Screening for Cerebral Palsy

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

CDC's Learn the Signs. Act Early. Program

We usually 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.

CDC's Milestone Tracker App

Through CDC's 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 as early as possible.

It is important for families and providers 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.

If any concerns about the child's development are raised during monitoring, then a developmental screening test should be given as soon as possible.

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 (AAP) recommends developmental and behavioral screening for all children during regular well-child visits at these ages:

• 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.

Early identification is important for getting needed services and support

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

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 a 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 is generally diagnosed during the first or second year after birth. However, if a child's symptoms are mild, it is sometimes difficult to confirm a diagnosis until the child is a few years older.

Visit the National Institute of Neurological Disorders and Stroke (NINDS) Cerebral Palsy Information Page to learn more about how CP is diagnosed.

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.

Contact your local early intervention program

If you, your child's doctor, or other care provider is concerned about your child's development, ask to be connected with your state or territory's early intervention program to find out if your child can get services to help. You do not need to wait for a doctor's referral or a medical diagnosis to make this call.

Early intervention services

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.