doctor listens to toddler's heart beat

The Diagnosis

Diagnosis is a process that often takes months, not weeks, to determine. Tests, evaluations and assessments also must be completed before a diagnosis is confirmed or ruled out. A diagnosis, however, is a first step in what is likely to be a complex care plan that will play out during a child’s formative years.

Before diagnosis

Diagnosing cerebral palsy takes time, and is usually not made until the brain is fully developed when the child is two to five years old. Exceptions exist, usually in severe cases, when the child may be diagnosed soon after birth. The average age of diagnosis for a child with spastic diplegia, a very common form of cerebral palsy, is 18 months.

There is no definitive test that confirms or rules out cerebral palsy. The baby is monitored for growth indicators, including:

  • When does the child reach development milestones?
  • How does the child compare to growth chart standards for height and weight?
  • How do children’s reflexes react?
  • Does it seem as though the child can focus on you or hear you?
  • Does posture and movement seem abnormal?

This can be a difficult time for parents who suspect something is different about their child. Often, parents are first to notice their child has missed one of the age-appropriate developmental milestones, like rolling, crawling, sitting and walking.

During diagnosis

The diagnosis process begins by monitoring the child’s development and watching for possible signs of impairment. If a baby is born prematurely, or at a low birth weight, he or she is monitored closely at time of birth in the hospital’s neonatal intensive care unit. If the infant attends regularly scheduled well-baby visits, the pediatrician may be first to notice signs of cerebral palsy, such as height, weight, reflex and response. The doctor may even begin to rule out other health conditions.

A pediatric neurologist may perform brain scans such as MRI or CT Scan to detect brain lesions or malformations, which indicate brain damage. During this process, the child’s parent or legal guardian is provided with observations, test results and opinions on diagnosis. When a health care professional provides this information, it is pertinent that parents request a copy of the results for the child’s file. The parent will likely be asked to provide these documents to several other medical providers during the child’s life; having a copy in the child’s home file will save time and money down the road.

When it becomes apparent that the child may have difficulties with muscle coordination, muscle tone, reflexes, posture, balance, fine motor skills, and gross motor skills, then the child will likely be referred to an orthopedic surgeon for evaluation. If the child has problems with breathing, chewing, swallowing, sucking or aspiration, the child will be sent to a speech and language pathologist. Vision and hearing tests are helpful.

Steps involved in the diagnosis process include:

The 12-Step Process of
Diagnosing Cerebral Palsy

Though there are no tests to definitively diagnose cerebral palsy, information on helpful screens, tests and evaluations include:

Screens, Tests and Evaluations for Cerebral Palsy:

After diagnosis

Once confirmed, the diagnosis allows the parents to better understand the child’s health status, remove doubt and anxiety, begin treatment, and secure benefits to offset the cost of raising a child with cerebral palsy.

A cerebral palsy diagnosis can be overwhelming as a parent begins to realize his or her child has a physical impairment that cannot be cured, but can be managed. Often, parents retain only a portion of information initially presented by doctors and other medical practitioners.

As the child grows, parents will meet with school administrators, physical therapists, adaptive equipment specialists, home care providers and others. In initial consults, the parent will be asked about the cause, type, and form of cerebral palsy their child has. Some medical specialists find it helpful to know the extent, location, and severity of the child’s impairment. The industry may use various common medical terms to define various aspects of the child’s impairment. Although health care providers will likely confirm diagnosis with the child’s primary care physician before formally treating the child, a parent may nonetheless benefit from a document that will document findings and test results.

The MyChild Diagnosis Checklist is designed by MyChild to provide a parent with better understanding and an easy-to-use checklist to document a child’s condition as provided by health care providers. Over the course of the child’s lifetime, it is likely a parent will need to provide this information to many individuals caring for the child. The information can be easily stored in the child’s home medical records.

For your copy of the MyChild Diagnosis Checklist:

Documenting diagnosis for care plan

The following information obtained during diagnosis will prove valuable in the months to years following, when talking to professionals for their expertise, to qualify for benefits, and to document care. These will be needed to assist in understanding, explaining, and managing the child’s health conditions.

Document cause of cerebral palsy

  • Radiological findings of brain injury or abnormality – PVL, IVH, HIE, Cerebral Dysgenesis
  • Cause of brain damage or abnormality – prematurity, low birth weight, asphyxiation, shaken baby, accident
  • Timing of brain damage – prenatal, perinatal, postnatal, acquired, congenital, or genetic predisposition

Document form of cerebral palsy

  • Severity – mild, moderate, severe, and no CP
  • Extent – plegia or paresis
  • Location/anatomical distribution – mono, di, hemi, para, tri, tetra, quad, and penta
  • Gross Motor Function Classification Level – Level I, Level II, Level III, and Level IV

Obtain medical records

During the diagnosis process many screens and tests may provide relevant information to confirm or rule-out a diagnosis of cerebral palsy. For efficient retrieval, these should be stored in a child’s home medical record file. They will be needed for visits with other medical practitioners, for qualifying for government benefits and for contracting professional services.

doctor holding baby's arms up during exam

Diagnosis of Cerebral Palsy

Parents are often disheartened to learn that there is no singular test that will accurately diagnose a child with cerebral palsy. Once a round of medical evaluations are initiated in order to form a diagnosis, parents prepare for a long and sometimes frustrating process that will, in time, provide answers about a child’s condition.
Diagnosis of Cerebral Palsy »

