While diagnosis of cerebral palsy typically occurs when children are 2 years of age or older, Nationwide Children’s has decreased the average age of diagnosis to 13 months, allowing for earlier therapy.
Little more than a month after a panel of international experts released new guidelines for early cerebral palsy diagnosis and intervention, Nationwide Children’s Hospital has become the first institution to demonstrate that they can be successfully applied in a clinical setting.
The Nationwide Children’s Early Developmental Clinic team reported on the experience recently in the journal Pediatric Neurology. Among other results, Nationwide Children’s has been able to make significantly earlier diagnoses of cerebral palsy in patients after guideline implementation.
“Research has shown us that if we can intervene early for children with cerebral palsy, when their brains have their greatest potential for recovery, we can have the greatest effect,” said Nathalie L. Maitre, MD, PhD, director of Neonatal Intensive Care Unit (NICU) Follow-up Programs at Nationwide Children’s and principal investigator in the Center for Perinatal Research. “This hospital is committed to helping children achieve the best possible outcomes, which is why everyone worked so hard to implement these guidelines.”
The guidelines were published in JAMA Pediatrics in July. Dr. Maitre was a contributing author of them, along with Garey H. Noritz, MD, chief of Complex Care and director of the Comprehensive Cerebral Palsy Program at Nationwide Children’s. Because of the involvement of Drs. Maitre and Noritz in developing the guidelines, Nationwide Children’s was able to begin implementing them a year before they were published.
The guidelines affirm that early diagnosis is important for improved outcomes, and they lay out a potential timeline for neuroimaging, movement and neurological assessments. Those can be used to determine as early as 3 to 4 months of age if a child is at high risk for developing cerebral palsy.
Cerebral palsy is the most common physical disability in childhood. It is the result of brain injury before, during or shortly after birth, and the phrase “cerebral palsy” actual refers to a group of disorders related to movement and posture. There is no cure, but many treatments can reduce the impact of cerebral palsy and help children adapt to their challenges.
For the ten months after implementation of guidelines in July 2016, Nationwide Children’s nearly doubled the number of NICU Follow-up Program clinic visits for children at 3 to 4 months of age compared to a similar time period in 2014. The average age of diagnosis for cerebral palsy decreased from 18 months (which was already earlier than a typical diagnosis) to 13 months.
“Our experience shows that it’s not only feasible for many hospitals to implement these guidelines, but that they do lead to early diagnosis and better support for these vulnerable children and their families,” said Dr. Maitre.