How to set realistic goals for children with cerebral palsy

How to set realistic goals for children with cerebral palsy

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A child diagnosed with cerebral palsy, whether right at birth or later as developmental or motor issues become apparent, should have a complete cerebral palsy life care plan. This plan includes a diagnosis, a team of experts and specialists, a thorough and ongoing evaluation, and a set of goals. [1]

The Purpose of Care Plan Goals

What do you want for your child’s current life and future? The goals should answer this critical question. Without goals, a life care plan will have a lot of details, but no direction. Rely on your trusted experts and your family to help you develop the goals that will give your child the best life possible.

The life care plan for a child with cerebral palsy has several purposes and is essential for several reasons. The main reason to have a care plan is to have something that acts as a roadmap for your child’s best life.

It includes everything you need to give him the best life, from a full diagnosis and evaluation of his condition, limitations, and abilities, to an assessment of how much care will cost over a lifetime.

The primary purpose of having goals as part of the life care plan is to fuel the efforts you and your care team are making to give your child a great life and to enable him to live his best life.

Goals may be short-term and health-related, such as changing the diet to make sure your child has no nutritional deficits. They may also be long-term, like achieving living independence or finding a job.

Experts Help You Develop Goals

Your child’s care plan will include a diagnosis, evaluation, and the establishment of a care team, and should consist of these before you start to set goals.

The team of specialists, caregivers, and supportive family and friends will help you decide on the purposes for your child.

Once you have those goals lined up—and these will change and adapt over time—you can start making a plan for achieving them, the real roadmap for your child’s care.

Developing goals will seem overwhelming, especially when the only goal you can think about is a healthy child. Rely on the expertise of your care team.

People such as educational experts, neurologists, nutritionists, and therapists can help you understand what is possible for your child and his future and will guide you as you create the goals.

Goal Categories

As you develop your care plan and start to think about the goals you have for your child, it can help to break them down into categories. Your child’s condition is a complex one, and organizing it in this way, makes a complicated situation a little easier to understand.

  • Managing the primary disability. Cerebral palsy is complicated, but the first goal you should consider is how to manage the prime condition. This is an overreaching kind of objective and one that your neurologist and pediatrician can help you develop.
  • Managing complications. Cerebral palsy often comes along with co-existing conditions like seizure disorders and cognitive impairment. Setting goals for managing these is the next important step.
  • Improving mobility. Mobility is a significant issue for most children with cerebral palsy. [2] Some will be severely impaired and unable to walk, while others may have more minor disabilities. Goals that address how well your child moves are essential for making him comfortable and giving him access to more opportunities throughout his life.
  • Managing pain. Pain is also a standard component of cerebral palsy. [3] Stiff and jerky muscles, spastic muscles, and other pain will likely affect your child, and setting goals for managing that pain will help him be more comfortable and be better able to achieve different goals.
  • Working on communication. A child with cerebral palsy may have limitations that prevent him from communicating fully. This is especially true for a child whose vocal cords are affected by the condition. If your child struggles with speech and language, you will want to make goals that will lead to a greater ability to communicate, either through speech or alternative methods.
  • Encouraging socialization. A child with any disability may struggle to socialize with peers. Connecting with others is essential, though, so set goals that will help your child to interact in positive ways with family, friends, and peers.
  • Educational goals. Education is crucial for all children. Still, if your child is facing cognitive impairments, learning disabilities, or physical impairments that make learning challenging, knowledge is not as simple as it is for other children. Setting goals for learning, special education, and the future are important.
  • Self-care and independence. An important all-around goal for a child with a disability is to achieve as much freedom as possible. This may mean setting small goals—taking a bath without assistance—that lead up to bigger goals, like living entirely independently.
  • Maximizing quality of life. The goal is to give the child the best quality of life possible in spite of any disabilities. Always keep this in the back of your mind while making other goals.

The life care plan that you develop for your child is an important road map for how he will live his life and how fulfilling and satisfying that life will be. It is a necessarily complicated set of documents, but goals should be simple.

