Children With Cerebral Palsy: A Manual for Therapists, Parents and Community Workers, 2nd Edition (Children with Cerebral Palsy: A Manual for Therapists, Parents,)

259 Pages·2007·7.222 MB·English

by  Archie Hinchcliffe

Children with cerebral palsy

Children with cerebral palsy
A manual for therapists, parents
and community workers
Second edition
ARCHIE HINCHCLIFFE
Illustrations by Barbara Lynne Price and Clare Rogers
Copyright © Archie Hinchcliffe, 2003, 2007
All rights reserved. No part of this book may be reproduced or utilised in any form or by any means,
electronic or mechanical, including photocopying, recording or by any information storage or retrieval
system, without permission in writing from the publisher.
First published in 2003 by Vistaar Publications
This revised second edition published in 2007 by
Sage Publications India Pvt Ltd
B1/I1, Mohan Cooperative Industrial Area
Mathura Road
New Delhi 110044
www.sagepub.in
Sage Publications Inc
2455 Teller Road
Thousand Oaks, California 91320
Sage Publications Ltd
1 Oliver’s Yard, 55 City Road
London EC1Y 1SP
Published by Vivek Mehra for Sage Publications India Pvt Ltd, typeset in 11/13 Berkeley by Star
Compugraphics Private Limited, Delhi, and printed at Chaman Enterprises, New Delhi.
Library of Congress Cataloging-in-Publication Data
Hinchcliffe, Archie.
Children with cerebral palsy: a manual for therapists, parents and community workers/Archie Hinchcliffe;
illustrations by Barbara Lynne Price and Clare Rogers.—2nd ed.
p. cm.
Includes bibliographical references and index.
1. Cerebral palsy—Treatment. 2. Cerebral palsied children—Care. I. Title.
[DNLM: 1. Cerebral Palsy. 2. Cerebral Palsy—therapy. 3. Child. WS 342
H659c 2007]
RJ496.C4H565 618.92'83606—dc22 2007 2006034191
ISBN: 978-0-7619-3560-5 (PB) 978-81-7829-720-0 (India-PB)
Sage Production Team: Rrishi Raote, Rajib Chatterjee and Santosh Rawat
To those children with cerebral palsy and their families,
and to the therapists and community workers
that I have been privileged to know

Contents
Acknowledgements
9
Introduction
10
Chapter 1
What is cerebral palsy and how does it affect children?
13
Chapter 2
Assessing a child with cerebral palsy
I. Observing and handling
25
Chapter 3
Assessing a child with cerebral palsy
II. Analysis of observations
50
Chapter 4
Contractures and deformities
71
Chapter 5
Principles of treatment
88
Chapter 6
Child, family and therapist working as a team
119
8 CHILDREN WITH CEREBRAL PALSY
Chapter 7
Useful equipment at a treatment centre and at home
141
Chapter 8
Sensory integration problems in
children with cerebral palsy
ANNIE BROZAITIS
172
Chapter 9
Assessment and management of
eating and drinking difficulties
MARIAN BROWNE
201
Appendix A
How to make equipment from appropriate
paper-based technology (APT)
JEAN WESTMACOTT
228
Appendix B
Choosing appropriate play activities to engage
a child’s active involvement in therapy
241
Glossary
244
Index
251
About the author
259
Acknowledgements
T
HIS book was written for the many physiotherapists who attended the
courses I taught in different countries in Africa and the Middle East. I am
indebted to them for the encouragement they have given me to write and the
friendship they showed me during the courses.
In order to teach it is necessary to reflect on one’s own learning, and my reflection causes
me to be deeply grateful for the opportunities I have had to attend Bobath courses and
study days. From these I learnt not only about cerebral palsy and the way it affects a child
but also a problem-solving way of thinking. The tutors on these courses were invaluable
inspirational role models.
I am also greatly indebted to the many wise and experienced mentors who guided me in
the writing and the putting-together of the book. Chief among these is David Werner, who
wrote Disabled Village Children. He took hours of painstaking trouble to check the drawings
and provide thoughtful and apt advice on sections of the text. He was kind enough to say
that he learnt a lot about cerebral palsy by reading the book.
During my many years of working with children with cerebral palsy, I have been blessed
by coming in contact with people who have helped me to see the children more holistically
and less as patients. Chris Underhill, who established Action on Disability and Development
(ADD), and his Ugandan counterpart Charles Lwangwa-Ntale gave me the opportunity
to understand how to link rehabilitation to the process of development as a whole. Peter
Coleridge, who wrote Disability, Liberation and Development, and who invitied me to teach
a course in Afghanistan, has also been a good friend and source of inspiration.
The book would not have been complete without the contributions of Marian Browne
and Jean Westmacott and, in this second edition, Annie Brozaitis’ chapter on sensory inte-
gration. I am deeply grateful to all three of them for the effort they put into writing these
sections of the book. I would also like to thank Lynne Price for her gifted work on the
drawings and Ann Sinclair and Clare Rogers for the work they did on updating these drawings
and creating new ones.
Without the help and support of my husband, Peter, this book would certainly never
have been written. In all our postings abroad, he made sure that my work with children
took precedence over my duties as a diplomatic wife and he has constantly encouraged me
in the writing of this book.
Finally I want to thank my daughter, Clare, who took great trouble to sort out a tangle
I had made in chapters 2 and 3. With clinical incisiveness, she took the strands of the tangle
apart and the words fell into clear, understandable sentences. She did the same for Annie
Brozaitis in the new chapter. What a wonderful gift!