Childhood Cerebral Palsy – the group of diseases concerned with motor disorders as the result of brain damage or dysfunction of certain brain centers – is usually acquired during the first years of life, at the time when the system of primary movement patterns is developing. Primary movements are genetically programmed for protection and survival, and also for the development of the conscious movement system. Developmentally their role is to support: – maturation of the nervous system (synaptogenesis, myelination, and brain plasticity) – brain function (cognitive development, emotional maturation) – sensory-motor integration. Dysfunctions of motor development and sensory-motor integration in the child with CP are a reflection of the type of neurological insult and the developmental stage of the infant/child when the neurological insult occurred.
The developmental stages can be divided into prenatal (in utero); natal (during the birth process); or postnatal (after birth but during the first years of life). Each developmental stage is vulnerable to specific neurological insults. Prenatal palsy can be caused by infection, toxicity in the fetus, or compromised health in the pregnant mother. Some primary motor patterns and reflexes, such as Trunk Extension, Automatic Gait, Grasp, Swallowing and Sucking develop in utero. Prenatal brain damage will cause poor expression of these reflexes and adversely impact the next stage of development. Natal palsy is generally caused by neurological insult during birth: a consequence of premature birth, sudden deliveries, narrow pelvis of the mother, use of forceps during birth, etc. Natal trauma can negatively affect the activation of primary motor patterns and reflexes characteristic of a normal successful birth. In such cases the expression of these genetic programs will be abnormal.
The primary movements and reflexes of childbirth, such as Head Righting, Perez, Tonic Labyrinthine (TLR) in extension, Bauer Crawling, Sequential Side Rotation, Spinning, and Sucking may be dysfunctional. Postnatal palsy is often caused by an infection with encephalitic symptoms. Other causes include childhood cranial injury, central nervous system injury, and poor systemic health. Infant motor patterns and reflexes will be stressed by postnatal CP, and may develop dysfunctionally or pathologically. Dynamic reflexes (e.g., Grasp, Hands Pulling, Automatic Gait, Sequential Side Rotation, Spinning); positional reflexes (e.g., Asymmetrical Tonic Neck Reflex [ATNR] Symmetrical Tonic Neck Reflex [STNR], Babkin Palmomental, Tonic Labyrinthine Reflex