Goals should also be changeable. As your child grows older, you will meet and surpass goals and develop new ones. You will also be able to involve your child in setting those goals. He should be able to contribute and decide what he wants for his future.

Goal setting is vital for everyone to achieve success, but for a child born with a disability, they take on new importance. Take goals seriously for your child, and you give him the best chance at living a great life.

Cerebral palsy refers to a number of neurological conditions that are caused by brain damage during pregnancy or in the early years of life. There are several known causes for cerebral palsy, including brain bleeds and traumatic childhood injuries, however many reasons are still unknown. Currently, there is no cure for cerebral palsy but many advances have been made in the treatment of children and adults living with cerebral palsy. At home care and in home supportive services augment these treatments by promoting the proper development of children growing up with cerebral palsy.

As a leading Minnesota home care agency, Best Home Care serves family members and home caregivers caring for children living with cerebral palsy in the Twin Cities. Our home care professionals have found that cerebral palsy presents some unique challenges that don’t easily fit in typical home care plans. In most cases, the best caregiving strategy involves setting daily goals that encourage the child to live more independently and socially. It’s important that children affected by cerebral palsy start to develop these traits early on in life and home care services can have a huge impact on this.

Here are some ways personal care assistants and parents/guardians caring for a child with cerebral palsy can set daily goals for their home care:

  • Practice activities of daily living such as dressing and bathing. An example of a small goal might be: learning to put on socks by the end of the month.
  • Encourage social interaction whenever possible. An example of this is saying “please” and “thank you” when out to eat or in other public situations.
  • Promote self-independence of the child at every opportunity. For example, instead of bringing them a toy encourage them to get the toy for themselves if they are able.

Home caregiving goals will (and should) shift depending on the child’s age and specific abilities. The purpose is to challenge children to become more independent and social on whatever level is appropriate.

If you are caring for a child with cerebral palsy, turn to Best Home Care for assistance and guidance with your home care services.

How To Help Children With Cerebral Palsy Stay Healthy

Children with cerebral palsy are vulnerable to other diseases. So, parents of these children must work around the clock to keep their children healthy. Helping your child develop healthy habits should be on the top of your to-do list. However, you will need to start early, as soon as the child is old enough to communicate and walk. Like other youngsters, children with cerebral palsy will need encouragement and a nudge here and there. Below, you will discover several tips to help get you started.

Keep Things On A Positive Level

Children with cerebral palsy are not keen on being told that they cannot do something. Instead of discouraging the child from participating in specific activities, encourage them to participate. Keeping things fun and positive will go a long way in getting your child to develop healthy lifestyle habits.

Reward Successes

Healthy children love to be rewarded for their accomplishments. Well, the same goes for children with cerebral palsy. Every time your child succeeds, give them praise and reward them for their efforts. Now, this does not necessarily mean you have to give them an expensive. Instead, give them praise, a hug and take them to the park, where they can spend time with other children.

Set Realistic Goals

A big mistake that parents of children with cerebral palsy make is setting unrealistic goals. If you set unrealistic goals for your child, she/he will never be able to reach success. When setting goals, stick with goals that are achievable. Along, the way you may need to make some adjustments in your strategy, but do not get discouraged because this is only normal.

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Family Time

Spending time with family is extremely important to children. In fact, most young children prefer spending time with their parents and siblings than their friends. Quality family time should include dinners, outings and other events.

Make Exercising Light And Fun

Proper and regular exercise should be on everyone’s daily list of things to do. While your special needs child might not want to or even enjoy exercise there are ways that you can get them to engage and stay interested. For instance, exercise doesn’t have to be extremely exhausting and all about lifting weights or running up hills. In fact, you can put on your child’s favorite music and dance around the house, ride a bike, or just simply go for a walk in nature. Whatever the situation is, a little cardiovascular working will go a long way to keeping your child healthy and safe.

Purpose: To explore therapists’ goal setting and intervention with children with cerebral palsy, and to examine their acceptance of children’s use of compensatory movement strategies.

