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There are many kinds of intellectual disabilities -- and many causes.
Intellectual disability is the most common developmental disability.
What Is an Intellectual Disability?
Intellectual disability (or ID) is a term used when a person has certain limitations in cognitive
functioning and skills, including communication, social and self-care skills. These limitations can
cause a child to develop and learn more slowly or differently than a typically developing child.
Intellectual disability can happen any time before a child turns 18 years old, even before birth.
Intellectual disability is the most common developmental disability.
According to the American Association of Intellectual and Developmental Disabilities, an
individual has intellectual disability if he or she meets three criteria:
1. IQ is below 70-75
2. There are significant limitations in two or more adaptive areas (skills that are needed to live,
work, and play in the community, such as communication or self-care)
3. The condition manifests itself before the age of 18
How Does an Intellectual Disability Happen?
Intellectual disability – formerly known as mental retardation -- can be caused by injury, disease,
or a problem in the brain. For many children, the cause of their intellectual disability is unknown.
Some causes of intellectual disability – such as Down syndrome, Fetal Alcohol Syndrome,
Fragile X syndrome, birth defects, and infections – can happen before birth. Some happen while
a baby is being born or soon after birth.
Other causes of intellectual disability do not occur until a child is older; these might include
severe head injury, infections or stroke.
What Are the Most Common Causes?
The most common causes of intellectual disabilities are:
Genetic conditions. Sometimes an intellectual disability is caused by abnormal genes inherited
from parents, errors when genes combine, or other reasons. Examples of genetic conditions are
Down syndrome, Fragile X syndrome, and phenylketonuria (PKU).
Complications during pregnancy. An intellectual disability can result when the baby does not
develop inside the mother properly. For example, there may be a problem with the way the
baby’s cells divide. A woman who drinks alcohol or gets an infection like rubella during
pregnancy may also have a baby with an intellectual disability.
Problems during birth. If there are complications during labor and birth, such as a baby not
getting enough oxygen, he or she may have an intellectual disability.
Diseases or toxic exposure. Diseases like whooping cough, the measles, or meningitis can
cause intellectual disabilities.They can also be caused by extreme malnutrition, not getting
appropriate medical care, or by being exposed to poisons like lead or mercury.
We know that intellectual disability is not contagious: you can’t catch an intellectual disability
from anyone else. We also know it’s not a type of mental illness, like depression. There are no
cures for intellectual disability. However, children with intellectual disabilities can learn to do
many things. They may just need take more time or learn differently than other children.
How Common Are Intellectual Disabilities?
Approximately 6.5 million people in the United States have an intellectual disability.
Approximately 1 percent of the global population has an intellectual disability.
Intellectual disability is significantly more common in low-income countries – 16.41 in every
1,000 people. Disabilities overall are more common in low-income countries.
The United Nations Development Program estimates that 80 percent of all people with
disabilities live in low-income countries. While people with disabilities represent one in 10
people worldwide, they are one in every five of the world’s poorest people.
Sources: American Association of Intellectual and Developmental Disabilities; National Center
on Birth Defects and Developmental Disabilities; the United Nations Development Program; and
the Centers for Disease Control and Prevention.
Fragile X Syndrome
Our athletes with Fragile X Syndrome are used to overcoming challenges.
They do so, every single day.
When he was younger, Jonathan would stay in his room -- away from people and away from the larger world.
Step by step, Special Olympics helped Jonathan bring his talents to light and showed him ways to experience
success -- one sport at a time.
What Is Fragile X Syndrome?
Fragile X syndrome is a genetic disorder that affects a person’s development, especially that
person’s behavior and ability to learn. In addition, Fragile X can affect communication skills,
physical appearance, and sensitivity to noise, light, or similar information.
Fragile X syndrome is the most common form of inherited intellectual and developmental
disability.
People with Fragile X syndrome may not have noticeable symptoms, or they can have serious
symptoms that range from learning disabilities to cognitive and behavior problems.
What Causes Fragile X Syndrome?
Fragile X results from a change or mutation in the Fragile X
Mental Retardation 1 gene, which is found on the X
chromosome. The gene normally makes a protein called Fragile X
Mental Retardation Protein, or FMRP. This protein is important for
creating and maintaining connections between cells in the brain and
nervous system. The mutation causes the body to make only a little
bit or none of the protein, which often causes the symptoms of
Fragile X.
