Cerebral palsy. Diagnosis in young children.

Definite diagnosis of cerebral palsy is usually possible during the first six months of life in the hemiplegic child, but in the paraplegic or quadriplegic it may not be clear until the second half of the first year or later. Diagnosis should include not only type, degree and extent of motor handicap, but also intelligence, personality factors, sensory deficits, seizures and other physical problems. Diagnosis depends on detecting deviations from normal growth and development, of being aware of a multitude of progressive and other lesions which may simulate, at least early, the "static" group of conditions characterized by motor deficit due to central nervous system disease. Management involves early positioning, use of special equipment (mainly improvised), sensory stimulation and experience, as well as motor training, evaluation of intelligence and special learning situations to assist in discrimination learning and lengthening of attention span. Nursery schools for mentally capable children from 18 months to 3 years of age assist in developing independence, maturity and growth of personality. Except for patients with very severe mental or physical involvement, competitive employment in adult life is not related so much to the physical handicap as to personality characteristics, traits which are formed in early years.