A type of cerebral palsy, called spastic cerebral palsy, occurs when the brain damage occurs in the cerebral cortex, the outer layer of the brain. Spastic cerebral palsy is the most common form of cerebral palsy, affecting 70 to 80 percent of patients. Spastic cerebral palsy has varying forms depending on the areas of the body it affects, whether its one side of the body or just the legs.
Spastic cerebral palsy refers to the increased tone, or tension, in a muscle. Normal muscles work in pairs. When one group contracts the other group relaxes, allowing free movement in the desired direction. Due to complications in brain-to-nerve-to-muscle communication, the normal ebb and flow of muscle tension is disrupted. Muscles affected by spastic cerebral palsy become active together and block effective movement. This causes the muscles in spastic cerebral palsy patients to be constantly tense, or spastic. Spastic cerebral palsy patients may have mild cases that affect only a few movements, or severe cases that can affect the whole body. Although spastic cerebral palsy is not thought to be a progressive disorder, as brain damage does not get worse over time, spasticity in muscles can increase over time. This increased muscle tone and stiffness in spastic cerebral palsy can limit the range of movement in the joints. The effects of spastic cerebral palsy may increase with anxiety or exerted effort, leading to excessive fatigue.
Quadriplegia is a classification of severe cerebral palsy where the disability affects all four limbs and is sometimes referred to as double hemiplegia. It is not uncommon for there to be serious and extensive disability also involving the trunk and neck muscles often with a minimum requirement for a motorised wheelchair to facilitate any independent movement. Many children with this disability cannot function normally in almost any respect and require constant care and attention.
Most victims suffer from spastic quadriplegia cerebral palsy which is characterised by uncontrolled movement and poor muscle tone caused as a result of injury to the part of the brain responsible for movement control and coordination. As a result, the child often exhibits symptoms that include jerky movements, twitching and difficulties in walking, sitting and speaking
Section 13K. (a) For the purpose of this section the following words shall, unless the context requires otherwise, have the following meanings:—
“Abuse”, physical contact which either harms or creates a substantial likelihood of harm.
“Bodily injury”, substantial impairment of the physical condition, including, but not limited to, any burn, fracture of any bone, subdural hematoma, injury to any internal organ, or any injury which occurs as the result of repeated harm to any bodily function or organ, including human skin.
“Caretaker”, a person with responsibility for the care of an elder or person with a disability, which responsibility may arise as the result of a family relationship, or by a fiduciary duty imposed by law, or by a voluntary or contractual duty undertaken on behalf of such elder or person with a disability. A person may be found to be a caretaker under this section only if a reasonable person would believe that such person’s failure to fulfill such responsibility would adversely affect the physical health of such elder or person with a disability. Minor children and adults adjudicated incompetent by a court of law may not be deemed to be caretakers under this section.
(i) “Responsibility arising from a family relationship”, it may be inferred that a husband, wife, son, daughter, brother, sister, or other relative of an elder or person with a disability is a caretaker if the person has provided primary and substantial assistance for the care of the elder or person with a disability as would lead a reasonable person to believe that failure to provide such care would adversely affect the physical health of the elder or person with a disability.
(ii) “Responsibility arising from a fiduciary duty imposed by law”, it may be inferred that the following persons are caretakers of an elder or person with a disability to the extent that they are legally required to apply the assets of the estate of the elder or person with a disability to provide the necessities essential for the physical health of the elder or person with a disability: (i) a guardian of the person or assets of an elder or person with a disability; (ii) the conservator of an elder or person with a disability, appointed by the probate court pursuant to chapter two hundred and one; and (iii) an attorney-in-fact holding a power of attorney or durable power of attorney pursuant to chapter two hundred and one B.
(iii) “Responsibility arising from a contractual duty”, it may be inferred that a person who receives monetary or personal benefit or gain as a result of a bargained-for agreement to be responsible for providing primary and substantial assistance for the care of an elder or person with a disability is a caretaker.
(iv) “Responsibility arising out of the voluntary assumption of the duties of caretaker”, it may be inferred that a person who has voluntarily assumed responsibility for providing primary and substantial assistance for the care of an elder or person with a disability is a caretaker if the person’s conduct would lead a reasonable person to believe that failure to provide such care would adversely affect the physical health of the elder or person with a disability, and at least one of the following criteria is met: (i) the person is living in the household of the elder or person with a disability, or present in the household on a regular basis; or (ii) the person would have reason to believe, as a result of the actions, statements or behavior of the elder or person with a disability, that he is being relied upon for providing primary and substantial assistance for physical care.
