Spastic Cerebral Palsy, Cerebral atrophy, and PVL

Hi.

This is Jaya from India.  I would like somebody to give me advice who is a nuerologist or a pediatrician.  I would like to talk about my cousin's son who is 33 months of age who was diagnosed with spastic cerebral palsy, cerebral atrophy and PVL on an MRI.

He suffered seziures for two days after birth.  He did not cry immediately after birth.  He cried a little at 2 min and loud at 8 min duration after birth and he was given mouth-to-mouth resucitation.   Now at 33 months of age, he is not able to speak, but could utter 2-3 words.

He has right hand and right leg spasticity, strabismus, limping gait, and drooling.  Doctors in India said, he has slight mental retardation.      

Can u please tell me to what extent he is age-appropriate and to what extent he is not upto his age.  I feel that sometimes he is not abnormal, but he is not a normal child too.  The doctors in India say, he is not a normal child with regard to his development.  I am giving you few examples of his behaviour and after reading this, please guide me to what extent physio, occupational and speech therapy should be given.   We have taken him to physical,  speech and occupational therapy at the age of 18 months, but stopped now due to distance. He is not able to speak right now.  Will he be able to speak?   How can we teach him to speak.  

Coming to his behaviour at 33 months of age, he observes everything and does grasp things well.  He can recongnize people well with names and does follow 95% of the commnads well.  For example, if we ask him to close the door or open he does it.  if we ask him to bring anything he does it. He does know where the computer is, TV is etc and he tries to show how to operate them, he scrolls the mouse, types on the keyboard as he observes his father doing the same.  If there is any new change in the house, i mean change of curtains or sofa covers, he notices and if he likes it he shouts loud and laughs as a sign that he likes it. He does make signs to his mother for a bowel movement, but sometimes no control on bladder.  He does know to ask water and where his glass is and he goes there and gets water if mom is not available.  He does likes music very much and do have some favourite numbers and does dance well.  He is rather stubborn somtimes.  He just lies on the floor and cries and cries and just does not stop cyring till we pick him or do the thing what he wanted.  He even cries and shouts with agression and he wanted us to do the things what he likes.  He sometimes would threaten us that he is going to pull out phones or things in the house by sign language if we do not do the thing what he likes.  How to handle this situation?  How can we teach him?  He does not cooperate for physical therapy.  He does become restless sometimes and does not listen to what we say.  Does this kid has ADHD?.  He is trying to do things independently.  He wants to eat noodles with fork by himself, but he is unable to eat because of spastic right hand and if we do not give him the bowl he just starts crying lying on floor.  He tries to take bath while his mom is giving him bath, but he fails.  He wants to put buttons of his shirt he even cannot do that.  He majorly does not fear of anything like darkness or sounds.  He plays hide and seek, tires to ride his bycycle, but he cannot ride so he pushes it and drags it here and there.  He has very good grip strength of left hand. He cannot hold anything in right hand, if at all he can it is with great difficulty. He wants to place his toys in a particular area only.  He does not like the place to be changed, even if we change it, he places those toys at the former place.  He repeatdely does this.  If he is engaged in doing any task he seriously gets engaged into the task and we should repeatdly tell him or call him to get out of that activity.  He responds to his name when we call him.

Is it advisable for him to join in a regular play school or join him to a school for the learning disabled.  Does there any need to show him to a child psychologist?

Can u please tell me to what extent he is an abnormal child?

Thank you

Best Regards,
Jaya

[nastursim]

There is a great group on yahoo that give wonder advice and support as they are going through similar issues you  are facing. Here is the link, http://au.groups.yahoo.com/group/CPecialparents/. Cerebral Palsy is a common result of baby's who have PVL, although I am not a neuro, it does sound as though he may have some autistic behaviour, as they do become very engaged in things.
Physio and an OT assessment would be great for him as they can make suggestions to make tasks easier for him, and maybe provide some splints for his hand?? It is great that he has the motivation and is showing you he wants to do things, I believe that is a great sign. Does he do signing?? This is excellent if he does, the speech therapist told us to always say the words with the signs so they can pick up on them too.
Surround this little one with love and support and he will develop in his own time. Love to you and your family and I truly hope you find the therapy he needs in India.