Up to twenty-five percent of all Cerebral Palsy (CP) patients have behavioral problems. Cerebral palsy (CP) is a broad term used to describe a group of neurological disorders that affect movement, coordination, and muscle tone. The condition is caused by brain damage or abnormal brain development, often before, during, or shortly after birth. Most often as a result of medical malpractice. While CP is typically diagnosed in childhood, its impact persists into adulthood. As individuals with cerebral palsy grow older, they may face a wide range of challenges, both physical and behavioral.

While much attention has been given to the motor impairments associated with cerebral palsy, there is an increasing awareness of the behavioral issues that can affect adults with the condition. These problems are often overlooked or misunderstood, leading to inadequate support and intervention. Legal representation with The Oshman Firm is highly recommended as these individuals need the financial support to help build their support systems throughout development. 

In this article, we will explore the behavior problems that adults with cerebral palsy may experience, the underlying factors contributing to these issues, and potential strategies for managing and supporting those affected.

Understanding Cerebral Palsy in Adults

Cerebral palsy is a lifelong condition. The motor impairments typically caused by damage to the brain—such as muscle weakness, spasticity, and coordination issues—do not worsen over time. However, the way these impairments affect individuals can change as they grow older. While early childhood intervention, such as physical therapy and occupational therapy, can significantly improve mobility and motor skills, the transition to adulthood presents new challenges that are sometimes not fully addressed.

For many adults with cerebral palsy, the transition from school to the workforce or independent living brings a set of new expectations. These changes can put pressure on physical, social, and emotional well-being. As a result, behavior problems, emotional difficulties, and mental health challenges can arise.

Common Behavioral and Psychological Problems in Adults with Cerebral Palsy

Adults with cerebral palsy may experience a variety of behavioral issues, which can impact their quality of life and ability to function in society. While these challenges vary depending on the severity of the condition, the type of CP, and individual circumstances, there are several common problems that many adults with CP face:

1. Mental Health Disorders

One of the most common behavioral challenges faced by adults with cerebral palsy is mental health issues, particularly anxiety and depression. According to studies, individuals with CP are more likely to experience mental health disorders than the general population. The reasons for this are multifaceted:

• Social Isolation: Adults with CP may struggle with mobility issues, making it difficult for them to engage in social activities. This isolation can lead to feelings of loneliness and depression.
• Chronic Pain: Many adults with CP live with chronic pain, either from muscle spasticity, joint issues, or other physical impairments. Chronic pain is closely linked to mental health issues like depression and anxiety.
• Lack of Support: Transitioning from pediatric care to adult care can lead to gaps in support, as individuals with CP may not have access to the same level of therapy or assistance they received in childhood. This lack of a supportive environment can contribute to mental health struggles.

Symptoms of depression in adults with cerebral palsy may include a lack of interest in daily activities, difficulty concentrating, feelings of worthlessness, and changes in sleep or appetite. Anxiety can manifest as excessive worry, difficulty relaxing, or physical symptoms like a racing heart or shortness of breath.

2. Aggression and Impulsivity

Aggressive behavior or impulsive actions can sometimes emerge in adults with cerebral palsy, particularly if there are accompanying neurological issues or if the individual has difficulty with communication. Adults with CP who have difficulty expressing themselves or coping with frustration may resort to aggression as a form of expression. This can include verbal outbursts, physical aggression, or socially inappropriate behavior.

Impulsivity or aggression may also be linked to damage in areas of the brain that control impulse regulation, as CP often affects the brain’s motor cortex, basal ganglia, and other regions involved in emotional regulation.

3. Difficulty with Emotional Regulation

Emotional regulation—the ability to manage and respond to emotional experiences in a healthy way—can be challenging for adults with cerebral palsy. This issue can lead to:

• Mood swings: Fluctuations between irritability, frustration, or sadness may be more intense for some individuals.
• Frustration and low tolerance for stress: Due to the challenges faced by individuals with CP, such as mobility limitations, pain, or social stigma, emotional regulation can become difficult. Small setbacks may be experienced as significant sources of stress.
• Self-esteem issues: Adults with cerebral palsy may struggle with body image or self-worth, particularly if they feel stigmatized because of their disability. Low self-esteem can contribute to emotional dysregulation, leading to depressive symptoms or anger.

In many cases, the inability to express emotions effectively can further complicate social interactions, causing additional frustration and alienation.

4. Behavioral Changes Due to Cognitive Impairments

Some individuals with cerebral palsy experience cognitive impairments, including learning disabilities or intellectual disabilities, which can influence behavior. While CP is primarily a motor disorder, it can coexist with cognitive challenges in some individuals. Adults with CP may exhibit difficulties in:

• Problem-solving and decision-making: Cognitive impairments can make it harder to manage everyday tasks or make decisions independently, which can result in frustration or irritability.
• Attention and concentration: Difficulty focusing on tasks or following through with plans may cause individuals to appear disorganized or inattentive. This can lead to stress and poor performance in work or educational settings.
• Memory issues: Impairments in short-term or long-term memory can contribute to misunderstandings, social conflicts, or a sense of disconnection from others.

