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Cerebral Palsy (CP) is a group of permanent disorders of the development of movement and posture, causing activity limitations that are attributed to nonprogressive disturbances that occurred in the developing fetal or infant brain.1


  • Nonprogressive defect or lesion in the developing brain during prenatal, perinatal, or postnatal period.2
  • Major contributing factors include prematurity, coagulopathy with intrauterine stroke, and intrauterine or fetal infection and inflammation.3
  • However, the majority of cases in term infants have no identifiable etiology,4 and diagnosis is made according to clinical and neurological signs.5

Epidemiology including risk factors

  • Cerebral palsy is the most common motor disability in childhood. Overall prevalence of CP is approximately 1-4/1000 live births,6 with prevalence being the highest among African-American children and in boys. This rate remained constant for nearly 50 years.3,7
  • The single greatest risk factor for CP is prematurity, primarily prior to 28 weeks gestation.8
  • The rate of CP is suspected to be higher in lower-income countries due to differences in prenatal and perinatal care.5
  • The risk of CP in lower socioeconomic classes is nearly 70% higher than that in higher socioeconomic classes, suggesting significant health disparities impacting screening and management prenatally, perinatally, and postnatally.4 
  • The pooled prevalence in term infants was 1.4/1000 live births; at 32-36 weeks gestation, the prevalence was 6.8/1000 live births, and in premature infants (less than 28 weeks), the prevalence of CP was 82.3/1000 live births.3,7
  • The pooled prevalence of CP based on weight was 10.2/1000 live births for weight 1500 to 2499 grams, 59.2/1000 live births for weight 1000 to 1499 grams, 56.7/1000 live births for children with birth weight less than 1000 grams, and 1.3/1000 children with birth weight of 2500 grams or more.3,7
  • A study in Denmark found that children born after in vitro fertilization were 1.6 times as likely to have CP.3
  • Children born as part of a multiple birth pregnancy were found to be almost 5 times more likely to have CP than children born as singletons.3
  • Maternal genito-urinary tract infections are associated with CP in all births. Congenital TORCH infections are also risk factors.3
  • Spasticity is the most frequent motor event (60%).3


  • CP has possible multiple causes: Congenital, prenatal, perinatal brain injury and postnatal causes.2
  • Four motor types exist that are typically detected and may change within the first two years of life: spasticity (85%-91%), dyskinesia (4%-7%), ataxia (4-6%), and hypotonia (2%).5
  • CP can also be categorized according to limbs involved: hemiplegic, diplegic, and quadriplegic.
  • Spastic diplegia is commonly seen in premature infants and is associated with intraventricular hemorrhage leading to periventricular leukomalacia (PVL). Spastic hemiparesis is commonly secondary to focal cortical infarcts (middle cerebral artery).9
  • Dystonic CP is associated with deep gray matter or subcortical infarctions affecting the basal ganglia or thalamus.10
  • Developmental brain malformations are a factor in the development of CP. In general, insults during the first trimesters are associated with cerebral maldevelopment such as schizencephaly; in the second trimester, with periventricular white matter damage; and in the third trimester, with cortical and deep grey matter damage.11
  • Postneonatal cause is about 10% of all causes of CP. Majority are attributed to CNS infections such as meningoencephalitis and brain injury. Traumatic brain injury or stroke in the young child can lead to hemiparetic or tetraplegic CP.11
  • Hypoxic brain injury can also cause CP in in 10-20% due to encephalopathy.4 In order to diagnose CP due to hypoxic event, metabolic acidosis, early moderate to severe neonatal encephalopathy, CP of spastic quadriplegic or dyskinetic type and exclusion of other identifiable causes of CP must be met.12
  • Maternal-fetal infections including chorioamnionitis are associated with a higher risk of CP.13
  • Direct genetic causes or genetic variant causing susceptibility to insults causing CP is also being investigated. Mutation of KANK1, AP4MI, and GAD1 gene mutations have shown to cause CP.14

Disease progression including natural history, disease phases or stages, disease trajectory (clinical features and presentation over time)

Although the underlying disorder leading to cerebral palsy is nonprogressive by definition, secondary or associated conditions lead to functional loss and clinical progression over time.15 As the number of limbs involved and number of comorbidities increases, response to intervention decreases.16

