Cerebral palsy and occupational therapy: building everyday independence

Cerebral palsy (CP) is a non-progressive neurological condition resulting from injury to the developing brain before, during, or after birth. It can involve differences in muscle tone, posture, movement, balance and coordination, sensory processing, and sometimes communication or cognition — in varying combinations and degrees.

How CP is classified

CP is usually classified by the type of movement difference, the parts of the body affected, or the degree of functional limitation. Classification helps describe a child's level of independence and choose the most appropriate support.

• Spastic type — increased tone, brisk reflexes, slow and effortful voluntary movement (can affect both legs, all four limbs, or one side)
• Dyskinetic type — fluctuating, involuntary movements that reduce the quality of voluntary movement
• Ataxic type — weak head, trunk and pelvis stability, with unsteady balance and gait

Early signs can appear by age

• Around 3 months: arching of the head and heels when on the back; no social smile
• Around 4 months: no head control; persistently fisted hands; squint
• Around 8 months: not rolling or sitting; not using the hands well; legs stiff or crossing
• Around 1 year: not walking with support; tip-toe or scissoring gait

How occupational therapy helps

Within the multidisciplinary team, occupational therapists focus on helping a child take part in everyday activities and roles, increasing independence and quality of life. The approach is person-centred and individualised, looking at the child's strengths as well as their challenges.

• Fine and gross motor skills through tailored activities and play
• Daily-living skills — eating, dressing, toileting, self-care
• Sensory processing and sensory-integration support
• Visual-motor and handwriting skills (posture, tool use, visual perception, attention)
• Adaptive equipment and home/school environment adjustments
• Family education and emotional and social support

As function improves through physical and sensory work, children often gain confidence — which in turn supports social participation and a more active, goal-directed daily life.