Employees with Cerebral Palsy

Accommodation and Compliance Series
Practical Solutions • Workplace Success 

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Preface 

The Job Accommodation Network (JAN) is a service of the Office of Disability 

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contact JAN. 

Authored by Eddie Whidden, MA. Updated 03/22/10. 
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JAN’S ACCOMMODATION AND COMPLIANCE SERIES

Introduction 

JAN’s Accommodation and Compliance Series is designed to help employers determine 

effective accommodations and comply with Title I of the Americans with Disabilities Act 

(ADA). Each publication in the series addresses a specific medical condition and 

provides information about the condition, ADA information, accommodation ideas, and 

resources for additional information. 

The Accommodation and Compliance Series is a starting point in the accommodation 

process and may not address every situation. Accommodations should be made on a 

case by case basis, considering each employee’s individual limitations and 

accommodation needs. Employers are encouraged to contact JAN to discuss specific 

situations in more detail. 

For information on assistive technology and other accommodation ideas, visit JAN's 

Searchable Online Accommodation Resource (SOAR) at http://askjan.org/soar. 

Information about Cerebral Palsy (CP) 

What is CP? 

Cerebral palsy is a term used to describe a group of chronic conditions affecting body 

movement and muscle coordination. It is caused by damage to one or more specific 

areas of the brain, usually occurring during fetal development; before, during, or shortly 

after birth; or during infancy. Thus, these disorders are not caused by problems in the 

muscles or nerves. Instead, faulty development or damage to motor areas in the brain 

disrupt the brain's ability to adequately control movement and posture (United Cerebral 

Palsy, 2008). 

"Cerebral" refers to the brain and "palsy" to muscle weakness/poor control. CP itself is 

not progressive; however, secondary conditions, such as muscle spasticity, can 

develop, which may get better over time, get worse, or remain the same. CP is not 

communicable; it is not a disease (United Cerebral Palsy, 2008). 

How prevalent is CP? 

Exact figures are difficult to obtain because of the wide variation in the condition and 

lack of reporting requirements of doctors. However, the United Cerebral Palsy 

Association estimates that approximately 8,000 infants are born with CP each year. In 

the United States, 764,000 adults and children have one or more of the symptoms 

associated with CP (United Cerebral Palsy, 2008). 
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What are the symptoms of CP? 

CP is characterized by an inability to fully control motor function, particularly muscle 

control and coordination. Depending on which areas of the brain have been damaged, 

one or more of the following may occur: muscle tightness or spasticity; involuntary 

movement; disturbance in gait or mobility, difficulty in swallowing and problems with 

speech. In addition, the following may occur: abnormal sensation and perception; 

impairment of sight, hearing or speech; seizures; and/or mental retardation. Other 

problems that may arise are difficulties in feeding, bladder and bowel control, problems 

with breathing because of postural difficulties, skin disorders because of pressure sores, 

and learning disabilities (United Cerebral Palsy, 2008). 

What types of CP are there? 

Spastic Cerebral Palsy: People with spastic CP have stiff and jerky movements 

because their muscles are too tight. Mobility and handgrip are difficult to control. This is 

the most common type of CP and affects half of all people with CP (United Cerebral 

Palsy, 2008). 

Ataxic Cerebral Palsy: Low muscle tone and poor coordination of movements is 

described as ataxic. Shakiness or tremors make writing, page turning or using a 

keyboard difficult to perform. Poor balance and unsteady walking requires extra mental 

concentration or more time to complete the movements (United Cerebral Palsy, 2008). 

Athetoid Cerebral Palsy: Athetoid refers to a type of CP involving mixed muscle tone, 

too high or too low. Random, involuntary movements result in movements of the face, 

arms and upper body. Walking, sitting upright and maintaining posture control takes 

extra work and concentration. About one fourth of people with CP have athetoid CP 

(United Cerebral Palsy, 2008). 

Mixed Cerebral Palsy: When muscle tone is too low in some muscles and too high in 

other muscles, the type of CP is called mixed. About one fourth of all people with CP 

have this type (United Cerebral Palsy, 2008). 

Can CP be treated?

"Management" is a better word than "treatment." Management consists of helping the 

child achieve maximum potential in growth and development. This should be started as 

early as possible with identification of the very young child who may have a 

developmental brain disorder. A management program can then be started promptly 

wherein programs, physicians, therapists, educators, nurses, social workers, and other 

professionals assist the family as well as the child. Certain medications, surgery, and 

braces may be used to improve nerve and muscle coordination and prevent or minimize 

dysfunction (United Cerebral Palsy, 2008). 

