Category Archives: Associated Conditions

Hearing Loss in Children with Cerebral Palsy

Children with cerebral palsy are more prone to hearing loss than other children. In fact, research indicates that about 15-20% of children with cerebral palsy have a hearing impairment of some kind. Without proper treatment, hearing loss in children with cerebral palsy can lead to difficulties in language development and social interactions are they grow older. These issues can be particularly problematic when combined with a visual impairment. Learn more about hearing loss in cerebral palsy and available treatments.
 

Types of Hearing Loss

Hearing loss of any type interferes with a child’s ability to learn and interact with the world around them. Diagnosing the specific type of hearing loss affecting your child can help your doctor determine the appropriate course of treatment. Generally speaking, hearing loss falls into two categories:
 
Sensorineural Hearing Loss – This type of hearing loss affects either the nerve fibers or the cells found in the inner ear. Higher pitched or faint noises are often difficult to hear for those affected by this condition. Some sufferers also report imbalance and dizziness or frequent ringing in the ears. Birth injuries, head trauma or excessive exposure to loud noises have all been linked to sensorineural hearing loss.
 
Conductive Hearing Loss – This type of hearing loss affects the outer and middle ear, causing issues with the eardrums and ossicles. Generally speaking, this condition makes it difficult for your ears to process sounds properly. Conductive hearing loss is typically caused by trapped fluid or earwax buildup. Severe cases can be brought on by malformation of the ear canal at birth.
 
A third condition, mixed hearing loss, occurs when symptoms of both conditions are present. About 10% of children with cerebral palsy will develop sensorineural hearing loss, whereas conductive hearing loss is much more common.
 

Signs of Hearing Loss

Like many conditions associated with cerebral palsy, early detection of hearing loss in your child makes treating the condition much more effective. As a parent, it is likely that you will notice the early warning signs before your child’s teachers or doctors.
 
Children with hearing loss do not startle easily at loud noises. They pay closer attention to a person’s face while they are speaking than a normal child would. When communicating with them, they may frequently ask you to repeat what you said. These, as well as other signs, could indicate that your child has a hearing impairment. If you notice these signs at any time into your child’s life, schedule an appointment with an audiologist as soon as possible.
 

Treatment for Hearing Loss

There are a variety of treatments available to treat hearing loss in children with cerebral palsy. Most cases of conductive hearing loss can be treated and even completely restored with the use of corrective surgeries. Less invasive forms of treatment for this condition include the use of hearing aids and certain antibiotics.
 
Sensorineural hearing loss can be a bit trickier to correct. If the patient is brought in within 24 hours of the onset of the condition, certain surgeries have the potential to fully reverse the damage. Otherwise, corrective surgeries have yet to demonstrate a reliable outcome in treating sensorineural hearing loss; about 50% of those suffering from the condition can correct it using surgery. The most common methods to treat those suffering from sensorineural hearing loss include hearing aids or cochlear implants. In any case, talk to your child’s doctor or audiologist to best determine how to treat your child’s hearing impairment.
 
As with any condition associated with cerebral palsy, the earlier you obtain a diagnosis and begin treatment, the better the prognosis for your child.
 

Further Reading

Hearing Loss Association of America
KidsHealth.org – Hearing Loss

 

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Cerebral Palsy and Mental Health

Mental Disorders
If you’ve noticed any mood swings in your child, you’re not alone. Members of our community shared their wisdom when we posted the question, “Does anyone have any experience with kids with CP who suffer mood swings and emotional breakdowns when they enter their teenage years?” (Click here to read the comments.) At first glance, one might think that it’s typical teenage behavior, but studies have shown a link between psychiatric disorders and cerebral palsy.
 
There is growing evidence that children with neurodevelopmental disorders, such as cerebral palsy, are more prone to psychiatric disorders. One in two children with cerebral palsy met criteria for a psychiatric disorder, the most common being attention deficit hyperactivity disorder (ADHD). One in five children had more than one diagnosis, not determined by the type and severity of the child’s cerebral palsy. Because cerebral palsy is a result of injury to the brain, it is suggested that the same damage makes children vulnerable to mental disorders as well.
 

