A Baby with Cerebral Palsy – A Case Study
Y’ was brought to me when she was 25 months old. She was diagnosed with Hypotonia and Dystonia and, after a while, she was diagnosed with Cerebral Palsy.
Since Y’ was unable to hold herself at all—mostly, she was bent forward—her mother had carried her. Apparently during her physiotherapy sessions, the child was often forced to sit, thinking that this forced position will eventually teach her how to do so. The extensive treatments she had undergone led to trauma and fear of receiving any sort of treatment. Whenever her mother laid her on a mattress, Y’ would burst into tears, and, therefore, my work with her was very gentle and gradual so as to not cause her any further distress. Her hands would twitch and move spastically, she was unable to open her right palm, and, when holding something using her left palm, her grip was disorganized and her fingers were organized in a twitchy manner. There was severe rigidity in her shoulder girdle ; and, she would respond with panic and Moro-Reflex-like blinks at the sight of any movement (including her own hand movements) or at the sound of any new noise coming from her surroundings.
In the first few sessions, my aim was to establish secure connections between the two of us, hoping that she will learn that my Clinique was a safe haven, and not, as she was unfortunately used to, a place in which pain is inflicted upon her. I estimated that Y’s fear of lying on her back had plenty to do with the fact she spent two weeks in an oxygen tent after her delivery due to Meconium aspiration. Each reminder, I assumed, brought up the emotional terror and pain that are involved in being in a state of seclusion with hardly any contact. My work with her primarily took place as her mother was bottle-feeding her. Extensive work was done in order to enable her to hold her head up; and, by gently assisting her to move her head, we began connecting the movements of the head and the back.
The most prominent change, already in our second session, was that Y’ smiled at her mother once she had realized the two were on their way to see me. The mother also said that Y was more communicative and happier. The changes in language and her general tonus were much evident. Y’ started making clearer sounds and ramble; her face, first characterized by low muscle tone and her drooling, now became illuminating, her facial muscle tone increased and, as a result, her face were held better. Gradually, Y’ learned how to control her back and sit upright as her mother carries her. Her head, however, was still somewhat tilted and it was not sufficiently supported by the neck muscles.
Throughout the first three months of our mutual work, Y’ learned how to roll from one side to the other – whereas before, she was only barely able to roll on to one side. Using her hands became less spastic and her right palm fully opened. Y’ expressed a growing desire to hold various objects, such as her water bottle, she played more with her brother and felt more comfortably in the presence of strangers. In terms of her Gross motor skills, Y’ rolls more easily, she straightens her back with the support of her hands, while lying on her tummy, and, in general she seems ready to starts crawling.
Lately, her mother told me that Y’ already grabs objects which interest her with both her hands. During our session Y’ seemed vivacious and her expressions were lively and much interested. It was easy to bring her to the floor, with only slight crying and complains on her part. She now rolls to her tummy with more ease, and I have begun showing her how to roll back. Y’ is highly intelligent. It is my contention that despite her final diagnosis of Cerebral Palsy, Y’ will learn to function optimally, sit and walk as any other child her age – she already does so.