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About Cerebral Palsy
Cerebral palsy (CP) is a term used to describe a group of chronic conditions affecting body movement and muscle coordination. It is caused by damage to one or more specific areas of the brain, usually occurring during fetal development; before, during, or shortly after birth; or during infancy. Thus, these disorders are not caused by problems in the muscles or nerves. Instead, faulty development or damage to motor areas in the brain disrupt the brain's ability to adequately control movement and posture.
"Cerebral" refers to the brain and "palsy" to muscle weakness/poor control. CP itself is not progressive; however, secondary conditions, such as muscle spasticity, can develop, which may get better over time, get worse, or remain the same. CP is characterized by an inability to fully control motor function, particularly muscle control and coordination. Depending on which areas of the brain have been damaged, one or more of the following may occur: muscle tightness or spasticity; involuntary movement; disturbance in gait or mobility, difficulty in swallowing and problems with speech. In addition, the following may occur: abnormal sensation and perception; impairment of sight, hearing, or speech; and seizures. Other problems that may arise are difficulties in feeding, bladder and bowel control, problems with breathing because of postural difficulties, skin disorders because of pressure sores, and learning disabilities.
There are several types of CP:
- Spastic Cerebral Palsy: People with spastic CP have stiff and jerky movements because their muscles are too tight. Mobility and handgrip are difficult to control. This is the most common type of CP and affects half of all people with CP.
- Ataxic Cerebral Palsy: Low muscle tone and poor coordination of movements is described as ataxic. Shakiness or tremors make writing, page turning or using a keyboard difficult to perform. Poor balance and unsteady walking requires extra mental concentration or more time to complete the movements.
- Athetoid Cerebral Palsy: Athetoid refers to a type of CP involving mixed muscle tone, too high or too low. Random, involuntary movements result in movements of the face, arms and upper body. Walking, sitting upright and maintaining posture control takes extra work and concentration. About one fourth of people with CP have athetoid CP.
- Mixed Cerebral Palsy: When muscle tone is too low in some muscles and too high in other muscles, the type of CP is called mixed. About one fourth of all people with CP have this type .
Cerebral Palsy and the Americans with Disabilities Act
The ADA does not contain a definitive list of medical conditions that constitute disabilities. Instead, the ADA defines a person with a disability as someone who (1) has a physical or mental impairment that substantially limits one or more "major life activities," (2) has a record of such an impairment, or (3) is regarded as having such an impairment. For more information about how to determine whether a person has a disability under the ADA, see How to Determine Whether a Person Has a Disability under the Americans with Disabilities Act Amendments Act (ADAAA).
Accommodating Employees with Cerebral Palsy
People with cerebral palsy may develop some of the limitations discussed below, but seldom develop all of them. Also, the degree of limitation will vary among individuals. Be aware that not all people with cerebral palsy will need accommodations to perform their jobs and many others may only need a few accommodations. The following is only a sample of the possibilities available. Numerous other accommodation solutions may exist.
Questions to Consider:
- What limitations is the employee experiencing?
- How do these limitations affect the employee and the employee’s job performance?
- What specific job tasks are problematic as a result of these limitations?
- What accommodations are available to reduce or eliminate these problems? Are all possible resources being used to determine possible accommodations?
- Once accommodations are in place, would it be useful to meet with the employee to evaluate the effectiveness of the accommodations and to determine whether additional accommodations are needed?
- Do supervisory personnel and employees need training?
Situations and Solutions:
The following situations and solutions are real-life examples of accommodations that were made by JAN customers. Because accommodations are made on a case-by-case basis, these examples may not be effective for every workplace but give you an idea about the types of accommodations that are possible.
An accountant with cerebral palsy could not walk long distances.
His employer provided him with a reserved parking space close to the building and allowed him to work from home three days a week.
An office assistant with cerebral palsy had difficulty typing due to mild spasticity in her upper extremities.
Her employer purchased a keyguard to go over her keyboard to help her hit the right keys and forearm supports to help stabilize her arms.
A janitor with cerebral palsy and balance problems was having problems walking about the facility and safely climbing ladders to change light bulbs.
His employer provided him with a motorized cart and a rolling safety ladder.
A production worker with an intellectual impairment and cerebral palsy had difficulty grasping a plastic bottle to accurately apply an adhesive label.
JAN suggested making a wooden jig, which secured the bottle, thus allowing the employee to use both hands when applying the label.
A university employee with cerebral palsy used a speech generating communication device to meet her communication needs at work and elsewhere.
Her device worked well with her personal cellphone, but she needed a speakerphone in order to take calls on the office phone line. Due to workplace changes, she needed to start sharing an office with two coworkers. Her employer purchased an adapter for the device so that she could use her device with the telephone more discreetly.
A federal employee with cerebral palsy needed assistance with lunch, including getting food from the cafeteria and eating.
His employer provided a personal assistant for the employee’s entire lunch hour.
A teacher with cerebral palsy had difficulty manipulating papers and writing on the chalkboard.
She was provided a teacher’s aide to pick up and pass out student papers and an overhead projector to replace the chalkboard.