“The fragility of people with cerebral palsy puts them at risk of sexual abuse and it is therefore important to make them aware of this to prevent future problems.”
On the occasion of the World Cerebral Palsy Day from different institutions the focus is put on sexuality and affectivity of people with cerebral palsy, on the right to privacy of people with disabilities.
Dr. Manuel Antonio Fernández Fernández, Neuropediatrician, explains clearly what it means that a person suffers from cerebral palsy and why it is so important their education in sexual and affective matters.
To begin with and to clarify a fundamental concept, what is meant by cerebral palsy?
When we hear the term cerebral palsy, we may be used to thinking of a child in a wheelchair who can’t speak and can barely move. Beyond that, you may not be very clear on what cerebral palsy is or you may even think that someone with cerebral palsy has mental problems, but that is not the case. Cerebral palsy is a neurological disease of varying origin in which brain lesions occur that alter the body’s ability to regulate posture and muscle strength.
From this basic definition of cerebral palsy, we can find other more or less detailed variants, but the key to the picture is in the location and characteristics of the brain lesions causing the main symptoms of it.
Currently, the most frequent cause of infantile cerebral palsy is neonatal hypoxic-ischemic encephalopathy. This means that most cerebral palsies are due to problems related to pregnancy or childbirth.
Focusing on neonatal hypoxia, the main origin of cerebral palsy is a lack of blood flow to the brain. This results in not getting the amount of oxygen needed to maintain the minimum metabolic processes necessary to keep the neurons active. First, compensatory mechanisms begin to appear, but once their limit is exceeded, the result cannot be reversed. Therefore, unrecoverable lesions start to occur due to the death of the cells responsible for the functioning of our organism.
Can it be said that cerebral palsy affects the cognitive level?
No, it does not. In cerebral palsy there is mainly a motor alteration with consequences on balance, coordination and movements. There may also appear alterations in language and other areas, but there need not be alterations at the cognitive level. Generally speaking, we can say that in cerebral palsy there is damage to the white matter, as we said before, not to the gray matter. The gray matter is the area of the brain where the bodies of neurons are located and to simplify, we can say that it is there where the cognitive capacities are concentrated. It is likely that we think when we see someone with cerebral palsy that since they cannot control their body or hold their head, they have some mental problem. Especially if we meet someone who is drooling and cannot speak, we may have doubts about it. Nevertheless, a person with cerebral palsy does not necessarily have an altered intelligence. However, this does not mean that all people with cerebral palsy have a normal intellectual level. There are cases in which the sequelae affect both white matter and black matter and this causes lesions in large areas of the brain that end up altering both motor and intellectual abilities.
From the ASPACE Confederation they have designed an awareness campaign on the occasion of World Cerebral Palsy Day 2018, which includes a Videoclip with the theme “Don’t look away”, on sexuality and affectivity of people with cerebral palsy, don’t look away #MiraDeFrente. Dr. Fernandez, why do you think it is important to provide sexual and affective education to people with a disability such as cerebral palsy?
It is important to emphasize what was described above. People with CP have motor and movement problems, but they do not have to have altered cognitive or mental abilities. In spite of them, such a limited personal situation may cause emotional problems that hinder their social activity. This is especially evident in cases in which there are associated alterations in language or any other ability necessary for proper communication such as sight and hearing. People with cerebral palsy have needs very similar to any other person in aspects related to affectivity and sexuality. In addition, physical mobility problems can affect their ability to develop a full sex life and may even limit their intimate relationships. On an emotional level, mood and self-esteem problems are common, which further hinder their social relationships and integration with their peers. Given the dependency that in many cases they have, the existence of counseling on issues related to sex education and affectivity becomes essential.
Looking at the situation from another point of view, the fragility of persons with cerebral palsy places them at risk for sexual abuse and it is therefore important to make them aware of this in order to prevent future problems.