Overview
Because CP results from brain injury, and the brain controls much more than just movement, many people with CP experience additional conditions. These are called “associated conditions” or “co-occurring conditions.” They are not separate from CP — they are part of the same brain injury.
How many associated conditions a person has, and how severe they are, varies widely. Some people with CP have no associated conditions at all. Others may have several.
Epilepsy
Around 25–45% of people with CP also have epilepsy (recurrent seizures). Epilepsy is more common in people with:
- Quadriplegia (all four limbs affected)
- More severe forms of CP
- Intellectual disability
Epilepsy in CP is managed with anti-seizure medications. Some people achieve good seizure control; others may need ongoing management. Regular neurologist review is important.
Intellectual Disability
About 50% of people with CP have some degree of intellectual disability. However, it is essential to understand:
- Many people with CP have normal intelligence
- Physical disability can be mistaken for intellectual disability — a person who cannot speak or move easily may still understand everything
- Communication barriers often mask true cognitive ability
- Proper assessment requires tools that account for motor and communication limitations
Never assume a person's intelligence based on their physical abilities. Always presume competence.
Vision & Hearing
Vision problems are common in CP and may include:
- Strabismus (crossed eyes) — affects up to 50% of people with CP
- Refractive errors (needing glasses)
- Cortical visual impairment (the brain has difficulty processing visual information)
- Visual field deficits
Hearing loss affects a smaller percentage but should be screened for, especially in children born prematurely or with specific risk factors.
Pain
Pain is common in CP and often under-recognised. Sources include:
- Muscle spasticity and spasms
- Joint deformity and contractures
- Hip displacement or dislocation
- Musculoskeletal strain from altered movement patterns
- Gastrointestinal issues (constipation, reflux)
- Post-surgical pain
Pain management is a critical part of CP care. It may involve physiotherapy, medications, positioning, orthotics, and sometimes surgical intervention.
Speech & Feeding
CP can affect the muscles used for speech, chewing, and swallowing:
- Dysarthria — difficulty with speech clarity due to poor muscle control
- Dysphagia — difficulty swallowing, which can lead to aspiration (food or liquid entering the lungs)
- Drooling — due to poor oral muscle control
- Gastro-oesophageal reflux — common in more severe CP
Speech pathologists play a key role in managing these challenges, including introducing augmentative and alternative communication (AAC) when needed.
Behaviour & Mental Health
People with CP are at higher risk of:
- Anxiety and depression — especially in adolescents and adults
- Social isolation — due to physical barriers or communication difficulties
- Frustration and behavioural challenges — often related to communication barriers or pain
- Low self-esteem — particularly during school years
- Fatigue — CP requires more energy for movement, which can affect mood and function
Other Associated Conditions
- Constipation — very common, due to reduced mobility and muscle control
- Osteoporosis — reduced bone density due to limited weight-bearing
- Hip displacement — the hip joint can gradually dislocate, especially in more severe CP
- Scoliosis — curvature of the spine
- Sleep disorders — difficulty sleeping due to pain, positioning, or breathing issues
- Urinary issues — bladder control difficulties