Cerebral Palsy and Autism: Understanding difference between them

Though both Cerebral Palsy and Autism are developmental disorders seen in the paediatric age group, they are quite distinct considering their pathogenesis, treatment, and outcomes.

As parents and caregivers, it is important to understand the difference, to be able to give appropriate care and to seek help when needed from specialist doctors, support groups, special schools, psychologists, and physiotherapists.

Cerebral Palsy

The words cerebral palsy or (CP) may create an image of a wheelchair-bound child. But sometimes the disease is so mild it doesn't limit any activity at all. 

CP is a static, irreversible, non- progressive damage to the brain wherein the disability can be better managed, but not reversed. CP is caused by injuries or abnormalities of the brain. 

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Premature babies have a slightly higher risk of developing CP during early infancy as a result of several conditions, including bleeding in the brain, brain infections, head injuries, infections in the mother during pregnancy, or severe jaundice. 

CP can affect one limb, one side of the body, both arms and legs, three limbs, or all four limbs. The limbs might be floppy, rigid, or spastic. These limbs might even be completely unusable or function so well that most people would not notice. 

Children with CP may have a normal or superior intellect, though, a quarter of the children with CP may have developmental delays or mental retardation.

The goal of treatment is to help the child be as independent as possible and this usually needs a team of primary care doctors, dentists, social workers, nurses, specialists, and occupational, physical, and speech therapists. 

A variety of medicines can prevent or reduce the frequency of seizures, help with spasticity, and treat tremors but they need lifelong care.

Autism

Autism or ASD on the other hand is not a disease, but it is a condition in which the child’s learning of social interaction, social behaviour, and communication is impaired. There is also an innate tendency toward repetitive behaviours and restricted interests. If these deviancies are corrected early, then the child will have a good prognosis and can integrate well with society.

The increase in the diagnosis of children with ASD may be due to better recognition and newer definitions of ASD which now includes various subtypes of the disorder. Doctors can diagnose autism with one or more screening tests. 

These tests evaluate the child's ability to talk, move, and think. Because each child with autism is different, treatment is tailored to the child. Various remedial programs such as applied behavioural analysis can help kids learn the skills they need to be more independent. 

Sometimes, medicines can treat specific symptoms that are common in kids with autism, like aggression, hyperactivity, and trouble sleeping. Some kids with autism may respond well to gluten- or casein-free diets.

An element to know about in this spectrum of diseases is 'Specific learning disability'. It is a condition characterized by unexpected poor school performance of a child in spite of not having low intelligence quotient (IQ), neurological disorders, poor schooling or vision, and hearing problems. 

Therefore, the child struggles to acquire particular skills such as reading, writing, and calculations. Apart from these particular skills, the child is at par with his peers. 

Difficulty with reading, writing, and calculations result in poor academic performance, even though the child is quite competent, if judged on other aspects, for example, a child with dyslexia may be very good at computers or sports. 

It is important to keep in mind that stress and burnout among parents of children with CP, Autism and specific learning disability is common, so it is important to make sure that the parents get all the support they need.

The author is a consultant, paediatrics, Paediatric Haematology, Oncology & Stem Cell Transplantation; Kokilaben Dhirubhai Ambani Hospital, Mumbai

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