Cerebral Palsy Diagnosis
Cerebral palsy is diagnosed when a child shows delays in movement, posture, or developmental milestones. Doctors focus on evaluating motor function using a variety of exams and tests to rule out other neurological conditions. Learn how cerebral palsy is diagnosed and what next steps you can take if your child has CP.
When Is Cerebral Palsy Diagnosed?
In general, most children with cerebral palsy are diagnosed between 6 and 24 months of age, but milder cases may not be recognized until age 3-5.
Babies who are born prematurely, spend time in the NICU, or experienced complications like hypoxic-ischemic encephalopathy (HIE), kernicterus, meningitis, or stroke are monitored closely to catch early developmental delays.
These high-risk babies are often diagnosed even earlier, around 3 to 6 months, especially when using the General Movements Assessment (GMA) test and brain imaging, such as the MRI.
Detecting and diagnosing cerebral palsy early is important because the brain is the most adaptable during the first two years of a baby's life. Starting physical, occupational, and speech therapy early on significantly improves motor skills, communication, and long-term independence.
What Are the Early Signs of Cerebral Palsy?
Accurately assessing cerebral palsy requires specialists' guidance and conducting tests - whether it be brain scans or electrophysiological tests. However, parents might notice their child has unusual symptoms that can potentially signal if their child may have cerebral palsy.
Some common symptoms parents might notice include:
- Delayed milestones such as sitting, crawling, or walking
- Stiff or floppy muscle tone
- Difficulty controlling or balancing head movements
- Favoring one side of the body
- Difficulty controlling movements or posture
- Trouble with swallowing, coordination, or speech
- Unable to roll over by an expected age
- Difficulty grasping or holding objects
If you suspect your child is having developmental delays - even if symptoms seem mild, tell your doctor. Your child's pediatrician will recommend further testing by a neurologist or developmental specialist.
The Importance of Early Detection
By getting an earlier diagnosis, cerebral palsy can be managed with early intervention of treatment or medications that can improve quality of life. In fact, according to the CDC, children who begin therapy before age two significantly improve movement, strength, and independence compared to those diagnosed later.
It's important to remember that only severe cases of cerebral palsy are diagnosed at birth, while milder cases often take several months or even a couple of years to officially diagnose.
Since most neurodevelopmental disorders require ongoing screening to track progress, families should expect the diagnosis process to take time.
How Is Cerebral Palsy Diagnosed?
Physicians will diagnose cerebral palsy using a combination of neurological exams, neuroimaging, and laboratory or electrophysiologic tests to discover how a child's brain was injured and how it affects their movement, speech, and brain function.
Since diagnosing cerebral palsy cannot done with a single blood test or scan, it requires ruling out other neurological or metabolic conditions that can cause similar movement issues and reviewing results over time to decide whether cerebral palsy is the reason for a child's symptoms.
Neurological and Developmental Examinations
Doctors will assess muscle tone, reflexes, coordination, and developmental progress to determine if CP is a possibility by using a series of screening tests. A pediatric neurologist often leads this assessment to determine the type and severity of movement disorder.
Doctors will evaluate a child's:
- Muscle tone (whether spastic, floppy, or fluctuating)
- Primitive reflexes (e.g., when a baby is startled or starts feeding) that persist longer than normal
- Postural reactions (how the child balances and corrects movement)
- Gross and fine motor skills like grasping objects, crawling, or standing
- Coordination and motor planning, often through play-based tasks
Standardized screening tools they may use include:
Gross Motor Function Classification System (GMFCS): Grades mobility on a scale from 1 to 5 from minimal limitation to full dependence.
Gross Motor Function Classification System (GMFCS)
- Level I - Walks without limits, but running or jumping may look awkward.
- Level II - Walks in most settings but has more obvious difficulty with balance, uneven surfaces, or crowded spaces.
- Level III - Walks with a walker, crutches, or other type of mobility aid.
- Level IV - Uses a wheelchair most of the time; may stand or walk short distances with support.
- Level V - Very limited voluntary movement; relies on a wheelchair and full assistance for mobility.
Note: Where a child ranks on the GMFCS scale is not necessarily permanent, as their mobility can improve as they grow older.
General Movements Assessment (GMA): Evaluates spontaneous movements in infants under 5 months. Abnormal writhing or fidgety movements are highly predictive of CP.
Hammersmith Infant Neurological Examination (HINE): This exam measures posture, muscle tone, and reflexes in infants 2–24 months old. A score below 57 at 3 months strongly predicts cerebral palsy.
Bayley Scales of Infant and Toddler Development: Measures overall developmental functioning, including general motor and cognitive skills.
