Physicians use specific methods and tests to help determine if a child has cerebral palsy. A quality standard committee of the Child Neurology Society has established a series of assessment tools for diagnosing the disorder. They recommend that the physician:
• Take a history and perform an examination to rule out progressive or degenerative disorders of the central nervous system
• Classify the type of cerebral palsy
• Screen for associated conditions (including problems in development, seeing, hearing, speech and language, feeding and swallowing)
• Perform an EEG if the child is thought to have had seizures
• Conduct an MRI (preferred over CT scan)
• Do further studies such as genetic evaluation and testing the blood for coagulation problems in certain situations
Assessment Chart & Process
I. When assessing cerebral palsy, doctor will look examine a patient’s history to:
• Rule out progressive or degenerative condition
• Determine the classification of cerebral palsy
• Assess patient for secondary disorders (developmental delay or mental retardation; seeing and hearing problems; feeding or swallowing problems; speech and language delay)
• Perform an EEG if seizures have occurred
II. The next step is to see if the child has had former imaging or lab studies that determined the cause of cerebral palsy. If the answer if yes, there is really no need for further testing.
III. If the answer is no, an MRI or a CT scan may be performed.
A. If the MRI results come back normal, a metabolic or genetic test will be conducted to determine whether there is:
• Deterioration or are episodes of metabolic problems
• No cause is be found by medical examination
• A family history of childhood neurological issues secondary to cerebral palsy is present
B. If the MRI comes back abnormal, genetic tests may be conducted to check for developmental problems. Keep in mind a blood coagulation disorder or other possible explanations for a cause of cerebral palsy.
Cerebral Palsy Assessment Techniques
When evaluating a child for cerebral palsy, it is important that the child be relaxed and feel comfortable with the examiner and that the toys be familiar as well interesting. Have the child sit on the parent’s lap as much as possible. The doctor or physical therapist must explain what he or she is about to do before touching the patient. The examiner should interview the parents to find out
• When the parents first suspected there were problems
• If there are brothers or sisters with similar issues
• Problems the mother may have suffered during pregnancy such as drugs, severe stress, specific infections
• Complete history of labor and delivery including number of weeks pregnant, type of delivery, breech birth, problems of infant breathing at birth, length of time it took for the child to cry, Apgar score
• Take history of the newborn and young child including birth weight, possible brain injury due to trauma, meningitis, jaundice, hypoglycemia, medical treatment or surgery
• Perform tests for range of motion, reflexes, muscle tone, among others
The examiner also should observe how the child acts during the examination and take special notice of alertness, attentiveness, control of posture, reflexes, and how he or she uses hand and legs.
For more information from our cerebral palsy lawyers, please contact us.