Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy

This paper focuses on Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy; Advances in Diagnosis and Treatment. It was said that Cerebral palsy could be diagnosed as early as 12-24 months, but an infant can show clinical signs of CP as early as the 6th month of age. It is also known to be one of the most common physical disabilities in early childhood. Most parents tend to notice the lack of movement in motor activities which causes concern for them. The reasoning that babies are born with cerebral palsy is unknown but some risk factors can often be considered. Some of those risk factors include conception, issues during pregnancy and/or birth, and the postneonatal period. When diagnosing an infant and/or toddler with CP, a combination of numerous assessments (usually done by using clinical reasoning and standardized tools) is recommended ("Early, accurate diagnosis and early intervention in cerebral palsy: Advances in diagnosis and treatment", 2019). The article also stresses how early intervention is important because it optimizes and promotes learning and neoplastic, prevents impairments that can interfere with learning, and promotes coping methods for parents and/or caregivers of children who are being diagnosed.

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This research article focuses on accurately diagnosing CP and early intervention methods to optimizing neuroplasticity and function and summarizing the best available evidence about cerebral palsy so that early intervention could be followed. Three tools were said to be the best at predicting Cerebral Palsy. Those three tools were: Neonatal magnetic resonance imaging (MRI), Prechtl Qualitative Assessment of General Movements (GMs), and the Hammersmith Infant Neurological Examination (HINE). These tools were all used after 6 months of age. Before 6 months of age, a variety of motor assessments and neuroimaging (also known as MRI) were conducted on the infant. In situations where the parents did not feel as if it were safe for an Infant to have an MRI done, or could not afford one, there were other means to test and accurately diagnose CP.

Clinicians made an explanation that early diagnosis is not always clear. Infants are constantly growing and changing so their voluntary motor repertoires are expanding and changing. So, determining if an infant’s motor dysfunction is limiting their mobility can be difficult at times. Often clinicians said that False negatives can occur giving the parents false reassurance about their infant’s motor development. This happens when some infants only have a mild form of CP. With mild forms of CP, they are still able to achieve some of their motor milestones on time, offering false reassurance to parents that their infant does not have cerebral palsy.

This clinical study was conducted by collecting and analyzing data using infants that were before 6 months of age and after 6 months of age who had a detectable and nondetectable risk of cerebral palsy. Clinicians started by identifying the risk and then deciding if the risk were concerns or warranted an investigation or not. Once the data needed was collected, through MRIs, Gm’s, and AIMS (Alberta Infant Motor Scale), assessments were combined to indicate if the infant had a high risk of CP, it was unclear, or if they did not have CP at all. When data was being collected and analyzed, a sequence of actions through case studies was being performed.

After the case study was performed, it was clear that infants who were 6 months of age and older had lower scores when it came to their clinical neurological examination, neurological imaging, and motor testing. From those assessments, it was determined that those who scored lower were definitely at a higher risk of being diagnosed with cerebral palsy. Infants who scored less than forty on their Hammersmith Infant Neurological Examination and magnetic resonance imaging were likely to be considered non-ambulant. Infants who scored greater than or equal to forty were at a higher risk of having CP and also likely to be ambulant.

After reviewing the article, one problem that I found during this case study was that clinicians acknowledged that people were receiving false positives and false negatives due to some of their findings. In instances that this happened, the infant was re-diagnosed as having a neurological disability and not a normal developmental disability. False-positive and false negatives prolong the diagnoses process and put off getting an intervention to help parents assist in their infant’s development.

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The article that I chose inspired me in a few ways neuromotor system. The earlier you can receive a diagnosis, and get help, the earlier you can offer support for the parents and caregivers. As mentioned before, I would love to find out how or what causes damage to the brain cortex and to see an MRI of someone who has been diagnosed with having CP.  I would also like to do more research on CP to get a better understanding of what can be done to help relieve some of the pain that comes from CP and if medical marijuana would help those who suffer from pain that cerebral palsy causes.

I would love for future researchers to continue to study cerebral palsy to be able to diagnose CP earlier than 6 months of age. This scholar article mentioned that there is pregnancy, perinatal, and postneonatal risk that can lead to CP. I would love to know if there is a way that an infant can be diagnosed as having CP through ultrasound while still in the womb. Or for researchers to come up with a way that the brain cortex would be repaired or cured.

References:

• Early, accurate diagnosis and early intervention in cerebral palsy: Advances in diagnosis and treatment. (2019). Retrieved 25 July 2019, from https://escholarship.org/content/qt3qb3z8f0/qt3qb3z8f0.pdf