Specific secondary or associated conditions and complications

  • Secondary complications associated with CP can include17
    • Chronic pain (75%)
    • Joint/muscle contractures
    • Foot deformity (equinus foot is the most common musculoskeletal deformity in CP)
    • Hip dysplasia (chronic hip subluxation and progressive dislocation, 28%)
    • Neuromuscular scoliosis
    • Osteopenia
    • Visual impairment (11%)
    • Hearing impairment (4%)
    • Dysphagia
    • Speech impairment
    • Failure to thrive
    • Impaired airway clearance
    • GI problems: GERD, constipation
    • Sleep disorders (23%)
  • Co-occurring developmental disabilities
    • Seizure disorder (more common in tetraplegic and hemiparetic CP, although occurring in approximately 35-40% of children with CP.16
    • Autism spectrum disorders (higher in hypotonic CP, although 7.5% of patients with CP have ASD).6
    • Cognitive impairment (risk increases with greater degree of neuromuscular impairment, although prevalence is nearly 50% generally.16

Essentials of Assessment

To make the diagnosis of CP, the child should have motor dysfunction established via abnormal GMs or HINE Scores or early observed hand asymmetry, and either abnormal neuroimaging or a clinical history suspicious for high likelihood of cerebral palsy.


  • Important historical information includes:
    • Prenatal risk factors (prematurity, intrauterine growth restriction, genetics, birth defects, males, multi-gestation)
    • Maternal risk factors (history of stillbirths or miscarriages, drug/toxin exposure, maternal thyroid disease)
    • Perinatal history (as indicated by APGAR scores, birth weight and history of asphyxia)
    • Post-neonatal risk factors (stroke, infection, accidental and nonaccidental brain injury prior to 24 months of age)
    • Family history of similar conditions
    • Comprehensive developmental history including ages at which developmental milestones were met or if any were lost
  • Loss of achieved milestones suggests a neurodegenerative condition.

Physical examination18

  • Key neurologic findings may include:
    • Elevated tone (may be hypotonic for the first 6 months of life);
    • Retention of primitive reflexes;
    • Abnormal postural control;
    • Abnormal motor control, including:
      • Co-contraction of antagonist and agonist muscles
      • Synergy patterning
        • Flexion synergy upper extremities
        • Extension synergy lower extremities
      • Extrapyramidal findings
        • dystonia
        • athetosis
  • Key musculoskeletal findings in the examination may include
    • Contractures
    • Hip subluxation/postural asymmetries of the pelvis
    • Scoliosis
    • Foot changes: equinus foot, varus or valgus foot or foot drop
    • Abnormal gait pattern
    • Toe walking: can be physiologic up to 2 years
    • Jumpers gait: Equinus foot, genu flexum and coxa flecta
    • Crouched gait: Excessive dorsiflexion of the ankle and genu flexum with coxa flecta
    • Hemiparetic gait

Early Detection of Cerebral Palsy19

Value of early detection

Historically, CP would not be diagnosed prior to 12 months of age, as this was considered the silent period when it could not be diagnosed accurately.5 However, with advances in medicine, earlier detection is possible and can improve outcomes. Early detection enables timely early intervention and should be considered standard of care. Contemporary early interventions optimize neuroplasticity and functional outcomes, as the highest likelihood for functional gains ends at three years of age,8 and minimizes complications in children with CP.

Before 5 months’ corrected age, workup for those who have “newborn-detectable risks for CP” (e.g., prematurity, atypical intrauterine growth, encephalopathy, genetic abnormalities, seizures) should include:

  • Neonatal magnetic resonance imaging (MRI) (86-89% sensitivity)
  • the Prechtl Qualitative Assessment of General Movements (GMs) (98% sensitivity)
  • The Hammersmith Infant Neurological Examination (HINE) (90% sensitivity)

After 5 months’ corrected age, workup for those who have “infant detectable risks for cerebral palsy” (delayed motor milestones, e.g., not sitting independently at 9 months, hand asymmetry) should include:

  • MRI (86-89% sensitivity)
  • The HINE (90% sensitivity)
    • HINE < 73 suggests high likelihood of CP, while HINE < 40 almost always indicates CP.5
  • The Developmental Assessment of Young Children (83% sensitivity)

