Cerebral Palsy


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About cerebral palsy

Cerebral palsy describes a group of disorders that affects the way a person moves. Cerebral palsy occurs when there is damage to the brain when it is developing, and it affects a student’s ability to control their muscles. It is the most common form of physical disability in childhood.

A student with cerebral palsy may face challenges with muscle weakness and stiffness. Some students might have trouble with slowness or shakiness, and may not be able to control their movement. Balance, coordination and walking can be also be difficult. Cerebral palsy can affect different parts of the body - some students may have trouble with motor control on one side of their body, some may have challenges with both sides, and some may have challenges that affect only the lower part of their body.

About one third of young people with cerebral palsy also have epilepsy, which means that they have recurring seizures. There are different types of epilepsy and they affect young people in different ways. Some young people will stare blankly or look as if they are daydreaming during a seizure. For some young people, a seizure may involve stiffness or jerking movements. Some young people will benefit from medication, which means that seizures may be rare. If a student in your class has epilepsy, ask the parents and student’s support team about how you can recognise a seizure and what to do.

Strengths

What might be some strengths?
  • Students with cerebral palsy have different strengths depending on how they might be affected by the condition. 
  • Some students with cerebral palsy will have typical language and thinking skills and can learn like any other student (with adjustments to assist with motor challenges).
  • Some students with cerebral palsy may be good at managing challenges in their environment so that they can successfully participate.
  • Some students with cerebral palsy are able to understand what is expected of them at school and can then manage their own behaviour.
  • When given time and opportunities to practise, students with cerebral palsy can develop strong peer relationships and social skills.
    Where might you provide support?
    • Students with cerebral palsy will differ in how much their movement is impacted. Some students will walk independently, while others will use mobility aids (e.g. a walking frame or a wheelchair). Some students may also have trouble controlling their muscle movements, which can impact their coordination and motor tasks such as writing.
    • If muscles in the face, mouth, and throat are impacted by cerebral palsy, students can experience challenges with talking, eating and drinking. They may find speech challenging, which means they might have different ways of communicating (e.g. using computer technology, pictures or gestures with their hands or head), or they might need more time to communicate.
    • Students with cerebral palsy may experience chronic or recurring pain. This may affect their behaviour. They may become less motivated to join in or interact with others.
    • Students with cerebral palsy may also have difficulties with social interaction and peer relationships.

    Evidence-based strategies

  • Work with parents. Talk with the student and their family about the student’s unique strengths, preferences, and abilities. This includes areas they need extra help in and the best methods of communication.
  • Build a relationship with the support team. There may be various health professionals involved in supporting the student. Working together can lead to a shared understanding of the student, their goals, and strengths-based strategies that are consistent across other environments like home and the community.
  • Set joint learning goals. Work with the student’s parents as well as the professionals supporting the student to set some specific and measurable goals. Aim to set outcomes that focus on the student’s strengths and are challenging enough to support learning and social development. 
  • Focus on what students can do. Identify their strengths and positive efforts and provide encouragement. Your attitude matters and can make a difference in a student’s participation and learning.
  • Use multiple methods of communication. In addition to verbal direction, it may help to use visual instructions and hands on demonstrations. For example, demonstrate a task, ask a student to demonstrate, or use visual schedules or posters to outline or model a task. Materials such as captioned videos may also be helpful.
  • Allow the student to use technology or assistive devices. Some students with cerebral palsy might have assistive devices that they use to help them communicate or participate. For example, they might need to use adapted keyboards to help with writing. Encourage students to use technology that best supports the goals of learning and their needs.
  • Provide plenty of opportunities for students to work collaboratively with their classmates. This can be done through small group work and activities such as role playing. 

