Testing for cerebral palsy is never an easy undertaking, but if you understand what to expect beforehand and prepare yourself for the fact that your child may undergo a series of tests and exams, the process will go a bit smoother.
How is Cerebral Palsy Diagnosed?
Although there isn’t one single exam or test that confirms cerebral palsy, the diagnosis will likely be made by a series of observations, screenings, and testing over the first months to years of life. Testing can include physical examination, measuring growth, developmental screening, brain imaging, as well as ruling out other conditions.
In some instances, cerebral palsy symptoms are so severe that a physician can make the diagnosis shortly after birth. Early diagnosis is vital as the sooner intervention and treatment begins, the better the child’s quality of life can be.
All infants receive an APGAR (activity, pulse, grimace, appearance, and respiration) score at birth. This gives a measurement of the infant’s status and prognosis. If there are problems with breathing or neurologic function, the APGAR score will be low, indicating that further testing should be considered.
There are examinations and tests performed after birth which help uncover disorders or medical issues early in life so they can be treated. For example, all states in the U.S. administer screenings on newborns looking for diseases such as Sickle Cell Anemia, PKU (phenylketonuria), hypothyroidism, and galactosemia. Other screenings may include hearing and tests of cardiac or respiratory function.
Although these screenings will not diagnose cerebral palsy, they are a significant step in determining if further tests are needed to diagnose medical conditions.
Developmental screenings are done at all medical visits to determine if the child is developing appropriately and rule out any delays. At 6 to 9 months of age, issues with an infant’s movements can be noticed more easily when compared to birth. Cerebral palsy may be suspected at this stage, but physicians will need to run additional tests to be sure.
These developmental screenings are critical so your child’s physician can begin interventions as soon as possible. Early intervention services are available in most states to assist both children and families, including speech therapy, physical therapy, occupational therapy, assistive technology, and family trainings.
Specific testing is more conclusive when compared to screenings. They can help rule out conditions and assist physicians in diagnosing cerebral palsy. As mentioned earlier, there is no single test to diagnose cerebral palsy, but if a doctor suspects the disorder, a series of tests will be conducted.
The most common tests ordered when considering a diagnosis of cerebral palsy include:
Cranial ultrasound is a type of neuroimaging test used in infants to capture images of the brain via soundwaves. Cranial ultrasounds are a preferable method in the first month of life, as they are the least invasive of all neuroimaging techniques.
Cranial ultrasounds work by using reflected sound waves to create pictures of the brain and the inner chambers. They are carried out by a radiologist moving a transducer across the top of the baby’s head, on the soft spot (fontanelle), and images of the brain and its inner fluid chambers are displayed on a monitor.
Aside from the gel feeling cool on the infant’s head when applied, there’s usually no pain or discomfort involved in a cranial ultrasound, and the entire process only takes about 20 to 30 minutes. However, other imaging tests may still be needed as cranial ultrasounds don’t always lead to a definitive diagnosis.
Along with helping diagnose cerebral palsy, cranial ultrasounds can also help rule out other medical conditions, including brain hemorrhage and excessive fluid in the brain.
A CAT scan or CT scan, short for computerized tomography, is a test involving a special X-Ray machine that can be used to take pictures of the baby’s brain, skull, and vessels in the brain. The infant is placed into the scanner, which will then take the images. The process generally lasts around 10 to 15 minutes, or sometimes longer depending on whether sedation is needed and how many images are being taken.
MRI (magnetic resonance imaging) is a type of neuroimaging that uses magnetic fields to take images of the infant’s brain and spine. Although cranial ultrasounds are the easiest and least invasive, MRI scans will generate more definitive results.
The MRI scanner is a machine that uses a strong magnet. For a head MRI, the baby’s head is placed into the machine in order to take images of the brain. It’s safe and painless, but the infant has to be completely still while the scan is taking place. This is usually a difficult task for babies. Sedation is generally required to help babies remain calm and still during the scan.
For more detailed information on imaging tests and cerebral palsy, refer to our article, Cerebral Palsy Imaging Tests.
Numerous other tests and evaluations conducted which aid in the diagnosis of cerebral palsy, or associated conditions, may include:
- Oral motor tests, in which speech and language are evaluated
- Hearing testing
- Vision testing
- Feeding and swallowing evaluations
- Neurological evaluations
- Tests for cognitive impairment
- Gait testing, which evaluates any problems with walking