Not everyone with the mutated FMR1 gene has symptoms of Fragile
X syndrome, because the body may still be able to make FMRP. Severity of symptoms will
depend on how much of the protein the body can make and the number of cells affected.
Please note that females -- due to having two X chromosomes -- can usually make at least
some FMRP. Therefore symptoms of Fragile X are often milder in females than in males.
About 1 in 4,000 males and 1 in 8,000 females have Fragile X
syndrome.
What Are the Symptoms of Fragile X?
People with Fragile X don't all have the same signs and symptoms, but they do have some
things in common:
Cognitive functioning. Many people with Fragile X have problems with intellectual
functioning.These problems can range from the mild, such as learning disorders or problems
with mathematics, to the severe, such as an intellectual or developmental disability.The
syndrome may affect the ability to think, reason, and learn.
NOTE: Because many people with Fragile X also have attention disorders, hyperactivity,
anxiety, and language-processing problems, a person with Fragile X may have more
capabilities than his or her IQ score suggests.
Physical features. Most infants and young children with Fragile X don’t have specific features
connected to the syndrome. But when they start to go through puberty, many will begin to
develop physical features that are typical of those with Fragile X. These include: a narrow face,
large head, large ears, flexible joints, flat feet, and a prominent forehead.
Behavioral, social, and emotional. Most children with Fragile X have some behavioral
challenges.They may be afraid or anxious in new situations.
They may have trouble making eye contact with other people. Boys, especially, may have
trouble paying attention or be aggressive. Girls may be shy around new people. They may also
have attention disorders and problems with hyperactivity.
Speech and language. Most boys with Fragile X have some problems with speech and
language. They may have trouble speaking clearly, may stutter, or may leave out parts of
words. They may also have problems understanding other people’s social cues, such as tone of
voice or specific types of body language. Girls usually do not have severe problems with speech
or language.
Some children with Fragile X begin talking later than typically developing children. Most will talk
eventually, but a few might stay nonverbal throughout their lives.
Sensory. Many children with Fragile X are bothered by certain sensations, such as bright light,
loud noises, or the way certain clothing feels on their bodies.These sensory issues might cause
them to act out or display behavior problems.
NOTE: Between 6 percent and 20 percent of children with Fragile X syndrome have seizures.
Seizures associated with the syndrome are more common in boys than in girls.
Hiding From Lilfe
When Jonathan was a little boy, he'd stay alone in his room, never wanting to talk or interact
with family members or anyone else. He spent most of his time lining up his toys in straight
lines. Like other children with Fragile X, he avoided eye contact and shunned any physical
contact, even with loved ones.
When Jonathan's parents got him started in Special Olympics, this gave him a unique outlet.
The coaches understood his disability and helped him find a comfort zone -- and soon he was
playing whatever sport was in season -- softball, speedskating, golf, swimming and tennis. He
began making direct eye contact and even shaking people's hands, despite his tactile sensitivity
issues.
The lessons he has learned through his sports training and practice have had impact on other
aspects of Jonathan’s life. He began to be more interested in school and he learned now to
persevere – and not give up on something if it seems difficult. He also began setting realistic
goals for himself, and learned that if he works hard and is determined enough, he will eventually
succeed - just as he did in sports.
Jonathan has graduated from high school with an academic diploma and completed an
associate’s degree in computer science, persevering through eight years to earn that degree.
He has also been a longtime employee of Publix Supermarkets. These are accomplishments
that his parents were told he could never hope to achieve. Says mom, Kathy: "We truly believe
that his personal success, his transformation, is due primarily to his participation in Special
Olympics."
Excelling Skill by Skill
Jen had always wanted to take part in sports like her older brothers and other kids her age, but
she had trouble keeping up. Due to Fragile X , she has slower processing times and trouble
maintaining eye contact with coaches and other players. She also had motor skills issues. She
tried tennis at a local club, but it was at times frustrating.
Then her family found a Special Olympics program that made a huge difference. Her mom says
the Special Olympics coaches were able to break down the lessons, skills and drills she needed
for tennis so that Jen could really understand the game.
Jen isn’t the only athlete in her family. Her younger sister, Maria, 12, participates in Special
Olympics bowling. Maria also has Fragile X, along with Down syndrome. The Special Olympics
bowling program was a great fit for her.
