The Childrens Specialized Hospital

Recreational Therapy Program

Diagnostic Protocol
Diagnostic Grouping
Neurological Disorder: Disease of the brain, spine and the nerves that connect them.

Specific Diagnosis
Cerebral Palsy has been defined as:
A group of permanent disorders of the development of movement and posture,
causing activity limitation[s] that are attributed to non-progressive disturbances that
occurred in the developing fetal or infant brain. The motor disorders of cerebral palsy
are often accompanied by disturbances of sensation, perception, cognition,
communication and behavior, by epilepsy and by secondary musculoskeletal
problems.
(Rosenbaum el al, 2007)

Identified Problems (treatable by recreational therapy)

Physical
o muscle control, coordination and tone
o reflex
o posture
o balance
o fine and gross motor skills
Cognitive
o affected IQ
o difficulty communicating with others
Emotional
o difficulty processing emotional feelings
o anxiety and depression
o difficulty connecting emotionally with others
Social
o difficulty connecting emotionally with others

Related Factors
Motor Problems
o spasticity, athetosis and rigidity of muscles
o ataxia
o tremor
o motor development
Perceptual Problems
Behavior problems
o deviant propositionally
o catastrophic behavior
o perseveration
o behavioral rigidity
 o Initiatory delay
Emotional and Social Problems
o emotional lability
o anxiety and depression
Vocational Implications
Communication Implications
Learning Difficulties
(Mecham, 2002)

Etiologies
Cerebral Palsy can be caused in the prenatal, perinatal or postnatal
stages of development
o prenatal causes can be: radiation exposure, intrauterine infection, ingestion of
teratogenic drugs, chromosomal abnormalities
o perinatal are due to complications during birth
o postnatal causes can be: prematurity, asphyxia and sepsis
o Anoxia and Kernicterus are the main general causes of cerebral palsy
(Mecham, 2002)

Process Criteria
Self-Expression through Painting
Gardening with Buddies
Meditation in the Sunshine
Coping Skills
Leisure Education
Exercise Activities

Outcome Criteria
Client will improve ability to express feelings and emotions
Client will increase social interactions and improve in social skills
Client will increase knowledge of leisure opportunities and physical abilities
Client will increase sense of self
Client will increase ability to cope with stress, depression and/or anxiety
Client will improve in strength, flexibility and range of motion
Client will develop lifelong exercise habits and a desire to continue to exercise
Client will develop connection between leisure and exercise
Client will Improve ability to handle fatigue

C.Day TRS, CTRS (student)

18 October 2016
References
CerebralPalsy.org | Help, Resources for Children with CP. Retrieved October 04, 2016, from
http://www.cerebralpalsy.org/
Dodd, K., Imms, C., & Taylor, N. F. (2010). Physiotherapy and occupational therapy for
people with cerebral palsy: A problem-based approach to assessment and
management. London: Mac Keith Press.
Mecham, M. J. (2002). Cerebral Palsy. Austin, TX: PRO-ED.
Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., & Bax, M. (2006). The Definition and
Classification of Cerebral Palsy, NeoReviews, 7(11).