Methods: Interviews were conducted with 23 occupational therapists and 31 physical therapists. Goals and assumptions of relationships between intervention approaches and expected outcomes were coded using the International Classification of Functioning, Disability, and Health (ICF). Therapists’ acceptance of compensatory movement strategies was rated.

Results: Thirty-three therapists identified goals representing the ICF activity component. Therapists working with younger children identified goals representing the ICF body function/structure component. Twenty-four therapists assumed that an intervention targeted at 1 ICF component would affect an outcome in a different component. Eleven therapists would not accept compensatory movement strategies.

Conclusions: Most therapists’ goals are congruent with principles encouraging functional goals. The ICF matrix developed for this study may be useful for clinical evaluation and documentation of assumed relationships among interventions and outcomes.

Today, treatment for children with cerebral palsy predominantly aims at improving the children’s possibilities to perform everyday activities in their natural environment. The activities in focus for intervention are often expressed as specific goals, frequently defined in a collaborative goal-setting process between professionals and parents. The role of goal setting to improve the outcome of the intervention has not been shown in the literature so far. Thus, the aim of this systematic review was to explore if goal setting has an impact on treatment outcome assessed by standardized measures. CINAHL and MEDLINE were searched from January 2000 to October 2012, resulting in a final selection of 13 articles, six of which were randomized controlled trials. Methodological quality was assessed and study characteristics were analysed descriptively. Subject characteristics, type of intervention/s, frequency, and intensity of therapy varied largely. Outcome was assessed by standardized outcome measures as well as evaluated through aspects of goal attainment. Most studies showed robust within-group changes according to study-appropriate standardized measures, whereas the between-group comparisons exhibited less consistent differences in outcome. The review does not provide support for a positive effect of goal setting per se on treatment outcome. Studies that specifically measure the effect of goal setting on treatment outcome are needed.

© The Authors. Developmental Medicine & Child Neurology © 2013 Mac Keith Press.

Should you be concerned if your child with cerebral palsy is commando crawling?

Commando crawling is not your typical hands and knees crawling. As demonstrated in the video below, it’s characterized by the use of the arms to drag the body forward while the stomach and legs remain on the ground.

While it’s relatively common in infants, commando crawling might be a cause for concern amongst those with cerebral palsy. Parents of children with CP should be aware of what commando crawling might imply. For some, it is just a phase, but for others, it might be a sign of lower extremity impairment.

This article will explain why children with cerebral palsy commando crawl and when it becomes problematic.

Why Do Children with Cerebral Palsy Commando Crawl?

Cerebral palsy is a motor disorder that affects movement, balance, and coordination. Commando crawling is most commonly observed in children with spastic diplegia, a type of CP characterized by high muscle tone in the legs. This can cause stiff movements and make it difficult for children to control their lower extremity functions, resulting in developmental delays.

Alternatively, commando crawling may not be attributed to weakness in the legs, but rather a lack of core strength. Crawling is an activity that engages the entire body as it requires bilateral coordination of the arms and legs. Without sufficient strength in the core, children may struggle with tasks that require bilateral coordination and balance.

Now that you understand how cerebral palsy can cause commando crawling, let’s discuss its consequences.

Consequences of Prolonged Commando Crawling in Children with Cerebral Palsy

Even with cerebral palsy, many children who commando crawl learn to stand and walk, so it may not always be a cause for concern.

Commando crawling is problematic when it becomes a habit. Most infants learn to crawl between 6 to 10 months and transition out of it by 18 months. Prolonged commando crawling results in disuse of both the legs and core.

Our bodies are extremely adaptive and when you don’t use your muscles, they’ll weaken to conserve energy. Ultimately, weakened leg and core muscles will make it more challenging to phase out commando crawling.

Additionally, complications associated with cerebral palsy can cause further functional impairments. For example, most individuals with cerebral palsy experience spasticity (involuntary muscle contractions).

Severe spasticity can significantly restrict mobility, cause pain, and stunt growth. To prevent developmental complications, early intervention is essential.

In the following section, you’ll learn what you can do to correct your child’s commando crawling.

