Welcome
Start exploring here! We hope this will be a useful resource to help you find the information you need about cerebral palsy and other childhood-onset disabilities. We want to help you to find answers to your questions – so please let us know what else you would like us to cover. Here we are presenting videos, summaries, research information and other resources.
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Ways we can help
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Family-friendly Books
Discover our collection of family-friendly books featuring accessible, research-based insights. These titles include the perspectives of families and individuals with lived experience, offering valuable guidance while supporting parents on their journey.
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Free Chapters
We have selected a range of chapters from our books, offering helpful insights and practical tips. Our chapters summaries highlight key points. View the full chapter to explore each topic in more depth.
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The Knowledge Bank
Explore the answers to your questions here. Find out more about conditions, treatments, interventions, and all aspects of care. Follow signposts to find more in-depth, evidence-based information from Mac Keith Press content, as well as other great sources of knowledge.
4
Plain Language Summaries
Plain language summaries are an effective way of communicating scientific research to a wider audience. By presenting the key findings and significance of a study in easy-to-understand language, the content becomes more accessible to more people. Here we present summaries of papers published in Developmental Medicine & Child Neurology (DMCN).
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Helpful Videos
Here you will find a collection of short videos from authors and editors summarising their work. They cover Developmental Medicine & Child Neurology (DMCN) articles, Mac Keith Press books and e-learning. The aim of the videos is to help viewers get a clear understanding of why the research is important, how it was carried out, and real-world implications.
Gillette Children’s Healthcare Series
The goal of the Gillette Children’s Healthcare Series is to empower families through a greater understanding of their condition and therefore help optimize outcomes for children, adolescents and adults living with these childhood-acquired and largely lifelong conditions.
Scoliosis: Congenital, Neuromuscular, Syndromic and other Nonidiopathic Types
“I highly recommend this impactful book for families and professionals working in the field of scoliosis.”
Ann Marie Sutton, Parent of daughter with scoliosis, US
Click on ‘Buy Now’ to find out more!
Epilepsy
“Finally! A book that truly helps families understand epilepsy. As a mother of a special needs child with epilepsy, I found Epilepsy to be an invaluable resource. This book skillfully combines medical insights with heartfelt stories, addressing the real-life challenges families like ours face every day. … I wish I had this book at the beginning of my journey. It’s a must-read for any family navigating life with epilepsy.”
Colleen Peterson, parent of son with Wolf-Hirshhorn and Lennox-Gastaut syndromes, USA
Click on ‘Buy Now’ to find out more!
Spastic Diplegia
“This is an indispensable guidebook for navigating spastic diplegia, as it is written for families with the condition. It imparts a deep understanding of the medical science and treatment pathways, supported by comprehensive evidence-based references and information resources. The author’s generous sharing of her and her son’s journey, and those of many others, provides valuable sign-posting, hope, and inspiration for the reader.”
Jean and John Glynn, parents of a son with spastic diplegia, Ireland
Click on ‘Buy Now’ to find out more!
Spastic Hemiplegia
“As someone with right spastic hemiplegia, I was amazed by how much of the information was relevant to my memories of childhood therapy appointments and doctor visits. I deeply enjoyed reading the testimonies of those with CP, and I felt recognized inside their stories. From small things like official medical terminology to detailed explanations on why I was receiving certain treatments as a child, this book helped me not only recontextualize my own experiences but also prepared me to be a better medical advocate for myself moving into adulthood.”
Emmalynne Shumard, Student; Adult with spastic hemiplegia, US
Click on ‘Buy Now’ to find out more!
Spastic Quadriplegia
“This book presents clear and concise explanations and eliminates the confusion caused by misinformation online. It has helped me realize that we are not alone; there are other families just like ours experiencing the same highs and lows, joys and sorrows. It will provide comfort and hope to families striving to adjust to a new and oftentimes difficult diagnosis.”
Kristen Stier, Mother of a young adult with spastic quadriplegia, US
Click on ‘Buy Now’ to find out more!