Their mom says she’s seen so many positive changes in her daughters through Special
Olympics.
“I think it makes them more confident. Maria’s very confident. But Jen, I think, has always been
on the quieter side, more shy. She has social anxiety, so Special Olympics has totally brought
her out of her shell. It has really been a wonderful thing.”
Jen has also found a best friend through Special Olympics -- her short-court doubles partner,
Gina. “They have an amazing friendship,” says mom, a friendship that continues outside of
Special Olympics.
Down Syndrome
Adults and children with Down syndrome are different in so many ways.
Yet there may be some things they have in common.
Nandi made new friends at Special Olympics, and also learned lots of new skills and gained confidence in her
abilities. Today, she is an accomplished young woman and public speaker who gives great advice to parents
about all their child with intellectual disabilities can do.
What Is Down Syndrome?
Down syndrome is the term for a set of cognitive and physical symptoms that can result from
having an extra copy or part of a copy of chromosome 21.
Down syndrome is the most frequent chromosomal cause of mild to moderate intellectual
disability, and it occurs in all ethnic and economic groups.
The degree of intellectual disability in people with Down syndrome varies but is usually mild to
moderate. Generally, children with Down syndrome reach key developmental milestones later
than other children.
According to the Centers for Disease Control and Prevention, approximately 6,000 babies are
born in the United States each year with Down syndrome, or approximately 1 out of every 691
live births.
In recent decades, thanks to appropriate support and treatment, life expectancy for people with
Down syndrome has increased dramatically: from 25 years in 1983 to more than 60 years
today.
What Causes Down Syndrome?
Down syndrome is caused by a random error in cell division that results in the presence of an
extra copy of chromosome 21.
Usually, when one cell divides in two, all pairs of chromosomes are split so that one of the pair
goes to one cell, and the other goes to the other cell. But in rare cases, both chromosomes from
a pair go together into one cell.
Most of the time, the error occurs at random during the formation of an egg or sperm. No action
by parents or environmental factor is known to cause Down syndrome.
After much research on these cell division errors, researchers know that:
-In more than 90 percent of cases, the extra copy of chromosome 21 comes from the mother in
the egg.
-In about 4 percent of cases, the father provides the extra copy of chromosome 21 through the
sperm.
-In the remaining cases, the error occurs after fertilization, as the embryo grows.
Researchers also know some, but not all, of the risk factors for Down syndrome. For example,
parents who have a child with Down syndrome or another chromosomal disorder, or who have a
chromosomal disorder themselves, are more likely to have a child with Down syndrome.
In addition, the likelihood that an egg will contain an extra copy of chromosome 21 increases
significantly as a woman ages. Therefore, older women are much more likely than younger
women to give birth to an infant with Down syndrome.
Still, about 60 percent of babies with Down syndrome are born to women under age 35.
What Are Some Symptoms Related to Down Syndrome?
Symptoms of Down syndrome vary from person to person. Common physical symptoms
include:
-Decreased or poor muscle tone
-Short neck, with excess skin at the back of the neck
-Flattened facial profile and nose
-Small head, ears and mouth
-Upward slanting eyes, often with a skin fold that comes out from the upper eyelid and covers
the inner corner of the eye
-Single crease across the palm of the hand
-Deep groove between the first and second toes
Physical development in children with Down syndrome is often slower than development of
children without Down syndrome. For example, because of poor muscle tone, a child with Down
syndrome may be slow to learn to turn over, sit, stand, and walk.
Despite these delays, children with Down syndrome can learn to participate in physical exercise
and similar activities like other children. It may take children with Down syndrome longer than
other children to reach developmental milestones, but they will eventually meet all or many of
them.
Intellectual and Developmental Symptoms
Cognitive impairment -- which means problems with thinking and learning -- is common in
people with Down syndrome and usually ranges from mild to moderate. Down syndrome is only
rarely associated with severe cognitive impairment.
Common cognitive and behavioral problems may include:
-Short attention span
-Poor judgment
-Impulsive behavior
-Slow learning
-Delayed language and speech development
In addition, people with Down syndrome are at increased risk for a range of other health
conditions, including Autism Spectrum Disorders, problems with hormones and glands, hearing
loss, vision problems, and heart abnormalities.
