Resources for children with cerebral palsy and their families, such as research and educational presentations regarding therapies, care, and a free cerebral palsy toolkit you can download!

A blond woman kneels while speaking with her daughter braided hair in a wheelchair.

Results: Communication and Participation in CP

Kristen Allison, PhD, CCC-SLP. A smiling woman with long blond hair wearing earrings and a light grey sweater.

Kristen Allison, PhD, CCC-SLP, an Assistant Professor at Northeastern, is this month’s featured speaker for the MyCP Webinar Series, presenting the results of her recent study in speech and language for children with CP.

Next Wednesday, November 17, at 8 pm, Kristen Allison, PhD, CCC-SLP, will present the results of her study of Speech and Language Predictors of Participation in Children with Cerebral Palsy, as part of the CP Research Network’s MyCP Webinar series. Dr. Allison received our Research CP grant award in 2019 for her study investigating how speech and language capability affect a child’s quality of life in terms of participation in activities. Attendees of this webinar will learn what she discovered and be able to participate in a live Q&A with Dr. Allison.

“We found that several aspects of a child’s speech and language skills affect how often they participate and how involved they are in social activities.” said Dr. Allison. “Our results highlight just how important effective communication is to quality of life for children with CP!”

Dr. Allison is an Assistant Professor in the Department of Communication Sciences & Disorders and the director of the Speech Motor Impairment & Learning (SMILe) Lab at Northeastern University. The study was hosted and distributed through th CP Research Network Community Registry and data collection was completed in 2020. Dr. Allison will not only share the results of the study but talk about its meaning for both parents of children with CP, but also how the data will be used to inform future research questions.

Community members interesting in learning about the results of Dr. Allison’s research can sign up to receive webinar login instructions. People who have already registered for the whole MyCP webinar series will be sent an invitation with login details prior to the webinar. Note: Our MyCP webinar series now require a Zoom account to sign in. You can get a free Zoom account here.

A green page banner with a headshot of Dr. Wade Shrader. A smiling man with short brown hair and beard wearing a dark suit.

Webinar on Hip Surveillance and CP

Dr. Wade Shrader of Nemours/AI duPoint, smiling in a blue suit, is an orthopedic surgeon who leads the CP program at Nemours

Dr. Shrader, an orthopedic surgeon, leads the hip surveillance initiative for the CP Research Network.

After taking a break during the last month of summer, our MyCP webinar series will resume on Wednesday, September 29 at 8 pm ET with a presentation on our hip research program. Hip pain is the most frequent cause of pain in children with cerebral palsy and can cause problems with mobility and range of motion. We have begun a hip surveillance program at our the CP Research Network centers to proactively address this issue—a very challenging task to undertake. Our upcoming webinar will feature Dr. Wade Shrader, a pediatric orthopedic surgeon and Division Chief of Cerebral Palsy at Nemours/AI duPont Hospital in Wilmington, DE who leads this effort for the network. He is also the parent of four children, two of whom are adults with CP.

In order to protect the hips of children with CP, the American Academy for Cerebral Palsy and Development Medicine (AACPDM) released an updated “care pathway” recommending the frequency and techniques for monitoring the hip health of children with CP in June 2018. Care pathways combine the latest evidence-based medicine and expert opinion to provide guidance on how to treat complex conditions. Dr. Shrader will discuss the anatomy of childrens’ hips, the impact of CP, the importance of monitoring hips, and how parents and caregivers can advocate for their child’s hip health.

“I know first-hand as a Dad how tough recovery from hip reconstruction surgery can be, “ said Dr. Shrader. “I’m looking forward to talking with the CPRN community about hip issues in Cerebral Palsy, and to give my perspective as both a pediatric orthopedic surgeon and a family member.”

Community members and clinicians interested in the webinar can sign up on cprn.org. MyCP members and series registrants will receive the Zoom link automatically prior to the webinar. Join us!

“Traveling With a Wheelchair” on a bright green page banner with a photo of a wheelchair beside the ramp to enter the aircraft.

Traveling With a Wheelchair

A damning report has revealed how the country’s leading airlines have lost or damaged at least 15,425 wheelchairs or scooters since the end of 2018. As we travel from A to B, what steps can we take to safeguard the precious cargo our community relies on?

Traveling by air can be stressful for anyone but handing over a wheelchair to busy airline staff and hoping to find it unscathed and fully-functioning at your destination can feel like a lottery. Sadly, for many traveling with disabilities, vacations and other trips too often go hand-in-hand with the frustrating fallout of damaged equipment.

“As a family with a wheelchair user it is a continual frustration that airlines often take such little care,” says CPRN’s Michele Shusterman. “It seems like airlines would rather pay thousands of dollars to repair or replace broken equipment instead of figuring out a process for not destroying them. Some of the experiences our community members go through are awful.”

As we await much needed change and a commitment to better care from airlines, there are some preemptive measures we can take to lower the risks of equipment being damaged in transit. Here’s our guide to traveling with a wheelchair:

Before you go, carry out maintenance.