Craniosynostosis
“This is an excellent and informative book that is both clear and factual. It serves as a valuable resource for families, providing them with essential knowledge about craniosynostosis and empowering them to engage confidently with medical and health professionals. The personal stories included offer hope and reassurance, reminding families that they are not alone in their journey. This is the book I wish I had when my son was diagnosed with sagittal craniosynostosis in 2019.”
Elaine L. Kinsella, Parent; Chartered Psychologist and Associate Professor in Psychology, University of Limerick, Ireland
Click on ‘Buy Now’ to find out more!
Idiopathic Scoliosis
“This book is great for anyone on this journey! Our daughter was diagnosed with juvenile idiopathic scoliosis right before she started kindergarten, and we were so worried and overwhelmed, and had so many questions. We wish we had this book during that time as it answers so many questions. We still have many questions and this book helps us pave a path today and for the future.”
Amber Marlatt, Parent of daughter with juvenile idiopathic scoliosis, US
Click on ‘Buy Now’ to find out more!
Free chapter downloads
Feeding and Nutritional Management Strategies
Nutrition and Neurodisability highlights managing feeding and nutrition in children with neurological impairments. Chapter 9 highlights how a multidisciplinary team approach can improve feeding safety and efficiency, addressing issues like dysphagia, poor nutrition, and gastrointestinal problems. Interventions include oral nutrition support, tube feeding, and caregiver training.
Personal experiences from a young person with visual impairment, Holly Tuke
This chapter is a personal account by Holly Tuke, a woman with retinopathy of prematurity, which caused blindness. Despite challenges with accessibility and independence, Holly excelled academically with support and assistive technology. Now a university graduate, she works in the charity sector and runs a successful blog, advocating for disability awareness.
Cerebral Palsy: Through the Eyes of Parents
Parents raising children with complex cerebral palsy (CP) face emotional, practical, and social challenges, including balancing caregiving with personal needs. Support from clinicians, fostering the child’s independence, and improving quality of life through recreational activities are essential. Long-term care planning and focusing on the child’s interests are also important.
Life with and for a Person with Down Syndrome
Families of children diagnosed with Down syndrome often face concerns about health, development, and support. It’s essential to deliver the diagnosis with care and provide accurate, up-to-date information. Early health assessments, addressing feeding challenges, and fostering development are key to helping children thrive, supported by love, encouragement, and healthcare guidance.
What is Cerebral Palsy?
‘Cerebral palsy (CP) describes a group of permanent disorders of the development
of movement and posture, causing activity limitation, 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 behaviour,
by epilepsy, and by secondary musculoskeletal problems.’ This is the official (2007) definition – read the full chapter to find out much more.
How to Promote a Physically Active Lifestyle Across the Lifespan
The Knowledge Bank
Explore the answers to your questions here. Find out more about conditions, treatments, interventions, and all aspects of care. Follow signposts to find more in-depth, evidence-based information from Mac Keith Press content, as well as other great sources of knowledge.
Will scoliosis get worse over time?
While not the only outcome, scoliosis can get worse over time, particularly if left untreated. Untreated severe idiopathic scoliosis will continue to progress which may negatively impact health and quality of life.
Will scoliosis get worse over time?
This answer is adapted from the Gillette Children’s Healthcare Series book on Idiopathic Scoliosis.
While not the only outcome, scoliosis can get worse over time, particularly if left untreated. Untreated severe idiopathic scoliosis will continue to progress which may negatively impact health and quality of life.
By utilizing tools such as X-ray imaging, physical examination, and assessments of skeletal maturity, healthcare professionals can identify key risk factors of curve progression such as:
- Curve size: As the size of the curve increases, the risk of progression also increases. Scoliosis curves greater than or equal to 50 degrees have the highest risk of progression. Thus, a curve of 50 degrees or greater is typically the threshold for recommending surgical intervention because it is believed that the benefits of surgery typically outweigh the risks.
- Curve location: Scoliosis curves located in the thoracic region of the spine have the highest risk of progression.
