7 Ways to Discipline a Child With Cerebral Palsy

About 40 percent of children with cerebral palsy exhibit behavior problems. And while types of behavior problems vary, there are some specific ways to discipline a child with cerebral palsy that can improve behavior.

Behavior Problems Associated With Cerebral Palsy

Cerebral palsy refers to a group of neurological disorders that permanently affect muscle coordination. It’s caused by damage or abnormalities inside the brain that disrupt the ability to control movement and maintain posture and balance.

Cerebral palsy may result when the cerebral motor cortex doesn’t develop normally in utero. At other times, cerebral palsy stems from damage that results to the brain either before, during, or after birth. The damage is not repairable and the resulting impairments are permanent.

Research shows children with cerebral palsy are more likely to experience behavior problems such as:

  • Peer problems – Cerebral palsy can lead to speech difficulties and trouble communicating, which can contribute to difficulties relating to peers. Additionally, children with cerebral palsy may have trouble keeping up with their peers physically, which can affect socialization. Consequently, some children with cerebral palsy struggle to get along with their peers.
  • Emotional symptoms – Children with cerebral palsy may have increased difficulty regulating their emotions. Outbursts, temper tantrums, and trouble completing tasks may be common.
  • Hyperactivity – Approximately 20 percent of children with cerebral palsy are estimated to have ADHD.  But even those who don’t meet the criteria for ADHD are often hyperactive.
  • Conduct problems – Children with cerebral palsy may be more argumentative, defiant, or non-compliant than other children.

Effective Discipline Strategies for Children With Cerebral Palsy

Behavior problems may stem from impairments related to cerebral palsy. Some children experience chronic pain, which can affect their mood and their behavior.  The associated learning disabilities and speech difficulties may also play a role in behavior problems.

Children with cerebral palsy are also more likely to have sleep difficulties. Sleep-deprivation is linked to increased behavior problems in children.

Kids with cerebral palsy may feel frustrated because of their motor limitations. Trying to complete their activities of daily living may leave them exhausted.

It’s important to take the factors that contribute to behavior problems into consideration when establishing a discipline plan for a child with special needs. Here are seven effective discipline strategies that can improve behavior problems in children with cerebral palsy:

1
Teach Social Skills

The impairments associated with cerebral palsy may lead to specific behavior problems.
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The physical limitations caused by cerebral palsy may cause children to feel isolated and lonely. Consequently, your child may struggle to get along with other kids.

Teaching your child specific social skills can reduce conflict with peers. Teach her how to resolve conflict, solve problems, and cooperate. Role play how to be a good friend and how to speak up for herself.

Look for opportunities to get your child involved in playgroups or support groups to increase her opportunities to interact. A behavioral therapist may be able to assist your child in learning social skills as well.

2
Provide Outlets for Your Child's Energy

A child with cerebral palsy may not be able to run around at recess or get his wiggles out in gym class like the other kids. So it can be especially frustrating for a child with cerebral palsy to be hyperactive.

Look for positive ways to channel your child’s energy. Whether he can ride an adaptive bicycle, or he can participate in a swim class, sign your child up for activities that will help him exercise.

3
Teach Emotional Regulation Skills

Rather than punish your child for emotional outbursts, turn tough times into teachable moments. Teach him how to recognize when he’s getting frustrated so he can take a break before he has a meltdown. Similarly, teach him strategies to soothe himself when he’s anxious or sad.

When he’s calm, ask questions, like, “What can you do instead of hitting to show me you’re angry?” Problem-solve together and identify healthy ways for your child to communicate his feelings.

4
Praise Good Behavior

It’s important to catch your child being good. Praise will reinforce positive behavior and encourage her to keep up the good work.

Praise her for trying hard or for trying something new. Point out times when she’s stayed calm or when she’s used her new skills. She’ll be more willing to keep working when she knows you’re paying close attention to her efforts.

5
Establish a Reward System

Target specific behavior problems with a reward system. Young children may respond well to a sticker chart that simply shows them their progress.

Older children may need tangible rewards. A daily reward system that links your child’s good behavior to privileges, such as electronics, could serve as a motivator.

A token economy system can also be an effective way to keep kids on track. Just make sure to keep the reward system simple and provide a variety of rewards that serve as good incentives.

6
Follow Through With Consistent Consequences

Negative consequences will teach your child to make better choices in the future. But it’s important for those consequences to be consistent.

Logical consequences—those that are directly related to the misbehavior—can be most effective. So if your child throws his handheld video game, take away his electronics for a specified period of time. When your child has clear rules and consequences, he’ll be more likely to follow the rules.

7
Offer Choices

Often, children with cerebral palsy lack control over many things in their lives—including their ability to move their bodies. Giving your child a little bit of control over small decisions can help her feel empowered.

Giving her choices sometimes can help reduce defiance and oppositional behavior. So rather than insist she eat her carrots, ask, “Do you want carrots or peas with your chicken?” Or, ask, “Do you want to do your math homework before or after you eat dinner?” Offering simple little choices can reduce power struggles and increase your child’s sense of autonomy.

Choosing the Best Discipline Strategies for Your Child

The discipline strategies you choose should depend on your child’s abilities. What works well for one child may not work with another.

Getting support for yourself when raising a child with cerebral palsy is important too. The associated stress many parents feel when parenting a child with special needs can affect a child’s behavior. If you’re feeling stressed, consider attending a support group or seek help from a mental health professional.

It’s also important to work with other professionals and caregivers on addressing your child’s needs. Speech therapists, special education teachers, behavioral therapists, physical therapists, and physicians are just a few of the providers who can assist you in finding the best discipline strategies for your child.

Sources:

Brossard-Racine M, Hall N, Majnemer A, Shevell M, Law M, Poulin C, Rosenbaum P. Behavioral problems in school age children with cerebral palsy. European Journal of Pediatric Neurology. 2012;16(1):35-41.

Colver A. Why are children with cerebral palsy more likely to have emotional and behavioral difficulties? Developmental Medicine & Child Neurology. 2010;52(11):986-986.

Rackauskaite G, Bilenberg N, Bech BH, Uldall P, Østergaard JR. Screening for psychopathology in a national cohort of 8- to 15-year-old children with cerebral palsy. Research in Developmental Disabilities. 2016;49-50:171-180. 

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