Making sure your equipment is in the best shape possible before leaving will help it to be more durable and robust on your travels.

MANUAL WHEELCHAIRS: The newer designs of manual wheelchairs have solid inner tubes to combat against flats. Before you leave, check the tires for any inflation issues, cuts, or wear on the tread (Miller, 2017). Be sure to check the wheel locks, ensuring that they engage and disengage easily without getting caught. Go through and tighten bolts and nuts on any moving parts. This is to avoid any parts being lost during transit.

BATTERY-POWERED WHEELCHAIRS: Run through the same checks for the tires prior to your trip and consider book a service for your equipment. Battery-powered wheelchairs routinely need to be checked by an authorized dealer once or twice a year (Miller, 2017). An expert can check your battery voltage and flag up if it needs to be replaced soon.

Get familiar with the airline codes.

Airlines have a series of codes for people traveling with equipment or disability. These codes are called Special Service Request Codes, or SSR, and are given to you when you get your ticket (wheelchairtravel, 2020). They are used to keep track of special assistance requests and to assign appropriate staff to the person in need.

A few of these codes include:

CODE DESCRIPTION
WCHR Wheelchair assistance required
WCOB On-board wheelchair requested
WCMP Traveling with manual wheelchair
WCBD Traveling with dry cell battery-powered wheelchair. (WCBW for wet cell battery)

You’ll find a more comprehensive list here. Ensure that your flight ticket is marked with the correct one.

Attach instructions to your equipment.
Traveling with a wheelchair tips: A spare manual wheelchair is pictured on the tarmac with a bright pink instructional signTraveling with a wheelchair tips: A wheelchair should include handling instructions and fight details attached to the chair
It seems like a no-brainer that wheelchairs and other expensive and precious equipment should be handled with the utmost care but that can be far from the reality. Sadly, your equipment will likely encounter people who are unfamiliar with how it works and don’t have the time or inclination to find out how to operate it correctly. Attaching laminated instructions and bright reminder signs to your equipment can help to prevent rough mishandling.

Consider taking a spare if you have one.

Sometimes it is better to plan for the worst outcome so that mobility isn’t impaired during the trip. Take a spare wheelchair, often a manual one, if you can do so. This will ensure an easy back up if the airline does damage the wheelchair before you get to your destination. Having a spare wheelchair can also help when accessing certain areas where a power wheelchair may have some difficulties. If you do not have a spare, be mindful of the resources available to you in the area you are traveling. See if renting a wheelchair is an option.

Preparation for flight at the airport
Traveling with a wheelchair tips: A manual chair is bound with cellophane and loose items removed in prep for travel.
If you are using a manual collapsible wheelchair, ask if the aircraft has a closet large enough to accommodate it. This ensures you can take your equipment all the way to the gate. If your equipment is being stored in the cargo hold with baggage, carefully remove anything that you think may come lose during handling. Ask for reassurance that it will be handled with care.

Ask for assistance if you need it – it’s your right.

Airlines must provide assistance and offer preboarding to passengers with disabilities who make their needs known prior to travel or at the gate. Get familiar with the Air Carrier Access Act of 1986 (ACAA), a law that guarantees people with disabilities the right to receive fair and nondiscriminatory treatment when traveling on flights operated by airlines in the U.S (wheelchairtravel, 2020).

If an airline damages your equipment, it may be covered.
Plane travel with a wheelchair is challenging: a wheelchair, collapsed on its side, rides up a luggage ramp into an airplane
Airlines are mainly responsible for damaging equipment during their flights. This can be up to the entire cost of the original listing price of the wheelchair. For this process to happen properly, report damages IMMEDIATELY after your flight. This further ensures that it is documented and brought to the right people, a step in the direction of making the airline 100% responsible for damages!

Sources:

Flying With A Wheelchair: Guide To Air Travel For People With Disabilities. Wheelchair Travel. (2020, January 30).

Miller, F., & Bachrach, S. J. (2017). Cerebral palsy: a complete guide for caregiving (3rd ed.). Johns Hopkins University Press.

Four smiling women stand outdoors on a sunny day behind the UP Academy sign with their arms folded and resting on top.

CP Stories: Tanya Sheckley and UP Academy

Meet the CP mom who overcame her grief to build an incredible inclusive school in her daughter’s memory

Everyone needs a place to belong. Inclusivity is life.
Tanya Sheckley
Mom, Inclusive School Creator

Tanya Sheckley’s vision of creating an inclusive school empowering ALL children was almost shattered with the untimely death of her beloved daughter Eliza. Yet, the resilient mother channeled her grief into creating a school to embody everything Eliza taught her about ableism, education, and empathy.

Like many CP parents, Tanya Sheckley worked hard to research education options for her daughter Eliza, who was born with spastic quadriplegia cerebral palsy.

As her daughter’s kindergarten years approached, Tanya, who lives in Mountain View, California, was dismayed to learn that many schools provided the bare minimum when it came to educating children with disabilities.

Tanya Sheckley in a red blouse smiles at her daughter Eliza who is wearing a magenta taffeta party dress with red flowers in the neckline.