- Skeletal maturity: Children and adolescents who are still growing (skeletally immature) are more likely to have progression of their scoliosis curves than older adolescents who are near the end of their growth (skeletally mature).
- Early adolescence: Early adolescence is associated with an acceleration in the rate of growth, which is associated with an increased risk of curve progression.
A skilled spine care team can use these factors to make informed, individualized treatment decisions. With consistent follow-up, evidence-based care, and a shared decision-making approach, most individuals with idiopathic scoliosis can expect to lead healthy, active, and fulfilling lives, free from the negative impacts that unchecked progression might otherwise cause.
What are the main treatment options for scoliosis?
Treatment options for scoliosis can range from nonsurgical methods, such as observation with repeat X-rays, to surgical methods, such as spinal fusion.
What are the main treatment options for scoliosis?
This answer is adapted from the Gillette Children’s Healthcare Series book on Idiopathic Scoliosis.
Treatment options for scoliosis can range from nonsurgical methods, such as observation with repeat X-rays, to surgical methods, such as spinal fusion. Treatment options include the following:
- Observation: Regular spine X-rays and clinical exams with a spine specialist to monitor scoliosis curve for possible progression.
- Bracing: A spinal brace that applies corrective forces to the spine to slow or stop scoliosis curve progression.
- Casting: A full-torso cast (hardened plaster or fiberglass that must be cut off to remove) that applies corrective forces to the spine to improve the scoliosis curve (decrease the Cobb angle) or slow or stop scoliosis curve progression.
- Surgery: Surgery performed to prevent future progression and improve the scoliosis curve (decrease the Cobb angle). There are many types of scoliosis surgery. The most common type is spinal fusion, defined as fusing (joining together) two or more vertebrae in the spine; screws and metal rods are typically used to hold the spine in the straightened position and facilitate fusion between bones.
As the child grows, the risk of scoliosis progression may increase or decrease, resulting in treatment plans changing. It is common for an individual to undergo multiple treatment types over the course of their childhood and adolescence. For example, an individual may be observed for a period of time, then prescribed bracing treatment if their curve progresses.
The appropriate treatment chosen and the related goals depend primarily on individual patient goals and specific treatment indications. Indications include, but are not limited to, size of the curve, risk of curve progression, and skeletal maturity of the child.
Treatment indications and goals may vary at other hospitals and treatment centers. Surgical guidelines are general and depend on the surgery type and clinical practice continually evolves.
It is important to note that for most individuals, scoliosis cannot be “cured” (i.e., to achieve a Cobb angle less than 10 degrees). For some children with infantile idiopathic scoliosis, their curve may spontaneously resolve, or casting treatment can reduce the curve to less than 10 degrees, but that is the exception. The more common outcome and realistic goal is to have a small enough residual curve after treatment that will not adversely affect quality of life.
How effective is bracing at stopping curve progression in individual with idiopathic scoliosis?
In individuals with idiopathic scoliosis, two outcomes commonly used to measure bracing success are:
- Five degrees or less of curve progression during brace treatment
- Avoiding surgery (typically meaning that the Cobb angle does not progress to 50 degrees or more)
How effective is bracing at stopping curve progression in individual with idiopathic scoliosis?
This answer is adapted from the Gillette Children’s Healthcare Series book on Idiopathic Scoliosis.
In individuals with idiopathic scoliosis, two outcomes commonly used to measure bracing success are:
- Five degrees or less of curve progression during brace treatment
- Avoiding surgery (typically meaning that the Cobb angle does not progress to 50 degrees or more)
When a scoliosis curve progresses 6 degrees or more during brace treatment, or if surgery is recommended due to curve progression beyond 50 degrees, this may be called “treatment failure.” Successful bracing treatment in AIS is correlated with wear time. In a landmark multicenter, randomized controlled trial, two groups of individuals with AIS were studied: a full-time brace treatment group and an observation group that did not wear a brace. The brace treatment group was successful in preventing progression to 50 degrees 75 percent of the time compared to the observation group, which was successful only 42 percent of the time. Adolescents who wore the brace for more hours had a greater chance of success with brace treatment.
