Abstract:
This study aimed to evaluate assessment and referral practices for early detection and diagnosis of children at risk of or diagnosed with cerebral palsy by healthcare and education providers in Maryland and Delaware (US). A secondary aim was to identify barriers to the use oof early detection ools and identify opportunities for change to support early diagnosis and improve care. Seventy-two participants answered at least 50% of the survey questions. The majority were occupational or physical therapists (n=62,86%) and worked in early intervention (n=44, 62%). Eighty-eigh percent (n=57/65) of respondents indicated awareness that CP can be diagnosed by 12 months. Though 86% (n=61/71) stated that they typically suspect a diagnosis of CP between 0-12 months, only 19% (n=13/69) reported that their patients receive a CP diagnosis before 12 months. The most used assessments were the Developmental Assessment of Young Children (n=47/64, 73%) and the Peabody Developmental Motor-Scales 2 (n=36/61, 59%). Many respondents indicated that they had never used Magnetic Resonance Imaging (n=40/57, 70%), the General Movements Assessment (n=48/55, 87%), nor Hammersmith Infant Neurological Exam (n=41/59, 70%). Participants identified clinical signs and symptoms that prompt a referral for diagnostic assessment of CP with the most common being stiffness in the legs (n=59/62, 95%) excessive head lag (n=54/58, 93%) and persistent fisting (n=55/60, 92%). Legislation change, time and training are needed to support implementation of CP early detection guidelines.