Tanya Sheckley with her daughter Eliza.

Eventually, Tanya found a parent participation school that was great for Eliza, who was unable to walk or talk due to her cerebral palsy. Her daughter’s new kindergarten teacher had experience in special education and Tanya was happy to see Eliza thrive.

“She learned to read, do math, and was curious about science,” recalls Tanya. “Kids didn’t see her as ‘different.’ She fit in, she was happy and became one of the most popular kids at school. She did well academically with accommodation for the way she learned. We had gotten lucky.”

By first grade, things were changing. Despite Eliza’s stellar kindergarten record, Tanya and her husband Chris were frustrated by the recommendation to put their bright and inquisitive daughter into a modified curriculum for children with different abilities. The one-size-fits-all model meant the work would be made easier, and Eliza would not be expected to learn the same material as her able-bodied classmates.

Under the Individuals With Disabilities Education Act (IDEA), public schools are required to provide access to education. Unfortunately, in a system built to educate the masses, children who are “different” often aren’t encouraged to excel in the same way as their peers.

“It felt like a barrier to providing real opportunity,” says Tanya. “Just because a student doesn’t have an effective and consistent method of expressing knowledge doesn’t mean the student doesn’t possess the knowledge. All students should be challenged in areas of strengths and supported in areas of weakness so they leave school with the knowledge and skills to be successful and independent in the world.”

Tanya, who had previously worked in business and taught as a yoga and ski instructor, became frustrated that no one school could support Eliza and her younger siblings Breda and Keller in their individual strengths. Why couldn’t there be an inclusive elementary school set up for all children to thrive?

In 2015, she decided to create an inclusive school for kids with disabilities and their able-bodied siblings.

Kids work on painting and decorating a wall at the new UP Academy.

Students decorate the wall at UP Academy.

The determined mother sought funding, secured a lease, raised awareness, and reached out to her community to recruit and admit kids who would benefit from everything the school would have to offer. The new school, UP Academy, gained 501c3 status in December 2015.

Then the unthinkable happened. Eliza passed away in her sleep in March of 2016.

“It was completely unexpected,” says Tanya. “Eliza was fine and was having fun but one Friday she came home from school early because she was tired and not feeling well. I laid her down for a nap and told her I loved her. Our nanny was there to care for all three of our children so I went to the grocery store.

“When I checked on Eliza later she wasn’t breathing and her lips were blue. We did CPR until help arrived and Eliza was transported to the hospital where they did all they could. But there was nothing more the doctors could do. Walking out and leaving her behind was one of the hardest things I’ve done in my life.”

Despite her grief, Tanya could not give up on the school.

“I needed to find a way for the grief to serve me,” she says. “My family needed me to still be a mother and wife, and Eliza had taught me about ableism, education, and empathy. I had learned too much to walk away. I could lay in bed all day or use what I have learned to help others. There were still many families of children with disabilities who couldn’t find a fit for their children in the education system. To honor Eliza and to help them, I needed to work to create change.”

For the next two years, Tanya continued to build the school and welcomed her first group of students in 2018. There were plenty of challenges. The school’s first building lease fell through but Tanya persuaded a local church to let her use their rooms for a time. Eventually another location was found and the school has had a permanent home in San Mateo for the past three years.

With 20 students enrolled in UP Academy, Tanya is considering opening another location next year in the San Francisco Bay area. It is her vision to encourage other parents and educators to launch their own schools with a course she created, the Rebel Educator Accelerator.

“When we all work together, we can be more creative and achieve more,” she says. “Our vision for UP Academy is to build a method of education that can be shared and replicated. By teaching, training and sharing our curriculum with other schools we can serve more students in new and innovative ways.”

There is not a day that passes without Tanya thinking about her daughter who continues to inspire her.

“Eliza was sweet and kind,” she says. “She loved people and spending time with her friends. She was stubborn and wanted things to be done her way. She made decisions quickly and stood by them. We still have a dish we call Eliza Guacamole, which is smashed avocado and banana.

“It’s important to remember that despite any disability, all kids want to play, learn and make friends. Everyone needs a place to belong. Inclusivity is life, it is love, it is understanding and empathy, it is the thing that allows us to learn and work and play together.”

[ends]

The diagram patient priority framework from PSCORE shows an interrelationship among different interests in cerebral palsy care.

A step forward in Standardizing Patient Reported Outcomes

Hospitals and clinicians in the Cerebral Palsy Research Network will be able to track, learn from, and compare outcomes for their patient populations thanks to our selection of standardized patient outcome measures. The CP Research Network has collaborated with Dr. Unni Narayanan, the subject of our recent CP Stories series, at the Hospital for Sick Children in Toronto, Canada, to standardize a validated set of patient-reported outcome measures (PROMs) across the network. Working closely with Nationwide Children’s Hospital in Columbus Ohio and Dr. Narayanan’s PRIORITY-BASED SCALES FOR CHILDREN’S OUTCOMES – RESEARCH & EVALUATION (PSCORE) Program, the CP Research Network has released electronic versions of two PROMs to collate patient information across sites in our network.