From Weak to Strong
When Andy was little, he didn’t have a lot of muscle control. So his mother decided to
try exercising and playing with Andy in the water in an effort to strengthen him. Within four
weeks, his muscles got strong, then stronger. Andy started pulling himself up and began to
crawl.
At age 6, Andy started training for Special Olympics and has been a part of Special Olympics
for more than 20 years. His skills and speed have earned him plenty of medals and recognition
at Special Olympics events as well as in other swimming competitions. For example, Andy has
competed in U.S. Masters Swimming (USMS) Competitions -- alongside International Swimming
Hall of Fame members, International Masters Swimming Hall of Fame members, and USMS
national and world record holders.
As Andy puts it, “Down syndrome doesn’t matter to me at all.”
Fighting Low Expectations
When Nandi was born, doctors told her parents their child would probably never talk, walk or
even be toilet-trained. She is legally blind and has Down syndrome.
Born in the United Arab Emirates, Nandi joined Special Olympics at the age of 9 after the family
moved to the U.S. It opened up a whole new world. As she wrote in her journal, “After I came to
Special Olympics, I don’t feel lonely any more.”
As Nandi trained in various sports and developed a range of skills, she also developed
confidence as she was able to accomplish more and more, event by event –including track and
field, roller skating, sailing, ice skating, hockey and even basketball. “She can shoot a mean
basketball,” reports her mom. “I don’t know how she does it.”
Nandi's many accomplishments -- including having her own business -- are helping to change
attitudes and educate others about people with Down syndrome. Special Olympics has also
encouraged Nandi to become a public speaker -- and she makes a special effort to reach out
to families of children with intellectual disabilities. Her mom says Nandi has an inspiring way
of talking to families who had been told the worst – and now see positive possibilities ahead.
Her mother says, “I can hear her talking to them, ‘Don’t cry: My mom says I’m a blessing – and
your child will be a blessing, too.’”
Autism
Special Olympics volunteers and coaches are experienced working with
young people and adults with autism. The goal is to find a sport that is
best suited to each athlete, whether the athlete has sensory or
socialization issues -- or just
needs a confidence-booster.
What Is Autism?
Autism Spectrum Disorder (ASD), or autism,
is a complex neurological and developmental
disorder that affects how a person acts and
interacts with others, communicates and
learns.
ASD affects the structure and function of the brain and nervous system. Because it affects
development, ASD is called a developmental disorder. ASD can last throughout a person's life.
People with this disorder have problems with communication, interactions with other people
(social skills), restricted interests and repetitive behaviors.
Different people with autism can have different symptoms. For this reason, autism is known as a
spectrum disorder - a group of disorders with a range of similar features. ASD includes:
-Autistic disorder ("classic" autism). Autistic disorder is often what people think of when they
think of autism.
-Asperger syndrome. Asperger syndrome is sometimes said to be a milder version of classic
autism, mostly affecting social behaviors. Unlike people with autism, many people with Asperger
syndrome have normal or above-average intelligence and language skills.
-Pervasive developmental disorder not otherwise specified (PDD-NOS, or "atypical" autism).
PDD-NOS includes some, but not all, of the features of classic autism and/or Asperger
syndrome. This category also includes childhood disintegrative disorder and Rett syndrome, two
conditions in which a child develops normally for several months or years, then loses skills
related to language, movement and coordination, and other cognitive functions.
What Are the Symptoms?
The symptoms of one person with autism can be very different from another's. One person with
autism may have mild symptoms, while another may have more serious symptoms, but they
both have ASD.
Despite the range of possible symptoms, there are certain actions and behaviors that are
common. In general, the main signs and symptoms of ASD relate to: communication; social
behaviors; routines or repetitive behaviors, sometimes called stereotyped behaviors.
Communication:
-Does not respond to his/her name by 12 months of age
-Cannot explain what he/she wants
-Language skills are slow to develop or speech is delayed
-Doesn't follow directions
-Seems to hear sometimes, but not other times
-Doesn't point or wave "bye-bye"
-Used to say a few words or babble, but now does not
Social Behavior
-Doesn't smile when smiled at
-Has poor eye contact
-Seems to prefer to play alone
-Is very independent for his/her age
-Seems to tune people out
Steroeotyped Behavior
-Gets "stuck" doing the same things over and over and can't move on to other things
-Shows deep attachment to toys, objects, or routines
-Spends a lot of time lining things up or putting things in a certain order
-Repeats words or phrases
Other Behaviors
-Has unusual movement patterns
-Doesn't know how to play with toys
-Does things "early" compared to other children
-Walks on his/her toes
-Throws intense or violent tantrums
-Is overly active, uncooperative, or resistant
-Seems overly sensitive to noise
How Common Is Autism?