As individuals mature, they may require support services such as personal assistance 

services, continuing therapy, educational and vocational training, independent living 
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services, counseling, transportation, recreation/leisure programs, and employment 

opportunities, all essential to the developing adult. People with CP can go to school, 

have jobs, get married, raise families, and live in homes of their own. Most of all people 

with CP need the opportunity for independence and full inclusion in our society (United 

Cerebral Palsy, 2008). 

CP and the Americans with Disabilities Act 

Is CP a disability under the ADA? 

The ADA does not contain a list of medical conditions that constitute disabilities. 

Instead, the ADA has a general definition of disability that each person must meet 

(EEOC, 1992). Therefore, some people with CP will have a disability under the ADA 

and some will not. 

A person has a disability if he/she has a physical or mental impairment that substantially 

limits one or more major life activities, a record of such an impairment, or is regarded as 

having such an impairment (EEOC, 1992). For more information about how to 

determine whether a person has a disability under the ADA, visit 

http://askjan.org/corner/vol02iss04.htm. 

Accommodating Employees with CP 

(Note: People with CP may develop some of the limitations discussed below, but 

seldom develop all of them. Also, the degree of limitation will vary among individuals. Be 

aware that not all people with CP will need accommodations to perform their jobs and 

many others may only need a few accommodations. The following is only a sample of 

the possibilities available. Numerous other accommodation solutions may exist.) 

Questions to Consider: 

1. What limitations is the employee with CP experiencing? 

2. How do these limitations affect the employee and the employee’s job performance? 

3. What specific job tasks are problematic as a result of these limitations? 

4. What accommodations are available to reduce or eliminate these problems? Are all 

possible resources being used to determine possible accommodations? 

5. Has the employee with CP been consulted regarding possible accommodations? 

6. Once accommodations are in place, would it be useful to meet with the employee 

with CP to evaluate the effectiveness of the accommodations and to determine 

whether additional accommodations are needed? 

7. Do supervisory personnel and employees need training regarding CP? 
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Accommodation Ideas: 

Activities of Daily Living: 

• Providing close proximity to restrooms 

• Adapting accessibility features in the restrooms 

• Allowing use of personal care attendants 

• Allowing use of a service animal 

• Allowing extra time for activities of daily living (ADL) 

Fine Motor Impairment: 

• Modifying workstation design 

• Using alternative computer input devices/software 

• Using telephone assistance devices 

• Using writing aids and grips 

• Adjusting filing/storage systems 

Gross Motor Impairment: 

• Maintaining unobstructed hallways, aisles and other building egress 

• Assigning workspace in close proximity to office machines 

• Modifying workstation design and height 

• Providing lightweight doors or automatic door openers 

• Removing building barriers to access including close designated parking, 

accessible router and entrances 

Cognitive Impairment: 

• Using computer software programs for self-editing, word prediction, 

grammar/spell checkers, etc. 

• Providing electronic organizers, posting of notes/reminders 

• Allowing extra time to complete work assignments 

Communication Activities: 

• Developing a plan and providing equipment for safe evacuation 

• Alerting the fire department of probable location of the individual with mobility 

impairments in case of emergency 

• Providing speech augmentation devices 
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Situations and Solutions: 

An accountant with CP could not walk long distances. His employer provided him with a 

reserved parking space close to the building and allowed him to work from home three 

days a week. 

An office assistant with CP had difficulty typing due to mild spasticity in her upper 

extremities. Her employer purchased a keyguard to go over her keyboard to help her hit 

the right keys and forearm supports to help stabilize her arms. 

A teacher with CP had difficulty manipulating papers and writing on the chalkboard. She 

was provided a teacher’s aide to pick up and pass out student papers and an overhead 

projector to replace the chalkboard. 

A janitor with CP and balance problems was having problems walking about the facility 

and safely climbing ladders to change light bulbs. His employer provided him with a 

motorized cart and a rolling safety ladder. 

Products: 

There are numerous products that can be used to accommodate people with limitations. 

JAN's Searchable Online Accommodation Resource at <http://askjan.org/soar> is 

designed to let users explore various accommodation options. Many product vendor 

lists are accessible through this system; however, JAN provides these lists and many 

more that are not available on the Web site upon request. Contact JAN directly if you 

have specific accommodation situations, are looking for products, need vendor 

information, or are seeking a referral. 
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Resources 

Job Accommodation Network 

West Virginia University 

PO Box 6080 

Morgantown, WV 26506-6080 

Toll Free: (800)526-7234 

TTY: (877)781-9403 

Fax: (304)293-5407 

jan@askjan.org 

http://askjan.org 

The Job Accommodation Network (JAN) is a free consulting service that provides 

information about job accommodations, the Americans with Disabilities Act (ADA), and 

the employability of people with disabilities. 