Cognitive impairments can contribute to a range of behavioral problems, especially when individuals are not provided with appropriate accommodations or strategies for coping.

5. Social Challenges and Behavioral Issues

Adults with cerebral palsy often face social challenges that can lead to behavior problems. These challenges include:

• Difficulty forming and maintaining relationships: Due to mobility issues, communication difficulties, or social stigma, some individuals with cerebral palsy struggle to build and sustain relationships with peers. This can lead to feelings of frustration and social withdrawal.
• Social anxiety: The fear of being judged or stigmatized because of physical limitations or visible disabilities can cause social anxiety, making it difficult for individuals to interact in public or social situations.
• Behavioral withdrawal: As a result of previous negative social experiences or the difficulty of managing emotional responses, some individuals may withdraw from social interactions entirely. They may choose to isolate themselves to avoid situations where they feel uncomfortable or inadequate.

Factors Contributing to Behavioral Problems in Adults with Cerebral Palsy

Several factors can contribute to the behavioral issues experienced by adults with cerebral palsy. These include:

1. Neurological Damage and Brain Injury

The root cause of cerebral palsy is brain damage or abnormal brain development. The areas of the brain affected can also play a role in behavior problems. Damage to the frontal lobe, basal ganglia, or other areas involved in motor control, cognition, and emotional regulation can lead to behavioral difficulties. Impairments in these areas can disrupt the ability to control impulses, regulate emotions, or interact with others socially.

2. Chronic Pain and Physical Discomfort

Adults with cerebral palsy often experience chronic pain due to muscle spasticity, joint deformities, or abnormal posture. Chronic pain can lead to irritability, depression, and aggression, especially when pain is not effectively managed.

3. Social and Environmental Factors

Social isolation, discrimination, or lack of access to support services can exacerbate behavioral problems in adults with CP. The inability to participate fully in social or professional activities may lead to frustration and depression. Furthermore, a lack of accessible healthcare and support services tailored to adults with CP can result in unmet needs, leading to further behavioral issues.

4. Transitioning to Adulthood

The transition from childhood to adulthood can be a particularly difficult period for individuals with cerebral palsy. The expectation to live independently, find employment, or pursue higher education can create stress and anxiety. Additionally, many adults with CP face limited options for accessible housing or transportation, which can further compound behavioral and emotional difficulties.

Strategies for Addressing Behavioral Issues

While behavior problems are common in adults with cerebral palsy, there are many strategies that can help manage these challenges:

1. Comprehensive Mental Health Support

Providing mental health support is essential for individuals with CP who experience depression, anxiety, or emotional regulation difficulties. Therapy options such as cognitive-behavioral therapy (CBT), counseling, or mindfulness techniques can help individuals learn to manage their emotions and develop coping strategies. Medication may also be appropriate for individuals with significant anxiety or depression.

2. Pain Management and Physical Therapy

Chronic pain management is critical for adults with cerebral palsy. Physical therapy, medications, or even surgical interventions may be necessary to manage pain and improve mobility. By addressing the physical discomfort that can contribute to behavioral problems, individuals may experience an improvement in their emotional well-being.

3. Social Skills Training and Support Networks

Social skills training can help individuals with CP improve their communication and interpersonal skills. Building support networks of friends, family, and peers with similar experiences can reduce social isolation and provide emotional support.

4. Individualized Care Plans

Each adult with cerebral palsy is unique, and their care plans should reflect their specific needs and challenges. Personalized strategies for managing cognitive impairments, emotional regulation, and social difficulties can help individuals lead fulfilling, independent lives.

Seek Support for Adults with Cerebral Palsy

Adults with cerebral palsy may experience a wide range of behavioral challenges, including mental health disorders, aggression, impulsivity, emotional dysregulation, and social difficulties. They are prone to high levels of alcohol/opioid-related disorders. These challenges are often overlooked, but they are critical to understanding the full impact of cerebral palsy on an individual’s life. 

The best chance for success is setting these individuals up with the financial means to have continued medical and social support throughout their lives. Seek out help with The Oshman Firm, so that the future of your loved ones is secured. 

 

Sources:

1. National Institute of Neurological Disorders and Stroke. “Cerebral Palsy Information Page.” National Institute of Neurological Disorders and Stroke, 19 Jul. 2024
2. Patel DR, Neelakantan M, Pandher K, Merrick J. Cerebral palsy in children: a clinical overview. Transl Pediatr. 2020 Feb;9 (Suppl 1):S125-S135. doi: 10.21037/tp.2020.01.01. PMID: 32206590; PMCID: PMC7082248.
3. Pizzighello S, Uliana M, Michielotto M, Pellegri A, Vascello MGF, Piccoli S, Martinuzzi M, Martinuzzi A. Psychiatric symptoms in adult patients with cerebral palsy: A cohort study. Front Neurol. 2022 Sep 27;13:998922. doi: 10.3389/fneur.2022.998922. PMID: 36247792; PMCID: PMC9553524.
4. Stavsky M, Mor O, Mastrolia SA, et al. Cerebral palsy-trends in epidemiology and recent development in prenatal mechanisms of disease, treatment, and prevention. Front Pediatr 2017;5:21. 10.3389/fped.2017.00021