Cerebral Palsy and Developmental Delays

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All children reach physical, social and emotional, cognitive, and language milestones at their own pace. However, if a child is significantly behind the average for meeting milestones, it may signal a developmental delay. Cerebral palsy is a common cause of developmental delays.

Cerebral Palsy and Developmental Delays

Children with cerebral palsy are likely to have developmental delays because they suffered brain damage during or right after birth. Often, the failure to meet milestones within a reasonable period leads to the evaluation and diagnosis of cerebral palsy.

For parents, it is essential to know what the typical milestones are. They should know the reasonable time frames for a child to achieve milestones and be prepared to reach out to their pediatrician if milestones are consistently delayed.

Physical Milestones

For a child with cerebral palsy, which affects the muscles and movements, physical delays in development are often the first sign that leads to a diagnosis. Early milestones, up to about two months of age, include holding up the head and pushing up when lying on the stomach.

By four months old, most babies can lift the head unsupported, roll over front to back unassisted, hold and shake a toy, and bring the hand to the mouth.

By six months, babies start to roll over in both directions and remain sitting up without help. They stand, bounce on their legs, and rock back and forth.

By nine months, babies stand up with the support of something to hold on to, sit up without assistance, and crawl.

By one year, most children can pull themselves up to stand and walk with support. Toddlers should be able to feed themselves, walk without support, get dressed with minimal help, and go up and down stairs unassisted.[1]

Cognitive Milestones

Not all children with cerebral palsy will have cognitive impairments. The milestones may be right on time for these children, while others, like physical milestones, are delayed.

Some, on the other hand, will experience delays in standard milestones:[2]

• Two-month-old babies should react to faces and follow movements with their eyes.
• By four months, babies begin to examine their hands. They open their mouths when hungry.
• By six months, a baby should be able to observe everything nearby, bring objects to the mouth, and reach for toys to explore.
• By nine months, babies can play peek-a-boo and search for hidden items. They bang objects together.
• By one year, a child will start to explore objects in more detail, point at objects, and look for hidden objects.
• At eighteen months old, a child should play with toys in more complex ways and copy adults doing chores and other tasks.
• Two-year-olds can use more complicated toys, switches, and buttons. They can play with more than one toy at a time.

Social and Emotional Milestones

Emotional and social milestones are not always as easy to assess, but delays in these can also indicate a child has cerebral palsy or another developmental disorder. A 2-month-old baby should be able to smile at people and use simple self-calming techniques.

By three months, babies smile more and play with people. They get upset when play stops and will copy facial expressions. They also imitate facial expressions.

Six-month-old babies begin to recognize people and respond to emotions in others.

By nine months old, a baby may start to show fear of strangers or cling to the people they know. They also begin to indicate a preference for favorite toys.

By one year, a child should have favorite people, show fear in certain situations, be upset when mom or dad goes away, and make moves to get attention.

At eighteen months, children engage others in play by sharing toys, throwing tantrums, showing affection, playing pretend with toys, and beginning to explore alone.

Language and Communication Milestones

Language delays in a child with cerebral palsy are not uncommon. These delays could be due to cognitive delays or physical impairments in muscles that control speaking.

Children with cerebral palsy may also have physical defects that cause problems with vision and hearing:

• By two months of age, a baby should coo and gurgle and also turn toward sounds.
• At four months, babies make babbling sounds and attempt to copy adult sounds. Their cries sound different when they have different needs.
• By six months old, babies respond to sounds with sounds, react to their own names, use sounds to express emotion, and start to develop distinct consonant sounds.
• At nine months, a baby should understand the word no and say simple things like “mama” or “baba.”
• By one year, babies can respond to simple requests and make gestures like waving to greet someone. They try to copy words that adults say and change their tone as they do so.
• At eighteen months, most children can say several different simple words.

Evaluating Developmental Delays

For many parents of children with cerebral palsy, it is the evaluation of delays that leads to a diagnosis of the condition.

If you see delays in your child’s development, speak to your pediatrician and consider having specialists evaluate your child. Some children have early delays and then catch up later. If the delays persist, there is likely something else going on.

Your pediatrician may recommend a speech pathologist specialist, who will evaluate your child by observing them engaging in simple tests and tasks.[3]

A physical exam can uncover physical developmental delays, but gauging the other types of delays usually requires more thorough observations. A complete evaluation may require a developmental specialist, a neurologist, and a developmental psychologist.

Developmental delays are often characteristic of cerebral palsy, but interventions can help. Working with physical therapists, education specialists, psychologists, and others can improve your child’s development and help him catch up with other children.

The earlier you can determine there is a developmental delay and get treatments and interventions, the better the results will be.