Cerebral Palsy: Understanding the Pediatric Evaluation

Part 1: Fundamentals in Perspective

I thought it would be a good idea to begin this series of posts with a certain aspect that, in my opinion, is typically missing from most people when entering into any form of evaluation or assessment. It is not my intention to pass judgement on parents, professionals, or any other group of people...it simply exists. What is the missing ingredient? Perspective. Quite simply, the expectations of every parent with a child with CP must be tempered by the proper perspective. Without it, expectations can often run wild and ultimately lead to dashed hopes and unecessary feelings of guilt, frustration, and desperation.

Therefore, the question becomes: "What is the proper perspective?". The answer has been right in front of our (parents and professionals alike) noses. Conditions such as Cerebral Palsy, West Syndrome, etc...fall under the umbrella of Developmental Delay. Simply put, there is a significant delay in the development of healthy motor function. This is a reality that is inescapable...as chronological age proceeds at a regular pace, the developmental process lags behind. Therefore, by definition, the progression of each developmental phase is the ONLY component that matters when gauging progress. It is essential to remember that EVERYONE must pass through these developmental stages...irrespective of their chronological age. The very definition speaks for itself: Developmental Delay (CP) is characterized by the persistence or delay in the disappearance of
primitive reactions and pathologic or absent postural reactions. The vast majority of parents are focused in on the chronological age of their child and therefore attribute "age appropriate" expectations for their child. As mentioned in one of my previous posts: focused attention to your child's developmental age will give you the proper perspective on how they are "hardwired" to develop and therefore foster realistic expectations going into each evaluation or assessment.

Hopefully this small introduction serves to facilitate efficient absorption of the elements in Part 2 (The Developmental Process: Primitive and Postural Reactions).

Cheers!