To make an early clinical diagnosis before 6 months, a combination of validated assessments with clinical reasoning is recommended. Combining the GMs or HINE with imaging provides a more accurate diagnosis than simply an abnormal GMs or HINE, with 95% accuracy for use of GMs and neonatal MRI in infants younger than 5 months corrected age and 90% accuracy for use of HINE plus neonatal MRI in infants older than 5 months corrected age.5

Interim clinical diagnosis of “high risk of CP”

  • Those who are highly suspected for CP but the diagnosis cannot be made with certainty.
  • Important because CP patients’ needs and optimal treatments are different from other developmental disabilities.
  • The infant must have motor dysfunction (essential criterion) and at least one of the additional criteria (abnormal neuroimaging and clinical history indicating risk of cerebral palsy).
  • Ongoing diagnostic monitoring, referral to CP-specific early intervention, and standard medical investigations for associated impairments and functional limitations should be provided.

Functional assessment20

Commonly used assessment tools include18

  • Gross Motor Functional Classification System (age-based classification of mobility functions)
  • Gross Motor Function Measure (evaluates 5 dimensions of function, including lying/rolling, sitting, crawling/kneeling, standing, walking, running, jumping)
  • Pediatric Evaluation of Disability Inventory (assesses realms of activity and participation)

Laboratory studies20

Metabolic and genetic studies should be considered if neuroimaging does not demonstrate a specific structural abnormality, or if additional atypical history and clinical findings are noted.

Testing for coagulopathies should be considered if evidence of cerebral infarction is seen on neuroimaging.


Neuroimaging is beneficial in the evaluation of CP in order to establish a diagnosis and prognosis, although 13% have normal scans.

When available, MRI of the brain is preferred to CT scanning because of its higher yield (89% vs 77%). The yield on imaging depends on the type of CP, and MRI is more likely to show abnormalities associated with premature CP such as PVL.20

Findings on MRI may include white matter injury (56%), cortical and deep grey matter lesions (18%), and congenital brain developmental abnormalities.

Cranial Ultrasound is the least invasive and a fast imaging tool, preferably used in the first month of life before the cranial bones are completely formed. It is useful for detection and follow-up of intracranial hemorrhage, hydrocephalus, and PVL. It is also a good tool to follow-up CNS malformations, infections, and masses.21

Supplemental assessment tools19,22

Supplemental testing is patient-specific and based on associated secondary conditions and complications. Considerations include

  • Electroencephalography
  • Oropharyngeal motility studies (Oro-motor impairment and subsequent dysphagia are most common in tetraplegia.)
  • Hearing screening (Sensorineural hearing loss is associated with CP secondary to TORCH infections, meningitis.)
  • Vision screening (40%-100% prevalence of visual dysfunction)
  • Nutritional screening (risk of malnutrition secondary to oro-motor impairment, communication impairment and poor social support)
  • Bone density studies (Risk of osteopenia increases with severity of CP and non-ambulatory status.)
    • Dual Energy X-ray Absorptiometry (DXA) studies are recommended only following fragility fracture.

Early predictions of outcomes

  • Possible predictors of eventual ambulation include persistence of primitive reflexes, type of cerebral palsy and gross motor skills.
  • Achieving independent sitting by age 2 years is directly related to achieving ambulation.
  • A measure of functional strength and dynamic postural control in a sit-to-stand activity was significant predictor of taking ≥3 steps independently at age 2.23
  • Nearly 100% of children with spastic hemiparesis, and 85% with spastic diplegia, will ambulate.
  • Adverse factors affecting survival include severe/profound mental retardation, epilepsy and type of CP.

Social role and social support system

  • Federal law mandates the provision of educational support for children with special needs. The Individuals with Disabilities Education Act of 1997 (IDEA) ensures meaningful educational opportunities for individuals with disabilities from birth to 21 years.
  • IDEA includes early intervention services (Part C: birth to 3 years), special education services (Part B: 3y to 21y), and Individualized Education Program (IEP)
  • The most recent final rule was published in the Federal Register on November 21, 2016 and since initial publication from 2008, most recent version made a number of significant changes including clarifying and broadening the definition of “disability”. Also, it further clarified public accommodation’s obligations to provide auxiliary aids and services.