Although wear time is extremely important, the risk of treatment failure is not equal for all individuals with AIS, even with perfect adherence to the prescribed wear time. The following full-time brace failure risk factors have been identified for individuals with AIS:
- Poor adherence to prescribed full-time wear (less than 10 to 13 hours per day).
- Significant amount of growth remaining at the start of brace treatment (Risser 0, triradiate cartilage open). For example, individuals with open triradiate cartilage at baseline have a 30 percent greater risk of treatment failure than those with closed triradiate cartilage at baseline.
- Cobb angle greater than or equal to 40 degrees prior to reaching adolescent growth spurt. For example, individuals with a 40-degree curve at baseline had a 40 percent greater risk of treatment failure than individuals with a 25-degree curve at baseline.
- Poor correction of the scoliosis curve in the brace as seen on the first in-brace X-ray.
- Large amount of vertebral rotation (rotation of the spine in the axial plane).
- Curves in the thoracic region
- Osteopenia (a lower bone density than is typical for the individual’s age in the general population).
- Higher body mass index (BMI), which can make it difficult to achieve adequate brace fit and in-brace curve correction.
Knowing these risk factors, spine specialists choose appropriate candidates for brace treatment, meaning those who are most likely to benefit from wearing the brace. Clinical tools, such as risk calculators, can guide spine specialists, orthotists, individuals and their families in being able to assess the risk of progression by using their baseline characteristics. Together, they can decide if treatment with a brace is likely to be beneficial and therefore warranted.
How do we know if scoliosis surgery is necessary?
Surgery is generally only considered necessary for infantile idiopathic scoliosis when scoliosis curves progress to a severe degree that threatens spinal function, cardiopulmonary health, or quality of life.
How do we know if scoliosis surgery is necessary?
Surgery is generally only considered necessary for infantile idiopathic scoliosis when scoliosis curves progress to a severe degree that threatens spinal function, cardiopulmonary health, or quality of life. Depending on the individual, surgery may be recommended to decrease curve progression, improve the scoliosis curve (decrease the Cobb angle) while allowing continued spine and chest wall growth.
For Juvenile idiopathic scoliosis and adolescent idiopathic scoliosis surgical treatment may be considered necessary if the Cobb angle reaches or exceeds 45–50 degrees, especially if the curve continues to progress and is having a negative impact on the child’s health and quality of life.
This answer is adapted from the Gillette Children’s Healthcare Series book on Idiopathic Scoliosis.
Surgery is also typically considered when non-surgical treatments fail to stabilize the curve or when there is a high risk of further deterioration that would impact long-term health and function. The decision is made by a spine specialist using clinical evaluation, imaging (such as X-rays), and patient-specific factors like age, skeletal maturity, and curve pattern.
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Plain Language Summaries
Plain language summaries are an effective way of communicating scientific research to a wider audience. By presenting the key findings and significance of a study in easy-to-understand language, the content becomes more accessible to individuals with disabilities, parents, caregivers, and others. Here we present summaries of papers published in Developmental Medicine & Child Neurology (DMCN).
Sleep problems in children with cerebral palsy and their parents
The study found that sleep problems are common in children with cerebral palsy (CP) aged 0 to 11 years. The most common problems reported by parents were: daytime fatigue, difficulty falling asleep, and early-morning waking. Children with CP were also more likely to have sleep problems than typically developing children, and children with CP who cannot walk were more severely affected by sleep problems than children with CP who can walk.
Quality of life in caregivers of a child with a developmental and epileptic encephalopathy
Developmental and epileptic encephalopathies (DEEs) are severe forms of epilepsy that usually start during infancy. There are many types of DEE, making each specific diagnosis extremely rare. Children with a DEE typically have seizures that are hard to treat and that impact their development and learning. Other symptoms may include feeding difficulties, movement problems, and features on the autism spectrum.
