Cerebral palsy is a common disorder caused by a disturbance to the fetal or newborn brain. The injury usually occurs before birth or shortly thereafter, but signs of cerebral palsy may not be visible until later.

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Cerebral palsy (CP) is the most common cause of childhood disability in the United States.

CP is caused by atypical development or injury to a baby’s brain occurring during pregnancy or in early infancy. The brain changes don’t progress or worsen over time, but they don’t resolve.

Depending on what part of the brain is affected and the severity of the injury, children with CP can have a wide range of symptoms and outcomes. But everyone with cerebral palsy will have some degree of difficulty with movement or posture.

Particularly when risk factors for CP are present, even the youngest infants can be screened for early signs of cerebral palsy.

Learn more about cerebral palsy.

Cerebral palsy (CP) is the most common cause of childhood disability in the United States, occurring in 1.5 to 4 per 1000 live births worldwide.

The signs of cerebral palsy arise over time as a baby develops. Symptoms are often undetectable during the newborn period but may appear within the first 6 months of life.

Signs and symptoms in early infancy may include:

  • delayed or absent motor developmental milestones
  • atypical reflexes (including persistence of primitive reflexes)
  • atypical muscle tone (unusual stiffness or floppiness)
  • atypical movements (persistent arching/extension, stiff straight legs that cross or scissor, early hand preference)
  • muscle weakness
  • atypical head growth (micro- or macrocephaly)

The American Academy of Pediatrics has developed a Motor Delay Tool to help review motor development and facilitate discussion with your child’s doctor.

A baby’s early years are a crucial period for neurodevelopment, and earlier diagnosis and treatment of CP can help maximize a child’s capabilities. Babies with CP often appear healthy at birth.

When there are concerns for CP, your doctor will review your pregnancy and your baby’s medical history and perform a physical examination.

Standardized observational tools, such as the Hammersmith Infant Neurological Exam (HINE), assess your baby’s development and motor skills. Doctors can use these screening tools in babies as young as 2 months old.

You might also be referred to specialists in Pediatric Neurology, Developmental-Behavioral Pediatrics, Physical or Occupational Therapy for evaluation.

Imaging studies, such as brain MRI, can also help diagnose CP.

Cerebral palsy is caused by a disturbance to the development of the fetal or newborn brain.

In approximately 90% of cases, CP is congenital. This means that the brain changes occur in the womb.

The underlying brain injury could be caused by medical problems during pregnancy or delivery, developmental or genetic conditions, or complications of prematurity.

Often, the precise underlying cause isn’t identifiable.

Although the exact cause of CP is not always clear, there are known risk factors for congenital cerebral palsy:

  • low birthweight (less than 2.5 kilograms, or 5.5 lb)
  • prematurity (less than 37 weeks)
  • multiple births (e.g., twins or triplets)
  • in-vitro fertilization (IVF)
  • infections during pregnancy
  • kernicterus (a form of severe newborn jaundice)
  • congenital anomalies
  • maternal medical conditions (e.g., thyroid disease, preeclampsia, substance use)
  • complications during birth (e.g., early detachment of the placenta, rupture of the uterus, umbilical cord problems, hypoxic-ischemic encephalopathy)

Risk factors for cerebral palsy acquired after the first month of life include:

  • severe head injury
  • stroke
  • infections (e.g., meningitis or encephalitis)

Having one or more risk factors for CP doesn’t necessarily mean your child will have cerebral palsy. But when risk factors are present, your doctor will monitor more closely for CP.

While cerebral palsy can’t be cured, an individualized treatment plan can help your child reach their peak abilities.

Once a child is diagnosed with CP, starting the recommended physical, occupational, or speech therapies as soon as possible can help optimize your baby’s development.

Your doctor may also recommend screening tests to detect changes in your baby’s hearing, vision, or possible seizures.

As your child gets older, educational supports will encourage cognitive achievement. Assistive devices like orthotics, mobility and communication devices, and hearing or vision aids can help your child navigate their world.

Oral and injectable medications can help treat a variety of CP complications as they arise, like muscle spasticity, pain, feeding or drooling problems, and/or seizures.

Sometimes, orthopedic and other surgeries are needed to treat complications of CP. These are not typically necessary during infancy.

Research into potential future treatments, including stem cell therapy, is ongoing.

In addition to the muscle tone and movement difficulties seen in the early stages of CP, other complications can arise. These include:

  • feeding problems and growth delays
  • seizure disorders
  • cognitive and speech delays/disorders
  • hearing impairment
  • eye problems like strabismus (crossed eyes) or functional blindness

Over time, you may notice:

  • additional musculoskeletal disorders like hip problems, joint contractures, bone density problems, or scoliosis
  • sleep and/or neurobehavioral disorders like autism spectrum disorder or ADHD
  • pain
  • urologic problems, such as incontinence or neurogenic bladder

There are four main types of CP, and each can cause differing degrees of cognitive and motor impairment. Your doctor can help you best understand your child’s outlook.

All people with CP will have some lifelong problems with movement and posture, and many will have related complications, including cognitive, sensory, and musculoskeletal issues. But prompt diagnosis and early therapy can help maximize your child’s healthy development.

In high-income countries, two-thirds of children with cerebral palsy will learn to walk, three-fourths will speak, and half will have normal intelligence. The majority of children with CP will survive into adulthood.

Can you tell if a newborn has cerebral palsy?

Usually, you cannot definitively tell whether cerebral palsy is present during the newborn period. Your doctor will help you closely monitor your baby’s development, particularly if risk factors for CP are present.

Early signs of CP may be apparent by 6 months of age. Your doctor can help you screen for CP when there are risk factors or concerns.

What causes cerebral palsy in a newborn?

CP is caused by disturbances in the development of the fetal or newborn brain.

Brain injury in CP can be caused by genetic conditions (in an estimated 14% of cases), congenital brain changes, infections, injuries, stroke, hypoxia, or prematurity.

What are the behavioral signs of cerebral palsy?

Newborns with cerebral palsy can have unusual irritability, excessive crying, or feeding difficulties. These symptoms are also common in babies without CP.

As children get older, CP-associated neurobehavioral disorders may emerge. These include autism spectrum disorder (ASD), attention deficit-hyperactivity disorder (ADHD), anxiety or depression, or memory and learning issues.

Do newborns with cerebral palsy look different?

Cerebral palsy is generally not apparent in the immediate newborn period. Unless other health issues are present, infants with CP may appear healthy at birth.

Cerebral palsy is a common developmental disability. It causes motor delays and varying degrees of posture and movement problems, along with other complications.

CP is caused by injury to the developing brain, usually in the womb or during or shortly after birth. There is no single cause of CP, but there are multiple known risk factors.

Historically, CP has been diagnosed around two years of age. But the signs may be noticed much earlier. Symptoms of CP can often be detected as early as six months of age, especially in infants with known risk factors.

Early diagnosis and treatment can improve the capabilities of children with cerebral palsy. If you are concerned about your newborn or infant’s motor development or believe they may be at risk for CP, talk with your child’s doctor about developmental screening right away.