Diagnosing cerebral palsy (CP) has not always been an easy path. In the past physicians would “wait and see” how the child developed before making a diagnosis. This left families in a state of limbo wondering about their child’s development. There are now standard evaluations of movement that can be used with existing tests and tools to decide with high accuracy, and in some cases in infancy, if a cerebral palsy diagnosis is appropriate. Not all children who miss developmental milestones have cerebral palsy. Screening for cerebral palsy should be done when a child has risk factors for developing cerebral palsy.
How is Cerebral Palsy Diagnosed?
Your child’s medical team will decide when to give your child a diagnosis of cerebral palsy, or decide if they are at high risk for CP. These clinicians may include a pediatrician, developmental specialist, rehabilitation physician, neurologist, or any other specialty physician needed to support the care and wellbeing of your child. One or more of these doctors will determine (or you may ask) if your child is at high risk for cerebral palsy by collecting the following information:
- Watching and examining your child’s movement patterns and using a combination of standardized movement assessments (ie GMA, HINE, AYC)
- Reviewing their medical history
- Evaluating their muscle tone, reflexes, and posture
- Considering whether your child has common risk factors for cerebral palsy
- Asking if your child has missed multiple developmental milestones (ex. delays in rolling over, sitting independently, pulling to a stand and reaching out for objects)
- Getting your input on feeding, vision, hearing, language, cognitive functioning, behavior and social skills
The information from those evaluations will be looked at along with imaging of the child’s brain, also known as an MRI.
Other tests may include genetic, metabolic or a combination of both.
Standardized Movement Assessment Tools for Diagnosing Cerebral Palsy
The latest research states that a diagnosis for cerebral palsy may sometimes be made earlier than 6 months corrected age (baby’s age minus the number of weeks the baby was preterm).
Standardized infant movement assessments may be used at different ages, and with other medical evaluations like the MRI, to determine whether a diagnosis of cerebral palsy is accurate.
Some of the standardized movement assessments that may be used for diagnosing cerebral palsy (or high risk for cerebral palsy) include:
- General Movements Assessment (GMA)
- Hammersmith Infant Neurological Exam (HINE)
- Developmental Assessment of Young Children (DAYC)
- Test of Infant Motor Performance (TIMP)
There are additional standardized movement assessments that a clinician may use depending on the infant’s age and circumstances.
A Continuing Medical Education e-learning program for professionals is being built to provide in-depth information on how to diagnose high risk for cerebral palsy early. To learn more or express an interest in getting more information contact: Lynda McNamara Lynda.McNamara@health.qld.gov.au.
Importance of Early Diagnosis
A diagnosis of cerebral palsy should be made as early as possible. Access to support and services while the brain is still in early development is important to:
- Take advantage of the brain’s early ability to change, also known as neuroplasticity, to maximize the child’s movement and cognitive outcomes.
- Early and ongoing monitoring for common musculoskeletal complications can help prevent hip displacement, contractures, and scoliosis.
- Reduce caregiver anxiety and stress associated with an extended period of not knowing their child’s diagnosis. By having a diagnosis early, parents may gain support from peers.
Receiving a diagnosis of cerebral palsy feels overwhelming. Coping with the diagnosis will become easier over time with professional guidance and peer support. Having a diagnosis puts you in the best position to help your child. It allows you to access appropriate therapies and treatments, and it gives you a way to organize your thoughts and actions.
For more information, download our free cerebral palsy tool kit.
Sources
- Novak, I., Morgan, C., Adde, L., Badawi, N., Blackman, J., Boyd, R. N., . . . White, R. (2017, September). Care Pathways: CARE PATHWAY FOR EARLY DETECTION OF CEREBRAL PALSY. Retrieved from https://www.aacpdm.org/publications/care-pathways/early-detection.
- Alliance, C. (n.d.). Early Diagnosis Clinic – Cerebral Palsy. Retrieved from https://cerebralpalsy.org.au/about-conditions/cerebral-palsy/early-diagnosis/.
- Einspieler, D. (2009). General Movements Trust- The Prechtl General Movement Assessment. Retrieved from https://general-movements-trust.info/47/dates.