Experiences of children and adolescents with attention-deficit/hyperactivity disorder taking methylphenidate
Understanding the experiences of adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD) and taking ritalin and other stimulant medication is crucial in order to improve medical counselling to them. A central theme in these experiences is adolescents’ self-esteem and their sense of control on their body and life.
Epilepsy and cannabis: so near, yet so far
In 2018, the UK government changed the law so that cannabis-based medicines could legally be prescribed. Since then, very few prescriptions have been issued. Why is this?
Some children with epilepsy have seizures that respond very poorly to standard medications and their quality of life suffers. CBMPs may have an important role in helping those children. There are many forms of CBMPs and one medicine, cannabidiol, now has a license for some rare types of epilepsy.
Child-led goal setting and evaluation tools for children with a disability: A scoping review
Children with disabilities and delays benefit from being involved in setting and evaluating intervention goals. When goals hold personal value for children, they can feel more motivated to work towards them, which can improve their intervention outcomes. However, in current practice, parents or therapists are most often the primary decision-makers about intervention priorities. Which practices support allied health professionals to involve children with disabilities in goal setting and evaluation?
‘Power in Mobility’: Parent and therapist perspectives of the experiences of children learning to use powered mobility
This study focuses on the importance of mobility for children with mobility impairments and the impact of using powered mobility devices on their development and participation. To gather data, interviews with parents and therapists of children who had recently started using powered mobility devices were analyzed to identify common themes and gain insights into the experiences and perceptions of parents and therapists.
Survival of individuals with cerebral palsy: A Victorian longitudinal cohort study spanning four decades
The aim of this research was to provide an updated description of the death rates, trends in death rates over time, and predictors of deaths of persons with cerebral palsy (CP) who were born in the Australian state of Victoria between 1970 and 2012. The authors found that improvements in survival for those born in the 2000s was likely mainly related to a proportional reduction in complex CP, a finding that is supported by other studies.
Letting Tourette’s be: The importance of understanding lived experience in research and the clinic
Tourette syndrome is a neurodevelopmental condition characterized by involuntary movements and sounds that are known as tics. Historically, the focus of biomedical and clinical research and treatment has been on reducing these tics, viewing them primarily as symptoms of a neurological disorder. However, in this article we argue that this approach is too narrow as it does not adequately consider the lived experiences of Tourettic individuals.
UK research priority setting for childhood neurological conditions
In this project, the researchers wanted to find the most important unanswered questions about treatments, or therapies for children and young people with childhood neurological conditions such as epilepsies, cerebral palsy, and many rare conditions. This is called a Priority Setting Partnership. Priority Setting Partnerships aim to help patients, carers, and health professionals work together to agree research priorities. After two rounds of surveys, the top 10 priorities were identified.
Environment-based approaches to improve participation of young people with physical disabilities during COVID-19
Personalized interventions to enhance participation in meaningful activities in everyday environments are recommended for young people with physical disabilities. Pathways and Resources for Engagement and Participation (PREP) is one such intervention, focusing on changing the environment (e.g. inaccessibility, limited social support, lack of availability of programs) and coaching young people/parents and community members on removing environmental barriers.
Magic-themed motor training for daily bimanual task performance in children with unilateral spastic cerebral palsy: A systematic review and meta-analysis
Unilateral spastic cerebral palsy (CP) is a disorder of motor and postural development caused by early brain injury. This impairment poses significant challenges for daily physical tasks such as getting dressed, taking a shower, cutting food, etc. The authors of this study undertook a systematic literature review to discover what research has taken place on the effectiveness of magic-themed interventions in improving task performance in both hands in children with unilateral spastic CP.
Helpful videos
Here you will find a collection of short videos from authors and editors summarising their work. They cover Developmental Medicine & Child Neurology (DMCN) articles, Mac Keith Press books and e-learning. The aim of the videos is to help viewers get a clear understanding of why the research is important, how it was carried out, and real-world implications.
UK research priority setting for childhood neurological conditions| Jill Cadwgan & Rhys Inward |DMCN
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