{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:04:06Z","timestamp":1793379846999,"version":"4.5.0"},"reference-count":44,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Cerebral palsy (CP) is the most common childhood motor disability. The emergence of genetic CP etiologies, variable inclusion of hypotonic CP in international registries, and involvement of different medical disciplines in CP diagnosis can promote diagnostic variability. This variability could adversely affect patients\u2019 understanding of their symptoms and access to care. Therefore, we sought to determine the presence and extent of practice variability in CP diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We surveyed physicians in the United States and Canada interested in CP on the basis of membership in the American Academy of Cerebral Palsy and Developmental Medicine or the Child Neurology Society Neonatal Neurology, Movement Disorders, or Neurodevelopmental Disabilities Special Interest Groups. The survey included the 2007 consensus definition of CP and 4 hypothetical case scenarios.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Of 695 contacted physicians, 330 (47%) completed the survey. Two scenarios yielded consensus: (1) nonprogressive spastic diplegia after premature birth with periventricular leukomalacia on brain MRI (96% would diagnose CP) and (2) progressive spastic diplegia (92% would not diagnose CP). Scenarios featuring genetic etiologies or hypotonia as the cause of nonprogressive motor disability yielded variability: only 46% to 67% of practitioners would diagnose CP in these settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>There is practice variability in whether a child with a nonprogressive motor disability due to a genetic etiology or generalized hypotonia will be diagnosed with CP. This variability occurred despite anchoring questions with the 2007 consensus definition of CP. On the basis of these results, we have suggested ways to reduce diagnostic variability, including clarification of the consensus definition.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2020-010066","type":"journal-article","created":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T04:35:11Z","timestamp":1609821311000},"source":"Crossref","is-referenced-by-count":48,"title":["Variability in Cerebral Palsy Diagnosis"],"prefix":"10.1542","volume":"147","author":[{"given":"Bhooma R.","family":"Aravamuthan","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurology, Department of Neurology, School of Medicine, Washington University in St Louis and St Louis Children\u2019s Hospital, St Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darcy","family":"Fehlings","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Toronto and Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheetal","family":"Shetty","sequence":"additional","affiliation":[{"name":"Departments of Child Health, Neurology, Genetics, and Cellular and Molecular Medicine, College of Medicine \u2013 Phoenix, University of Arizona and Cerebral Palsy and Pediatric Movement Disorders Program, Barrow Neurological Institute, Phoenix Children\u2019s Hospital, Phoenix, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Fahey","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Monash University, Melbourne, Australia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurology, Department of Neurology, School of Medicine, Washington University in St Louis and St Louis Children\u2019s Hospital, St Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Tilton","sequence":"additional","affiliation":[{"name":"Louisiana State University Health Sciences Center New Orleans and Children's Hospital of New Orleans, New Orleans, Louisiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"Kruer","sequence":"additional","affiliation":[{"name":"Departments of Child Health, Neurology, Genetics, and Cellular and Molecular Medicine, College of Medicine \u2013 Phoenix, University of Arizona and Cerebral Palsy and Pediatric Movement Disorders Program, Barrow Neurological Institute, Phoenix Children\u2019s Hospital, Phoenix, Arizona;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2021,2,1]]},"reference":[{"issue":"6","key":"2021121100044118700_B1","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1212\/01.WNL.0000117981.35364.1B","article-title":"Practice parameter: diagnostic assessment of the child with cerebral palsy: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society","volume":"62","author":"Ashwal","year":"2004","journal-title":"Neurology"},{"key":"2021121100044118700_B2","first-page":"3","volume-title":"Capute and Accardo\u2019s Neurodevelopmental Disabilities in Infancy and Childhood","author":"Accardo","year":"2008","edition":"3rd ed"},{"issue":"4","key":"2021121100044118700_B3","doi-asserted-by":"crossref","first-page":"e20190811","DOI":"10.1542\/peds.2019-0811","article-title":"Prevalence and trends of developmental disabilities among children in the United States: 2009-2017","volume":"144","author":"Zablotsky","year":"2019","journal-title":"Pediatrics"},{"issue":"5","key":"2021121100044118700_B4","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1111\/dmcn.13363","article-title":"The genetic basis of cerebral palsy","volume":"59","author":"Fahey","year":"2017","journal-title":"Dev Med Child Neurol"},{"issue":"10","key":"2021121100044118700_B5","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1038\/s41588-020-0695-1","article-title":"Mutations disrupting neuritogenesis genes confer risk for cerebral palsy","volume":"52","author":"Jin","year":"2020","journal-title":"Nat Genet"},{"key":"2021121100044118700_B6","first-page":"35","article-title":"Recommendations from the SCPE collaborative group for defining and classifying cerebral palsy","volume":"109","author":"Christine","year":"2007","journal-title":"Dev Med Child Neurol Suppl"},{"issue":"12","key":"2021121100044118700_B7","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1017\/S0012162200001511","article-title":"Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers","volume":"42","author":"Surveillance of Cerebral Palsy in Europe","year":"2000","journal-title":"Dev Med Child Neurol"},{"issue":"4","key":"2021121100044118700_B8","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1111\/dmcn.12262","article-title":"What constitutes cerebral palsy in the twenty-first century?","volume":"56","author":"Smithers-Sheedy","year":"2014","journal-title":"Dev Med Child Neurol"},{"key":"2021121100044118700_B9","article-title":"Patient and family perspectives on common CP therapies and interventions.","author":"Gross","year":"2016"},{"issue":"9","key":"2021121100044118700_B10","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1001\/jamapediatrics.2017.1689","article-title":"Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment","volume":"171","author":"Novak","year":"2017","journal-title":"JAMA Pediatr"},{"key":"2021121100044118700_B11","first-page":"8","article-title":"A report: the definition and classification of cerebral palsy April 2006","volume":"109","author":"Rosenbaum","year":"2007","journal-title":"Dev Med Child Neurol Suppl"},{"issue":"7001","key":"2021121100044118700_B12","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1136\/bmj.311.7001.376","article-title":"Consensus methods for medical and health services research","volume":"311","author":"Jones","year":"1995","journal-title":"BMJ"},{"issue":"5","key":"2021121100044118700_B13","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1097\/ACM.0000000000001092","article-title":"Is there a consensus on consensus methodology? 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