Cerebral Palsy
If someone has cerebral palsy it means that part of their brain is not working properly or has not developed. This will have happened before they were born, around the time of birth or in early childhood. The affected area of the brain is usually one of the parts that controls the muscles and certain body movements. In some people, cerebral palsy is barely noticeable. Others will be more severely affected.
Cerebral palsy is more common than people realise. It is believed that currently about one in every 400 children is affected by CP, ie about 1,800 babies are diagnosed with cerebral palsy in Great Britain each year. It can affect people from all backgrounds. It is often not possible for doctors to give a reason why part of a baby's brain has been injured or failed to develop. Some possible causes are:

• the mother of the baby had an infection in the early part of the pregnancy
• the baby had a difficult or premature birth, maybe they were unable to breathe properly
• there was some bleeding within the baby's brain
• the baby has a genetic disorder - (this is a very rare cause)

Cerebral palsy jumbles messages between the brain and the muscles. There are three types of cerebral palsy, depending on which messages are affected, called spastic, athetoid and ataxic. Many people with cerebral palsy have a combination of two or more types. One of the difficult things about cerebral palsy is that its effects vary so much from one person to another, making it difficult for doctors to say what type of cerebral palsy a person has.
It is therefore complicated for a doctor to predict how a young child with cerebral palsy will be affected later in life. Cerebral palsy is not progressive - it does not become more severe as the child gets older - although some difficulties may become more noticeable. There is no cure for cerebral palsy. If children are positioned well from an early age and encouraged to play in a way that helps them to improve their posture and muscle control, they can be helped to develop and achieve more things for themselves. There are also a number of therapies, which may be suitable for some individuals.

Down's syndrome
The word 'syndrome' means a collection of signs or characteristics. The name Down comes from the doctor, John Langdon Down, who first described the condition in 1866.

There are more differences between people with Down's syndrome than there are similarities. They will have many of their family's distinctive characteristics and will therefore resemble their brothers and sisters. As well as these individual characteristics however, they will have physical features shared by others with Down's syndrome. They will also have learning difficulties. This means they have greater difficulty learning than the majority of people the same age.

People with Down's syndrome look a little different and are in general relatively less able than the population as a whole. People react in different ways to those who have a learning difficulty. Some avoid contact because of embarrassment. Others are over-protective; insisting on helping with things people can do themselves.

Stereotyping and generalisations such as, 'people with Down's syndrome have lovely temperaments' are not uncommon, but mean that those people are not being treated as individuals. Encouraging people with Down's syndrome to behave in ways not permissible in other people of the same age, such as being very friendly with strangers, does not help people with Down's syndrome to become accepted.

Many people will talk about a 'Down's syndrome' person. It is more appropriate to talk about a person with Down's syndrome. They are people first and foremost. The fact that they have Down's syndrome is of secondary importance.

Down's syndrome is not a disease, so it is inaccurate to say people suffer from it or that it can be treated. People with Down's syndrome used to be described as mentally handicapped. Saying a person has a learning difficulty or learning disability is now considered to be more acceptable. Mental handicap is associated with demeaning terms such as 'mental', 'backward', 'subnormal' and suggest an old-fashioned image of being incapable and dependent. It can lead to confusion with mental illness. The terms 'integration' and 'segregation' are often used. In the context of people with learning disabilities, segregation means to set apart, to isolate. Integration means sharing places and activities alongside others. Many organisations connected with disability now prefer to use the term 'inclusion' rather than 'integration'.

For every 1,000 babies born, one will have Down's syndrome. About 600 babies are born with Down's syndrome each year. It occurs in families from all social, economic, cultural, religious and racial backgrounds. Accurate figures for the number of people with Down's syndrome in the country, or in different regions, are not available. It is only in the last few years that the number of babies born with Down's syndrome has been accurately recorded.

The characteristic features of people with Down's syndrome were first described in 1866 by John Langdon Down. In 1959 Professor Lejeune proved that Down's syndrome is a genetic condition caused by the presence of an extra chromosome. The body consists of millions of cells, too small to be seen with the naked eye. Every cell contains a number of chromosomes. Chromosomes are tiny particles that carry the blueprint for all the characteristics that we inherit.

Normally, there are 46 chromosomes in every cell; half of these come from our mother, half from our father. The person with Down's syndrome has an extra chromosome 21, making 47 in all. This results in a disruption to the growth of the developing baby.

This extra chromosome can come from either the mother or the father, and is present because of a genetic accident when the egg or the sperm is made, or during the initial cell division following conception, (ie when the egg and sperm fuse).

There are three different types of Down's syndrome. 95% of people with Down's syndrome have the type known as 'standard trisomy 21'. This type of Down's syndrome is always an accident of nature. It can happen to anyone and there is no known reason why it occurs.

Braille
Louis Braille was born in 1809 in a small village outside of Paris. At the age of three, he accidentally injured his eye while playing with his father's tools and soon after, lost all the sight in both of his eyes. Encouraged by a local priest and his schoolteacher, Louis went on to live and study at the National Institute of the Blind in Paris in 1819, where, at the age of 11, he began to experiment with a new raised code for letters based on a 'night writing' code used by the French army. Louis wrote in his diary, 'If my eyes will not tell me about men and events, ideas and doctrines, I must find another way.'

Although Louis introduced his revolutionary braille code in 1824, the French government did not officially approve his dot system, simply called 'braille', until 1854 - two years after Louis's death. A memorial plaque in his village reads: 'He opened the door to knowledge for all those who cannot see'. Eventually, braille became the standard system used throughout the world.

Professionals who work with disabled people

• GP - also referred to as the General Practitioner or Family Doctor. This is the local doctor that advises on a wide range of health concerns. Your GP can put you in touch with other medical services and may also be able to provide information on getting welfare benefits or other kinds of help.

• Audiologists - work with people who have hearing difficulties and advise on hearing aids.

• Community or District Nurse - a nurse who treats people in their homes.

• Educational Psychologists - visit schools to assess children and advise on their learning and behaviour.

• Genetic Counsellor - it is rare for cerebral palsy to be inherited, but if you are worried it may help to talk to a genetic counsellor. They are based at genetic advisory centres, usually attached to large hospitals. Ask your GP, hospital doctor or family welfare centre to refer you.

• Health Visitors - nurses with extra training in advising parents of children under five years. Contacted via the GP.

• Neurologists - doctors specialising in the brain and nervous system.

• Occupational Therapists - advise on equipment and adaptations to the home. Can be contacted via the GP.

• Orthopists - work with people who have visual problems and abnormal eye movements.

• Paediatricians - doctors specialising in the care of children.

• Physiotherapists - specialise in assisting people with movement problems, using methods such as exercise, manipulation, heat and massage to develop good patterns of movement. When working with a child with cerebral palsy they can also advise carers on ways of carrying, holding and positioning the child.

• Social Worker - a local authority social worker can advise on practical and financial problems or tell you how to access local services. You can contact a social worker via your local social services department. Some areas will have special child and adult disability teams, in others you may not be assigned a named person; instead, you may have to speak to the duty social worker.

• Speech and Language Therapist - can assess and treat communication difficulties and associated difficulties in eating and drinking. If appropriate, they may recommend communication aids or sign language.