Spastic cerebral palsy: the most common form of cerebral palsy, it accounts for 70%–80% of cases. It results from injury to the upper motor neurons of the pyramidal tract. It may occasionally be bilateral. It is characterized by at least two of the following: abnormal movement pattern, increased tone, or pathologic reflexes (e.g., Babinski response, hyperreflexia).
Dyskinetic cerebral palsy: occurs in 10%–15% of cases. It is dominated by abnormal patterns of movement and involuntary, uncontrolled, recurring movements.
Ataxic cerebral palsy: accounts for <5% of cases. This form results from cerebellar injury and features abnormal posture or movement and loss of orderly muscle coordination or both.
Dystonic cerebral palsy: also uncommon. It is characterized by reduced activity and stiff movement (hypokinesia) and hypotonia.
Choreoathetotic cerebral palsy: rare now that excessive hyperbilirubinemia is aggressively prevented and treated. This form is dominated by increased and stormy movements (hyperkinesia) and hypotonia.
Mixed cerebral palsy: accounts for 10%–15% of cases. This term is used when more than one type of motor pattern is present and when one pattern does not clearly dominate another. It typically is associated with more complications, including sensory deficits, seizures, and cognitive-perceptual impairments.
educational attainment. CP cannot be cured, but a host of interventions can improve functional abilities, participation in society, and quality of life. Like all children, an assessment and reinforcement of strengths are important, especially for intellectually intact or gifted children who have simple motor deficits.
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Infant crying, a sign of pain, distress, hunger, or fatigue, is interpreted by caregivers according to the context of the crying. The cry just after birth heralds the infant’s health and vigor. The screams of the same infant, 6 weeks later, may be interpreted as a sign of illness, difficult temperament, or poor parenting. Crying is a manifestation of infant arousal influenced by the environment and interpreted through the lens of the family, social, and cultural context.
Crying is best understood by the characteristics of timing, duration, frequency, intensity, and modifiability of the cry (Fig. 11-1). Most infants cry little during the first 2 weeks of life, gradually increasing to 3 hours per day by 6 weeks and decreasing to 1 hour per day by 12 weeks.