Monitoring/ Auditing Criteria:  to assess gridline implementation or adherence to recommendations.  This is achieved if the quality of life of BDMH/CP is improved with no increase in rate of complications

Cerebral palsy is not a single disorder but a group of disorders with diverse implications for children and their families.

Clinicians should be able to:

- Follow up of "at risk" infants, such as those born prematurely

-  Delayed motor milestones, particularly learning to sit, stand and walk

-  Asymmetric movement patterns, for example, strong hand preference early in life

-  Abnormalities of muscle tone particularly spasticity or hypotonia

-  Management problems, for example, severe feeding difficulties and unexplained irritability. Many other conditions present with these features.

*Observation of the child often provides more information than 'hands on' examination. Look for the presence or absence of age appropriate motor skills and their quality. 

Clinicians should be aware of associated disorders as:

• Visual problems (approximately 40%) e.g. strabismus, refractive errors, visual field defects and cortical visual impairment
• Hearing deficits (approximately 3 - 10%)
• Speech and language problems
• Epilepsy (approximately 50%)
• Cognitive impairments. Intellectual disability, learning problems and perceptual difficulties are common. There is a wide range of intellectual ability and children with severe physical disabilities may have normal intelligence

Management

Management involves a team approach with health professionals and teachers. Input from the family is important.

1. Accurate diagnosis & Establish the cause of cerebral palsy if possible.
2. Management of the associated disabilities, health problems and consequences of the motor disorder

- Recognize the following as red flags for neurological disorders other than BDMH (CP), and refer the child or young person to a specialist in pediatric neurology if any of these are observed:

·  Absence of known risk factors.

·  Family history of a progressive neurological disorder.

·  Loss of already attained cognitive or developmental abilities.

·  Development of unexpected focal neurological signs.

·  MRI findings suggestive of a progressive neurological disorder.

-Working with families 
Care of the child with cerebral palsy involves developing a trusting and cooperative relationship with parents. Parents may need practical support such as provision of respite care and information about financial allowances