How to Determine the Severity of Your Child’s Cerebral Palsy
Cerebral palsy (CP) is a condition caused by brain damage that affects muscle control and coordination, purposeful movement, and balance. Most injuries leading to cerebral palsy occur in a fetus or newborn’s developing brain.
While early signs can indicate a child has cerebral palsy, many are not visible at birth and only become obvious as a baby develops. As such, it can be difficult to gauge the severity of your child’s condition, especially before developmental milestones occur.
Signs of Cerebral Palsy in Babies and Toddlers
Most medical professionals can’t definitively diagnose children with cerebral palsy until they’re at least 18 months old. While the child might have begun showing signs sooner, the condition may not be immediately obvious until that point.
Even so, babies with cerebral palsy might exhibit a few symptoms, including:
- Swallowing or feeding difficulties
- Muscle spasms
- An inability to hold their head in a support position or while lying on the stomach
- Low muscle tone (the baby might feel “floppy” when picked up)
- Delayed development
- Poor posture, reflexes, and muscle control
- A preference for using one side of the body
Toddlers and children with cerebral palsy will continue to have the difficulties they exhibited as babies. Fortunately, the injury does not get worse as they develop. Depending on the severity of the condition, toddlers will likely experience difficulties walking by 12 to 18 months or speaking simple sentences by 24 months.
Classifying Cerebral Palsy by Severity
Cerebral palsy is often classified by severity level. However, even if a pediatrician has classified your child’s CP by severity, the category alone doesn’t give much insight into your family’s experience living with the condition.
Still, severity classification is a common way for medical professionals to define a child’s impairment and overall needs, even if the label isn’t entirely accurate.
Cerebral palsy currently falls under three categories:
- Mild: CP doesn’t limit the child’s daily activities, and he or she can move without assistance.
- Moderate: The child will likely require adaptive technology, medications, and braces to participate in daily activities.
- Severe: The child will face significant challenges and will require a wheelchair.
If your child’s doctor hasn’t used this method to classify the condition, you can probably determine the severity of your child’s CP based on how much it has impacted his or her life and development.
A fourth classification of “No CP” also exists, which means someone has signs or symptoms of cerebral palsy but acquired the impairment after the brain finished developing. In these cases, doctors classify the condition by the incident that caused the impairment to occur, such as encephalopathy or traumatic brain injury.
Using the Gross Motor Function Classification System
Another way to classify the severity of cerebral palsy is with the Gross Motor Function Classification System (GMFCS), which consists of five levels of motor impairment:
- Level I (least severe): A child with CP is fully independent and only has slight coordination or balance issues.
- Level II: The child can walk independently for the most part but has trouble balancing on uneven surfaces. He or she requires handrails on stairs and struggles to run or jump.
- Level III: The child requires mobility aids such as a walker, crutches, or a manual wheelchair but may be able to use stairs with a handrail.
- Level IV: The child’s ability to walk is affected to the point that he or she needs a wheelchair to get around.
- Level V (most severe): The child cannot sit, stand or walk independently due to significant restrictions in voluntary control.
How Soon Can Doctors Diagnose Cerebral Palsy?
Doctors can typically diagnose moderate to severe cases of cerebral palsy by the time children are two years old. Mild cerebral palsy, however, can go unnoticed until the child enters kindergarten.
Diagnosing cerebral palsy isn’t always easy because it’s a complex disability. A doctor will generally order a noninvasive screening test to identify neurological issues from birth to about 20 weeks of age. He or she might also order a series or MRIs or CT scans to look for certain changes in the brain.
Additional tests may include:
- Vision tests
- Speech tests
- Hearing tests
- Intellectual tests
Understandably, waiting for a CP diagnosis can be frustrating, but parents need to remember that doctors must rule out other types of movement disorders that may worsen over time. They must also rule out any hereditary conditions that might affect a child’s motor function. For more information about diagnosing CP, speak to your doctor.
Although incredible advancements have been made in the medical field, cerebral palsy can greatly impact a family’s emotional and financial well-being. However, there are many resources available to you that can help. Additionally, if you think your child’s CP was caused by medical malpractice, you may be eligible for financial compensation. Contact the Cerebral Palsy Family Lawyers at Janet, Janet & Suggs LLC to learn more.
Trish Fletcher, MS, BSN, CRNP, NNP-BC, ALNC
Neonatal Nurse Practitioner | Birth Injury Legal Nurse Consultant
Tricia is a dedicated, focused, Birth Injury Legal Nurse Consultant and Neonatal Nurse Practitioner with more than 25 years of experience. Her strong clinical and critical thinking skills, paired with expertise caring for neonates in a Level III Neonatal Intensive Care Unit (NICU), ensures meticulous medical records review. READ FULL BIO