How to Correct Commando Crawling in Children with Cerebral Palsy

Early management will promote movements that can replace commando crawling before it becomes a habit.

Every individual experiences the effects of cerebral palsy differently, so a personalized approach to management is essential.

Below, we’ll discuss some management interventions that can help your child transition out of commando crawling

1. Consult with a Pediatric Physical Therapist

A pediatric physical therapist can identify weaknesses early and set realistic goals for improvement.

They’ll create a customized exercise plan to maximize your child’s mobility. The exercises may help:

  • Stretch spastic muscles to maintain full range of motion
  • Strengthen underused muscles to counteract spastic muscles
  • Repetitively stimulate spastic muscles to reduce their hyperexcitability

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2. Wear Orthotic Devices

Your child’s body is constantly growing and unmanaged spasticity can negatively impact their development.

Wearing orthotic devices like braces or splints support normal musculoskeletal alignment, gently stretch spastic muscles, and combat progressive muscle tightening.

3. Focus on Repetitions

While the brain damage from cerebral palsy cannot be reversed, functional improvements are possible. Neuroplasticity is the brain’s ability to rewire itself and the most effective way to promote it is through repetitive movement.

Every movement your child makes sets off a unique set of neural pathways in their brain. Consistent stimulation helps the brain perceive a demand for that movement and promotes rewiring.

Ultimately, you want to encourage your child to move their legs as much as possible, often through creative play activities

Should You Be Worried About Commando Crawling?

If your child has just started commando crawling, just be vigilant at first. Many children with cerebral palsy commando crawl without ever transitioning onto their hands and knees. Instead, they’ll just start standing or walking.

However, if your child continues to commando crawl beyond the age of 18 months, you should consult with their pediatrician.

Hopefully, this article helped you better understand how cerebral palsy can affect commando crawling.

How to set realistic goals for children with cerebral palsy

Wondering what you can do to support and accommodate a student with cerebral palsy in the classroom?

This article will help you understand what cerebral palsy is and how to help a student with CP succeed academically.

Understanding Cerebral Palsy

Cerebral palsy is a spectrum disorder, meaning that individuals can demonstrate a wide range of symptoms at varying severities. Therefore, classroom accommodations should be different for each child.

In fact, not all children with cerebral palsy will need accommodations. Cerebral palsy is a motor disorder, meaning that it affects an individual’s movements, balance, posture, and coordination.

While all children with cerebral palsy have motor impairments, the severity and locations of their motor impairments will vary from person to person. Some are able to walk independently, while others need the assistance of a wheelchair, crutches, or a walker.

If cerebral palsy affects the hands, individuals may struggle with fine motor tasks like writing. Likewise, if cerebral palsy affects the oral muscles, individuals may be non-verbal.

Children with cerebral palsy can exhibit a wide range of associative conditions. These are conditions that are not directly related to CP but often co-occur. Associative conditions of CP include:

Generally, the milder a child’s cerebral palsy is, the easier it will be for them to integrate into an inclusive classroom. However, with the right support, children with more severe forms of cerebral palsy can also succeed in school.

In the following section, we’ll discuss what accommodations can help children with cerebral palsy maximize their potential at school.

Want 19 pages of CP recovery tips in PDF form? Click here to download our free illustrated ebook now (link opens a pop up for uninterrupted reading)

Effective goal setting is an integral part of learning how to develop a meaningful career. It’s a skill your son or daughter with cerebral palsy (CP) needs to start learning in high school.

Goals need to have substance. They must be connected to your youngster’s values.

Imagine for a moment that your youngster has the desire to be a computer network administrator for a medium-sized company. How can he or she embark on this journey (which will likely entail years of training and hands-on experience) without making plans? Without establishing goals, how would your youngster know when he or she had achieved that dream?

Your high school student needs to practice these two steps for effective goal setting.

In the business world, job seekers succeed because they know where they want to go. It is essential to set both short-term and long-term goals in a sequence that shows where they’re going. These goals become more potent and more easily attainable when they are aligned with personal values and drive by a personal vision.

