University of Edinburgh

Cerebral Palsy and Visual Impairment in Children: Experience of Collaborative Practice in Scotland


Adaptive behaviour - a purposeful and goal directed behaviour made in anticipation of or in response to an environmental challenge.

Associated reaction - an increase in muscle tone in the more affected part of the body when effort is used in a less affected part of the body.

Autonomic nervous system - the part of the nervous system responsible for the control of bodily functions that are not consciously directed, including regular beating of the heart, intestinal movements, sweating, salivation, etc.

Ataxia - jerky, uncoordinated movements.

Athetosis - involuntary movements - uncontrolled/unwanted movements outwith the childÍs control.

Contracture - permanently tight muscles with some loss of joint movement.

Deformity - joints permanently fixed in abnormal positions, eg: hip dislocation.

Diplegia - all four limbs affected but lower limbs more affected than upper limbs.

Dyskinetic - a group of involuntary movements seen as the child moving too much and is unable to control his movements.

Dystonic - sudden changes in postural tone which can result in a movement that is extreme in range.

Functional - a task that involves the co-ordination of the whole child to perform an activity.

Grapho-motor skills - pre-writing skills.

Hemiplegia - one side of the body affected arm and leg may be equally or unequally affected.

Hypertonia - increased postural tone, stiffness of muscles.

Hypotonia - reduced postural tone, floppiness of muscles.

Lesion - an area of tissue with impaired function as a result of damage by disease or wounding.

Lilli Nielson's Little Room- a large box with no bottom and holes in the top so that a variety of real objects can be suspended over the child. Any movement the child makes when lying in the little room should cause him to come into contact with something. The child is then encouraged to explore further and gradually comes to realise that he can have an effect on his environment.

Postural tone - the level of activity in the muscles, which enables maintenance of posture against gravity but still allowing for smooth flowing movement of the body and its parts.

Prognosis - an assessment of the future course and outcome of the child's condition, based on knowledge of the course of the condition in other children together with the general health, age and sex of the child.

Proprioceptive - related to the sense of movement and position of the body parts.

Quadriplegia - all four limbs affected but upper limbs more affected than lower limbs and the children are not able to use their upper limbs efficiently to support themselves when moving from one position to another.

Retinoscopy - is a way to assess if a child might benefit from wearing glasses. By moving a light across the pupil an estimate of how long or short sighted an eye is can be made. Optometrists and ophthalmologists can perform this test. Dynamic retinoscopy is a way of doing the test that allows an estimate of the power of 'near focusing' (accommodation) as well. The test is done without putting any drops into a child's eyes, and comparing the results of the test when a child is looking at a distant object and then at a near object. This information can help decide if a child might also benefit from wearing bifocal or multifocal glasses for near work.

Sensory processing - the process by which the nervous system takes in, recognises and assigns significance to information arising from one of the various sensory systems. The latter step involves inhibiting or enhancing perception of this information. Finally, the process organises sensory information for use in selecting and planning adaptive behaviour.

Snellen Letter Chart - a distance acuity vision chart that is commonly seen in the doctor's surgery. The test is usually carried out at 6m. In order to use the test the tester needs to be certain that the child can confidently recognise the letters of the alphabet. If the child has 6/6 vision it means she has normal vision. The scores are in multiples of 6. A score of 6/24 means that the child can see at 6m what the normal eye is expected to see at 24m and is a moderate visual impairment. A score of 6/60 means the child can see at 6m what the normal eye can see at 60m and is a more severe visual impairment.

Tactile - relating to or affecting the sense of touch.

Vestibular - related to the sense of head position and movement of the body through space.

Useful websites

Cerebral palsy (CP)

  • Scope (was the Spastics Society England & Wales service) - it has good information, etc, about CP.
  • Capability Scotland
  • Bobath ChildrenÍs Therapy Centre Scotland A non-profit making organisation that specialises in the treatment of cerebral palsy and acquired neurological conditions in children and adults, the training of postgraduate therapists and doctors in the Bobath approach, and carries out research into these conditions and the ways of mitigating their effects.
  • Cerebral Palsy Info Central (USA). Information about cerebral palsy. Material is written and compiled by a cerebral palsy sufferer.
  • National Institute of Neurological Disorders and Stroke: Cerebral Palsy: Hope Through Research (USA - medical & research information) <
  • CALL Centre

Visual impairment and other disabilities

  • Scottish Sensory Centre
  • Visual Impairment Scotland
  • International Council for Education of People with Visual Impairment and
  • RNIB
  • Sense
  • Sense Scotland
  • SeeAbility A charity working with adults who are blind or partially sighted and have a range of additional disabilities. Services and research (reports).


  • Let me see This video was filmed at Westerlea School, Edinburgh, which caters for pupils who have cerebral palsy. It considers ways in which children with CPVI can be enabled to make best use of their vision while fully taking account of their physical disability. Cost: £17.63 (inc VAT). Available from: MALTS, Moray House School of Education, The University of Edinburgh, Holyrood Road, Edinburgh, EH8 8AQ.