The Gait Outcomes Assessment List (GOAL) and the Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD) will ensure CP families can provide information and communicate their needs to clinicians in patient facing portals like Epic’s MyChart. On a wider scale this submitted data will also help improve treatment more widely in the CP community. Shared decision-making helps balance the input of doctors and experts with the priorities and preferences of patients and their families.

The patient priority framework from PSCORE shows an interrelationship among patient priorities, interventions and outcomes for people living with cerebral palsy.

The patient priority framework from PSCORE shows an interrelationship among patient priorities, interventions and outcomes for living with cerebral palsy.

In addition to these benchmarking capabilities, the PROMs allow patients and patient families to identify important goals, which clinicians can take into account as they make decisions about treatments. And the standardization of PROMs holds the promise to improve medical and surgical outcomes across the network.

Dr. Narayanan has been funded by the Canadian Institute for Health Research (CIHR) to study the impact of these tools in improving shared decision making.

Patient families can use these tools today in MyCP – the CP Research Network’s personalized platform for cerebral palsy resources. The CPCHILD and GOAL Questionnaires are available in the MyCP Community Registry that can be taken annually to track a child’s progress across numerous domains like activities of daily living, mobility or participation. Once a family takes the survey, they can download a PDF of their results which includes their important goals, and bring these results to an appointment with their CP focused physician or therapy team.

The CP Research Network will enhance these tools over time to provide summary reports that will include the scores and list of important goals to better support shared decision making. Parents of children under the age of 18 can sign up for MyCP and take these surveys now.

A banner with MyCP Webinar Series, ‘What is a learning Health Network and why should you care?’ and a photo of Dr. Amy Bailes.

What is a Learning Health Network – and why should you care?

Amy Bailes, PT, PhD

Amy Bailes, PT, PhD

On Monday, June 21, at 8 pm ET, we invite you to tune in for our next MyCP Webinar, to discover why the Cerebral Palsy Research Network is working to become a learning health network and how doing so will enhance our efforts to improve health outcomes.

The webinar will be presented by Amy Bailes PT PhD, leader of the CP Research Network’s quality improvement initiatives. She will outline how learning networks – that often form a registry at their core – can quickly gather and share data that rapidly improve treatment experiences for patients.

During the 40 minute webinar, Dr. Bailes, a physical therapist and researcher at Cincinnati Children’s Hospital, will also outline the CP Research Network’s efforts to become a learning health network and how that ties in to clinical initiatives we already have underway.

“Taking the most effective practices from the best CP centers across the nation and spreading those practices in a systematic fashion, will have profound impact on the health of people with CP,” says Dr. Bailes. “This is how we should be caring for all people with CP.”

Learning health networks seek to improve outcomes through a combination of research and quality improvement (QI) initiatives. While some research studies can take years to complete and can require more time to affect a change in practice, QI initiatives can drive systemic change and bring results as early as six months.

“While QI cannot answer fundamental questions about treatment effectiveness or discover new therapeutic interventions, it can be used to dramatically improve health outcomes very rapidly,” says Paul Gross, President and Chief Executive Officer of CP Research Network.

Members of the community, clinicians and researchers interested in learning more about the CP Research Network’s drive to become a learning health network can tune in to the June 21 webinar by registering on the sidebar at the top (or on the MyCP Webinar Registration page).

Four laughing young adults in a line; two young men in the middle with two young women on either side of them pose for a photo.

Preparing for College – Part 3

Carol Shrader, mother of four, two of whom have cerebral palsy.

In the third installment of her inspiring story, CP and triplet mom Carol Shrader shares how she watched her son Benjamin, who has spastic quadriplegia, flourish during his college years…

The night before my son Benjamin began his freshman year, I could not sleep. I worried all night long.

“I know, right?” my husband Wade consoled, observing my nervous disposition. “I have been thinking about this day for 18 years!”

Benjamin, our triplet with spastic quadriplegia, lived at home with us and his younger sister Cate for the first three years of college, but getting around campus independently was still a big deal.

He was only a week and a half into the first semester when we hit our first snag. Benjamin was heading across campus in his wheelchair with a fellow student and following her lead. When she pointed at the curb where they needed to cross the street and asked him if he could make it, he assumed it was flat. Unfortunately, his depth-perception issues prevented him from knowing for sure. It wasn’t flat. He drove right off the curb.

His professor called me, and I rushed to the campus to find my shaken son, clearly in pain and surrounded by college kids, security, and the head of the theatre department. The footplates on his wheelchair were the only thing that prevented him from landing on his face. His feet still took the brunt of the 300-pound weight of him and his wheelchair.

I have never wanted to jerk back control of a situation more – and it was clear I needed to.

Quickly rearranging my schedule, I ensured I could be on campus the rest of the school year. I assisted between classes, shuttling Benjamin between the upper campus and the lower campus where theatre classes were held. I brought him lunch. I took care of his toileting needs. I brought him back to campus for late night events and drove him wherever he needed to go, ensuring he could fulfill his college kid schedule.

