About Cerebral Palsy
Cerebral palsy is a group of lifelong conditions affecting movement, posture and coordination, caused by damage to the developing brain before, during or shortly after birth.
It is the most common physical disability in childhood. Cerebral palsy presents differently in every individual. Some children walk independently with minor difficulties, while others use wheelchairs or require full physical support. The Gross Motor Function Classification System (GMFCS) is used by clinicians to describe five levels of physical ability, from Level I (walks without limitations) to Level V (transported in a wheelchair in all settings).
Many pupils with cerebral palsy are cognitively able and succeed well in mainstream settings with appropriate adjustments. An Individual Healthcare Plan should be developed in partnership with parents and the child's multidisciplinary team, including physiotherapists, occupational therapists and speech and language therapists where involved.
How Cerebral Palsy May Present in School
The condition varies widely. Associated features may include:
- Difficulties with fine motor skills (writing, cutting, handling small objects)
- Difficulties with gross motor skills (walking, running, climbing stairs, sitting upright)
- Fatigue, as physical tasks require greater effort
- Speech and communication difficulties (dysarthria, limited oral control)
- Visual perception difficulties, including tracking and spatial awareness
- Hearing difficulties in some children
- Epilepsy (occurs in approximately 30% of children with cerebral palsy)
- Pain or discomfort, especially during growth periods
- Drooling or difficulties with eating and drinking
- Emotional and social challenges, including frustration and low self-esteem
Classroom and School Strategies
Physical Access and the Environment
- Conduct a thorough access audit of the school site
- Ensure ramps, lifts and accessible toilets are available and maintained
- Allow extra time for moving between lessons
- Position the pupil where they can see the teacher and the board clearly
- Provide appropriate seating and positioning equipment as recommended by the occupational therapist
- Ensure desks are at the correct height for wheelchair users
- Minimise clutter in corridors and classrooms to allow safe movement
- Consider a personal evacuation plan for emergency situations
Supporting Learning and Curriculum Access
- Offer alternatives to handwriting where needed, such as a laptop, tablet or voice recognition software
- Provide adapted equipment (e.g. pencil grips, sloping writing boards, adapted scissors)
- Allow extra time for tasks, especially those involving writing or practical work
- Break tasks into smaller steps and provide regular check-ins
- Use visual supports, graphic organisers and structured worksheets
- Pre-cut materials or provide pre-prepared resources for practical tasks
- Avoid time-pressured activities where possible
- Seat the pupil near the front, with good sightlines to the whiteboard
Communication Support
- Allow extra time for the pupil to respond verbally
- Do not finish sentences for the child; wait patiently
- Use augmentative and alternative communication (AAC) if recommended
- Check understanding regularly, as speech difficulties do not indicate cognitive difficulties
- Liaise with the speech and language therapist to implement targets
Physical Education and Activities
- Include the pupil in PE wherever possible with adapted activities
- Follow physiotherapy advice regarding exercises and positioning
- Consider alternative roles (e.g. referee, coach, scorer) when activities cannot be adapted
- Be mindful of fatigue; offer rest breaks as needed
- Ensure accessibility on school trips, including transport
Social and Emotional Wellbeing
- Promote independence and avoid overprotection
- Foster peer understanding and friendships
- Be aware that the child may feel frustrated by physical limitations
- Provide emotional support, particularly during transitions
- Involve the pupil in decisions about their support and adjustments
- Be sensitive to changes in physical ability, particularly during growth spurts
Further Information and Resources
Scope provides information, advice and support for disabled people and their families.
Cerebral Palsy UK offers resources and guidance specific to cerebral palsy.
NHS information on cerebral palsy provides accessible medical information.