Early Detection and Intervention for Children with High Risk of Cerebral Palsy: A Survey of Physical Therapists and Occupational Therapists in Brazil

Abstract

Aims

The purpose of this study was to assess the current clinical practice of physiotherapists and occupational therapists on early detection and early intervention for children with cerebral palsy (CP) in Brazil.

Methods

This was a cross-sectional study. A purpose-developed electronic survey was disseminated across the country to physiotherapists and occupational therapists working with young children with or at risk of CP.

Results

A total of 205 anonymous respondents were included. Most participants (64.4%) agree that the diagnosis of CP can be made before 6 months of age. General Movements Assessment (26.8%) and Hammersmith Infant Neurological Examination (37.1%) were used infrequently. Infants at risk for CP receive therapy twice a week or more by 58.5% of therapists, 93.2% identified parents’ goals as the most important factor in customizing the early intervention program. The most frequent intervention strategies for this age group were active stimulation of the child (n = 182), family training (n = 161), strategies to optimize the environment (n = 143), and neurodevelopmental treatment/Bobath (n = 99).

Conclusions

Currently, pediatric physiotherapists and occupational therapists in Brazil do not fully incorporate best practice tools for early identification of children with CP, nor sufficient best evidence-based interventions.

Keywords:

• Cerebral palsy
• early detection
• early intervention
• occupational therapy
• physical therapy

Acknowledgements

We sincerely thank the regional Councils of Physiotherapy and Occupational Therapy from Brazil (CREFITO), and the rehabilitation centers, hospitals and associations, for supporting us in distributing the survey and participants who filled it out. The authors acknowledge Alfredo Carlos da Silva, statistician from SARAH Network of Rehabilitation Hospitals, for his support during the statistical analysis. We also have to thank the National Council for Scientific and Technological Development (CNPq).

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Rosiane F. A. Souza

Rosiane F. A. Souza, OT, Master’s degree student in Medicine and Health at Federal University of Bahia (UFBA). She is a pediatric occupational therapist at SARAH Network of Rehabilitation Hospitals in Salvador, Brazil.

Hércules R. Leite

Hércules R. Leite, PT, PhD, Professor and Researcher at School of Physical Education, Physical Therapy and Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

Rita Lucena

Rita Lucena, MD, PhD, Professor and Researcher at the Postgraduate Program in Medicine and Health at Federal University of Bahia (UFBA). She is a pediatric neurologist in UFBA, Salvador, Brazil.

Alessandra Carvalho

Alessandra Carvalho, MD, PhD, Developmental Pediatrician, at SARAH Network of Rehabilitation Hospitals in Salvador, Bahia, Brazil.