At the same time, I worked to find ways to help him achieve independence. I began by phoning the ADA compliance officer and asking for the sidewalks to be revamped on campus. They needed ramps so Benjamin could navigate them safely. When the ramps were consistently blocked by mail delivery vehicles, maintenance, and even professors, I called the dean.

With problems still arising, I called the university president and, in my sweetest Mama Bear voice, told him that Benjamin could not succeed at his college if he could not ever get into the classrooms. A few weeks later, every ramp on campus had been repainted with the words “DO NOT BLOCK” in bold letters.

Meanwhile, Benjamin worked with the ADA office to secure a scribe for tests. The professors assigned a student to copy their notes for him. I was his scribe at home for each assignment. We even burned the midnight oil together, working on a 24-hour theatre assignment to write a play overnight so his team could memorize lines and perform them the next day. Poor Benjamin had to dictate to a scribe who fell asleep between lines.

The triplet’s freshman year continued to be a long year of learning for all of us. Mason was doing well, living a relatively independent life on campus at his college. Claire, my triplet without cerebral palsy, had moved onto campus about half an hour from our home. Throughout her four years, she called, texted, and sent video messages. Sometimes she would share a funny story about life on campus; sometimes, she just needed her mom and emotional support.

When April arrived, I noticed a shift in Benjamin. During a course selection meeting with his advisor, he took an assertive new tone.

“I need to arrange my schedule so that I am at the upper campus for three days a week and the theatre campus for two days a week or vice versa,” he said. “I need for my mom to be able to leave me on campus.”

By the time Benjamin began his sophomore year, he had a personal care team trained to assist him. Having a personal care attendant meant he could be independent of me and could organize his study time, extra-curricular activities, and classes the way he wanted. By his senior year, Benjamin felt confident to move into a newly built dorm with accessible units. It was an enormous step.

Initially, Benjamin didn’t love staying in the dorm, but he grew to enjoy his independence. It was empowering for him to be in charge of his schedule, meals, and life. The accessible dorm and the ultimate willingness of the college administration gave him this opportunity. He had a great college experience participating in theatrical productions as both an actor and a dramaturg and was elected to homecoming court twice in four years.

Benjamin Shrader in his second round of being elected to the Homecoming chord.

Benjamin Shrader at a college graduation celebration.

Benjamin graduated Magna Cum Laude with a major in dramatic writing and a minor in political science. When he presented his final script as a read-through performance for his senior project, every single one of his team of PCAs was in the audience because they were so invested in him.

His brother Mason was recently accepted to his second Master’s program in Anthropology, focusing on Bio Archaeology at Texas Tech. Claire is currently in her second semester of Occupational Therapy School at Thomas Jefferson University in Philadelphia.

Claire enjoyed a semester studying abroad in Argentina and founded sibling workshops for the brothers and sisters of differently-abled children worldwide. When she got an internship with an autism foundation, she discovered they had nothing for siblings, so she created a program. She went on to graduate Magna Cum Laude with a major in Spanish, a minor in English, and all her pre-occupational therapy courses.

When I reflect on the triplets’ journey, I would like to call the educators who didn’t want to invest in their potential. I want them to know that those little preschoolers they thought would place an undue burden on their teachers graduated with honors – lots and lots of honors.

I would like to tell them that when Benjamin rolled across the stage with his diploma, the faculty were the first to stand in what turned into a standing ovation throughout the graduation hall. Those faculty did not stand because Benjamin had been a burden on their teaching. They stood because he worked hard in their classes, he engaged on a day-to-day basis, he encouraged his fellow students, and set the bar high for their performance.

I would like to show them photos of Mason digging in the ancient acropolis in Majorca and receiving his hood for his thesis. I want them to read his undergraduate thesis on disability in the ancient world. I want them to know that his honors project won the Phi Beta Kappa award for best honors project at his school. They missed the chance to list this amazing Summa Cum Laude graduate and all of his accolades among their alumni.

The Shrader children -- triplets to the right with sister Cate on the left.

The Shrader children — triplets to the right with sister Cate on the left.

They also don’t get to brag about our soon-to-be Occupational Therapist Claire who is already changing the world for young people with CP and their families.

College looked different for each of my three. But they each found the school that matched their needs, the path that worked for their personal dreams, and made it not just a possibility but a reality.

College IS possible for young people with CP. They can make their mark and change the world. They can recolor the way society views students with CP. They can affect change. They CAN succeed.

A smiling young man with glasses, short hair and a beard lies on his side at an archaeological site giving the thumbs up sign.

Preparing for College – Part 2

Carol Shrader, mother of four, two of whom have cerebral palsy.

[In the second installment of her moving three-part story, triplet and CP mom Carol Shrader describes her son Mason’s experience of finding independence as he left home for college for the very first time.]

When you’re a mama bear who has raised four children with very different needs, it’s instinctive to be a helicopter parent. But as I stood on the sidelines watching a college administrator empower my son Mason, I knew the time had come to take a backseat.

“Mason, I’ve heard what your mom thinks you need,” he remarked. “What support do YOU think you need to be successful?”

