CP Social Aspects

According to the assessment of UN experts the disabled persons constitute 10 per cent of the total population. This gives rise to a number of ethical, social and economic problems. It is one of the most important characteristics of the modern society: at what level could they be solved?

Problems of the handicapped persons from birth take special place among them while having both a local and a global, common to all mankind character. Handicapped children are the least protected group of invalids which is of specific nature. Depending on the time when impairments and restrictions of the vital activity have emerged they do not dispose of any social experience accumulated by the invalids disabled after 16 years of age.

Disability connected with an impairment of the musculoskeletal system is of appreciable importance in the structure of invalidism in all. Besides, it is the cerebral palsy (CP) that plays a leading role among disorders of such kind. In case of CP both affections of the musculoskeletal system of different severity degrees and a change in the work of the internal organs, and – this is of particular importance – intellectual and characterologic disturbances can be observed.

Combinations of disturbances in the motor system and intellect vary in case of different types CP. In case of spastic diplegia where the superior extremities suffer more than the inferior ones children are often able to serve themselves, to write, to acquire a number of practical skills. A satisfactory development of the verbal thinking and an unsatisfactory visual-figurative thinking are recorded. Many of these children are able to be at general schools. The hyperkinetic type of the disease is characterized by a triad: hyperkinesia, hearing loss, mental deficiency. The verbal thinking suffers most of all in connection with speech disturbances while the visual – figurative thinking remains intact. In case of the hemiparetic type with oligophrenia in the background (30 per cent of children suffer from this type) impairment of the language function and counting, and also mirror writing  are found.

The experimental psychological research carried out in the sphere of motivations with respect to CP children reveals a predominance of a motive of obeying adults’ orders. However, this inhibits forming their own active personal orientations. A clear tendency to developing a low level of pretensions of a CP child manifests itself which is combined with a selectively too high self-appraisal with respect to its own health, – and, perhaps, this is a defense mechanism alleviating a sense of inferiority. In case of cerebral palsy the motor impairment with a number of concomitant factors can cause developing pathological personality properties of a deficient type; the influence of some social factors accumulates inevitably on the rough organic pathology and has a psychotraumatic effect. There are the following factors to be referred:

1.      a feeling of the ill-disposed attitude from the part of the healthy children of the same age, and a sense of the excessive attention of the people surrounding a CP child;

2.      a syndrome of hospitalism, because a patient spends much time in a hospital or a sanatorium;

3.      living apart from mother or single-parent family (25 per cent of fathers leave their family);

4.      psychic traumatism, linked with treatment procedures (operations) because of inadequacy of a child’s hope of a quick recovery to the necessity of a long rehabilitation period;

5.      difficulties in the course of training because of paralyses, hyperkineses, spatial impairments;

6.      sensorial deprivation with frequently concomitant visual and hearing impairments;

7.      incorrect education as a result of supercare (which causes forming egocentricity, capriciousness, shyness, emotional immaturity).

In connection with a sense of inferiority psychogenic reactions arise in a child and – in case of hypercompensation – they are formed in two directions: passive-defensive and aggressive-defensive. When solving this problem some researchers turn to account of Jung’s concepts of extraversion and introversion. The introvert features: timidity, susceptibility to various fears, love for increased kindness which guarantees a sense of security – are characteristic of the children of spastic diplegia. The extravert traits, such as: sociability, easy excitability, emotional instability are characteristic of the children with hyperkineses.

Forming a personality in the children with psychic and motor impairments is going on under conditions of a limited vital space and sociability, and sometimes completely subject to outside aid while self-serving. Although the handicapped persons from birth, as a rule, possess a high interior receptiveness of attitudes and developed self-analysis which secure necessary prerequisites developing creative abilities, it is much more difficult for them than for other invalids to realize their capacity. The absence of conditions which are indispensable for forming and developing various abilities, purposefulness, activity, and vitality negatively influences upon forming skills of independence, adequate relations with people around, which are necessary for harmonious interaction between the environment and a human being’s internal world. This causes a lack of self-confidence and an inferiority complex, directs toward a consumer’s conscience and dependence, and so leads to the syndrome of social infantilism. As a result, the potential of a personality, and the expenses on social aid do not confer any benefit to the society in practice.

This presupposes the necessity of a special approach when diagnosing an invalidism from birth and formulating a global chain of rehabilitation. While the rehabilitation aim of the disabled persons who had normal childhood and lost their ability to work after they had become 16-18 years of age, is an integration into society, – as applied to handicapped children from birth the question should be about their adaptation.

The handicapped children from birth are in need of a permanent complex rehabilitation, uninterrupted social and psychological adaptation to life and society, social and legal protection, adapted to the natural habitat. One should create special conditions where independence and initiative indispensable for overcoming the hidden infantilism and realizing the potential abilities are forming and developing.