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Identifying Cerebral Palsy Early Can Help Children Thrive

Cerebral palsy is the most common motor disorder in children. It affects between 1 and 4 out of every 1,000 kids. Identifying cerebral palsy early gives families, physicians and specialists a better chance to improve a child's outcomes by acting as a team. They can provide evidence-based therapies while the young brain is still developing and most adaptable to change.

The American Academy of Pediatrics (AAP) and the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) provide updated guidance for doctors in the clinical report, "Providing a Primary Care Medical Home for Children and Youth with Cerebral Palsy." The report is published in the December 2022 Pediatrics.

Coordinating care for kids with cerebral palsy

"As a primary care physician, a critical task is to integrate and orchestrate care across multiple organ systems and health care specialists. At the same time, we provide families with resources and support to help the child or adolescent thrive" said Garey Noritz, MD, FAAP, FACP, lead author of the report and chairperson of the AAP Council on Children With Disabilities.

"Physicians also act as advocates who can help families navigate their relationships with the medical system, therapy providers, school, community groups and other resources," he said.

The importance of developmental screening

Children with cerebral palsy may show delays in meeting development milestones, or problems with movement and coordination, speech and eating, development or muscle tone.

Some children will be identified as "at risk" for cerebral palsy or other developmental disorders because of their medical history. This may include preterm birth and difficulties during and shortly after pregnancy. These children should be followed closely to monitor for motor problems.

However, many children with cerebral palsy have no identifiable risks from their birth history. That's why it is important to identify them through sceening and surveillance in the primary care medical home.

The AAP recommends that standardized developmental screens be given to children at ages 9 months, 18 months and 30 months. Screenings should include a neuromotor examination with particular attention to motor skill milestones and muscle tone.

The AAP and AACPDM also recommend:

  • Children with cerebral palsy should receive standard primary care visits to promote health and well-being. These should include receiving vaccinations according to the recommended childhood and adolescent immunization schedule, with additional vaccines for those with chronic pulmonary or other conditions.

  • Cerebral palsy is more prevalent in Black children and children who come from families with lower socioeconomic status. Because race is a social construct rather than biological construct, these disparities may be attributable to systemic racism within the medical system. It is important that physicians identify implicit biases and barriers to screening, identification, treatment and family support for children with cerebral palsy whose lives are affected by social determinants of health.

  • Children with cerebral palsy benefit from a multidisciplinary approach to care. Teams typically consist of the child and family, primary care provider and medical specialists. There are also other health professionals vital to the team, too, such as physical, occupational and speech therapists.

  • Physicians should encourage families to participate in social, recreational, and community activities based on the child and teen's interests. Pediatricians can assist with locating opportunities for adaptive sports and recreation when indicated.

  • When a child has new symptoms or functional declines, these should be investigated fully as new medical problems. It should not be assumed that they are related to the underlying cerebral palsy.

  • Begin a health care transition process for shifting from pediatric care to adult care by the time a patient reaches age 12 to 14.

"It really does 'take a village' to help children with cerebral palsy reach their full potential," Dr. Noritz said. "Families and physicians share this goal. We can partner to improve quality of life by focusing on the strengths of the child and family, providing appropriate services and adapting the environment to the needs of each child."

More information

Published
11/21/2022 12:00 AM
Source
American Academy of Pediatrics (Copyright © 2022)
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