一、身心特質
腦性麻痺(cerebral palsy，簡稱CP)是屬於一種非進行性的腦部神經損傷，其原因乃是在大腦未發育成熟之階段受到傷害，而造成動作控制障礙，其發生之時間有可能在產前、産中或是產後;發生原因有遺傳疾病、母體感染、早產、難產、缺氧、產中傷害與黃疸等。由於傷害的位置不同，腦性麻痺個案常會伴隨出現其他的障礙，包括如感官、認知、語言及學習能力障礙，甚至有些還會伴隨癲癇。
腦性麻痺學生的特質與發展，因個別間和個別內存在著很大的差異，主要的影響因素包括:腦性麻痺的成因、智力和語言功能以及是否伴隨有其他障礙等。
以下分別就動作、認知、心理及語言各層面的發展進行簡單介紹:

1. 動作的發展:
腦性麻痺學生動作發展的主要問題有:發展遲緩或停滯、異常動作與姿勢、手部操作能力、行走能力、生活自理能力受限，平衡反應、動作協調差、肌力與肌耐力、體適能不足、肌肉張力異常與缺乏活動的動機等。
2. 認知的發展:
不是每位腦性麻痺學生都會伴隨智能障礙，除了有些智力受損或是有學習困難的學生外，約有 25%的腦性麻痺學生在學習方面是正常或是優異的。尤其是有機會進入大專校院就讀之學生。
3. 心理的發展:
腦性麻痺學生因障礙造成長期的挫折或不被同儕接納的情形下，使得其較容易產生自卑感和缺乏信心，而有較低的自我概念，進而產生退縮甚或過度的自我防禦，並視與一般人接觸為畏途，因而造成社會功能障礙以及有不適應行為的表現。
4. 語言的發展:
有些腦性麻痺學生會因動作發展的障礙影響到說話能力的控制，導致無法以口語與他人溝通、口齒不清或構音困難的現象，甚至有時會因不適當或奇怪的表情而引起他人誤解。

二、輔導原則
1. 學習活動空間的安排:
(1)學校應提供符合「建築物無障礙設施設計規範」的各種無障礙設施與設備。尤其是經常進出的學習空間。
(2)教室空間要夠大，足以讓學生可以方便地進出，且座位的安排需考量輪椅的迴轉半徑。演講廳也應設有輪椅乘坐者的座位，以方便腦性麻痺障礙學生參加學校的大型活動。
(3)班級教室內可設置個人的專屬置物箱或櫥櫃，讓學生方便存放書籍與設備。置物空間與書桌間的行走動線要簡明寬敞，以利學生往返取物。
(4)注意學生的座位安排，尤其是乘坐輪椅或使用溝通輔具的同學，其座位儘量安排在前排，以方便和老師做溝通。但也需要注意，安排座位時不要擋到其他正常同儕的視線，以免造成困擾。

2. 學習資料:
(1)課堂使用之投影片或相關的輔助教材，建議依學生學習情況於課前或當場提供，以補強腦性麻痺學生因抄寫不及、或因視、聽覺障礙所造成的學習上的困難。
(2)腦性麻痺學生由於動作上的障礙，在翻書或筆記抄寫上所需之時間會較其他正常同儕要長。因此，應給予較寬裕的時間，以便獨立完成任務。

3. 儘量參與原則:
請勿因腦性麻痺學生的活動能力受限，而減少其參與活動的機會。應鼓勵他盡可能地參加各種休閒、體育及其他活動。但因學生可能容易產生疲勞，必要時可提供間歇性休息。除了一些無法經由接觸或基於安全考量，不讓腦性麻痺學生接觸的事物外，盡可能安排讓他們參與，以提升他們的實際經驗。

4. 對學生的期望:
對於學校中各項學習活動或要求，盡可能採用和一般學生一樣的期望標準，但允許腦性麻痺學生有較充裕的工作時間或使用輔具來完成學習任務。由於在各項學習過程需要全神貫注，因此學生較容易疲憊、分神而錯失學習重點，故應給予額外的協助，但不需要過度保護，避免造成其失去獨立的機會。

三、教學提醒
(1)由於許多腦性麻痺學生會伴隨肢體障礙，因此，當有戶外課程或上體育課時，需考量學生的能力，並給予安排適切的體育課程。
(2)腦性麻痺學生常伴隨不同程度的語言問題，授課教師需耐心地瞭解他所說的話，同時也請鼓勵班上同學多與其談話，並加強腦性麻痺學生的心理建設，不要讓其擔心別人取笑而不敢開口。
(3)對於無法說話或書寫困難的腦性麻痺學生，應善用輔助溝通系統(AAC)或書寫輔具來解決其語言表達的問題。
(4)伴隨語言障礙的腦性麻痺學生，課堂口試、口頭報告時，授課教師應視學生情況，改以書面報告替代，或以電腦語音報讀或其他方式進行之。
(5)若學生伴隨有癲癇，上課時需留意其發病的可能，並隨時給予適當的協助或送醫。
(6)鼓勵腦性麻痺學生參加校內社團活動，發展與人互動的興趣與技巧。
(7)很多腦性麻痺學生不僅有動作障礙而已，經常還會伴隨語言障礙，故在生理、心理方面，較一般的身心障礙學生更需要協助，因此，授課教師應隨時注意其個別需求並適時滿足其需求。

