Early cerebral palsy detection is crucial

Two parents from Waterford, whose son was diagnosed with cerebral palsy at just four months old after participating in a study at Cork University Hospital (CUH), have said that the early diagnosis was a huge benefit.

Clíodhna and Brian Gallagher's son MJ was born in October 2023 by emergency caesarean section at University Hospital Waterford, following concerns about reduced movement. He needed medical support immediately after birth and was transferred to CUH where he received cooling therapy.

At four months old he received a cerebral palsy diagnosis.

The early diagnosis meant that he could access tailored physiotherapy, occupational therapy, and speech and language therapy, while his parents received guidance on how best to support his development.

"Early diagnosis has made a huge difference, not only for MJ but for us as a family. It meant his physiotherapy, occupational therapy and speech and language therapy could be adapted to his needs from an early age. It also gave us the opportunity to learn about cerebral palsy and how to support his development at home," said the Gallaghers.

The study which MJ took part in was run across four hospitals - Cork University Maternity Hospital (CUMH), and the Rotunda, Coombe, and National Maternity Hospitals in Dublin, and was led by the INFANT Research Centre at University College Cork (UCC).

The study, which was published in The Journal of Pediatrics, examined outcomes for 1,161 infants at increased risk of cerebral palsy, comparing care before and after the introduction of new early detection pathways.

It found that the median age of cerebral palsy diagnosis fell from 24 months to just seven month, and that the proportion of children diagnosed before their first birthday also increased from 20% to 88%.

The level of early neurological assessments increased in the hospitals from 3% to approximately 90% at three to four months.The hospitals introduced a consistent approach to monitoring babies at increased risk, including specialist neurological assessments at key stages of development, staff training, and structured follow-up.

Professor Brian Walsh, Consultant Neonatologist at CUMH and Principal Investigator at the INFANT Research Centre said: "Previously, children at increased risk of cerebral palsy were routinely followed in neonatal clinics, but many were two years old before receiving a diagnosis."By introducing specialist assessments at key stages of development across four hospitals, we changed how these children were monitored. With guidance and support from international experts, we adapted established recommendations to the Irish healthcare settings.

"The reductions in age at diagnosis was almost immediate, and importantly, it has been sustained," he said.

Work is already underway to extend the early detection pathways to additional services, including University Hospital Waterford and Children's Health Ireland, with the aim of standardising early assessment for children at increased risk of cerebral palsy across Ireland.

Professor Geraldine Boyle, Director of the INFANT Research Centre said that there was a need for a national approach.

"The next challenge is to ensure that children across Ireland can benefit from earlier diagnosis, regardless of where they live. A National Cerebral Palsy Framework, backed by sustained investment, is needed to ensure people with cerebral palsy can access the right care at the right time throughout their lives," she said.