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Cerebral Palsy

Summary

Cerebral palsy (CP) is a condition that affects movement and posture due to early brain development issues. It is the most common cause of physical disability in children, affecting about 2 in 1,000 people.

CP is not a progressive disease, meaning it does not worsen over time. However, the effects on muscle control and movement may change as a child grows. The most common type of CP involves muscle stiffness (spasticity), but some children may experience involuntary movements (dyskinesia) or problems with balance and coordination (ataxia).

Children with CP may also have other challenges, such as difficulties with speech, feeding, learning, or seizures.

Diagnosis and When to Seek Help

CP is usually diagnosed in infancy or early childhood when parents notice delays in movement and coordination. Signs to watch for include:

  • Delays in reaching motor milestones (e.g., not sitting by 8 months or not walking by 18 months).
  • Muscle stiffness or floppy muscles.
  • Difficulty with balance, coordination, or uncontrolled movements.
  • Feeding and speech difficulties.
  • Seizures or unusual movements.

If you notice any of these signs, consult a doctor for evaluation. Early diagnosis allows for timely intervention to help your child develop to their fullest potential. 

Management

Managing CP involves a multidisciplinary approach to support a child’s movement, communication, and daily activities.

  • Physical therapy: Helps improve strength, coordination, and mobility.
  • Occupational therapy: Focuses on daily activities like dressing, eating, and using assistive devices.
  • Speech therapy: Supports communication and feeding challenges.
  • Medications: Muscle relaxants or botulinum toxin injections may help reduce stiffness and improve movement.
  • Surgical options: In some cases, procedures such as selective dorsal rhizotomy (SDR) or orthopedic surgeries can help with muscle tightness or joint problems. 

Follow-Up and Monitoring

Children with CP benefit from ongoing care to monitor their progress and adjust treatments as needed. Key aspects include:

  • Regular check-ups with pediatric specialists (neurology, orthopedics, physical therapy, etc.).
  • Assistive devices such as braces, wheelchairs, or communication aids when needed.
  • Educational and vocational support to promote independence and learning.
  • Support for families through therapy, counseling, and community resources.

With the right interventions and support, children with CP can lead fulfilling and meaningful lives. 

History and Exam

Key diagnostic factor

  • presence of risk factors
  • early general movement abnormalities
  • abnormal HINE scores
  • delay in motor development

Other diagnostic factors

  • muscle weakness
  • joint instability/dislocation
  • dystonia
  • chorea

Risk factors

  • prematurity
  • low birth weight
  • fetal birth asphyxia
  • multiple births

Diagnostic Investigations

1st investigations to order

  • MRI brain

Investigations to consider

  • ultrasound/CT brain
  • coagulation studies
  • genetic testing
  • metabolic screen

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    Other Related Conditions

    epilepsy and seizures

    headaches and migraines

    tic disorders

    developmental delay, neurodevelopmental disorders

    weakness

    neurogenetic disorders

    neurometabolic disorder

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      Social and emotional functioning refers to a child’s ability to understand, express, and manage their emotions, as well as to interact effectively with others. These skills are fundamental for building positive relationships, developing empathy, and coping with the everyday challenges of growing up.

      Children who experience difficulties in social and emotional functioning may struggle with recognizing their own feelings or those of others, regulating emotional responses, or responding appropriately in social situations. This can lead to challenges such as anxiety, low self-esteem, difficulty making friends, or misunderstandings with peers and adults.

      In the school environment, social and emotional difficulties can impact a child’s engagement, cooperation, and overall learning experience. Emotional distress may manifest as withdrawal, irritability, or disruptive behaviour, which can further affect academic progress and peer relationships.

      Assessment of social and emotional functioning as part of a neuropsychological evaluation typically includes behavioural observations, standardized rating scales, and information gathered from parents, teachers, and sometimes the child. This comprehensive approach helps identify strengths and areas for support in emotional regulation, social skills, and adaptive behaviours.

      Understanding a child’s social-emotional profile allows for the development of tailored strategies to enhance emotional wellbeing, build resilience, and improve social communication. Early intervention and supportive environments can empower children to navigate their emotions more effectively, fostering confidence and meaningful connections. 

      At Offspring Health, we aim to provide transparent information about the costs involved in neurodevelopmental and educational assessments.

      Neuropsychological assessments typically involve multiple sessions that usually take between 8 and 16 hours in total, depending on the complexity and individual needs. Our hourly rate is $260, so the total cost typically ranges between $2,300 and $4,230.

      Fees generally cover:

      • Initial consultation and history gathering
      • Testing sessions where your child will complete various fun and interactive tasks
      • Liaison with schools or health professionals as needed
      • Comprehensive case analysis and report preparation
      • Feedback sessions with families and, where applicable, educators or other professionals

      Please note that standard neuropsychological assessments are generally not covered by Medicare. However, some assessments and therapy services may be funded through the National Disability Insurance Scheme (NDIS) for eligible participants. We recommend discussing funding options with your NDIS planner or support coordinator prior to booking. Private health insurance may offer partial rebates depending on your level of coverage.

      What’s the next step?

      Please phone reception for a discussion about your needs or email psychology@offspringhealth.com