Around the age of six all children are going off to school. Children move from explorative play, which is fairly informal to a much more formal day. That can be a lengthy day and it's quite structured.
Children with cerebral palsy can get quite fatigued during the day which can have impacts on both their physical posture and abilities, in addition to their learning.
They need to use their hands in a much more structured, formalized way. They need to learn how to use writing instruments, how to do things in craft.
These challenges can change the way that parents think about their children's manual abilities and the sorts of goals that they identify and come back to the clinic to talk about.
Communication changes as children start at school. Children are expected to listen and then respond, and often they're only given a certain amount of time to respond. That can be really challenging for a child who's got cerebral palsy who may need more time to formulate their response and to get that information out verbally.
"Communication changes as children start at school."