Cerebral Palsy and Spasticity Center | Cerebral Palsy Evaluation

If your child has indications of cerebral palsy (CP), it’s important to get a definitive diagnosis. CP evaluation at Boston Children’s provides you and your pediatrician with accurate, objective information about your child’s condition. Addressing symptoms of CP in early childhood—before your child peaks developmentally—is critical to making the most of cerebral palsy treatment.

Our cerebral palsy experts look beyond muscle tone, muscle contractures and your child’s gait and evaluate how they are functioning and developing in their daily life. At Boston Children’s, we treat the whole child, working toward their overall well-being and your dreams for them. Meet our cerebral palsy team.Cerebral Palsy Patient

Comprehensive Cerebral Palsy Testing at Boston Children’s Hospital 

A child is usually diagnosed with CP when he or she starts missing developmental milestones, such as walking and controlling hand and head movements. This commonly happens between six–24 months, but might not occur until about two years of age.

At Boston Children’s, diagnosing cerebral palsy begins with a physical examination. During this initial exam, a doctor will obtain a complete history of the mother’s pregnancy, the child’s birth and early development and the family history. Your child will also have a neurological examination to evaluate his or her reflexes and motor function, cognitive abilities, behavior, global development, risk for seizures and sleep patterns.

Your child may then have any number of the following diagnostic tests:

  • gait analysis, a review of your child’s walking patterns
  • X-rays
  • magnetic resonance imaging (MRI), which uses a combination of large magnets, radiofrequency waves and a special computer to create detailed pictures of organs and structures within the body
  • computerized tomography (CT) scans, which use X-rays and computer technology to produce cross-sectional images of parts of the body (including bones, muscles and organs)
  • Genetic studies, which screen for conditions that tend to run in families due to known abnormalities in DNA.  
  • Metabolic tests, which detect the absence or insufficiency of specific enzymes (including amino acids, vitamins or carbohydrates) necessary to maintain normal body functions

Advanced Walking Analysis at the Gait Laboratory

We refer selected patients with complex walking problems to a state-of-the-art Gait Laboratory on the grounds of nearby Spaulding Rehabilitation Hospital, where they undergo an evaluation by expert physiatrists.

Walking analysis at the Gait Laboratory includes:

  • Multiple high-speed movie cameras that record your child's steps
  • Electronic monitors that measure muscle activity during walking 
  • Specialized floor sensors to determine force and function during walking
  • Computerized data evaluation to help determine the extent of walking issues and the optimal treatment approach

Evaluating Functional Ability at Boston Children’s

Our specialists want an accurate picture of your child’s functional motor abilities to ensure the best possible treatment. Our cerebral palsy team uses two important systems to accurately assess and describe your child’s ability to sit and walk (motor skills) and to use his or her hands (manual function).

  • The Gross Motor Function Classification System (GMFCS) describes the ability of children with CP to sit, walk and be otherwise mobile, based on a series of exercises your child will be asked to perform. The system categorizes abilities into five distinct levels.
  • The Manual Ability Classification System (MACS) describes how children with cerebral palsy use their hands to handle objects in daily activities. The system also categorizes abilities into five distinct levels.

These systems are useful because they:

  • Provide you and your doctor with a clear picture of your child’s physical abilities
  • Help anticipate the future physical abilities of your child
  • Help determine what kinds of equipment or mobility aids your child may need, such as crutches, walking frames or wheelchairs
  • Help predict the risk for hip displacement

Make an Appointment

For an appointment, more information or to obtain a second opinion for your child, please call us at 617-355-6021 or request an appointment online.

International Patients

For families residing outside of the United States, please call Boston Children's International Health Services at +1-617-355-5209.