Neuroimaging (Brain Scans)
In addition to observing developmental progress, brain imaging tests are used to get a visual image of potential lesions, bleeding, or malformations that may explain a child's symptoms.
According to the American Academy of Neurology, neuroimaging can reveal an underlying cause in up to 80-90% of children diagnosed with cerebral palsy, especially when MRI is used.
The most common neuroimaging tests used are:
MRI (Magnetic Resonance Imaging): MRIs are used to detect structural abnormalities, scarring, or white-matter damage in the brain. Often considered the gold standard for CP diagnosis because it shows both prenatal injuries like periventricular leukomalacia and perinatal issues such as hypoxic-ischemic encephalopathy (HIE).
Undergoing an MRI is a safe and easy process. The child will simply lie on a table that retracts into a tube-like scanner while the machine uses magnetic fields and radio waves to scan the brain—with no radiation exposure.
The process typically takes up to an hour, so some children may need sedation to stay still for more accurate results.
Quick Fact: MRIs and other brain scans do not directly detect cerebral palsy but instead reveal potential abnormalities in the brain that are often related to the condition.
Cranial Ultrasound: Detects bleeding or fluid buildup in infants, especially those who were born prematurely. Cranial ultrasounds, while less detailed than an MRI, use high-frequency sound waves to create real-time images of brain tissue.
The process is pain-free and takes less time to perform than an MRI (usually done in 10-15 minutes, but results may take longer to present).
CT Scan (Computed Tomography): Also known as a CAT scan, it uses x-rays to create cross-sectional images of the brain and helps to identify brain bleeding, calcifications, major malformations, or even skull fractures.
CT scans use radiation; however, the risk of radiation exposure is low and equivalent to a few chest x-rays. The procedure takes about 20 minutes from start to finish.
Electrophysiological Tests
Electroencephalogram (EEG): EEGs do not detect cerebral palsy but record electrical brain activity to check for seizure disorders such as epilepsy (which occurs in nearly 40% of children with CP).
During the procedure, which can take 20-60 minutes, electrodes are placed on the scalp and connected to a machine that amplifies brain waves and records the activity.
Electromyography (EMG): Measures electrical signals in the muscles and nerves to differentiate cerebral palsy from similar conditions such as peripheral neuropathy or muscular dystrophy.
Evoked Potentials (Visual, Auditory, Somatosensory): Measures how quickly the brain responds to sensory input. This helps reveal delayed processing function linked to white-matter injury of the brain.
Laboratory, Genetic, and Metabolic Testing
Roughly 10-15% of children suspected of having cerebral palsy are later found to have genetic or metabolic conditions that mimic its symptoms. If imaging cannot explain the cause, physicians may order:
Genetic testing panels: (e.g., whole-exome sequencing) to detect mutations in genes such as COL4A1, GNAO1, or SPAST, which can cause movement disorders.
Metabolic testing: Including blood and urine screens for disorders of energy metabolism (mitochondrial disease) or amino-acid imbalances.
Thyroid and coagulation studies: If other hormonal issues are suspected.
Other Tests Used for Diagnosis
There are a number of other types of tests that can be used to diagnose cerebral palsy, especially when there are other motor or cognitive issues that appear, such as:
- Speech and language tests
- Hearing tests
- Vision tests
- Physical and occupational therapy evaluations
- Oral motor tests (such as feeding and swallowing examinations)
- Cognitive function testing
- Neuromuscular testing
- Gait testing (walking and balance tests)
Why Is Cerebral Palsy Hard to Diagnose?
Diagnosing cerebral palsy can be challenging because no single test can confirm the condition. Children with milder symptoms can often go undiagnosed for months or even years.
Some motor disorders may improve over time, while others become more pronounced as the child grows. This makes it difficult to accurately diagnose since cerebral palsy can be confused with other motor disabilities.
Parents should be aware of what normal development looks like and inform their doctor if they suspect anything is out of the ordinary with their child's milestones. Doctors and specialists will help families to determine whether their child has cerebral palsy or another medical condition.
What Kind of Specialists Are Involved in Diagnosis?
Doctors and specialists play an important role in diagnosing cerebral palsy. Here are some of the medical professionals that are involved in cerebral palsy diagnosis:
- Pediatric neurologists: Evaluate motor function and brain health involving abnormalities or injuries.
- Developmental pediatricians: Track and monitor developmental milestones involving physical or cognitive delays.
- Physical and occupational therapists: Examine functional movement, muscle tone, and independence.
Note: Be sure to work with specialists and therapists who have experience with cerebral palsy.
What Kind of Milestone Delays Indicate Cerebral Palsy?
