Age at Referral of Children for Initial Diagnosis of Cerebral Palsy and Rehabilitation: Current Practices

Abstract

OBJECTIVES: This study describes current practices in the age at referral for diagnosis of cerebral palsy and factors that influence earlier referral. STUDY DESIGN: Retrospective chart review (2002-2012). RESULTS: Of 103 children referred for diagnosis, 81 were referred to a neurologist by other medical specialists at a mean of 13.6 ± 15.7 months, whereas primary care providers referred much later (mean = 28.8 ± 27.1 months). Children admitted to the neonatal intensive care unit were referred earlier (mean = 9.3 ± 10.2 months) than those not (28.1 ± 24.9 months). Referral to rehabilitation was similarly delayed. CONCLUSIONS: Primary care providers generated a minority of referrals, of concern given their role in developmental surveillance. Remarkably high variability suggests knowledge of cerebral palsy attributes varies widely among service providers. Half of children with cerebral palsy do not have a complicated birth history; subsequently, referrals for diagnosis and management are often delayed. New strategies are needed to optimize prompt referral by primary care providers.