One in 700 Australian babies are diagnosed with cerebral palsy.

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What is cerebral palsy?

Every 15 hours, an infant in Australia is born with a brain injury that underlies cerebral palsy. Most often injury to the brain occurs during pregnancy; however, it may also occur during childbirth or shortly after birth.

Cerebral palsy affects muscle tone, movement and motor skills. It is caused by abnormal development or damage to the parts of the brain that control movement, balance and posture.

Early diagnosis and intervention in children with cerebral palsy is critical for maximising their potential.

Melanie and Arlo’s story

Arlo is a bright, beautiful three-and-a-half-year-old boy who delights in musicals, including Frozen and Moana, and has an intense love of books.

Even though Arlo is non-verbal, when his mother Melanie tries to skip words or passages, he can certainly let her know that he’s not impressed.

When Arlo was just six months old, his parents were told he had cerebral palsy. Cerebral palsy is measured on a scale of 1-5, 1 being the mildest form, and 5 being the most severe. As the months rolled on, Melanie and her partner, Rowan, were also told Arlo is a 5, and would be unlikely to ever walk. It was heartbreaking news that no parent ever wants to hear.

While many parents know throughout the pregnancy whether their child is a high risk for brain damage, Melanie’s story reveals how cerebral palsy can come with no warning.

Reduced fetal movement

Arlo was four days past his birthing due date when Melanie noticed his movements had lessened, so she and Rowan decided to go to the hospital to make sure nothing was amiss.

“When I arrived at hospital everything looked okay, and I was prepped to be induced the following day. That next morning, just as my waters were about to be broken, Arlo’s heart rate suddenly dropped. It virtually disappeared.

“The midwife scrambled about my belly with a stethoscope trying to find it, the emergency button was pushed, doctors flooded the room, and in an instant I was being whisked down a corridor to theatre,” Melanie said.

This happens to others, not us

Arlo was born by emergency caesarean section in 10 minutes flat, but during that time his brain was deprived of oxygen, which made him a high risk for cerebral palsy. He was immediately placed on oxygen, and had to be cooled down to stop further brain damage. This meant Melanie and Rowan were not able to hold him for the first 72 hours.

“We were told that there was a chance he may have brain damage, and that the worst-case scenario would be cerebral palsy. However, at this point, we didn’t think anything would be wrong.

“You always think, that’s the sort of stuff that happens to other people. It doesn’t happen to us. For six months we told ourselves everything would be okay, right up until Arlo was diagnosed with cerebral palsy. Quadriplegic cerebral palsy.”

It takes a community

Now, Melanie, Rowan and Arlo have a great team of specialists that help Arlo thrive. His team includes two speech pathologists, a physiotherapist, an occupational therapist, a feeding specialist and a neurologist.
After being diagnosed as never able to walk, Arlo is now using a gate trainer to aid him getting about. His desire to play and keep up with his younger sister, Odette, spurs on his determination.

“His sight isn’t affected and he isn’t intellectually delayed, but he is non-verbal. We were told his brain damage meant he would only be physically affected. But, of course, using your tongue and mouth muscles is movement.

“We communicate with him on an augmentative and alternative communication, or AAC device, which lets the movement of his eyes communicate with us.”

While Arlo’s dedicated parents and superstar team of specialists are helping him reach his full potential, Melanie hasn’t ruled out that medical advances, such as stem cell therapies, may help improve Arlo’s quality of life.

“We’ve kept Arlo’s sister Odette’s umbilical cord stem cells, just in case.”

Helping kids like Arlo

Cerebral palsy is a condition that can arise during pregnancy, during childbirth or shortly after birth.
Our research is working to help kids like Arlo, by providing developing therapies that can be given immediately after birth for babies who have been oxygen deprived and are a high risk for inflammation and brain damage.

Our teams research how early intervention in childhood and adolescence can promote better bone health for adults with cerebral palsy. They are studying factors that contribute to low bone density so their findings will allow for a better quality of life.

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One in 700 Australian babies are diagnosed with cerebral palsy. It has no known cause, no known cure.

Our researchers are on a mission to change this!

Preventing early brain injury

Strong evidence now suggests that much of the brain injury that underlies cerebral palsy occurs before birth. By identifying how abnormal conditions in the womb impact the developing brain, our researchers are finding ways to prevent cerebral palsy.

A leading cause of brain damage while in the womb is too much inflammation in a baby’s blood and brain. Research by Associate Professor Tim Moss and Dr Robert Galinsky and their teams is aimed at identifying how the developing brain is affected by inflammation before birth and shortly after birth. By understanding how inflammation triggers abnormal brain development, they hope to identify therapeutic targets that will reduce the incidence and severity of cerebral palsy.

Dr Galinsky and his team, with collaborators at the University of Auckland in New Zealand, have discovered that blocking key inflammatory proteins that are over-expressed in the circulation system of cerebral palsy patients reduces brain inflammation and promotes healthy brain cell development and function.

Another common cause of cerebral palsy is fetal growth restriction (FGR), a condition where a baby stops growing in the womb and is born very small, usually due to the placenta failing to deliver the oxygen and nutrients required to meet the baby’s needs.

Discovering how brain damage develops in growth-restricted infants is a key research area for Associate Professor Suzie Miller and her team. She is working to identify treatments that can be given during pregnancy to prevent injury. She has shown, in one promising study, that brain damage may be prevented if the ‘sleep hormone’ melatonin is given during pregnancy.

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Stopping further damage

Prematurity is associated with higher rates of cerebral palsy, with 40 per cent of children with cerebral palsy born prematurely. While being born premature does not always result in cerebral palsy, it is classified as a risk factor because preterm babies encounter a number of stressors that make them vulnerable to brain injury.

The brain is still relatively immature when a baby is born preterm, and the altered environment that occurs with premature birth means the brain is very vulnerable to damage. In addition, the life-saving respiratory support they receive in hospital can be too much for premature newborns’ under-developed lungs to cope with. This in turn can also lead to inflammation and injury in the brain.

Associate Professor Graeme Polglase’s team are researching methods to support these tiny patients at birth. This includes optimising the timing of clamping and cutting the umbilical cord, finding ways to improve how respiratory support is delivered, and identifying ways to stimulate breathing, thus preventing the need for respiratory support.

In addition, A/Prof Miller’s and A/Prof Moss’s groups are tackling this issue by looking at novel treatments, such as stem cell therapies, that could be administered soon after birth to reduce brain inflammation and injury. These treatments would be suited to high-risk infants, such as those born extremely preterm or those exposed to inflammation in the womb.

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Maximising potential

Research by Associate Professor Fran Milat and her team indicates that low bone density in adults with cerebral palsy is most likely a result of not building sufficient bone mass during childhood. Puberty is a critical time for building bone in cerebral palsy, as it is with typical adolescents.

This research supports the practice of early intervention in childhood and adolescence to promote better bone health for adults. A focus on intervention would ensure that people with cerebral palsy are able to remain mobile for longer and in turn reduce bone fractures.

A/Prof Milat’s team are studying the factors that contribute to low bone density, including a lack of movement, nutritional deficiencies, use of anti-seizure medication and hormonal deficiencies. These findings will help inform clinical care that will allow for a better quality of life.

Maximising the potential of children with cerebral palsy is critical for providing the best quality of life. Intensive therapy programs studied by A/Prof Tim Moss in collaboration with families of children with cerebral palsy aim to allow children living with physical disabilities to thrive and reach once unimaginable levels of mobility and independence.

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