person. The computer is probably the most dramatic example of a new device that can make a difference in the lives of those with cerebral palsy. For example, a child who is unable to speak or write but can make head movements may be able to learn to control a computer using a special light pointer that attaches to a headband. Equipped with a computer and voice synthesizer, this child could communicate with others. In other cases, technology has led to new versions of old devices, such the traditional wheelchair and its modern offspring that runs on electricity. Children with CP often are not able to use their hands well enough to use a computer keyboard or a mouse so they use a switch to operate their computer to talk. You might see kids pushing a switch with their hand, foot, head or chin - whichever is the fastest and easiest for them.

You know what a helmet is - just like you wear when you ride your bike, but you may be surprised to see somebody wearing one in school. They are wearing it to protect their head in case they fall while walking (remember, balance may be a problem) or have a seizure and fall to the ground.