Cerebral Palsy

What is 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 child’s ability to control their muscles. It is the most common form of physical disability in childhood. A child with cerebral palsy may face challenges with muscle weakness, stiffness, slowness and/or shakiness of movement. Balance, coordination and walking can be challenging.

Every child with cerebral palsy will show different strengths and challenges. For example, some kids may only have limitations with motor control on one side of their body, while others will have challenges controlling both sides. If muscles in the face, mouth, and throat are impacted by cerebral palsy, kids 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 or pictures).

Kids with cerebral palsy may have challenges across other areas, for example, they may have hearing or vision problems. Children may have difficulties with their vision and it may impact their ability to see things clearly, their eye movements may be slow or less controlled, and they may not pick up moving objects as quickly as other children. Some kids with cerebral palsy may have intellectual disability or learning disorders, which impact the way they think, learn and understand. It is important to get to know each child with cerebral palsy, so you know how best to include them in footy.

About 1/3 of kids with cerebral palsy also have epilepsy, which means that they have reoccuring seizures. Just like cerebral palsy, epilepsy includes many different types and it affects people in different ways. For some kids, a seizure will mean that they stare blankly or look as if they are daydreaming for a period of time; for other kids, a seizure may involve stiffness or jerking movements. Some kids will benefit from medication, which means that seizures may be rare. Parents know their children best – if a child in your team has epilepsy, ask the parents about how you can recognise a seizure and what to do if this happens at footy.

What might be some challenges on the footy field?

  • Kids with cerebral palsy will differ in how much their movement is impacted. Some kids will walk independently, while other kids will use mobility aids (e.g. a walking frame or a wheelchair).
  • Coordination of movement for sport may be very challenging.
  • Kids with cerebral palsy who have challenges with talking may have different ways of communicating, such as by using computer technology (e.g. iPads), pictures or gestures.

Quick tips

Each child with cerebral palsy will show different areas of strengths and challenges. The most common area of challenge involves motor skills and mobility. See the Coach Tips for Mobility and Motor. Kids with cerebral palsy may also have challenges in the areas of Hearing, Vision, Cognition, Communication, Attention, Learning and Memory, and Behaviour. See the ‘Coach Tips’ for these areas.

General principles

  • Parents know their child best: No matter how much you know about a particular disability, parents know their child the best. It’s always a good idea to talk to parents to find out the best way to communicate and work with their child. Parents can help you understand a child’s unique strengths and areas they need more help.Before starting to coach the child you could ask questions like: What activities does your child enjoy the most? Are there any things they find particularly challenging? Are there things I can do to support his/her participation as much as possible? Are there situations that he/she finds stressful? Are there things that I can do to help your child understand or learn a new skill? What is the best way to communicate?
  • Change the activity, not the child: If a child is struggling with an activity don’t attribute the problem to the child, instead attribute it to the strategy. E.g. ‘You seem to have difficulty doing this drill. I think we chose the wrong size target to use, let’s try it with a larger target.’
  • Allow alternate ways to play: If a child with coordination difficulties can’t kick a drop punt, allow them to kick the ball off the ground, or practice kicking it off a stand.
  • Allow more time to learn skills: Some kids might not be able to kick, catch or run as well as other kids and may need more time than others to learn these skills.
  • Change the rules so everyone can play: Make changes to the rules where appropriate so everyone can play. For example, in wheelchair tennis the ball can bounce twice before being hit. Hand balling drills might be difficult for children with stiffness in their arms, so you may allow them to use 2 hands or to throw the ball.
  • Make eye contact at the kids level: Think about how to have good eye contact for kids who may sit at a lower height (e.g. in a wheelchair). You can kneel down or sit on a bench. Check that you have the child’s attention before giving instructions.
  • Let parents or siblings help: Parents and siblings know the child best. They might be able to help get them more involved and feel safe to play.
  • Consider different roles: Game play may sometimes be difficult for some kids. They might prefer to do another role (e.g. umpire) or activity.
  • Give kids time: Allow time to let kids reply or comment as language production can be halting. Don’t rush them as they may take more time to get going and complete an activity. Remember to praise and reward every effort!

Consider the environment

  • Consider the surface for kids who use wheelchair: When the oval is too muddy or not appropriate for wheelchair access consider running the session or activities using an alternate surface like the car park or clubrooms so that kids who use wheelchairs can play too.
  • Consider playing indoors in bad weather: Bad weather (rain, storm, too hot, too cold) might make it hard for some kids to play outside. Consider finding a place indoors like the clubroom to run sessions.

Consider the activity and equipment

  • Modify activities so everyone can play: Adapt the size of the target or the distance the child is from it. For example, you can use a bigger target for handball drills or allow the child to be closer to the target.
  • Modify equipment so everyone can play: Consider using a different type of ball such as a soccer ball, bean bag, balloon, tennis ball or beach ball rather than an AFL football depending on the activity.
  • Kids with motor problems and/or kids who use wheelchairs can carry the ball: If a child with coordination difficulties has problems kicking or handballing consider allowing them to carry the ball between two points. Similarly, allow children who use wheelchairs to carry the ball between two points instead of kicking it.
  • Even out the playing field: Consider having one person in a wheelchair on the team opposite to the child in a wheelchair to equal out the playing field. This can give all kids an opportunity to get a true sense of what it’s like to have a physical disability.
  • Be aware and recognise the signs of fatigue: Some children will get tired more quickly. Signs that kids need a break include them slowing down, looking tired, having difficulty catching their breath, or showing signs of frustration.
  • Shorten activities: Shortening activities can help limit fatigue. The length of an activity may need to be tailored to the individual child.
  • Give frequent breaks: Giving frequent, short breaks gives children time to recover. Multiple short breaks can be more helpful than less frequent longer breaks. Provide a chair or a bench for children to sit on to catch their breath.

Things to consider

Sometimes people may assume that kids with physical disabilities have difficulties with thinking and understanding. This is often not the case. Similarly, just because a child faces challenges with talking or communicating does not mean they are not smart or that they have difficulties with thinking or learning. As a coach, learning how to communicate most effectively with a child with talking or communication challenges is important so that they have every opportunity to participate and have fun. Coaches should speak with the child’s parents or guardians if they are unsure about how much they say is being understood.

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