Investigating Pediatricians' Practice, Knowledge, and Barriers in Diagnosing Cerebral Palsy

Background/Objectives: Data from the Canadian Cerebral Palsy (CP) Registry suggests that children in British Columbia (BC) are diagnosed, on average, at 25 months of age. This is much later than currently recommended. This study aimed to examine current practices and beliefs of pediatricians in the province related to CP and CP diagnosis. Methods: All pediatricians and subspecialty pediatricians in the province were invited to participate in two consecutive online surveys. The initial survey aimed to assess current practice, knowledge of CP, and beliefs about diagnosis. The second survey, which was distributed to the same group of pediatricians, as well as pediatric neurologists and geneticists, aimed to re-assess current practice and identify specific barriers and facilitators to CP diagnosis. Results: The two surveys were completed by 76 and 59 respondents, respectively. Less than 60% of general pediatricians, in both surveys, reported diagnosing children with CP. In survey 2, only 50% of respondents felt that pediatricians should provide a diagnosis of CP. Most general pediatricians (93%) identified that pediatricians, with support from a developmental pediatrician or neurologist, should provide a diagnosis. Common barriers to an early CP diagnosis included uncertainty about other potential diagnoses and uncertainty over diagnosing at a young age. Lack of access to education and therapists to help inform the diagnosis were also frequently identified barriers. Conclusions: While general pediatricians are knowledgeable about CP, a significant proportion in those surveyed were not diagnosing CP, despite believing that early diagnosis is important. Findings from these surveys have identified that general pediatricians have gaps in knowledge, skills, and confidence in diagnosing CP. Support from a developmental pediatrician or neurology colleague was identified as a potential strategy to support earlier diagnosis.