He may not have made my list of favorite people right then but, as Mason replied with his thoughts, I recognized he was encouraging my son to take charge and have a voice in his own support structure. He was also empowering me to hand over the controls. I could tell by Mason’s face that he was happy. I knew this was the place for him.

Mason was born with spastic diplegic CP, and while he is physically more independent than his brother Benjamin, who has spastic quadriplegia, he has a longer list of medical issues.

When my triplets’ college years arrived, our first hurdle was to find the proper support for our sons to sit for their SATs. I spent hours finding a test site that provided the accessible space we needed for the boys and would allow for scribes to help them write their answers. I filled out multiple forms to ensure the scribes would be permitted and assembled the required medical documentation.

With all the approvals in place, the first test date approached. But even with the best-laid plans, there were obstacles we could not anticipate. My trio was as prepared as I could help them be. They were ready. Then the school called the day before the exam. The scribes had decided they didn’t want to work that Saturday, and the school could not replace them. They would “try” to hire someone for the next test date. Claire took it that day, but Benjamin and Mason had to reschedule. They ended up taking the SAT twice and gained good scores. The relief would carry us through the college application process and all that it entailed.

Our college wish list consisted of schools with excellent access, a manageable student population, and programs of interest. We visited campuses all over the country. We toured schools in Philadelphia, Minneapolis, Chicago, and their more expansive geographic areas, and checked out small liberal arts colleges in California, Mississippi, and Arizona.

We saw great colleges with insufficient access and colleges with excellent access but seemingly a million students. In the end, all three of my triplets chose small liberal arts colleges that offered them an intimate learning environment.

Once Mason had secured his favorite college choice, I helped him put everything we thought he needed in place to live independently. While his campus was only 15 miles from our home, we had made a cross-country move just a few weeks before college started. We had to find Mason doctors to manage his cerebral palsy and his related high blood pressure caused by problems with one of his kidneys, as well as his ulcerative colitis. I had equipped him to talk to doctors himself, but I had failed to teach him to talk to pharmacists. We would have more than one tense mother and son discussion about refilling meds BEFORE they ran out. Equipping him to call in his prescription refills in time and pick them up before he missed a dose was a skill I had overlooked as I prepped him for college. The truth is you can’t predict everything, and you will always be problem-solving on the go.

Mason navigated campus with an electric scooter and his power sticks. Like most moms sending her first born to college, I worried a lot and followed all the campus social media, hoping to get a glimpse of him without nagging him to send me photos.

I was nervous about the electric scooter he took to navigate campus. What if it had negative connotations for him? There was no need to worry. It didn’t. When he joined a fraternity, the president made a point of climbing on the back of Mason’s scooter with the official flag. “We’re going in last!” the president enthused. Staff and students together nicknamed that scooter and were disappointed when rain the weekend of graduation prevented “Bocephus” from attending the swiftly organized indoor ceremony.

Mason threw himself into campus life, serving his fellow students as a resident assistant in the dorms. He was elected student body senator.

When Mason called home his needs varied from emotional to physical, to help with an essential decision like which bow tie matched which shirt. My personal favorite phone call was when he needed me to stop by campus to button the little tiny buttons on his dress shirt.

Mason’s college was not perfect from an accessibility standpoint – the sidewalks were in a deteriorated state, and navigating them in the scooter could be hazardous. The beautiful old buildings had elevators that broke down and didn’t work almost as often as they worked, but the administrators were committed to Mason and his needs.

Mason Shrader on an archeological dig in SpainThe professors recognized his abilities far exceeded his limitations and worked to maximize his opportunities. He thrived, even studying abroad on archaeological digs in the Yucatan of Mexico and off the coast of Barcelona, Spain. Mason worked hard and he had chosen a school with the heart necessary for his success.

He graduated Summa Cum Laude in four years with a major in Classics (Greek and Latin), a major in Anthropology, and a minor in Archaeology. His picture hangs on the wall of the student center as one of just four students in his graduating class chosen for the Hall of Fame. Mason earned this accolade because he took the heart his school poured into him and gave it back with dedication.

Today, Mason is finishing up a Master’s in Classics at Texas Tech University. Before the pandemic, he was living alone, on campus a thousand miles from home.

Whatever the problem, Mason has taken it in his stride. Despite living independently, fine motor skills are challenging, but we work out the solutions.

When he started to look like a hairy mountain man with unkempt hair, beard, and nails, we organized a reconnaissance day sending him on Uber rides around the city to find somewhere he could get his hair and beard cut plus a manicure and pedicure. Now Mason knows exactly which strip mall can serve all those needs and heads there every six weeks.

Mason has CP which has thrown some curveballs his way over the course of his life. But when he lectures, cerebral palsy is the last thing on his students’ minds. Recently, I had the opportunity to speak alongside Mason to a class of students working on their masters in special education. We were in fact, lecturing about CP and the impact these students would have as teachers. But when Mason started speaking about his archaeological research, the entire discussion shifted and the previously quiet class began raising their hands to ask questions. Even they, who were there specifically to discuss CP, had completely forgotten that Mason is affected by this challenge.

