Synopsis
Coordinate lifelong, family-centred cerebral palsy care by defining function, anticipating associated difficulties, setting meaningful goals, preventing secondary complications and responding safely when a child's usual neurological or respiratory state changes.
- Cerebral palsy describes a permanent disorder of movement and posture caused by a non-progressive disturbance in the developing brain; the child's needs still change over time.
- Record the motor distribution and predominant tone pattern, but use functional systems and family priorities to describe what the child can do in daily life.
- At every review ask directly about pain, sleep, feeding, constipation, respiratory symptoms, seizures, vision, hearing, communication, mood and participation.
- Treat new deterioration as acquired illness until assessed; diagnostic overshadowing can delay recognition of infection, fracture, aspiration or shunt malfunction.
- Set specific participation goals with the child and family before choosing therapy, equipment, orthoses, medication or surgery.
- Use hip surveillance, growth and nutrition review, bone-health assessment and contracture monitoring according to age, function and local pathways.
- Provide reliable communication support and accessible information so the child participates in decisions at their developmental level.
- Plan education, respite, equipment maintenance and transition across health, therapy, social care and school rather than relying on isolated appointments.
Key red flags
Repeated coughing, colour change, wet breathing or oxygen desaturation during feeds suggests unsafe swallowing and aspiration risk.
A sudden painful limb, swelling or refusal of transfers may represent an occult fracture, hip displacement or other orthopaedic emergency.
Persistent vomiting, abdominal distension, constipation with systemic illness or bilious vomit requires urgent gastrointestinal assessment.
New headache, vomiting, drowsiness or neurological change in a child with a cerebrospinal fluid shunt raises concern for shunt obstruction or infection.
Loss of previously reliable communication, mobility or self-care deserves prompt assessment for pain, mood disorder, safeguarding concern or intercurrent disease.
Investigation priorities
Define motor pattern, associated impairment and functional trajectory over time.
Management branches
A routine review, new concern or important developmental transition is due.
- Elicit the child's and family's current priorities and participation barriers.
- Assess function, pain, associated health needs and environmental support.
- Agree measurable goals, responsible professionals and a realistic review date.
- Share the plan with primary care, education and emergency services as appropriate.