The Journey: Awaiting Diagnosis »

  • baby holding onto father's finger

    The Journey: Awaiting diagnosis

    A parent may be concerned about developmental delays or a doctor may observe a sign outside of growth norms. There is no definitive test for cerebral palsy, causing doctors to diagnose over time. For parents that suspect a child may have cerebral palsy, the long wait between that initial suspicion and an official diagnosis can be an emotional one. But, what is often a time of anxiety evolves into an empowering experience that leads to acceptance and unconditional love.
    Awaiting Diagnosis »

  • doctor listening to toddler's breathing

    The Journey: Recent diagnosis

    Many parents find it difficult to explain their emotions and thoughts at the time they receive their child’s diagnosis, and for the years ahead. That’s understandable. It’s a life-altering moment often filled with feelings of sadness, helplessness, shock, anxiety, disbelief, and confusion. But, that gives way to strength, joy, tolerance, and triumphs. It may not be the expected journey we had for our children, but it is a beautiful journey, nonetheless.
    Recent Diagnosis »

  • two doctors examining a happy baby

    Treatments for cerebral palsy

    Although the brain injury that causes cerebral palsy cannot be healed, the resulting physical impairment can be managed with a wide range of treatments and therapies. Each child’s impairment is unique and therefore no universal treatment for cerebral palsy exists. While therapy and adaptive equipment are the primary treatment for cerebral palsy, a child may also require other forms of treatment.
    Treatments for Cerebral Palsy »

  • gallery_6

    Therapies for cerebral palsy

    A person’s ability to transcend his or her physical limits is in no small part due to the kinds of therapies that are used to fine-tune his or her abilities. Therapy fosters functionality, mobility, fitness, and independence. The types of therapies vary based on a person’s unique needs, type of cerebral palsy, extent of impairment and associative conditions. Therapy can also help parents and caregivers.
    Therapies for Cerebral Palsy »


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The Unexpected Journey

baby's hand holding parent's finger

Awaiting Diagnosis

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Cerebral Palsy Diagnosis

newborn under jaundice lights in NICU

The Importance of Early Diagnosis

Many people involved with the research and treatment of cerebral palsy believe the earlier a diagnosis is made, the better the child will fare. Early diagnosis allows the child to begin treatment before impairments have “set in.”

An infant’s brain, muscles, reflexes, and motor control continue to develop long after birth. For children with cerebral palsy, their brain injury prevents normal development. Eventually, muscles, coordination, and posture may become impaired. Beginning treatment early in infancy can yield some of the largest gains.

Because the young brain is developing (in a way, learning how to be a brain) treatment may help the child’s brain to adjust to the injury. The younger the brain, the more adaptable it may be, perhaps increasing the chance that the brain can “rewire” itself to mitigate the extent of the injury.

Motor control and reflexes are also still developing in babies. Spasticity becomes more apparent as the child grows. During infancy, the child may show no or little spasticity. As a result, the limbs are easier to move, possibly increasing the effectiveness of physical therapy both on the muscles and the brain.

Early diagnosis also enables parents to find benefits and funding for their children. A diagnosis increases the chances of qualifying for Early Intervention programs and receiving state and government aid.

Cerebral Palsy Diagnosis

doctor examining baby's development

Reasons for Delayed Diagnosis

For all the benefits of early diagnosis, delayed diagnosis does occur – predominantly because the disorder is difficult to diagnose and doctors worry about the impact on parents. Receiving a diagnosis of cerebral palsy can be devastating, and doctors fear parents may withdraw and further hamper the child’s development.

Doctors do not want to deliver premature diagnoses. Where they may suspect cerebral palsy, doctors might keep the suspicions to themselves and talk to the parents about the symptoms. They may mention their suspicions, or just subtly prepare the parents for an eventual diagnosis.

Of course, the main reason to delay diagnosis is the difficulty of clearly identifying the disorder. Many possibilities exit, including the brain’s potential to compensate for the injury. Additionally, a number of other conditions may appear as cerebral palsy. Misdiagnosis is a danger of early diagnosis.

Cerebral Palsy Diagnosis

baby hand holding on to father's finger

Avoiding Misdiagnosis

Misdiagnosing any condition can be harmful to a child and can lead to inappropriate treatment such as unnecessary surgeries, medications, and expense.

Misdiagnosis can mean the condition was wrongly identified, altogether. Or, it can mean the condition was correctly identified, but the subtype was classified in error. Misdiagnosis could also entail wrongly identifying the underlying condition, the cause of the condition, the extent or severity of the condition, or complications of the condition.

For instance, the diagnosis of cerebral palsy may be correct, but the severity, extent or co-mitigating factors may have been improperly diagnosed. Not all specialists agree on the classification of the condition as provided and defined by another specialist.

Commonly diagnosed conditions are misdiagnosed less, while difficult-to-diagnose conditions are more commonly mistaken. Misdiagnosis can be the result of a doctor’s error, misread test results, incorrect laboratory readings, or overlooked alternatives.

It is recommended that parents avoid misdiagnosis by obtaining a second opinion, consulting with specialists, having medical tests thoroughly explained, and becoming educated on the child’s diagnosed condition.

If a child who has cerebral palsy is not diagnosed properly, the untreated impairment can result in more severe spasticity, abnormal posture, contractures and deformities. Other conditions can be mistaken for cerebral palsy.

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