“Elder”, a person sixty years of age or older.
“Mistreatment”, the use of medications or treatments, isolation, or physical or chemical restraints which harms or creates a substantial likelihood of harm.
“Neglect”, the failure to provide treatment or services necessary to maintain health and safety and which either harms or creates a substantial likelihood of harm.
“Person with disability”, a person with a permanent or long-term physical or mental impairment that prevents or restricts the individual’s ability to provide for his or her own care or protection.
“Serious bodily injury”, bodily injury which results in a permanent disfigurement, protracted loss or impairment of a bodily function, limb or organ, or substantial risk of death.
(a1/2) Whoever commits an assault and battery upon an elder or person with a disability shall be punished by imprisonment in the state prison for not more than 3 years or by imprisonment in a house of correction for not more than 2 1/2 years, or by a fine of not more than $1,000, or both such fine and imprisonment.
(b) Whoever commits an assault and battery upon an elder or person with a disability and by such assault and battery causes bodily injury shall be punished by imprisonment in the state prison for not more than five years or in the house of correction for not more than two and one-half years or by a fine of not more than one thousand dollars or by both such fine and imprisonment.
(c) Whoever commits an assault and battery upon an elder or person with a disability and by such assault and battery causes serious bodily injury shall be punished by imprisonment in the state prison for not more than ten years or in the house of correction for not more than two and one-half years or by a fine of not more than five thousand dollars or by both such fine and imprisonment.
(d) Whoever, being a caretaker of an elder or person with a disability, wantonly or recklessly permits bodily injury to such elder or person with a disability, or wantonly or recklessly permits another to commit an assault and battery upon such elder or person with a disability which assault and battery causes bodily injury, shall be punished by imprisonment in the state prison for not more than five years or in the house of correction for not more than two and one-half years or by a fine of not more than five thousand dollars or by both such fine and imprisonment.
(d1/2) Whoever, being a caretaker of an elder or person with a disability, wantonly or recklessly commits or permits another to commit abuse, neglect or mistreatment upon such elder or person with a disability, shall be punished by imprisonment in the state prison for not more than 3 years, or imprisonment in the house of correction for not more than 2 1/2 years, or by a fine of not more than $5,000, or by both such fine and imprisonment.
(e) Whoever, being a caretaker of an elder or person with a disability, wantonly or recklessly permits serious bodily injury to such elder or person with a disability, or wantonly or recklessly permits another to commit an assault and battery upon such elder or person with a disability which assault and battery causes serious bodily injury, shall be punished by imprisonment in the state prison for not more than ten years or by imprisonment in the house of correction for not more than two and one-half years or by a fine of not more than ten thousand dollars or by both such fine and imprisonment.
(f) Conduct shall not be construed to be wanton or reckless conduct under this section if directed by a competent elder or person with a disability, or for the sole reason that, in lieu of medical treatment, an elder or person with a disability is being furnished or relies upon treatment by spiritual means through prayer if such treatment is in accordance with the tenets and practices of the established religious tradition of such elder or person with a disability, and is provided at the direction of such elder or person with a disability, who shall be competent, or pursuant to the direction of a person who is properly designated a health care proxy under chapter two hundred and one D.
What are they?
Flashbacks are memories of past traumas. They may take the form of pictures, sounds, smells, body sensations, feelings or the lack of them (numbness). Many times there is no actual visual or auditory memory. One may have the sense of panic, being trapped, feeling powerless with no memory stimulating it. These experiences can also happen in dreams.
The Massachusetts Hospital School made it difficult to see my Parents. The visitation time, was to bring you home was Saturday mornings, return you Saturday evenings, then Sunday mornings return you Sunday evenings. For most of my life, I intellectualized my feelings; to put it another way, I was feeling "numb"! It was few months short of my tenth birthday, when I was admitted to the Massachusetts Hospital School.
Do you think a ten year child who can fully understand like an adult? To this day, I still do not understand for what reason the Massachusetts Hospital School made it difficult to visit your Parents! Oh yes, "Politics and Money"! All "state institutions" take "head count" each morning to determine how much money it was going to receive.
When that part comes out, the little one is experiencing the past as if it were happening today. As the flashback occurs, it is as if we forget that we have an adult part available to us for reassurance, protection and grounding. The intense feelings and body sensations occurring are so frightening because the feelings/sensations are not related to the reality of the present and many times seem to come from nowhere.
