When should a parent begin to seek orthopedic specialist intervention for the child that is not obviously but could be impaired with cerebral palsy?

When a child is born with cerebral palsy it is not always immediately apparent. He may be diagnosed with probable cerebral palsy while his diagnosis team waits to see how his characterizing symptoms progress or if they progress.

If there is suspicion that an infant may have cerebral palsy a parent should of course follow the recommendations of the pediatrician. An orthopedic specialist can and will see an infant soon after birth if the child has some characterizing issues such as spasticity, contracture, or pronation, though the former is not really visible until the child is pulling to stand.

An orthopedic specialist will observe the child on a regular basis throughout the first several years of life keeping track of progress being made with physical therapy and occupational therapy. An orthotist, which is a physical therapist more specialized in the area of orthopedics though he is not a medical doctor, often will be on the child抯 medical team suggesting different types of intervention to help the child with range of motion, pronation, etc. Ankle-foot orthotics, leg or ankle braces, and shoe inserts are often prescribed for little ones even before they learn to walk. Waiting until a child is walking to use such orthotics will only make the patient have to learn to pull-up, walk, run, etc. all over again as he will have compensated for his weaknesses and will need to relearn the skills once he is in braces or another form of orthotics.

An orthopedic specialist will continue to monitor the child referring to physical and occupational therapists for prevention and intervention. A doctor can guess if walking or other daily skills will be threatened, but he cannot really say if or how until the child begins to attempt these skills. Self feeding with a spoon for a baby is a milestone during which cerebral palsy indications surface. A child will have difficulty with range of motion perhaps needing to move the entire arm around to reach the mouth rather than just lifting the forearm and moving the hand toward the mouth. Feet will be an obvious indicator of the disease as well.

An orthopedic specialist monitors seemingly without intervening at all, but he is watching for conditions that may lead to surgery. Bone and joint deformities that cause pain, permanent stiffness of the joints called contracture, and some spinal issues will merit surgery and a doctor needs to be immediately aware when these issues develop so that surgery can be done sooner rather than later. While most doctors prefer to wait to operate until a child is two or more, if a condition is painful and can be eased with surgery, children may have surgery at a younger age.