Implementation of an early detection of cerebral palsy clinic in victoria.

Abstract

Background: Cerebral palsy (CP) has traditionally been diagnosed between 1-2 years of age. A history of high-risk birth, imaging at term equivalent age, along with standardised assessment tools have contributed to the feasibility of early diagnosis of CP. Method(s): An early neurodevelopment clinic at a tertiary children's hospital in Victoria was commenced based on recent best evidence for early CP diagnosis. The multidisciplinary clinic including a neonatologist, paediatric physiotherapists and social worker assess the infants and the families together. Medical history, neuroimaging at term equivalent age, Prechtl's General Movements (GMs) and the Hammersmith Infant Neurological Examination (HINE) are used to diagnose CP in high-risk infants at three months corrected age. We present the early experience from this clinic. Result(s): 55 out of the 84 eligible high risk infants (gestation less than 29 weeks' gestation, birth weight less than 1000 grams) born in the last 12 months have been seen in the clinic till date. 5 (9%) infants presented with absent fidgety GMs. Mean (SD) HINE scores were 55.2 (7.5). A diagnosis of CP/ high risk of CP was made in 6 infants before the age of six months. Conclusion(s): Implementation of an early detection of cerebral palsy clinic has led to early diagnosis of CP in high-risk infants. Early detection of CP aims to lead to early intervention, which supports best evidence-based practice to optimise infant motor and cognitive performance, prevent secondary complications, and enhance caregiver well-being.