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New Guidelines Dramatically Improve Cerebral Palsy Outcomes

While diagnosis of cerebral palsy typically occurs when children are 2 or older, Nationwide Children’s has decreased the average age of diagnosis to 13 months, allowing for earlier therapy.

The Nationwide Children’s Early Developmental Clinic cut the time while demonstrating that new guidelines for early diagnosis and intervention, released by a panel of international experts that included two from Nationwide Children’s, can be successfully applied in a clinical setting. The clinic reported its experience in Pediatric Neurology.

“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,” says 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.

Dr. Maitre and Garey H. Noritz, MD, chief of Complex Care and director of the Comprehensive Cerebral Palsy Program at Nationwide Children’s were authors of the guidelines, published in JAMA Pediatrics in July. Because of their involvement, 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 lay out a potential timeline for neuroimaging, movement and neurological assessments. The assessments 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.

For the 10 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 here from 18 months 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,” says Dr. Maitre.

Byrne R, Noritz G, Maitre NL. Implementation of early diagnosis and intervention guidelines for cerebral palsy in a high-risk infant follow-up clinic. Pediatric Neurology. 2017 Nov;76:66-71.

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