90 chapter 9
3. POOR BALANCE OR ‘ATAXIA’
The child who has ‘ataxia’, or poor balance, has difficulty beginning to sit and stand.
She falls often, and has very clumsy use of her hands. All this is normal in small
children, but in the child with ataxia it is a bigger problem and lasts longer (sometimes
for life).
Because children who have mainly a balance problem often appear more clumsy than
disabled, other children are sometimes cruel and make fun of them.
TEST FOR ATAXIA:
To keep her balance the child with ataxia walks bent
forward with feet wide apart. She takes irregular
steps, like a sailor on a rough sea or someone who
is drunk.
Hold a finger or a toy in front of
the child and ask him to touch
it on the first try. The child with
ataxia cannot do it.
Many children who have spasticity or athetosis also have problems with balance.
This may be a major obstacle in learning to walk. However, much can often be done
to help a child improve her balance.
NOTE: Children with any type of cerebral palsy as babies are often
mainly limp or floppy. Stiffness or uncontrolled movements begin little
by little. Or the child may be limp in some positions and stiff in others.
Parts of the body affected
DEPENDING ON WHICH LIMBS ARE INVOLVED, THERE ARE 3 TYPICAL PATTERNS:
arm bent;
hand
spastic
or floppy,
often of
little use
ARM AND LEG
ON ONE SIDE
(HEMIPLEGIC)
BOTH LEGS ONLY
(PARAPLEGIC) or
with slight
involvement elsewhere
(DIPLEGIC)
this side
completely
or almost
normal
upper body
usually
normal or
with very
minor signs
BOTH ARMS AND
BOTH LEGS
(QUADRIPLEGIC)
She walks
on tiptoe
or outside
of foot on
affected
side.
Child may
develop
contractures
of ankles
and feet.
When he walks,
his arms, head, and
even his mouth may
twist strangely.
Children with all 4
limbs affected often
have such severe
brain damage that
they never are able
to walk.
The knees press
together.
legs and feet
turned inward
Although most cerebral palsy children fit one or another of these patterns, check also
for minor problems in other parts of the body.
Disabled village Children