Office of Disability Employment Policy 

200 Constitution Avenue, NW, Room S-1303 

Washington, DC 20210 

Toll Free: (866)633-7635 

TTY: (877)889-5627 

Fax: (202)693-7888 

http://www.dol.gov/odep/ 

The Office of Disability Employment Policy (ODEP) is an agency within the U.S. 

Department of Labor. ODEP provides national leadership to increase employment 

opportunities for adults and youth with disabilities while striving to eliminate barriers to 

employment. 

American Academy for Cerebral Palsy & Developmental Medicine

6300 North River Road, Suite 727 

Rosemont, IL 60018-4226 

Direct: (847)698-1635 

Fax: (847)823-0536 

woppenhe@ucla.edu 

http://www.aacpdm.org 

Devoted to the study of cerebral palsy and other childhood onset disabilities, to 

promoting professional education for the treatment and management of these 

conditions, and to improving the quality of life for people with these disabilities. 

American Academy of Neurology

1080 Montreal Avenue 

St. Paul, MN 55116 

Toll Free: (800)879-1960 

Direct: (651)695-2717 
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Fax: (651)695-2791 

memberservices@aan.com 

http://www.aan.com/ 

The American Academy of Neurology (AAN) provides valuable resources for medical 

specialists worldwide who are committed to improving the care of patients with 

neurological diseases. 

Cerebral Palsy Research Foundation of Kansas, Inc.

PO Box 8217 

5111 East 21st Street N. 

Wichita, KS 67208 

Direct: (316)688-1888 

Fax: (316)688-5687 

info@cprf.org 

http://www.cprf.org/default.asp 

Cerebral Palsy Research Foundation of Kansas primary goal is to provide opportunities 

allowing physically disabled persons to reach their full potential through employment, 

recreation, education, and independent living. 

Rehabilitation Engineering Society of North America

1700 North Moore Street, Suite 1540 

Arlington, VA 22209-1903 

Direct: (703)524-6686 

TTY: (703)524-6639 

Fax: (703)524-6630 

http://www.resna.org 

RESNA's purpose is to promote and support the development, dissemination, 

integration, and utilization of knowledge in rehabilitation engineering, and to assure that 

these efforts result in the highest quality of care and service delivery for all citizens. 

TASH

1025 Vermont Ave., Floor 7 

Washington, DC 20005 

Toll Free: (800)482-8274 

Direct: (202)263-5600 

Fax: (202)637-0138 

info@tash.org 

http://www.tash.org 

An international association of people with disabilities, their family members, other 

advocates, and professionals who work in the disability field. Promotes the full 

participation of people with disabilities in integrated community settings that support the 
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same quality of life available to people without disabilities. Provides information and 

referral resources; renders targeted advocacy. 

Trace Research & Development Center

University of Wisconsin - Madison 

2107 Engineering Centers Bldg. 

1550 Engineering Dr. 

Madison, WI 53706 

Direct: (608)262-6966 

TTY: (608)263-5408 

Fax: (608)262-8848 

info@trace.wisc.edu 

http://trace.wisc.edu 

The Trace Research & Development Center's mission is to prevent the barriers and 

capitalize on the opportunities presented by current and emerging information and 

telecommunication technologies, in order to create a world that is as accessible and 

usable as possible for as many people as possible. 

United Cerebral Palsy

1660 L Street, NW, Suite 700 

Washington, DC 20036 

Toll Free: (800)872-5827 

Direct: (202)776-0406 

TTY: (800)872-5827 

Fax: (202)776-0414 

info@ucp.org 

http://www.ucp.org 

United Cerebral Palsy's mission is to advance the independence, productivity, and full 

citizenship of people with cerebral palsy and other disabilities through its commitment to 

the principles of independence, inclusion, and self-determination. 
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References 

Equal Employment Opportunity Commission. (1992). A technical assistance manual on 

the employment provisions (title I) of the Americans with Disabilities Act. 

Retrieved September 5, 2008, from http://askjan.org/links/ADAtam1.html 

United Cerebral Palsy. (2008). Cerebral palsy: facts and figures. Retrieved September 

5, 2008, from http://www.ucp.org/ucp_generaldoc.cfm/1/9/ 37/37-37/447 
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This document was developed by the Job Accommodation Network, funded by a 

contract agreement from the U.S. Department of Labor, Office of Disability Employment 

Policy (DOL079RP20426). The opinions expressed herein do not necessarily reflect the 

position or policy of the U.S. Department of Labor. Nor does mention of trade names, 

commercial products, or organizations imply endorsement by the U.S. Department of 

Labor.