Testing for cerebral palsy is never an easy process, but if you understand what to expect beforehand and prepares 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, a series of observations, screenings, and testing over this first 2 to 5 years is typically how the diagnosis is made. Testing can include measuring growth, development, and ruling out other conditions.
In some instances, cerebral palsy symptoms are so severe shortly after birth that a physician can make the diagnosis right away. Early diagnosis is important as the sooner intervention and treatment begins, the better the child’s quality of life can be.
All infants undergo screenings when born in order to uncover any disorders or medical issues. For example, all states in the nation administer screenings on newborns for sickle cell diseases, PKU (phenylketonuria), hypothyroidism, and galactosemia. Other screenings that occur in most states including hearing screenings and metabolism disorder screenings.
An APGAR (activity, pulse, grimace, appearance, and respiration) score is almost always performed on newborns in order to check for heart and respiratory health. A low APGAR may indicate that further screenings and possible tests are needed.
Although screenings will not diagnose cerebral palsy, they are an important factor in determining if further tests are needed in order to diagnose medical conditions that can’t be diagnosed with screenings alone.
Developmental screenings are generally given at certain ages (9 months, 18 months, and 24 or 30 months) to see if the child is developing properly and rule out any issues. During 9 months of age, issues with an infant’s movements can be seen more easily when compared to birth. Cerebral palsy may be noticed at this stage, but physicians will need to run additional tests to be sure.
Mild movements, however, are easier seen when the baby turns 18 months old, but between 24 and 30 provides doctors with the best options in observing all kinds of movement.
These developmental screenings are extremely important as your child’s physician can start early intervention as soon as possible. Numerous early intervention services are available in most areas to help both children and families, including family training, speech therapy, physical therapy, occupational therapy, assistive technology, and much more.
Tests, more definitive and conclusive when compared to screenings, can help rule out conditions and assist physicians in pinpointing 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 when diagnosing cerebral palsy include:
A cranial ultrasound if a common type of neuroimaging test used to capture images of the infant’s brain via soundwaves. Cranial ultrasounds are a preferable method 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. It’s used more often on babies instead of adults, especially infants born prematurely. It’s carried out by a radiologist moving a transducer across the top of the baby’s head, on the soft spot (fontanelle). While the radiologist is moving the transducer, 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 images tests may still be needed as cranial ultrasound don’t always produce the same type of quality results as other types of imaging scans and tests.
Cranial ultrasounds must be performed before the baby’s cranial bones are fully developed. Performing this type of imaging test after the infant’s cranial bones are formed will prohibit the sound waves from passing through the bones, resulting in inaccurate results.
Along with helping diagnose cerebral palsy, cranial ultrasounds can also help rule out other medical issues, including infections and excessive fluid in the brain.
An MRI (magnetic resonance imaging) is a type of neuroimaging test that uses radio waves and magnetic fields to take images of the infant’s brain and spine. Although cranial ultrasounds are the easiest and least invasive, most physicians prefer MRI scans as they generally produce the best results.
MRI tests can scan various parts of the body via 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 available to help babies remain calm and still during the scans.
CAT Scan (CT Scan)
A CAT scan or CT scan, short for computerized tomography, is a test involving a special X-Ray machine that takes pictures of the baby’s brain, skull, and vessels in the brain. The infant is placed in an X-Ray machine or a 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.
For more detailed information on imaging tests and cerebral palsy, refer to our article, Cerebral Palsy Imaging Tests.
Gross Motor Function Classification System (GMFCS)
The Gross Motor Function Classification System (GMFCS) is movement-based test in which the child’s various motor skills and movement skills are measured, starting from birth until 18 years of age.
There are four levels of GMFCS, I-IV, with the first level being the mildest form of cerebral and the last being the most severe.
For additional information, refer to our article, Gross Motor Function Classification System (GMFCS).
Other Cerebral Palsy Tests
Numerous other tests and evaluations are conducted to get a correct diagnosis, which may include:
- Oral motor tests, in which speech and language are evaluated
- Hearing and vision tests
- Feeding and digestion evaluations
- Neurological evaluations, which tests for cognitive impairment
- Gait tests, which evaluates any problems with walking