Insights lead to new guidelines for children with cerebral palsy | Pediatric Research
When we think about the transformative power of research, we often think about new drug development, discovering a new molecular pathway or developing a new device or procedure. Another way research transforms care is when experts gather the latest evidence and use it to inform guidelines for the care of people with specific conditions.
In late November, the American Academy of Pediatrics and the American Academy for Cerebral Palsy and Developmental Medicine did just that when they released new guidelines to help primary care providers, which can include doctors, nurse practitioners and physician assistants, support optimal care for children and adolescents with cerebral palsy (CP).
CP is a group of disorders that affect a person’s ability to move and maintain balance and posture. It is the most common motor disorder diagnosis in children. Cerebral palsy is often caused by preterm birth or complications just before or after birth, such as maternal infection. As many as 30% of children likely have a genetic cause for their CP.
As the medical home for children with complex care needs, primary care providers serve as a sounding board and support for families, source of referrals to specialists and therapists and someone who can help keep the whole health of the child and family at the center of care.
These guidelines, updated from the original 2006 report, include a focus on the importance of early identification of cerebral palsy. The guideline revision team, led by Dr. Garey Noritz, a physician at Nationwide Children’s Hospital and chairperson of the American Academy of Pediatrics Council on Children with Disabilities, relied on the latest research and evidence to support the new recommendations.
Since 2006, research has provided significant evidence on the importance of early diagnosis of CP. Published studies show that cerebral palsy can be reliably detected much earlier than it has typically been diagnosed. And with earlier detection, earlier referral to appropriate therapies can improve outcomes for children with CP.
Research shows that cerebral palsy can be accurately diagnosed at nine months of age or even earlier. Because of this, the new guidelines recommend standard developmental screens at nine, 18 and 30 months. If a neuromotor disorder is suspected, primary care providers should take three simultaneous actions: begin a diagnostic workup, refer to a specialist for diagnostic evaluation and refer the family to early intervention programs and therapies.
Research shows that earlier treatment and therapy take advantage of the neuroplasticity of the developing infant brain. That is, they give the infant an opportunity to essentially rewire certain tasks in their brain, supporting better mobility and motor function over the child’s lifetime.
Early detection and treatment aren’t the only updates in the revision. The guidelines also include updates based on the latest research related to addressing disparities and barriers to care, behavioral and mental health, pulmonary and digestive problems, pain and palliative care and transition to adult care.
As researchers continue to learn more about the diagnosis and care of children and adolescents with CP, the guidelines will be reviewed and updated. The transformative power of research is not stagnant — with new information comes new insights, new challenges and new opportunities.
Abbie (Roth) Miller is the managing editor for Pediatrics Nationwide and manager for science and medical content at Nationwide Children’s Hospital.
Abbie.Roth@nationwidechildrens.org
This article originally appeared on The Columbus Dispatch: Guidance provided for identifying, managing cerebral palsy in kids
