Signs of Cerebral Palsy
There are some signs that may indicate a child has cerebral palsy. Not all signs are visible at birth and may become more obvious as babies develop.
- Low muscle tone (baby feels ‘floppy’ when picked up)
- Unable to hold up his/her own head while lying on their stomach or in a supported sitting position
- Muscle spasms or feeling stiff
- Poor muscle control, reflexes and posture
- Delayed development (can’t sit up or independently roll over by 6 months)
- Feeding or swallowing difficulties
- Prefers to use one side of their body
Although the brain of toddlers/children with cerebral palsy remains injured, the injury does not get worse as they develop.
Depending on the level of severity of cerebral palsy, toddlers and children may experience difficulties with physical development such as:
- not walking by 12-18 months
- not speaking simple sentences by 24 months
If your child is not reaching these milestones or they display some of the signs of cerebral palsy, you may need to speak to your early childhood nurse, general practitioner or paediatrician.
In NSW, questions relating to developmental milestones are described in the Personal Health Record book (Blue Book) provided to families when their child is born.
When is cerebral palsy diagnosed?
Cerebral palsy is a complex disability and diagnosis is not always an easy process. Doctors may suspect cerebral palsy if a baby has slow motor development, has tight or floppy muscle tone, or displays unusual postures.
The time varies when parents are given an official diagnosis that their child has cerebral palsy. Very premature babies are usually watched carefully and may have an early MRI scan (magnetic resonance imaging). However, most children with cerebral palsy are not born prematurely. Most are born at full term and it is not until they do not meet the usual infant milestones that any form of disability is considered. A MRI might show that they have an injury to the brain, but at that stage it is often too early to predict the impact.
The General Movements Assessment can be conducted from birth until 5 months of age. It is a strong predictor of cerebral palsy, particularly when certain changes to the brain are seen on an MRI. However, General Movements Assessment cannot predict the severity of cerebral palsy.
If a General Movements Assessment suggests that a baby is ‘at risk of cerebral palsy’, then intervention can start as early as possible.
How do doctors diagnose cerebral palsy?
They will pay special attention to the child’s movements – both their voluntary movements as well as their muscle tone.
Some children may have very relaxed, floppy muscles, while others have stiff, tight muscles.
Doctors will also look for any unusual postures or if the child favours one side over the other.
Scans such as MRI or CT may be ordered by the doctor.
One of the frustrations for parents is that sometimes a diagnosis can take a long time, with repeated tests and visits to specialists.
This may be because the child has a mild form of cerebral palsy, but it could also be because the doctor needs to make sure it is not another type of movement disorder that may be progressive (get worse over time).
- McIntyre, S., Morgan, C., Walker, K., & Novak, I. (2011). Cerebral palsy–don’t delay. Developmental Disability Research Reviews, 17(2), 114-129. doi: 10.1002/ddrr.1106 See abstract
- Rosenbaum, P. (2003). Cerebral palsy: what parents and doctors want to know. British Medical Journal, 326(7396), 970-974. doi: 10.1136/bmj.326.7396.970
- Smithers-Sheedy, H., Badawi, N., Blair, E., Cans, C., Himmelmann, K., Krageloh-Mann, I., . . . Wilson, M. (2014). What constitutes cerebral palsy in the twenty-first century?, Developmental Medicine and Child Neurology, 56(4), 323-328. doi: 10.1111/dmcn.12262
(Update: 17 Nov 2015)