Rehabilitation Management and Treatments

Available or current treatment guidelines

Evidence-based treatment guidelines are limited in cerebral palsy. Applicable guidelines are as follows:

  • Botulinum neurotoxin for the treatment of spasticity.24
  • Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society.
  • Practice parameter: pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society.24
  • AACPDM Care Pathway topics includes central hypotonia, dystonia, early detection of cerebral palsy, hip surveillance, osteoporosis, sialorrhea in cerebral palsy.25
  • Australian hip surveillance guidelines for children with cerebral palsy 2014.25

More recently, a systematic review of interventions for CP using GRADE and the Evidence Alert Traffic Light System identified the following treatment options as the best available evidence interventions for managing CP26

  • Motor interventions: CIMT, partial body weight support treadmill training, mobility training, treadmill training, strength training, action observation training, bimanual training, goal-directed training, home programs using goal-directed training, functional chewing training, and occupational therapy post botulinum toxin.   
  • Tone management: botulinum toxin, intrathecal baclofen, diazepam, and selective dorsal rhizotomy.
  • Contracture prevention and management: serial casting can effectively reduce or eliminate early/moderate contractures in the short term, casting effects can be enhanced by casting four weeks post botulinum toxin injections, and after casting, active strength training and goal-directed training are recommended.
  • Hip surveillance: comprehensive hip surveillance practices are recommended for early detection and management of hip displacement.
  • Dysphagia management: electrical stimulation and oral sensorimotor therapy.
  • Cognition: literacy interventions.
  • Parent outcomes: acceptance and commitment therapy, stepping stones triple

At different disease stages15

  • During infancy and early childhood, the focus of management primarily is on motor and cognitive development. Considerations during this time must include spasticity management (oral medications, botulinum toxin injections), contracture prevention (passive range of motion, splinting, both static and dynamic), feeding and nutrition, motor education, adaptive equipment (orthotics, postural control devices), and communication.
  • As the child grows and develops many of these considerations remain, but new factors may emerge that affect management strategies. Options for spasticity management expand (baclofen pump, selective dorsal rhizotomy, muscle-tendon lengthening). Mobility needs increase and are addressed through adaptive mobility equipment (walkers, crutches, wheelchairs) and orthoses. The initiation of routine skeletal surveillance is recommended in early childhood and may include annual hip films (anterior-posterior and frog views) and scoliosis series radiographs.
  • As the child enters school age, school entry programming should begin and includes formal cognitive testing and IEP development.
  • Considerations for the adolescent and young adult must include social adaptation, including disabled sports programs, vocational rehabilitation assessment, and impaired-drivers evaluation.
  • Planning the transition to adulthood is also critical. It includes developing goals for education, independent living, medical care and legal guardianship.

Coordination of care

  • The cost of medical care in children with CP vs. children without is 26 times higher in CP ($43,338 vs. $1,674 in 2005).6
  • The longitudinal management of the individual with CP should be carried out as a multidisciplinary, integrated, or coordinated effort.
  • Specialists in pediatric orthopedic surgery, neurosurgery, physiatry, neurology, nutrition, physical therapy, occupational therapy, speech therapy, social work and nursing all play critical roles in addressing the myriad needs (physical, medical, social) of this population.
  • Providing services to adults is challenging due to the lack of specialists trained and interested in adults with CP.

Patient & family education

  • Patient and family education are key to the successful management of the individual with CP.
  • Nearly 90% of parents of children with CP suspect their child has CP prior to official diagnosis. Not only is earlier detection beneficial for patient outcomes, it has been shown to reduce stress and anxiety among family members, as well as trust and communication with the medical team.9
  • Important topics to address include social participation, educational resources, legal resources, school transitions, family centered care concepts, advocacy for the child, anticipatory guidance and transition to adulthood (vocational, medical, social, legal).