We begin to think we are crazy and afraid of telling anyone (including our therapist) of these experiences. We feel out of control and at the mercy of our experiences.
We begin to avoid situations, and stimuli, that we think triggered it. Many times flashbacks occur during any form of sexual intimacy, or it may be a person who has similar characteristics to the perpetrator, or it may b a situation today that stirs up similar trapped feelings (confronting aggressive people).
If you are feeling small...you are experiencing a flashback.
If you are experiencing stronger feelings than are called for in the present situation...you are experiencing a flashback.
Flashbacks are normal
Vietnam vets have normalized this experience and have coined the term post traumatic stress syndrome.
Even the diagnostic category book for psychiatry defines post traumatic stress syndrome as the normal experience of all people experiencing an event that is outside the range of normal human experience.
Flashbacks feel crazy because the little one doesn't know that there is an adult survivor available to help.
What helps
Updated: Mar 4, 2008
Posttraumatic stress disorder (PTSD) in children and adolescents occurs as a result of a child's exposure to one or more traumatic events that were life-threatening or perceived to be likely to cause serious injury to self or others. In addition, the child or adolescent must have responded with intense fear, helplessness, or horror. Traumatic events can take many forms, including physical or sexual assaults, natural disasters, traumatic death of a loved one, or emotional abuse or neglect. Severe emotional trauma has widespread effects on children's development, in that it clearly obliterates the belief that their parents will protect them. The premature destruction of these beliefs can have profound negative consequences on development.
Traumatized children and adolescents are understandably frequently preoccupied with danger and vulnerability, sometimes leading to misperceptions of danger, even in situations that are not threatening. Multiple researchers (eg, Kardiner, van der Kolk1 ) note that, once posttraumatic stress symptoms emerge, PTSD leads to neurophysiologic correlates that impact brain function in developing children and adolescents.
In 1980, the term PTSD first came into existence in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III).2 Only in 1987 did the DSM series make reference to traumatized children. The first major studies of the effects of large traumas on children were Bloch's 1956 study of the effect of a tornado in Mississippi, Lacey's 1972 study of the effects of an avalanche on a Welsh school, Newman's 1976 work on the Buffalo Creek disaster,3 and Terr's 1979 research on the Chowchilla bus kidnapping.4 
Evidence indicates a genetic predisposition for PTSD, suggesting that it may be linked to the individual's temperament and to reactivity of the hypothalamic pituitary axis.
Lifetime prevalence of PTSD is 8%.5 The incidence and course of PTSD vary and depend on various factors, including the type of trauma, the proximity to the stressor, and the reaction of the child's parents. After being kidnapped, witnessing the death of a parent, or suffering domestic violence, the rate of PTSD may be 95-100%. Following a sniper attack at school, 40% of children experienced moderate-to-severe PTSD. In one study of children in foster care, 64% who had experienced sexual abuse had PTSD, and 42% who had experienced physical abuse fulfilled the PTSD criteria. Moreover, 18% of the children who were not abused also met PTSD criteria, presumably because they had witnessed violence.
The prevalence in a location overwhelmingly depends on the endemicity of violence in the region.
Alone, PTSD is not a fatal disorder. Nevertheless, it frequently leads to conduct disorder, substance abuse, depression, and risk-taking that poses considerable danger.
PTSD has a considerable morbidity rate, particularly for children. In addition to the symptoms of numbing, hyperarousal, and recollections of the event that adults experience, children suffer from a decreased ability to participate in the normal academic and social activities of childhood. Therefore, a traumatic event can send a child down a new developmental path, one that is less favorable than the one the child was previously on.
A host of emotional and behavioral problems frequently arise as a result of PTSD and are not part of the criteria for categorical diagnosis. These include disruptive behavior disorders, eating disorders, sexual acting out, other risk-taking activities, depression, the full range of anxiety disorders, dissociation, mood lability, violence, and difficulty concentrating.
Studies of adults who were sexually or physically abused as children demonstrate significantly higher rates of PTSD (72-100%) than studies of children who were abused (21-55%). This finding indicates that the full impact of abuse may not be experienced until a child reaches adulthood, engages in adult relationships and responsibilities, and develops more sophisticated cognitive capabilities.
No major racial predominance is observed; however, PTSD is more common among individuals in low socioeconomic groups and among those living in areas in which violence is endemic.
PTSD is more common in women than in men.
PTSD occurs in people of all ages, but younger and elderly persons are the most vulnerable.
Diagnostic criteria
Diagnosing posttraumatic stress disorder in children