Key points
- Diagnosing cerebral palsy (CP) at an early age is important to the well-being of children and their families. It can take several steps.
- Developmental monitoring tracks a child's growth and development over time.
- Developmental screening checks for developmental delays.
- Developmental and medical evaluation diagnoses the specific disorder.
Developmental monitoring
Developmental monitoring (also called surveillance) means tracking a child's growth and development over time. At each well-child office visit, to monitor the child's development, the doctor may do the following:
- Ask parents if they have any concerns about their child's development
- Take or update the child's developmental history
- Watch the child during the exam to see how they move
If any concerns about the child's development are raised during monitoring, then a developmental screening test should be given as soon as possible.
Fact
It is important for doctors to monitor the development of all children, but especially those who are at a higher risk for developmental problems due to preterm birth or low birthweight.
Developmental screening
A short developmental screening test is routinely given to see if the child has specific developmental delays, such as motor or movement delays. Some tests are in the form of interviews or questionnaires completed by parents, others are given to the child by the doctor. The American Academy of Pediatrics recommends that all children be screened for developmental delays during regular well-child office visits at
- 9 months: Many issues involving movement are seen easily at this age.
- 18 months: Mild movement delays might be easier to see at this point.
- 24 or 30 months: Most movement delays can be found at this age.
A developmental screening test also can be given whenever the child's parents, doctor, or other caregivers have concerns about the child's development. Concerns from the test results can prompt the doctor to make referrals for both of the following:
- Developmental and medical evaluations AND
- Early intervention or early childhood services
Did you know?
Early identification is important for getting needed services and support.
We naturally think of a child's growth as height and weight, but from birth through 5 years, a child should reach milestones in how they play, learn, speak, act, and move. A delay in any of these areas could be a sign of CP or other developmental disability.
Through the Learn the Signs. Act Early. program, CDC and its partners aim to improve early identification of children with CP and other developmental disabilities by promoting developmental monitoring, so children and families can get the services and support they need.
Developmental and medical evaluations
The goal of a developmental evaluation is to diagnose the specific type of disorder that affects a child. To evaluate movement or motor delays, the doctor will look closely at the child's motor skills, muscle tone, reflexes, and posture and take a careful medical history from the parents. The doctor will try to rule out other disorders that could cause similar problems.
Because many children with CP also have related developmental conditions such as intellectual disability; seizures; or vision, hearing, or speech problems, it is important to evaluate the child to find these disorders as well.
The developmental evaluation can be performed by the primary care doctor or by a specialist. Specialists who can do this type of developmental evaluation include
- Developmental pediatricians or neurodevelopment pediatricians (doctors with special training in child development and in evaluating children's developmental problems)
- Child neurologists (doctors with special training in childhood diseases of the brain, spine, and nerves)
- Pediatric physiatrists or pediatric rehabilitation doctors (doctors with special training in physical medicine and rehabilitation for children)
In addition to the developmental evaluation, additional tests can be done to look for a cause of CP. Specialists might suggest brain imaging tests, such as x-ray, computed tomography (CT scan), or magnetic resonance imaging (MRI). An electroencephalogram (EEG), genetic testing, or metabolic testing, or a combination of these, also might be done.
Diagnosis
CP generally is diagnosed during the first or second year after birth. But if a child's symptoms are mild, it is sometimes difficult to make a diagnosis until the child is a few years older.
What to do if you are concerned
If you think your child is not meeting movement milestones or might have CP, you can take the following steps to find help:
- Contact your doctor or nurse and share your concerns.
- Ask for a referral to a specialist who can do a more in-depth evaluation of your child.
- Call your state or territory's early intervention program to request a free or reduced cost evaluation.
Did you know?
In addition to talking to your child's healthcare provider, you can call your state or territory's early intervention program to request a free or reduced cost evaluation to find out if your child qualifies for intervention services. This is sometimes called a Child Find evaluation.
You do not need to wait for a doctor's referral or a medical diagnosis to make this call.