Handbook

Question 1

What is ICF-CY

Answer 1

ICF-CY stands for ‘International Classification of Functioning, Disability and Health for Children and Youth’. It has been derived from the World Health Organization’s (WHO) International Classification of Functioning, Disability and Health (ICF). • ICF is a framework designed to record the characteristics of the developing child and the influence ‘environment’ and ‘personal’ factors have on the child’s activities, participation, and engagement in life.

Question 2

When does CP start?

Answer 2

Majority of causes that lead to CP commence antenatally. ~ 80% of cases of CP are congenital. ~ 10– 20% are acquired (vascular, traumatic, inflammatory, etc.).

Gada, Srinivas. Community Paediatrics (Oxford Specialist Handbooks in Paediatrics) (p. 124). OUP Oxford. Kindle Edition.

Question 3

What is selective vulberability in CP?

Answer 3

Specific regions and cells in the brain are susceptible to insults during specific times in brain development.
Injury at:
< 20th week of gestation can lead to neuronal migration deficit.
26th– 34th week leads to periventricular leucomalacia (PVL).
34th– 40th week cause focal/ multifocal cerebral injury.

Question 4

What age does CP present?

Answer 4

The more severe the CP, the earlier the presentation. • Hence, severe CP could present soon after birth and mild cases could present even after 2– 3 years.

Question 5

Is there any caution about diagnosing CP in preterms?

Answer 5

A number of preterm babies can demonstrate transient abnormalities in tone and reflexes that interfere with acquisition of motor skills. Many of these transient manifestations of CP resolve at follow up by 1 or 2 years of age. In such a scenario:
All the necessary interventions/ therapy should be put in place.
Parents should be informed about the fact that CP is a possibility.
All such patients should be followed-up.

Question 6

What are different classifications systems for CP?

Answer 6

1. Based on functional limitations: mild, moderate, devere
2. Gross Motor Function Classification System is a functionally based system that has been documented to be stable over time. Hence, GMFCS is increasingly used for research studies and to answer questions about prognosis such as ambulation and survival.
3. according to the child’s abilities and limitations as proposed by ICF
4. according to resting tone and limbs involved (topography)

Question 7

What is GMFCS classification?

Answer 7

Level 1: walks without restrictions; limitations in more advanced GM skills.
Level 2: walks without assistive devices; limitations walking outdoors.
Level 3: walks with assistive devices; limitations walking outdoors.
Level 4: self-mobility with limitations; children are transported or use power mobility outdoors and in the community.
Level 5: self-mobility is severely limited even with the use of assistive technology.

Question 8

How often is epilepsy seen in CP?

Answer 8

30-50%. Can be any type and present at all ages.

Question 9

What is the frequency of visual problems in CP?

Answer 9

~ 50– 80% have problems with vision.
They include refractive errors, strabismus, visual field defects, ambylopia, dyskinetic eye movements, cortical vision impairment

Question 10

How often is speech affected in CP?

Answer 10

40%