Assessment tools

  • Impairment-based measures are commonly used to clearly define an individual level of physical impairment. Frequently used tools include:
    • Modified Ashworth Scale (assesses degree of spasticity across a joint)
    • Tardieu Scale (assesses degree of spasticity across a joint)
    • Berg Balance Test (measures balance in individuals with mild to moderate motor impairment)
    • Range of motion/goniometry (angular measure of passive and active range of motion)
    • Selective voluntary Motor Control Assessment of the Lower Extremities (SCALES) (assesses isolated active motion across a joint)
    • Hypertonia Assessment Tools (to differentiate spasticity, dystonia, rigidity and mixed tone)
  • Tools for measuring functional outcomes include:
    • Gross Motor Function Measure
    • Gross Motor Function Classification System
    • Manual Abilities Classification System
    • Jebsen-Taylor Hand Function Test
    • Assisting Hand Assessment
    • Melbourne Assessment of Unilateral Upper Limb Function
    • Functional Independence Measure for Children
    • Pediatric Evaluation of Disability Inventory
    • Pediatric Outcomes Data Collection Instrument

Cutting Edge/Emerging and Unique Concepts and Practice

  • Although the mainstays of treatment for CP continue to be physical therapy, occupational therapy and speech-language pathology therapy, some newer interventions are emerging.
  • In a recent meta-analysis of 5 RCTs (n=282), there was a significant improvement in growth motor function for those who received stem cell treatment compared to those who received symptomatic standard care only.27
  • Robotic assisted therapy for various functional goals are emerging such as robotic trunk support trainer for functional and independent sitting for children and robot-assisted gait training for motor control.28
  • COVID-19 and Children with CP: Although there is very little data regarding COVID-19 rates in children with CP, one study found that 83% of children admitted to the pediatric ICU had pre-existing conditions, of which 44% were considered “medically complex,” in which CP falls. Children with CP classified as GMFCS IV and V are very likely to experience significant sialorrhea, dysphagia, recurrent respiratory infections and hypoventilation during sleep. Impaired respiratory function is seen even in children with CP classified as GMFCS III, with worsening respiratory function as CP severity increases. Thus, if individuals with CP test positive for COVID-19, they should undergo closer monitoring, as they are at higher risk of experiencing severe respiratory distress.29

Gaps in the Evidence-Based Knowledge

  • Effectiveness and long-term safety of stem cell therapy
  • Prevalence of CP in COVID-19 transmitted children
  • A knowledge and translational research gap exist between basic and clinical research


