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The contribution of developmental surveillance to early detection of cerebral palsy
1Department of Paediatrics, Huddinge University Hospital, Sweden.
Insights
Child Health Centre (CHC) check-ups at 6 months significantly aid early cerebral palsy (CP) detection. However, other CHC screenings rarely lead to timely referrals for children with CP.
Area of Science:
- Pediatrics
- Neurology
- Public Health
Background:
- Early detection of cerebral palsy (CP) is crucial for timely intervention and improved outcomes.
- Child Health Centres (CHC) play a vital role in monitoring child development and identifying potential health issues.
- The effectiveness of routine CHC examinations in the early identification of CP requires further investigation.
Purpose of the Study:
- To evaluate the contribution of Child Health Centre (CHC) examinations to the early detection of cerebral palsy (CP).
- To assess the age of referral to habilitation units for children diagnosed with CP.
- To identify which specific CHC examinations are most effective in prompting referrals for CP.
Main Methods:
- Retrospective study analyzing data from 23,924 children born between 1986-1990 in Stockholm County.
- Utilized CHC examination records and habilitation unit referral data to identify children with CP.
- Reviewed 19 CHC records for moderate to severe CP cases to assess referral triggers.
Main Results:
- A total of 66 children (2.76/1000) were diagnosed with CP.
- The median age of referral was 8 months, with a mean of 12.4 months.
- CHC check-ups at 6 months of age correlated with a peak in referrals between 8-9 months.
- No other CHC examination significantly increased referrals; only 11/20 aberrant findings led to referrals in moderate/severe cases.
Conclusions:
- Six-month CHC examinations are valuable for the early detection of cerebral palsy (CP).
- The current system shows limitations, as not all aberrant findings lead to timely referrals.
- Further improvements in developmental screening and referral protocols within CHCs are needed for optimal CP management.
Abstract:
A retrospective study of the contribution of examinations at Child Health Centres (CHC) for early detection of cerebral palsy (CP) was performed in 23,924 children, born in 1986-90, in the south-western part of Stockholm County. The outcome assessed was age of referral to a habilitation unit. A total of 66 children with CP (2.76/1000) were identified through the register at the responsible habilitation unit. The age of referral was, median 8 months, mean 12.4 months and range 0.5-54 months. A peak of referrals at 8-9 months was produced by CHC checks at 6 months of age. No other examination at the CHC resulted in a significant number of referrals. Nineteen records from CHC concerning moderate and severe cases were reviewed. Out of all examinations with aberrant findings only 11/20 resulted in referrals or further examinations. No child with moderate or severe CP was referred due to developmental screening test findings only.