AAP provides guidance on identifying, treating cerebral palsy

The American Academy of Pediatrics (AAP) and the American Academy for Cerebral Palsy and Developmental Medicine (AACPDM) have released new guidance on identifying and treating cerebral palsy in a clinical report, “Providing a Primary Care Medical Home for Children and Youth with Cerebral Palsy.”

Cerebral palsy is seen in 1 to 4 out of every 1000 children, making it the most common motor disorder in youth. Cerebral palsy is defined as permanent motor system disorders caused by disturbances in the developing fetal or infant brain. 

Early identification allows families, physicians, and specialists to provide evidence-based therapy at a time when the brain is most adaptable to change, improving the chance of better outcomes.

In the clinical report, information is given on the definition, manifestations, and management of cerebral palsy. The report was published online on November 21, 2022, and in the December 2022 issue of Pediatrics.

According to Garey Noritz, MD, FAAP, FACP, lead author of the report and chairperson of the AAP Council on Children with Disabilities, the report focuses on early collaboration, family choice, and child and family strengths. Noritz also stated that primary care physicians must implement care across multiple organ systems and specialists.

“Physicians also act as advocates who can help families navigate their relationships with the medical system, therapy providers, school, community groups and other resources,” Noritz said.

Signs of cerebral palsy include delays in meeting development milestones and issues with movement and coordination, development, speech and eating, or muscle tone. Medical history factors such as preterm birth or perinatal difficulties could make some children be identified as at risk of cerebral palsy or other developmental disorders.

Some children with cerebral palsy will not have any identifiable factors that increase risk. Screening and surveillance in primary care medical homes should be used to identify cerebral palsy in these children.

Screening should occur for children aged 9 months, 18 months, and 30 months, according to the AAP. These screenings should also include neuromotor examination focusing on motor milestones and muscle tone.

Additional recommendations form the AAP and AACPDM include standard primary care visits for children with cerebral palsy, acknowledgement from physicians on socioeconomic barriers to screening and treatment, use of a multidisciplinary approach, and encouragement from physicians to engage in social, recreational, and community activities.

The report also states that new symptoms or further declines in patients should be given full investigation and should not be immediately assumed as related to cerebral palsy. Also, the transition from pediatric care to adult care should begin when a patient is aged from 12 to 14 years.

Reference

Major health organizations release guidance on identifying, treating cerebral palsy. American Academy of Pediatrics. November 21, 2022. Accessed November 28, 2022. https://www.aap.org/en/news-room/news-releases/aap/2022/major-health-organizations-release-guidance-on-identifying-treating-cerebral-palsy2/