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  4. Flanagan, D., D. Gaebler, E. B. Bart-Plange, and M. E. Msall. “Addressing Disparities among Children with Cerebral Palsy: Optimizing Enablement, Functioning, and Participation.” J Pediatr Rehabil Med 14, no. 2 (2021): 153-59. https://doi.org/10.3233/PRM-210015. https://www.ncbi.nlm.nih.gov/pubmed/34092660.
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  6. “Data and Statistics for Cerebral Palsy | CDC.” CDC. Accessed October 5, 2023. https://www.cdc.gov/ncbddd/cp/data.html. 
  7. Oskoui, M., F. Coutinho, J. Dykeman, N. Jette, and T. Pringsheim. “An Update on the Prevalence of Cerebral Palsy: A Systematic Review and Meta-Analysis.” Dev Med Child Neurol 55, no. 6 (Jun 2013): 509-19. https://doi.org/10.1111/dmcn.12080. https://www.ncbi.nlm.nih.gov/pubmed/23346889.
  8. Maitre, N. L., D. Damiano, and R. Byrne. “Implementation of Early Detection and Intervention for Cerebral Palsy in High-Risk Infant Follow-up Programs: U.S. And Global Considerations.” Clin Perinatol 50, no. 1 (Mar 2023): 269-79. https://doi.org/10.1016/j.clp.2022.11.005. https://www.ncbi.nlm.nih.gov/pubmed/36868710.
  9. Scher MS, Belfar H, Martin J, Painter MJ. Destructive brain lesions of presumed fetal onset: Antepartum causes of cerebral palsy. Obstet Gynecol Surv. 1992. doi:10.1097/00006254-199206000-00005
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  13. Patel, D. R., M. Neelakantan, K. Pandher, and J. Merrick. “Cerebral Palsy in Children: A Clinical Overview.” Transl Pediatr 9, no. Suppl 1 (Feb 2020): S125-S35. https://doi.org/10.21037/tp.2020.01.01. https://www.ncbi.nlm.nih.gov/pubmed/32206590.
  14. MacLennan AH, Thompson SC, Gecz J. Cerebral palsy: Causes, pathways, and the role of genetic variants. Am J Obstet Gynecol. 2015. doi:10.1016/j.ajog.2015.05.034
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  16. Morgan, C., L. Fetters, L. Adde, N. Badawi, A. Bancale, R. N. Boyd, O. Chorna, et al. “Early Intervention for Children Aged 0 to 2 Years with or at High Risk of Cerebral Palsy: International Clinical Practice Guideline Based on Systematic Reviews.” JAMA Pediatr 175, no. 8 (Aug 1 2021): 846-58. https://doi.org/10.1001/jamapediatrics.2021.0878. https://www.ncbi.nlm.nih.gov/pubmed/33999106.
  17. Vitrikas K, Dalton H, Breish D. Cerebral palsy: An overview. Am Fam Physician. 2020.
  18. Kim H, Shin MR. Special Considerations in Pediatric Assessment. Phys Med Rehabil Clin N Am. 2018;29(3). doi:10.1016/j.pmr.2018.03.002
  19. AACPDM. AACPDM Care Pathway. https://www.aacpdm.org/publications/care-pathways. Published 2020.
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  25. AusACPDM. Australian Hip Surveillance Guidelines. https://www.ausacpdm.org.au/resources/australian-hip-surveillance-guidelines/. Published 2014.
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  27. Eggenberger S, Boucard C, Schoeberlein A, et al. Stem cell treatment and cerebral palsy: Systemic review and metaanalysis. World J Stem Cells. 2019. doi:10.4252/wjsc.v11.i10.891
  28. El-Shamy SM. Efficacy of Armeo® Robotic Therapy Versus Conventional Therapy on Upper Limb Function in Children with Hemiplegic Cerebral Palsy. Am J Phys Med Rehabil. 2018. doi:10.1097/PHM.0000000000000852
  29. Brandenburg, J. E., M. J. Fogarty, and G. C. Sieck. “Why Individuals with Cerebral Palsy Are at Higher Risk for Respiratory Complications from Covid-19.” J Pediatr Rehabil Med 13, no. 3 (2020): 317-27. https://doi.org/10.3233/PRM-200746. https://www.ncbi.nlm.nih.gov/pubmed/33136080.

Suggested Readings and Resources

Alexander MA, Matthews DJ. Pediatric Rehabilitation: Principles and Practice. 4th ed. New York, NY: Demos Medical; 2010.

Ment LR, Bada HS, Barnes P, et al. Practice parameter: neuroimaging of the neonate. Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2002;58(12):1726-1738.

Ashwal S, Russman BS, Blasco PA, et al. Practice Parameter: diagnostic assessment of the child with cerebral palsy. Report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2004; 62(6):851-863.

Strauss D, Shavelle R, Reynolds R, Rosenbloom L, Day S. Survival in cerebral palsy in the last 20 years: signs of improvement? Dev Med Child Neurol. 2007;49:86-92.

Sala DA, Grant AD. Prognosis for ambulation in cerebral palsy. Dev Med Child Neurol. 1995;37(11):1020-1026.

Tosi L, Maher N, Winslow Moore D, Goldstein M, Aisen ML. Adults with cerebral palsy: a workshop to define the challenges of treating and preventing secondary musculoskeletal and neuromuscular complications in this rapidly growing population. Dev Med Child Neurol. 2009;51(suppl 4):2-11.

Yeargin-Allsopp M, Van Naarden Braun K, Doernberg NS, Benedict RE, Kirby RS, Durkin MS. Prevalence of cerebral palsy in 8-year-old children in three areas of the United States in 2002: a multisite collaboration. Pediatrics. 2008;121(3):547-554.

Original Version of the Topic

Robert Rinaldi, MD. Cerebral Palsy. Published 12/27/2012.

Previous Revision(s) of the Topic

Mi Ran Shin, MD, Heakyung Kim, MD. Cerebral Palsy. Published 4/17/2017.

Mi Ran Shin, MD, Nahyun Kim, MD. Cerebral Palsy. 4/1/2021

Author Disclosures

Kristen Santiago, BA
Nothing to Disclose

Lauren O’Keefe, MD
Nothing to Disclose

Rajashree Srinivasan, MD, MBBS
Nothing to Disclose