Researchers don't know exactly how many people in the United States have ASD.
The latest estimates suggest that about one out of every 88 children in the United States has
autism. About 36,500 of every 4 million children born each year in the U.S. will have autism.
Communicating Without Words
For athletes with autism, the social experience at Special Olympics events can be both
rewarding and empowering. Not only do our athletes learn new skills -- and get to show them off
a little bit! -- but they're in a "safe" environment where they can interact with other people in a
non-pressured, relaxing way.
Special Olympics volunteers and coaches are experienced working with young people and
adults who may have trouble communicating or who have sensory issues. We will find a way -and a sport -- that is best suited to each athlete.
For parents and care-givers, the ultimate reward sometimes comes in unexpected ways. One
mom of an athlete with autism knew her son liked Special Olympics -- he just wasn't able to tell
her.
Michael doesn't communicate well, so it can be hard to tell what he thinks. Then one day, the
15-year-old redecorated his room. His mom says, "We got a glimpse inside his mind when
Michael decided to decorate."
Apparently what Michael feels about Special Olympics ...is pride. He collected all his Special
Olympics medals and hung them on his wall in a proud display. His mother says, "Now I am so
proud. And happy! Sometimes it is so hard to make sure he can participate - it takes quite a lot
of juggling to make the schedule work. This makes it all worthwhile."
Other Intellectual Disabilities
A wide range of conditions can lead to intellectual disabilities. As
a Special Olympics athlete put it, "No one overcomes more than we do
and still loves life so much." Here's a look at other types of conditions that
some of our athletes face.
Apert Syndrome
Apert syndrome is a genetic disease in which the seams between the skull bones close earlier
than normal. This affects the shape of the head and face.
Apert syndrome can be passed down through families (inherited). The syndrome is inherited as
an autosomal dominant trait, which means that only one parent needs to pass on the faulty
gene for a child to have the condition.
Some cases may occur without a known family history.
Apert syndrome is caused by mutations in a gene called fibroblast growth factor receptor 2. This
gene defect causes some of the bony sutures of the skull to close too early, a condition called
craniosynostosis
Symptoms include fusion or severe webbing of the 2nd, 3rd, and 4th fingers; webbing or fusion
of toes; hearing loss; slow intellectual development; prominent eyes; under-development of the
mid-face; skeletal (limb) abnormalities; small stature.
Williams Syndrome
Williams syndrome is a developmental disorder that affects many parts of the body. This
condition is characterized by mild to moderate intellectual disability or learning problems, certain
personality characteristics, distinctive facial features, and heart and blood vessel
(cardiovascular) problems.
Williams syndrome is caused by the deletion of genetic material from a specific region of
chromosome 7. The deleted region includes more than 25 genes.
People with Williams syndrome typically have difficulty with visual-spatial tasks such as drawing
and assembling puzzles, but they tend to do well on tasks that involve spoken language, music,
and learning by repetition (rote memorization). Affected individuals have outgoing, engaging
personalities and tend to take an exceptional interest in other people. Attention deficit disorder
(ADD), problems with anxiety, and phobias are common among people with this disorder.
Young children with Williams syndrome have distinctive facial features including a broad
forehead, a short nose with a broad tip, full cheeks, and a wide mouth with full lips. Many
affected people have dental problems such as small, widely spaced teeth and teeth that are
crooked or missing. In older children and adults, the face appears longer and more gaunt.
A form of cardiovascular disease called supravalvular aortic stenosis (SVAS) occurs frequently
in people with Williams syndrome. Supravalvular aortic stenosis is a narrowing of the large
blood vessel that carries blood from the heart to the rest of the body (the aorta). If this condition
is not treated, the aortic narrowing can lead to shortness of breath, chest pain, and heart failure.
Other problems with the heart and blood vessels, including high blood pressure (hypertension),
have also been reported in people with Williams syndrome.
Additional signs and symptoms of Williams syndrome include abnormalities of connective tissue
(tissue that supports the body's joints and organs) such as joint problems and soft, loose skin.
