A PROVIDER'S GUIDE TO FOUR DISABILITIES

by Maureen T. Mulroy, Ph.D., Human Development Specialist
Cooperative Extension System, University of Connecticut

Unless you are a special education teacher or have had personal experience with the following disability conditions, you probably aren't very infomed about Cerebral Palsy, Seizure Disorders, Tourette's Syndrome and Attention Deficit Disorder. This chart provides some basic insight and understanding which can help you to welcome a child with these disabilities into your program.

QUESTIONS ABOUT CEREBRAL PALSY(CP) ABOUT SEIZURE DISORDERS(SD) ABOUT TOURETTE'S SYNDROME(TS) ABOUT ATTENTION DEFICIT DISORDER(ADD)

What is it? CP is a term for a number of disorders that affect a child's ability to move and to maintain posture and balance. A seizure is a temporary change in behavior resulting from sudden, abnormal bursts of electrical activity in the brain. TS is a physical disorder of the brain which causes involuntary movements (motor tics)and involuntary vocalizations (vocal tics). An attention deficit disorder is a neurological condition that makes it difficult for a child to focus his attention, control his impulses, and behave appropriately.

What causes it? CP is caused by a brain injury that occurs before, during or within the first few years after birth. The child's muscles and nerves are not damaged only the brain's ability to control them. There are many different causes of seizures including scars, a tumor, a loss of blood supply, certain toxins, or a lack of blood sugar or calcium. Environmental factors such as sleep deprivation and flickering lights can trigger seizures in someone who is genetically susceptible, e.g., epilipsy. Although the precise cause of Tourette syndrome has yet to be pinpointed, studies suggest that it is due to chemical abnormalities in the brain. It appears that tics are caused, in part, by an excess of or oversensitivity to the brain chemical dopamine. Researchers have speculated on the cause of ADD for many years without coming to a conclusion. Current thought is that ADD is caused by a chemical imbalance in the brain.

Are all children with this disability the same? No. Children with CP differ in a number of ways Some children's muscle tone is high so their movements will be stiff and awkward. Others have such low tone that they are floppy and unable to move or stay upright without help. No. Children with SD's differ in terms of whether they lose or maintain consciousness during a seizure, experience muscle rigidity, jerkiness, or loss of muscle control, stare or have unusual eye movements, or experience abnormal sensory sensations. No. Children with TS may have any combination of vocal and motor tics. In addition, their symptoms usually change over time as new ones appear, replacing or adding to old tics. There is also great variation among children in terms of intensity of tics. No. Some children have problems only with attention (ADD), while other children have the added problems of impulse control and hyperactivity (ADHD). The severity of the disorder varies from mild (few symptoms and litle or no problems in school or with peers)to severe.
Do these children have other problems? Depending upon the location and severity of the brain injury, a child with CP may have mental retardation, seizures, language disorders, learning disabilities, and vision and hearing problems. The brain damage that causes seizures may also cause other problems such as memory loss and learning disabilities. Incorrect medication doses or side effects may result in slower functioning, hyperactivity or an inability to concentrate. In addition to having tics, 50% have obsessive compulsive symptoms (OCD) and/or Attention Deficit Disorders. These children may also have problems controlling tantrums and aggressive behavior and in processing sensory information, and may have learning problems. Children with ADD/ADHD show delays in academic achievement and motor coordination. Depression, low self-esteem and poor peer acceptance are also more common in these children. They also have more allergies and accidental injuries.
How is it treated? The movement, posture and balance problems are best treated via physical and occupational therapy. If needed other specialists provide services. Most children with seizure disorders receive anti-convulsant medication daily. Some take meds several times a day. The goal is to eliminate seizures completely with a limited amount of medication. The treatment of choice for Tourette's is medications. The meds prescribed fall into three broad categories: anti-tics, anti-OCD and anti-ADD drugs. Ideally the child will be given the drug or group of drugs with the fewest side effects and the lowest possible dose. The treatments that appear to have the greatest effect are: use of stimulant medications, parent training in effective child management, classroom behavior modification, and training in self control and social skills.

QUESTIONS	ABOUT CEREBRAL PALSY(CP)	ABOUT SEIZURE DISORDERS(SD)	ABOUT TOURETTE'S SYNDROME(TS)	ABOUT ATTENTION DEFICIT DISORDER(ADD)
What is it?	CP is a term for a number of disorders that affect a child's ability to move and to maintain posture and balance.	A seizure is a temporary change in behavior resulting from sudden, abnormal bursts of electrical activity in the brain.	TS is a physical disorder of the brain which causes involuntary movements (motor tics)and involuntary vocalizations (vocal tics).	An attention deficit disorder is a neurological condition that makes it difficult for a child to focus his attention, control his impulses, and behave appropriately.
What causes it?	CP is caused by a brain injury that occurs before, during or within the first few years after birth. The child's muscles and nerves are not damaged only the brain's ability to control them.	There are many different causes of seizures including scars, a tumor, a loss of blood supply, certain toxins, or a lack of blood sugar or calcium. Environmental factors such as sleep deprivation and flickering lights can trigger seizures in someone who is genetically susceptible, e.g., epilipsy.	Although the precise cause of Tourette syndrome has yet to be pinpointed, studies suggest that it is due to chemical abnormalities in the brain. It appears that tics are caused, in part, by an excess of or oversensitivity to the brain chemical dopamine.	Researchers have speculated on the cause of ADD for many years without coming to a conclusion. Current thought is that ADD is caused by a chemical imbalance in the brain.
Are all children with this disability the same?	No. Children with CP differ in a number of ways Some children's muscle tone is high so their movements will be stiff and awkward. Others have such low tone that they are floppy and unable to move or stay upright without help.	No. Children with SD's differ in terms of whether they lose or maintain consciousness during a seizure, experience muscle rigidity, jerkiness, or loss of muscle control, stare or have unusual eye movements, or experience abnormal sensory sensations.	No. Children with TS may have any combination of vocal and motor tics. In addition, their symptoms usually change over time as new ones appear, replacing or adding to old tics. There is also great variation among children in terms of intensity of tics.	No. Some children have problems only with attention (ADD), while other children have the added problems of impulse control and hyperactivity (ADHD). The severity of the disorder varies from mild (few symptoms and litle or no problems in school or with peers)to severe.
Do these children have other problems?	Depending upon the location and severity of the brain injury, a child with CP may have mental retardation, seizures, language disorders, learning disabilities, and vision and hearing problems.	The brain damage that causes seizures may also cause other problems such as memory loss and learning disabilities. Incorrect medication doses or side effects may result in slower functioning, hyperactivity or an inability to concentrate.	In addition to having tics, 50% have obsessive compulsive symptoms (OCD) and/or Attention Deficit Disorders. These children may also have problems controlling tantrums and aggressive behavior and in processing sensory information, and may have learning problems.	Children with ADD/ADHD show delays in academic achievement and motor coordination. Depression, low self-esteem and poor peer acceptance are also more common in these children. They also have more allergies and accidental injuries.
How is it treated?	The movement, posture and balance problems are best treated via physical and occupational therapy. If needed other specialists provide services.	Most children with seizure disorders receive anti-convulsant medication daily. Some take meds several times a day. The goal is to eliminate seizures completely with a limited amount of medication.	The treatment of choice for Tourette's is medications. The meds prescribed fall into three broad categories: anti-tics, anti-OCD and anti-ADD drugs. Ideally the child will be given the drug or group of drugs with the fewest side effects and the lowest possible dose.	The treatments that appear to have the greatest effect are: use of stimulant medications, parent training in effective child management, classroom behavior modification, and training in self control and social skills.