    • Best practice tips

  • Consider providing different ways to get information and show learning. For example, students who need support with writing can be assessed using computers or tablets. Other options include providing tests with large print texts, allowing the student to use finger pointing, or encouraging the student to say the answers.
  • Consider whether the physical space can be rearranged and check that pathways are free. This may mean checking if pathways are wide enough for a student to easily navigate and that there are no loose objects on the floor.
  • Some students with cerebral palsy may need extra time to move between classrooms and buildings. Alternatively, plan the student’s classes so it minimises how much they need to move from class to class.
  • When possible, allow the student to choose what they would like to do. Encourage teachers and support staff to give students space to interact with peers and participate independently. This can help to encourage social interactions with peers.
  • Some students may need more time to process and learn new skills in the classroom. Breaking down key learning concepts and activities into smaller but challenging sequences may be helpful.
  • Some students might need extra help to support their posture. This may help with pain management, as well as with classroom tasks such as handwriting. Bean bags or pillows may help. Consider talking to the student, and other professionals that support the student, to find out the best seating position for the student.
    • Create a school culture around acceptance, inclusion and belonging. Social supports and positive attitudes can promote participation. Model positive attitudes and beliefs toward students with disability to your classroom. Consider where peer mediation and group work appropriate. Visit AllPlay Learn's Inclusive Communities for Schools page to access a suite of resources to support you in building an inclusive school culture.
    • Promote self-determination. Empower and teach students to make simple choices, set goals, be independent, and develop problem-solving abilities. Use technology as needed. For example, technology can be used by students who communicate non-verbally to indicate preference.

    Curriculum considerations

  • Some students with cerebral palsy may be very motivated by, and interested in, the arts. Promote creativity to allow self-expression. This might encourage positive behaviour, friendships and self-esteem. 
  • Consider adjusting activities and equipment. Adapted materials may be needed for full participation. For example, thicker pencils and paintbrushes might enhance grip.
  • Consider the environment to allow safe participation of students with cerebral palsy. For example, check that materials and equipment are at an appropriate height for the student to reach, and that pathways are wide enough for the student to move within
  • Consider letting the student work with friends who can assist with motor tasks that the student may find challenging
  • Some students with cerebral palsy may experience delays with reading and writing. They may need more support and learning time.
  • It may be helpful to sound out words with the student and show them how to blend these sounds to create phrases and sentences. Some students might need more time and multiple repetitions.
  • It can be useful to use multiple modes of communication when teaching literacy skills. For example, consider using pictures to teach a concept to students.
  • Maximise technology. Use assistive technology to enable students to access instruction and demonstrate their understanding.
  • Consider literacy instructions to assist with reading and writing skills. This may include instruction designed to teach phonics, reading fluency, written expression or spelling skills.
  • Identify what the student needs help with. For more specific strategies for literacy, refer to tips for teaching students with a specific learning disability.
  • Students with cerebral palsy who have challenges with movement, coordination, and balance may find physical activity challenging. In a group setting this might lead to lowered self-esteem and motivation. 
  • To provide a sense of belonging and acceptance encourage team work and give a student with cerebral palsy an active role in sporting activities. 
  • Consider the environment. Check that the surface of the sporting area is not too slippery or sticky for the student to move around.
  • Some students may need to take frequent breaks to manage pain and fatigue.
  • See AllPlay Footy and AllPlay Dance for more inclusive tips.
  • Some students with cerebral palsy may have trouble with speech and this might result in feelings of frustration as well as disruptive behaviours.
  • Assess whether learning a language will be of advantage to them on a case-by-case basis. 
  • If they are learning a language, focus on areas of strength and build from there. 
  • A teaching tip that may be relevant is  work collaboratively. For example, open communication with the student’s speech therapist may help identify effective strategies for learning a new language.
  • Students might need support with tasks that require the use of fine motor skills (e.g. writing).
  • Give students plenty of time to learn new mathematical skills. They may need instructions or key concepts repeated multiple times.
  • If a student uses adaptive technology to assist with everyday tasks, use these in the maths classroom. For example, if a student uses a laptop with an adapted keyboard, consider making the maths exercises available in an online format.
  • Consider using adapted materials, including magnetised mathematical equipment such as rulers.
  • Some students with cerebral palsy may be unsteady in their movements and may have problems with balance and coordination.
  • Consider how the science classrooms can remain safe in order to prevent injury and discomfort for the student. For example, if in a laboratory, check that pathways are wide enough for the student to move within and pay attention to the placement of breakable objects.
  • Check that students have a workstation that is at an accessible height, has plenty of leg room, and is free from any physical or visual barriers.
  • Consider providing the student with a lab partner that can assist with measuring, handling delicate equipment, or other manual tasks that the student may find challenging.
  • Some students with cerebral palsy might benefit from computer software or modified keyboards to help them participate. They may have strengths in technologies if they already use these on a day-to-day basis to support their needs.

