Psychological problems

Psychological Problems

Questions and Answers for parenting of adolescents with Cerebral Palsy By Dr. Ujjwal Nene, MA Clinical Psychology, Ph.D, KEM Hospital, Pune

Q.No.	Question	Answer
1	When a man has cerebral palsy, will he pass it to his children?	This is a very common question and the answer is No. Cerebral palsy is not a disease, but a condition that is not contagious in any form. A parent or parents who have cerebral palsy cannot pass it to their children.
2	I have an 11 year old child with cerebral palsy. The right side of his body is affected. He often gets very angry with himself. What can I do to help him?	There are several “types” of cerebral palsy and it seems that your son has “hemiplegia” meaning that one side of the brain is affected. Children can become very upset and confused when dealing with cerebral palsy. I would recommend that your child see a counsellor to help him understand what is going on in his life. This may help your son deal with his anger and frustration. Physical and occupational therapy are always helpful in patients with cerebral palsy.
3	What happens to these kids once they grow up as adults?	We must recognize that many, and possibly most, children with cerebral palsy can lead full, meaningful, and happy lives. The team of parents, caregivers, and health practitioners have the responsibility to help the child with cerebral palsy to achieve this goal
4	How to handle our adolescent teens with CP?	Adolescence is very crucial time for teens. In this age they have to learn how to make friends, to learn about his changing body and to learn about sexuality and responsibility. It is strongly suggested that resources in terms of social workers and psychologists working with adolescent should made available to them. Some good books that tell about a man’s and a woman’s body and how they change during adolescence can be used. Some encyclopaedia types of books — they tell about the parts of the body — particularly the parts that undergo change during the adolescent years are more helpful. The second type of book is the book that describes what it is like to be a teenager and live with all the changes of adolescence. This type of books are normally used by “high interest — low vocabulary” books, with many pictures and diagrams. What is important to know, however, is that sexuality and relationship skills are best learned in a group of individuals who have similar interest and ability.
5	How to handle issue of masturbation of teens with CP?	Parents should not punish the child for this act since it is natural need. Prohibiting masturbation can lead to further hostility and conflict in the family. The problem with masturbation is not the act itself but learning where and when it is appropriate. Hence, most important thing is to seek guidance from professionals so that child can learn appropriate way of action which is suitable for social and family structure. They can provide information and guidance on how to address this issue.
6	What are the side effects of masturbation? If boys with CP are involved in this act then how to control that?	It is very important to address this issue. There are no side effects of masturbation as far as health is concerned but if child is involving in this act due to boredom or isolation than the solutions should be found for those reasons.
7	Does cerebral palsy affect individual’s sexual desire or functioning level?	Generally speaking, cerebral palsy (CP) itself does not affect a person’s sexual desire or functioning level. CP can, however, limit a person’s ability to use particular sexual positions, give themselves or others pleasure in certain ways, and more. CP can also affect body- and self-image in ways that can cause people with CP to isolate themselves from sexual relationships.
8	Is hemiplegia or mild cerebral palsy can affect woman’s ability to give birth?	Clinical observations provide adequate evidence that patients with cerebral palsy have ability to have a normal pregnancy, labour, and delivery without any complications.
9	What about sexual needs and marriage of people who have cerebral palsy?	This is a very interesting question. In our society the expression of sexual urges especially if the person is disabled is not considered as need. Disability surpasses all other aspects of their personal life. Hence, it is left up to the individual to establish and develop sexually intimate relationships with others during the course of their lives. Acceptance or rejection of one as a lover (especially in the beginning) is unfortunately often connected to those images of attractiveness and functioning of an individual. Level of mobility and degree of disability also matters in case of marriage and establishing sexual relationship with the spouse.
9	Are there any effects of cerebral palsy on sexual desire and the ability to engage in sexual relations?	Having cerebral palsy has no physical effect on sexual desire. Genital arousal and erectile function are usually not directly affected. What may affect sexual desire for the person with cp. are the for the most part negative socio cultural attitudes toward sexuality and disability and the cultural ideals of attractiveness that currently hold sway.
10	Is it possible for a male with cerebral palsy not to achieve an erection until his mid-20’s?	Not much information is available regarding the incidence of erectile dysfunction and cerebral palsy. Cerebral palsy is a broad term used to describe a group of chronic disorders impairing control of movement that appear in the first few years of life and generally do not worsen over time. The disorders are caused by faulty development of or damage to motor areas in the brain that disrupts the brain’s ability to control movement and posture. Symptoms of cerebral palsy include difficulty with fine motor tasks (such as writing or using scissors), difficulty maintaining balance or walking, involuntary movements. The symptoms differ from person to person and may change over time. Because there is a wide variation in signs and symptoms of cerebral palsy patients, it is difficult to generalize how the disease may affect each individual.