影音資料:

2017年大專院校腦性麻痺夏令營紀錄片

資料出處:

全國特殊教育資訊網-學生輔導原則

https://special.moe.gov.tw/article.php?paid=181

1. Physical and mental characteristics

Cerebral palsy (CP) is a non-progressive neurological condition resulting from brain damage during the immature developmental stage. This damage leads to motor control impairments. Cerebral palsy can occur before, during, or after birth due to factors such as genetic disorders, maternal infections, premature birth, dystocia, oxygen deprivation, birth trauma, or jaundice. Depending on the location of the brain injury, individuals with Cerebral palsy may experience additional challenges, such as sensory, cognitive, language, and learning disabilities, and in some cases, epilepsy.

The characteristics and development of students with cerebral palsy vary significantly between individuals, influenced by factors such as the cause of Cerebral palsy, students’ intellectual and language abilities, and the presence of other disabilities. Below is an introduction to the developmental aspects of motor skills, cognition, psychology, and language:

1. Motor Development

Students with Cerebral palsy often face the following motor development issues:

• Delayed or stagnant development.
• Abnormal movements and postures.
• Limited hand function, walking ability, and self-care skills.
• Poor balance reactions and motor coordination.
• Muscle weakness, low physical fitness, and abnormal muscle tone.
• A lack of motivation for physical activity.

2. Cognitive Development

Not all students with Cerebral palsy experience intellectual disabilities. About 25% of students with Cerebral palsy have normal or exceptional learning abilities, especially those able to pursue higher education. Others may encounter learning difficulties or intellectual impairments.

3. Psychological Development

Due to prolonged frustration or social rejection, students with Cerebral palsy may experience:

• Lower self-esteem and confidence.
• Negative self-concept, leading to withdrawal or excessive self-defense.
• Anxiety about interacting with others, resulting in social dysfunction and maladaptive behaviors.

4. Language Development

Motor impairments in Cerebral palsy can affect speech control, causing issues like:

• Inability to communicate verbally.
• Slurred speech or articulation difficulties.
• Misunderstanding by others due to inappropriate or unusual facial expressions.

2. Guidance Principles

1. Arrangement of Learning Spaces

• Accessible facilities: Schools should provide barrier-free facilities that comply with the law of standards for accessible design, especially in commonly used learning spaces.
• Spacious classrooms: Ensure ample space for wheelchair access and rotation. Provide designated wheelchair seating in lecture halls for school events.
• Personal storage: Install dedicated lockers or cabinets for books and equipment for students, along with clear and spacious paths for their movement.
• Seating arrangements: Position wheelchair users or those using communication aids at the front for better interaction with teachers while avoiding obstruction of other students' views.

2. Learning Materials

• Provide PowerPoint slides or supplementary materials before or during class to assist students who struggle with note-taking or have sensory impairments.
• Allow extra time for tasks like turning pages or writing due to motor challenges, enabling students to complete assignments independently.

3. Inclusion Principle

• Avoid limiting participation in activities due to mobility restrictions. Encourage students to engage in leisure, sports, and other activities, allowing for intermittent breaks if needed.
• Provide opportunities for hands-on experiences unless safety concerns or practical limitations apply.

4. Setting Expectations

• Apply the same learning expectations as other students while allowing more time or assistive tools for task completion.
• Offer additional support to help students focus and keep up with lessons but avoid overprotection to encourage independence.

Teaching Tips

1. Outdoor and Physical Education Classes: Adjust activities according to students’ abilities, ensuring appropriate participation.
2. Communication Assistance: Be patient when communicating and encourage classmates to interact more with Cerebral palsy students to enhance their confidence to speak with others.
3. Assistive Communication Tools: Provide AAC (Augmentative and Alternative Communication) or writing aids for nonverbal or writing-impaired students.
4. Oral and Written Tasks: Substitute oral exams or presentations with written reports, text-to-speech tools, or other suitable methods.
5. Epilepsy Awareness: Monitor students with epilepsy during class and provide immediate assistance or medical care if necessary.
6. Social Interaction: Encourage participation in school clubs to develop social skills and interests.
7. Holistic Support: Given their physical and psychological challenges, Cerebral palsy students often need more support than others with disabilities. Teachers should monitor and address individual needs promptly.

Video materials:

2017 Universities Cerebral Palsy Summer Camp Documentary