    • Other considerations

  • Some students with cerebral palsy may have trouble communicating when they are tired, in pain, or unwell. In addition to crying or vocalizations, look for non-verbal signs such as changes to facial expressions, changes in movement, changes in behaviour, and changes in interactions with others. Encourage the use of gestures or other methods of communication to work out what may be happening.
  • Talk to the student’s caregivers. Identify the best ways to manage injury, illness, pain and fatigue early on.
  • Frequently check in with the student.
  • Build a relationship with other professionals that support the student (e.g. occupational therapist). That way you will be informed on signs to look for, adjustments that can be made to relieve discomfort, and the best ways to manage injury, illness, pain and fatigue.
  • Some students with cerebral palsy may not know how to tell an adult if there is an emergency, or what to do in an emergency or emergency drill. Consider spending time demonstrating and practising this with students.
  • Consider whether evacuation points and procedures are suitable for the students’ needs and mobility.
  • Some students might also show challenging behaviours. It’s important to remember students are most likely trying to communicate a need or want that is not being met.
  • Refer to the ABC approach for more information on how to reduce challenging behaviour by supporting the young person and promoting more helpful behaviour, and our emotions page for more information about supporting a young person with managing their emotions.
  • Excursions and camps might be challenging for students with cerebral palsy. Planning in advance can reduce these challenges.
  • Consider how to accommodate the transportation needs of the student. For example, if using a bus, check that it has ramps and is wide enough to accommodate a wheelchair or other mobility aids the student might need.  
  • Consider the destination and whether it is accessible and safe for the student.  Get extra support staff to assist if needed.
  • Planning for frequent breaks during the excursion may be helpful.
  • Some students with cerebral palsy may find completing homework tasks challenging.
  • Consider the students’ use of technology or assistive devices. Some students might need support with writing and may benefit from tests and workbooks provided in an online format.
  • It may be helpful to work with the students’ parents to develop an effective and consistent homework routine at home. Consider discussing and demonstrating some teaching strategies.
  • Some students may need additional time to complete assessment tasks or it may be more helpful to provide them fewer tasks to complete in the set time.
  • Encourage a safe and supportive environment in the classroom. Consider using role-play in the classroom to highlight how students can identify bullying, and how they can address it.
  • Discuss with students what to do, and where to go, if they require additional support at school.
  • See  work collaboratively to identify additional strategies that can support the student in the area.
  • See AllPlay Learn's Teacher guide to bullying and exclusion
  • For more information about supporting students with disabilities when transitioning across education settings, access AllPlay Learn's transition page.
  • Post-school transition to adult life should begin as early as possible in school.
  • Aim to increase independence by working on organisational, social and problem-solving skills, and time- and self- management skills. Provide plenty of opportunities to practise them across a range of contexts.
  • It may be helpful to identify skill gaps and develop a support plan to help them be successful (e.g. social skills, academic and/or employment skills).
  • Some students with cerebral palsy may also experience  d/Deaf and hard of hearing, intellectual disability, specific learning disability, or blind or low vision. Some students may have challenges with  attention or communication. 

    • Relevant resources

    Visit our resources page for a range of resources that can help to create inclusive education environments for students with disabilities and developmental challenges. Some particularly relevant resources for students with cerebral palsy include:

    Strengths and abilities communication checklist
    Character strengths poster
    Peer mediation communication prompts poster

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