Delays or missed milestones can indicate mobility and motor control difficulties that are often linked to cerebral palsy. While each child may have slightly different timelines for achieving milestones, parents should be aware of typical progressions so they can monitor their child's development.
The chart below shows typical milestones at different ages.
Common Developmental Milestone Delays Linked to Cerebral Palsy
By 3 Months
Most infants can lift their head, open and close their hands, and bring hands to their mouth. Possible red flags:
- Difficulty holding head up during tummy time
- Stiff or floppy body tone (too rigid or too limp)
- Arms or legs that cross or "scissor" when picked up
- Limited spontaneous movement or one-sided use of limbs
- Hands stay clenched most of the time
By 6 Months
Typically, babies can roll over, push up on arms, and sit with some support. Red flags may include:
- Cannot roll in either direction
- Trouble lifting their head or pushing up when lying on their stomach
- Stiff legs when feet touch a surface
- Favors one hand over the other (early hand preference)
- Poor head and neck control when being pulled to sit
By 9 Months
Most infants can sit without support, transfer toys between hands, and begin crawling or scooting. Potential red flags:
- Cannot sit independently
- Uses one side of the body much more than the other
- Drags an arm or leg while moving
- Doesn't reach for or grasp nearby objects
- Has poor balance or exaggerated stiffness
By 12 Months (1 Year)
Children typically pull up to stand, take supported steps, and may start walking with assistance. Possible red flags:
- Doesn't crawl or pulls with one side only
- Cannot stand even with support
- Stiff legs, on tiptoes when standing
- Poor coordination or lack of balance
- Delayed or absent babbling or speech
By 18 Months
Toddlers usually walk independently, stack blocks, and say several words. Red flags:
- Not walking or only walking on their toes
- Still unable to sit or stand without help
- One-sided weakness or dragging a foot
- Limited hand control for feeding or playing
- Poor coordination between their arms and legs
By 24 Months (2 Years)
Most children can run, climb, and use two-word phrases. Possible red flags:
- Still not walking independently
- Jerky, awkward, or scissoring gait
- Frequent falls or inability to balance
- Poor coordination of both sides of the body
- Minimal speech or difficulty forming words
By 3 Years
Typical skills include jumping, riding a tricycle, and using short sentences. Possible red flags may include:
- Cannot jump or run smoothly
- Walks on toes persistently
- Difficulty holding crayons, feeding themselves, or dressing
- Limited emotional or social engagement due to motor frustration
By 4-5 Years
Children usually can hop, skip, climb stairs with alternating feet, and engage in play that requires coordination. Red flags:
- Frequent tripping or falling
- Rigid movements or unusual posture
- Delays in drawing, writing, or cutting
- Ongoing speech or swallowing difficulties
- Visible fatigue during physical play
What Happens After a Cerebral Palsy Diagnosis?
After getting a thorough evaluation, your doctor will assemble a team of experts, including physical, speech, or occupational therapists, to begin therapy and treatment.
They will help you create what is called a patient care team. This group of medical professionals is usually made up of a:
- Neurologist
- General or developmental pediatrician
- Dietitian
- Counselor
- Orthopedic specialist
- Nurse case manager
- Physical and occupational therapist
- Speech and language therapist
- Plus any other specialists needed
Your child's patient care team can create a customized therapy and treatment regimen that fits your child's abilities and needs.
What Should I Do if My Child Is Diagnosed with Cerebral Palsy?
If you suspect your child's cerebral palsy resulted from medical malpractice, you can reach out to a cerebral palsy lawyer to discover your legal rights and potentially pursue legal action. Receiving a settlement from a birth injury lawsuit can help to cover the costs of ongoing therapy and treatment.
What if My Child Was Diagnosed Late?
A late diagnosis does not eliminate treatment options. The same intervention treatments and therapy used in earlier diagnosed cases can still improve strength, coordination, and independence at any age.
However, a delayed diagnosis may affect legal rights if your child's cerebral palsy was caused by medical malpractice. Parents should thoroughly document all medical records and consult both a neurologist and a cerebral palsy lawyer if concerned.
Each state has what are called statutes of limitations - meaning the amount of time a family or child has to file a medical malpractice claim. If you are concerned, be sure to speak with a cerebral palsy lawyer in your state to better understand your legal rights and options, as laws may change.
Cerebral Palsy Diagnosis FAQs
Written and Medically Reviewed by:
Cerebral Palsy Hub Team
Cerebral Palsy Hub was founded to help support children and their families with cerebral palsy and to create a safe space for those affected. We strive to provide the most accurate, up-to-date information, and tools to help give your child the life they deserve.
Last Updated: January 27, 2026