Affected people may also have increased calcium levels in the blood (hypercalcemia) in infancy,
developmental delays, problems with coordination, and short stature. Medical problems
involving the eyes and vision, the digestive tract, and the urinary system are also possible.
Fetal Alcohol Syndrome
Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person
whose mother drank alcohol during pregnancy. These effects can include physical problems
and problems with behavior and learning. Often, a person with an FASD has a mix of these
problems.
Signs of FASDs can be physical or intellectual. That means they can affect the mind or the
body, or both. Because FASDs make up a group of disorders, people with FASDs can show a
wide range and mix of signs.
Physical signs of FASDs can include abnormal facial features such as narrow eye openings and
a smooth philtrum (the ridge between the upper lip and nose), small head size, short stature,
and low body weight
In rare cases, there are problems with the heart, kidneys, bones, or hearing.
Intellectual and behavioral signs of FASDs might include problems with memory, judgment or
impulse control, motor skills, academics (especially in math), paying attention, and low IQ.
Specific learning disabilities are also possible.
Prader-Willi
Prader-Willi syndrome is the most common of the genetic disorders that cause life-threatening
obesity in children. The syndrome affects many aspects of a person's life, including eating,
behavior and mood, physical growth and intellectual development.
The syndrome usually results from deletions or partial deletions on chromosome 15 that affect
the regulation of gene expression, or how genes turn on and off. Andrea Prader and Heinrich
Willi first described the syndrome in the 1950s.
One of the main symptoms of Prader-Willi syndrome is the inability to control eating. Other
symptoms include low muscle tone and poor feeding as an infant, delays in intellectual
development, and difficulty controlling emotions.
Individuals with Prader-Willi syndrome have varying levels of intellectual disabilities. Learning
disabilities are common, as are delays in starting to talk and in the development of language.
Phenylketonuria (PKU)
Phenylketonuria (pronounced fen-l-kee-toh-NOOR-ee-uh), or PKU, is an inherited disorder that
that can cause intellectual and developmental disabilities (IDDs) if untreated.
In PKU, the body can't process part of a protein called phenylalanine, which is in all foods
containing protein. If the phenylalanine level gets too high, the brain can become damaged.
All children born in U.S. hospitals are tested routinely for PKU soon after birth, making it easier
to diagnose and treat early. Children and adults who are treated early and consistently develop
normally.
Depending on the level of phenylalanine and tolerance for phenylalanine in the diet, PKU is
classified into two different types: classic, which is the severe form, and moderate.
Children with untreated PKU appear normal at birth. But by age 3 to 6 months, they begin to
lose interest in their surroundings. By age 1 year, children are developmentally delayed and
their skin has less pigmentation than someone without the condition. If people with PKU do not
restrict the phenylalanine in their diet, they develop severe intellectual and developmental
disabilities.
Other symptoms include: behavioral or social problems; seizures, shaking, or jerking
movements in the arms and legs; stunted or slow growth; skin rashes, such as eczema; small
head size (microcephaly); musty odor in urine, breath, or skin that is a result of the extra
phenylalanine in the body; fair skin and blue eyes, due to the body's failure to transform
phenylalanine into melanin.
Cerebral Palsy
The term cerebral palsy refers to any one of a number of neurological disorders that appear in
infancy or early childhood and permanently affect body movement and muscle coordination but
don’t worsen over time. Even though cerebral palsy affects muscle movement, it isn’t caused by
problems in the muscles or nerves. It is caused by abnormalities in parts of the brain that
control muscle movements.
The majority of children with cerebral palsy are born with it, although it may not be detected until
months or years later. The early signs of cerebral palsy usually appear before a child reaches 3
years of age. The most common are a lack of muscle coordination when performing voluntary
movements (ataxia); stiff or tight muscles and exaggerated reflexes (spasticity); walking with
one foot or leg dragging; walking on the toes, a crouched gait, or a “scissored” gait; and muscle
tone that is either too stiff or too floppy.
A small number of children have cerebral palsy as the result of brain damage in the first few
months or years of life, brain infections such as bacterial meningitis or viral encephalitis, or head
injury from a motor vehicle accident, a fall, or child abuse.
People with CP have problems with movement and posture. Many also have related conditions
such as intellectual disability; seizures; problems with vision , hearing, or speech; changes in
the spine (such as scoliosis); or joint problems (such as contractures).