Predictors for early diagnosis of cerebral palsy from national registry data

Abstract

Aim As early intervention is important in cerebral palsy (CP), an early diagnosis is desirable. The aim of this study was to establish the median diagnostic age of CP and to identify predictors of an early diagnosis in a population‐based cohort. Method Using the Danish National Cerebral Palsy Registry (NCPR), we identified 1291 children with CP (764 males, 527 females) born between 1995 and 2003. The date of diagnosis was defined as the day the parents were told that their child was spastic or had CP. We calculated the age of diagnosis and analysed the following predictors: type of CP, degree of motor disability, cerebral ultrasonography results, epilepsy, gestational age, and degree of cognitive impairment. Results We found the overall median corrected diagnostic age of CP to be 11 months. Early diagnosis was associated with the type of CP, presence of epilepsy, a high degree of motor disability, and abnormalities in the cerebral ultrasonography. The gestational age was not associated with the diagnostic age. Interpretation The median diagnostic age implies that half of the Danish children with CP will be able to enter an early intervention program before 1 year of age. A late diagnosis was associated with less severe symptoms, and gestational age did not influence the diagnostic age.

Pain symptoms in patients with severe cerebral palsy: Prevalence among patients with higher degree of locomotor impairment

“…The findings are similar to a study conducted in Denmark, which showed that the mean age of diagnosis for CP, associated with the onset of symptoms such as high degree of motor disability, abnormalities on cerebral ultrasound and the presence of epilepsy, was around 11 months of age [19]. As verified in our study and reported in other studies, epilepsy is a prevalent comorbidity in patients with CP [4,[19][20][21].…”

Diagnosing cerebral palsy in full‐term infants

“…This lack of clinical history often leads to late diagnosis and delayed referral for intervention. A Danish register study found that ambulant children with CP are the latest to be diagnosed, particularly those with bilateral spastic CP who are a mean age of 23.9 months at diagnosis . In contrast, non‐ambulant children typically receive their diagnosis by 6 months of age.…”

Comparing parent and provider priorities in discussions of early detection and intervention for infants with and at risk of cerebral palsy

“…Preterm infants and those with encephalopathy at birth are more at risk for CP than their peers, but children without apparent risk factors can also be diagnosed with CP (Facts about Cerebral Palsy, Key Facts). The average age at diagnosis of CP varies by country and setting and is reported to be between 12 and 27 months of age (Byrne, Noritz, Maitre,, & NCH Early Developmental Group, ; Granild‐Jensen, Rackauskaite, Flachs, & Uldall, ; Hubermann, Boychuck, Shevell, & Majnemer, ; Novak et al, ). A late diagnosis may result in missed intervention opportunities for children and their families: Delays in diagnosis are associated with significant parental dissatisfaction, stress, and depression (Baird, McConachie, & Scrutton, ; Novak et al, ) and higher rates of mental health problems in children and adolescents (Whitney, Warschausky, & Peterson, ).…”