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Early detection of cerebral palsy using general movements assessment and MRIs – a sensible way forward

Pediatric Research volume 95, pages 1191–1192 (2024)Cite this article

Cerebral palsy remains the most common long-term physical disability beginning in childhood. Population based registers from high income countries report that 42% of children who have cerebral palsy will have been born prematurely (less than 37 weeks gestation) and approximately 50% of babies subsequently diagnosed with cerebral palsy will have spent time in a newborn intensive care (NICU) or special care unit.1 Studies show that identification of those infants in the NICU most at risk of cerebral palsy is feasible and essential.

We know from adult literature that following a neurological incident such as a stroke, starting early intervention within the first few days of life has a significant clinical and long-term effect on outcomes, including fine motor mobility, and speech. The evidence for this is clear and there are national guidelines available for early intervention after stroke in high income countries such as Australia. (https://strokefoundation.org.au/what-we-do/for-health-professionals/clinical-guidelines) The evidence for the type, timing, and intensity of early intervention in babies at high risk of CP is less researched, partly due to historical teaching suggesting that cerebral palsy is not diagnosable before the first or second year of life. Clinicians were previously taught that adopting a wait and see approach was preferable, although evidence around neuroplasticity and maximal brain growth would suggest that this is undesirable, if not harmful, to the child’s future development.

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References

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Authors and Affiliations

  1. The Children’s Hospital Westmead, Hawkesbury Rd, Westmead, NSW, 2145, Australia

    Nadia Badawi & Cathryn Crowle

  2. Cerebral Palsy Alliance Research Institute, PO Box 171, Allambie Heights, NSW, 2100, Australia

    Nadia Badawi, Iona Novak & Catherine Morgan

  3. University of Sydney, Faculty of Medicine and Health, Campderdown, NSW, 2006, Australia

    Nadia Badawi, Iona Novak, Catherine Morgan & Cathryn Crowle

Authors
  1. Nadia Badawi
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  2. Iona Novak
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  3. Catherine Morgan
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  4. Cathryn Crowle
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Correspondence to Cathryn Crowle.

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No declarations of interest, however Catherine Morgan is a licensed tutor with the General Movements Trust.

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Badawi, N., Novak, I., Morgan, C. et al. Early detection of cerebral palsy using general movements assessment and MRIs – a sensible way forward. Pediatr Res 95, 1191–1192 (2024). https://doi.org/10.1038/s41390-023-03008-z

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  • DOI: https://doi.org/10.1038/s41390-023-03008-z

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