Providing a Primary Care Medical Home for Children and Youth With Cerebral Palsy

Abstract

ABSTRACT. Children and youth with cerebral palsy present pediatricians with complex diagnostic and therapeutic challenges. In most instances, care also requires communication and comanagement with pediatric subspecialists and pediatric surgical specialists, therapists, and community developmental and educational teams. The importance of family resilience to the patient's wellbeing broadens the ecologic scope of care, which highlights the value of a primary care medical home from which care is initiated, coordinated, and monitored and with which families can form a reliable alliance for information, support, and advocacy from the time of diagnosis through the transition to adulthood. This report reviews the aspects of care specific to cerebral palsy that a medical home should provide beyond the routine health maintenance, preventive care, and anticipatory guidance needed by all children. Pediatrics 2004;114:1106-1113; cerebral palsy, developmental disability, medical home, chronic illness, spasticity.

Early detection of cerebral palsy in high-risk infants: diagnostic value of primitive and developmental reflexes as well as ultrasound

“…Moderate and severe HIE were significant risk factors of CP, as were grade 3 and 4 IVH. Ultrasound abnormalities associated with CP included PVL, grade 3 and 4 IVH, encephalomalacia, meningitis, hydrocephalus, and ventriculomegaly, which were similar to previous findings in the published literature.1 [3][4][5][6][7][8][9][10][11][12][13][14][15] The diagnosis of CP is straightforward in cases of severe CP or in older children. It is difficult to accurately diagnose CP in the first 6 months of life, in milder cases, or in cases of isolated motor delay.…”

“…3 Early detection of CP within the first year of life is essential to enable early intervention, which will affect the natural course of the disease. 4 Identification of CP in young infants is problematic due to the limited motor development in these infants, making it difficult to determine the types of motor delay that can be used to detect CP.…”

Home care management among mothers having children with cerebral palsy in Erbil city

“…This could occur because several studies have shown associations between low income and poor oral health. Families from low SES group lack of knowledge which led to poor home care management skills 6 . The SES is considered one factor which affects mothers' nurtures of the children care.…”

“…22 Other stated that the brain injury resulting in cerebral palsy may also affect higher cognitive functioning, resulting in evidence of learning disability, language and communication impairment. 6 Most mothers were in child bearing age. The disabilities were mainly due to financial problems rather than inadequate preparation to care for the child or lack of information regarding the condition.…”

“…6 Home-based programs are necessary because almost none of parents have received appropriate training for working with children with neurological disorders. 7 Likewise, despite efforts to enhance home care, the National Health System in Spain depends heavily on outpatient clinic-based care and there are few opportunities for home care.…”