I can’t help beaming with pride.

(For more information on preparing for college, visit this resource developed by Carol Shrader from her experiences.)

Three Polaroid photos labeled ‘Benjamin’, ‘Mason’, and ‘Claire’ of premature triplets with nasal cannulas in their incubators.

Preparing for college — a three part series

Carol Shrader, mother of four, two of whom have cerebral palsy.

[With this year’s college search and acceptance period having come to a close, we thought it would be a good idea to plant the seeds for future planning if you have a teenager with cerebral palsy. There is no one better to do this than Carol Shrader, mother of four, two of whom have CP and have recently graduated from college. So this week we return to our educational Tuesday programming with a three part series written by guest blogger Carol Shrader.]

With two out of three of her triplets diagnosed with cerebral palsy, Carol Shrader discovered that setting her children up with an excellent education would take resolve and advocacy. Today, in the first installment of her heartwarming story, she reveals how she fought to get educators to take a positive approach to her triplets’ formative school years…

As the mother of triplets, I was a bit too busy to worry much about my children’s formal education — at least not until it was time for them to begin school.

The Shrader triplets all together in a baby swing.

The Shrader triplets all together in a baby swing.

From the moment Benjamin, Mason, and Claire were born almost three months prematurely on April 19, 1997, my days overflowed with all manner of baby things. Worrying about the future was not on my to-do list.

All three of my babies began their extraordinary lives in the NICU. For the first few weeks I spent hours at the hospital watching as doctors monitored our tiny trio’s progress. Dad was a medical student and came as soon as classes were over to see their progress, and take his turn holding babies.

One by one, we were able to bring them home. Mason was the last one to leave the NICU. We put our little 4lb boy down between Claire and Benjamin in one bed and he immediately laughed out loud and grabbed hold of both of them. It was the sweetest moment.

Like most new mothers, those early days were filled with the mundane and the miraculous but we had a routine. I fed the first baby to wake up hungry – always Mason – and then Benjamin, and then would wake our little sleeping beauty, Claire, to eat. There were dozens of diapers to be changed, endless baths, clothes to coordinate. Once all three were napping, I might have a minute to shower and dress before starting the mothering marathon all over again (might being the key word). But no matter how exhausted, or unkempt I felt, simply walking into their nursery to see three little heads pop up to smile at me was enough to warm my heart and make me smile too.

Although initially, Claire presented some healthcare concerns in the NICU, she was ultimately cleared of any concerns. She became the ruler against which we judged the milestones Benjamin and Mason seemed to be missing. Ultimately, both boys would be diagnosed with cerebral palsy.

Right from the NICU, the triplets were participants in a study on premature babies and were followed closely by physical therapists.

Early on Benjamin was off the chart for motor skills. At four months – four weeks past his due date – he was holding himself up. When a visiting physical therapist announced that his impressive progress could be due to spasticity from CP, I almost quit the study. Her words felt negative and were frankly terrifying.

However, she was right. Soon, Benjamin was clearly not meeting milestones. When Claire and Mason began to roll over, Benjamin could not. Then as Claire progressed to sitting up, Mason started to lag. He couldn’t sit without my help.

As their first birthday approached, our pediatrician recommended we see a developmental pediatrician. And it was this doctor who delivered the diagnosis with a jarring lack of empathy. He’d barely entered the room when he announced, “Of course your boys have CP; what did you think I was going to say today?”

Packing up to leave, I reeled with feelings of hurt, anger, and something else. It was the overwhelming conviction that this doctor had no idea how amazing my boys were going to be. I reeled with the knowledge that I would fight for them with everything I had, for as long as necessary.

Benjamin was diagnosed with spastic quadriplegia affecting all four of his limbs. He uses a power wheelchair. Mason was diagnosed with spastic diplegia. He uses forearm crutches – or what we call “power sticks” – to ambulate. While physically more independent than his brother, he has a longer list of medical issues.

When the triplets were babies, my husband Wade was in the first year of his orthopedic surgical training. His hours were insane, and his sleep schedule was worse than mine. His free time was limited and his worry over the multitude of hurdles and unknowns for our boys dominated that time. And perhaps because he was in his 128th year of higher education (not really, but it felt that way) their college years were what seemed to be of most concern. We vowed to give them every opportunity in life.

Dr. Wade Shrader with his triplets at Disneyland in 2002.

Dr. Wade Shrader with his triplets at Disney in 2002.

By the time we approached the triplets’ fifth birthday, I had begun to do the work to start their education. I took my three on a tour of an acclaimed private school in our then hometown of Rochester, Minnesota. As we sat across the desk from the headmaster, I asked him if he could accommodate my boys. Most of my friends’ children attended, and I was anxious to hear if this could be the place for us.

“Mrs. Shrader, this is what we can do,” he began. “We’ll enroll your children on a three-month probationary period. If in three months it proves too hard on my teachers, we will have to ask you to find somewhere else for them to attend school.”

