Early intervention for children with or at high risk for cerebral palsy should begin “as soon as possible” in order to build on “a critical developmental time,” according to results of a systematic review published in JAMA Pediatrics.
Researchers conducted the review to develop clinical guidelines for early intervention among children at high risk for cerebral palsy (CP) and their families … the researchers searched six databases for “the best available evidence” regarding early interventions tailored for CP across nine domains related to motor function, cognitive skills, communication, eating and drinking, vision, sleep, managing muscle tone, musculoskeletal health and parental support among children aged 0 to 2 years at high risk for or with CP.
The strongest evidence supported 28 recommendations, of which 24 were for and four were against, related to the nine domains, with the most recommendations in the domains of sleep and communication at seven each and the fewest in the domain of muscle tone at one.
“Early targeted intervention builds on a critical developmental time for plasticity of developing systems,” Morgan (Catherine Morgan, PhD, a research fellow at the Cerebral Palsy Alliance Research Institute in Australia) and colleagues wrote.
Early Intervention in Cerebral Palsy and Beyond (JAMA Pediatrics):
Cerebral palsy (CP) is a group of major neurodevelopmental disabilities that mainly affect early motor development, with movement, posture, and secondarily musculoskeletal impairments. The motor disorders are often associated with other neurodevelopmental diseases, such as intellectual disability, speech or language impairment, autism spectrum disorder, attention deficit, or comorbidities, such as epilepsy or psychiatric disorders, relative to the general population. Currently, early diagnosis of high-risk CP offers the opportunity for early intervention at a critical developmental plasticity window. The earlier we intervene, the better the outcome is. The international clinical guideline by Morgan et al in this issue of JAMA Pediatrics advocates, based on a high standard of evidence, for an early intervention for children aged 0 to 2 years who have CP or are at high risk of CP. This is a time window that encompasses maximum brain plasticity.