So, effective goal setting for your high school student starts with exploring and understanding personal values, the guiding principles for your youngster’s personal and eventual working life.

When I was 14, I knew I wanted to write as a vocation because, for me, writing was a way to increase understanding (my personal value) within a diverse group of people. That understanding would help people work together more effectively (my vision).

Your youngster’s values and vision are closely tied to his or her personal interests, one of the drivers of career development. Observation and casual conversation over the years can give you a good idea of what your youngster values most when it comes to a vocation: challenge, security, relaxation, renewal, adventure, an exotic environment etc.

Examples of values include excellence, honesty, innovation, spirituality, respect, and authenticity. Help your youngster think of values as guiding principles: what he or she wants and needs in a personal and work life.

Help your youngster make a list of values. Then, together, look for patterns and ways to group individual values together.

After reviewing my list of values as a 51 year old, for instance, with the help of a career coach, I grouped them into three distinct categories – learning, adventure, and communication. My communication category included creativity, authenticity, and connecting.

The next step is to create a clarifying statement, blending the values that your high school student has grouped into a category. Let’s continue to use my communication example. I developed the following clarifying statement:

“I value effective communication. It’s an essential part of who I am, both personally and professionally. Authenticity is an important part of communication for me. I strive to be authentic in the way I connect with others. I value life-long learning, and I continually work to sharpen my writing and strategic communication skills.”

Your youngster’s clarifying value statements can play a key role in the development of his or her personal brand.

For instance, I brand myself as a “ disability employment expert who helps individuals put disability to work as a competitive edge in today’s job market . ” That’s my 15-second elevator pitch, a reply I can use when I’m asked, “What do you do?”

My statement often leads to question in reply: “How do you do that?”

My standard response: “ I walk the people I coach through a series of career builders so they can gain the confidence they need to deal effectively with disability employment issues .

But, in today’s world, even my 1980s elevator pitch is too long. So, now I use three words to describe what I do: “ Showing Disability Works .

How to set realistic goals for children with cerebral palsy

Illustration courtesy of

Goal setting is the methodology by which individuals can systematically support their success. Accomplishing goals helps to create and sustain that success.

As your youngster begins to develop goals, guide him or her through the following questions:

  • Is there something that needs to be completed?
  • Do you have a concern that is unresolved?
  • Do you have an unfulfilled dream?
  • What things should have had a higher priority this last year?

When establishing a goal, our popular culture likes to cite the SMART principle:

  • Specific: Be very specific in writing a goal.
  • Measurable: Develop criteria to measure progress and success.
  • Attainable: Be sure the goal is realistic and attainable.
  • Relevant: Consider personal values. Is it relevant?
  • Time Bound: Establish timeframes.

But, Dr. Samantha Collins, CEO of Aspire Companies and founder of The Aspire Foundation (a mentorship program for women across 24 countries), is not a big fan of SMART goals, especially for high school students.

She recommends, instead, “developing more of a vision, going to your highest level.”

She adds, “You don’t have to be realistic at this stage. Your vision should invoke excitement as well as slight terror — terror because you’re clueless about how you’re going to pull it all off. All the planning can come later.”

In my case, I always had my values in my heart and my vision in my head. But, I could never make SMART work as an effective goal setting process because it didn’t seem to be helpful for me.

Instead, embracing happenstance, being open to change and knowing my end point (being able to live independently) seemed to work well for me. In short, I’ll admit that I “winged it” until I reached middle age.

I have a hunch that whichever effective goal setting track your youngster finds helpful will depend on his or her temperament.

This is Creative Commons content .  You can freely and legally use, share and repurpose it for non-commercial purposes only, provided you attach this sentence and the following attribution to it (including the two links):

Originally written and illustrated by Jim Hasse , ABC, GCDF, owner of Hasse Communication Counseling, LLC, who, as a person with cerebral palsy, served for 10 years as a vice president in a Fortune 500 company during his 29-year career in corporate communication. He’s an Accredited Business Communicator, certified as a Global Career Development Facilitator and author of 14 Amazon books about disability awareness and disability employment issues.