I was not quite five years into this Mama Bear role, but my conviction was growing. Looking him in the eye, I cleared my throat.

“Really?” I remarked. “And you think starting kindergarten, the beginning of their formal education, on PROBATION is the best way to set them up for success? I cannot even imagine the stress that would place on them and us as a family. No thank you.”

I left irritated but not heartbroken. I had heard of a choice school in town that also had high academic acclaim. I made an appointment with the principal there.

This time, after I had spoken warmly about my amazing children, the principal began to explain the school admittance policy – a blind-lottery basis. For triplets, if one name was drawn, all three would be accepted. I liked those odds, until she expressed concern about how hard her teachers would have to work to accommodate my differently-abled children. In a frustrating déjà vu moment, I heard how her teachers might need to be protected from my babies. It stung. I walked out knowing that even though the odds were in our favor – we had THREE entries in the lottery after all – my children would NOT be selected in this draw. I was right.

Determined that we would find a place where my wonderful children would all be wanted and able to thrive, I took my dynamic trio to our local public school for a visit.

We were met by a warm and smiling principal who took us on an enthusiastic tour, talking about the teachers and different activities. She didn’t treat my sons like they were anything but future students. I knew this school was the one. We didn’t need special treatment; we just needed to be welcomed.

The Shrader Triplets head off to pre-school two with their walkers but all three with matching backpacks.

The Shrader Triplets head off to pre-school two with their walkers but all three with matching backpacks.

Dropping my children off on their first day was emotional. Thankfully they were super excited, and I trusted they would be OK. Kindergarten and first grade would not be without challenges, but we never felt our presence was a burden or that having our triplets in class was an undue weight for the teaching staff.

As the years passed, we relocated with Wade’s job, spending stints in Dallas, TX, and Phoenix, AZ.

By fifth grade, things were getting harder. I knew Benjamin was bright, but despite having great teachers, some could not work out how to balance his sharp mind with the physical limitations of his body, and I spent a lot of time at the school. His six-grade school was overcrowded with 35 students pushing their desks around his wheelchair after he drove into the room. I worried about accessibility and what would happen in an emergency.

The triplets were joined by a younger sister in 2006.I took a leap of faith in the middle of that school year and decided to homeschool the triplets and their younger sister Cate. We got into our own little groove, studying during the hours that worked for us and taking fun field trips and outings.

Then, before we knew it, the triplets were 15. The moment my husband had been contemplating in his mind for many years had come. It was time to navigate college choices and campuses.

As we began selecting choices, the memories, emotions, and feelings of abject rejection during those first kindergarten visits resurfaced in my mind. I knew from that experience all those years prior we needed colleges with heart.

College would look different for each of my trio, but I am pleased to report they all found their independence, navigated hurdles, and flourished.

This series will continue on June 8th. You can read Carol’s guide to preparing for college in our Transitioning to Adulthood section.

A preview image of Dr. Garey Noritz leading to blog post ‘CP Stories: Dr. Garey Noritz’

CP Stories: Dr. Garey Noritz

As the new chair of the AAP’s Council on Children with Disabilities, Dr. Garey Noritz has the cerebral palsy community in mind.

CP Stories

Dr, Garey Noritz, Developmental Pediatrician, Nationwide Children’s Hospital

A long-time supporter of the CP Research Network, Dr. Garey Noritz understands how vital the American Academy of Pediatrics’ commitment to helping children with disabilities is for the cerebral palsy community.

Now, in his new role as chair of the organization’s Council on Children with Disabilities (COCWD), he is determined to ensure that all children with disabilities – and their broader community needs – are kept at the forefront of the AAP’s work.  

He tells the CP Research Network: “The health of children can only be improved by improving conditions for children and families in all areas of their lives as we advocate for safe environments, effective schools, and most of all, just policies at the federal and state level.”

As an internist and pediatrician specializing in neurodevelopmental disabilities at Nationwide Children’s Hospital in Columbus, Ohio, Noritz is a member of the CP Research Network’s Executive Committee and understands how COCWD provides vital support to our community.

The council is presently revising a clinical report, “Providing a medical home for children and youth with cerebral palsy,” from 2011 to ensure that it contains the most up-to-date information and guidance for pediatricians treating children with cerebral palsy. 

For many years, COCWD has played an essential role in improving care for those with cerebral palsy. This includes providing clinical reports to pediatricians on all aspects of the care of children with disabilities, from screening and diagnosing young children to transition to the adult health system.   

“There is a lot of political clout with the AAP, so it is important to make sure children with cerebral palsy are represented and advocated for,” he adds.

Excited to begin his new role, Noritz credits the council as one of the most active and influential AAP groups and is excited to continue its legacy.

As we come to the end of a year that brought countless health and racial inequities to the surface, Noritz is determined to ensure that no child is left behind and lists inclusivity, research, advocacy, and education as priorities. 

Encouragingly, as he begins this important work, he expresses a wish to continue to have open communication with CPRN members to understand the community’s continuing needs.  

Congratulations, Dr. Noritz. We’re excited to work with you in your expanded capacities!