Common Causes of Mood Swings

This does not necessarily mean that your child’s mood swings are a sign of a mental disorder. In fact, sometimes a mood swing is a sign that your child is experiencing pain or frustration. Approximately 65 percent of teenage girls and 50 percent of teenage boys report experiencing pain, mostly in the feet, ankles, knees, and lower back. Pain interferes with everyday activities and their ability to focus.
 
Physical impairments may also make teenagers feel different and isolated from their peers. They are trying to figure out who their are. They are seeking independence from mom and dad, and may even try out new identities. Teenagers with cerebral palsy may be concerned with how their physical limitations will affect their ability to live an independent adult life. Their self-esteem may be impacted and result in feelings of frustration, anger, shame, or even sadness.
 
Even if these emotions are common in teenagers, it is important to address them. For example, long periods of sadness may be a sign of depression. Encouraging your child to join a support group or participate in therapy or counseling may help them learn healthy ways to cope with their emotions. If you are concerned about your child’s emotional well-being, do not hesitate to seek the advice of a medical professional!
 

Signs of a Mental Disorder

Mood swings can also be a sign of mental disorder. Here are two disorders that are common in children with cerebral palsy.
 
Bipolar disorder, also called manic-depressive illness, is a serious condition. Children with bipolar disorder experience very extreme mood swings. Manic mood swings are periods of happiness and high activity, while depressive mood swings are periods of sadness and low activity. These are not your typical mood swings. In a depressive state, there is an increased risk of self-harm.
 
According to the National Institute of Mental Health, children and teens having a manic episode may:

  • Feel very happy or act silly in a way that’s unusual
  • Have a very short temper
  • Talk really fast about a lot of different things
  • Have trouble sleeping but not feel tired
  • Have trouble staying focused
  • Do risky things.

 
Children and teens having a depressive episode may:

  • Feel very sad
  • Complain about pain a lot, like stomachaches and headaches
  • Sleep too little or too much
  • Feel guilty and worthless
  • Eat too little or too much
  • Have little energy and no interest in fun activities
  • Think about death or suicide.

 
Attention deficit hyperactivity disorder, or ADHD, is a common childhood disorder associated with inattentiveness, hyperactivity, and impulsiveness. It is important to note that not all children will experience all three symptoms. These behaviors can make it difficult for a child to pay attention in school, get along with others, and finish tasks.
 
According to the National Institute of Mental Health, children who have symptoms of inattention may:

  • Be easily distracted, miss details, forget things, and frequently switch from one activity to another
  • Have difficulty focusing on one thing
  • Become bored with a task after only a few minutes, unless they are doing something enjoyable
  • Have difficulty focusing attention on organizing and completing a task or learning something new
  • Have trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
  • Not seem to listen when spoken to
  • Daydream, become easily confused, and move slowly
  • Have difficulty processing information as quickly and accurately as others
  • Struggle to follow instructions.

Children who have symptoms of hyperactivity may:

  • Fidget and squirm in their seats
  • Talk nonstop
  • Dash around, touching or playing with anything and everything in sight
  • Have trouble sitting still during dinner, school, and story time
  • Be constantly in motion
  • Have difficulty doing quiet tasks or activities.

Children who have symptoms of impulsivity may:

  • Be very impatient
  • Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
  • Have difficulty waiting for things they want or waiting their turns in games
  • Often interrupt conversations or others’ activities.

 

Treatments

Both Bipolar Disorder and ADHD do not have any cures, but treatment is available. If you suspect that your child’s mood swings are signs of a mental disorder, seek medical attention. A physician may prescribe medication to keep their mood swings under control or recommend therapy.
 
Does your child experience mood swings? Have you noticed any behaviors that are unique to children and teenagers with cerebral palsy? Share your experiences and advice in the comments section below.

Sources:

Facebook Question of the Day

Cerebral Palsy and Bipolar Disorder

National Institute of Neurological Disorders and Stroke

Mental Health in Children with Cerebral Palsy: Does Screening Capture the Complexity?

Challenging Behaviour and Cerebral Palsy

About Teens with Cerebral Palsy

NIMH: Bipolar Disorder in Children and Teens

NIMH: Attention Deficit Hyperactivity Disorder

 
 

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