Developmental Medicine & Child NeurologyVolume 49, Issue s109 p. 8-14 Free Access A report: the definition and classification of cerebral palsy April 2006 First published: 23 June 2009 https://doi.org/10.1111/j.1469-8749.2007.tb12610.xCitations: 482AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract For a variety of reasons, the definition and the clawification of cerebral palsy (CP) need to be reconsidered. Modern brain imaging techniques have shed new light on the nature of the underlying brain injury and studies on the neurobiology of and pathology associated with brain development have further explored etiologic mechanisms. It is now recognized that assessing the extent of activity restriction is part of CP evaluation and that people without activity restriction should not be included in the CP rubric. Also, previous definitions have not given sufficient prominence to the non-motor neurodevelopmental disabilities of performance and behaviour that commonly accompany CP, nor to the progression of musculoskeletal difficulties that often occurs with advancing age. In order to explore this information, pertinent material was reviewed on July 11–13,2004 at an international workshop in Bethesda, MD (USA) organized by an Executive Committee and participated in by selected leaders in the preclinical and clinical sciences. At the workshop, it was agreed that the concept ‘cerebral palsy’ should be retained. Suggestions were made about the content of a revised definition and classification of CP that would meet the needs of clinicians, investigators, health officials, families and the public and would provide a common language for improved communication. Panels organized by the Executive Committee used this information and additional comments from the international community to generate a report on the Definition and Classification of Cerebral Palsy, April 2006. The Executive Committee presents this report with the intent of providing a common conceptualization of CP for use by a broad international audience. References 1 Freud S.. (1897) Die infantile Cerebrallahmung. In: H. Nothnaget, editor. Specielle Patbologie und Therapie, Bd DC, Teil III. Vienna : Holder, p 1– 327. 2 Osier W. (1899) The Cerebral Palsies of Children. A Clinical Study for the Infirmary for Nervous Diseases. Philadelphia : Blakiston. 3 Little Club. (1959) Memorandum on terminology and classification of'cerebral palsy'. ( Keith R. Mac, et al., editors) Cereb Palsy Bull 1: 27– 35. 4 Bax MCO. (1964) Terminology and classification of cerebral palsy. Dev Med Child Neurol 6: 295– 307. 5 Mutch LW Alberman E., Hagberg B., Kodama K., Velickovic MY (1992) Cerebral palsy epidemiology: where are we now and where are we going? Dev Med Child Neurol 34: 547– 555. 1 World Health Organization. (2001) International Classification of Functioning, Disability and Health (ICF). Geneva : World Health Organization. 2 Cans C. (2000) Surveillance of Cerebral Palsy in Europe: a collaboration of cerebral palsy surveys and registers. Dev Med Child Neurol 42: 816– 824. 3 NINDS Workshop on Classification and Definition of Disorders Causing Hypertonia in Childhood. (2001) http:www.ninds.nih.govnews_and_eventsHypertonia_ Meeting_2001.htm. 4 World Health Organization. (1980) International Classification of Impairment, Activity and Participation -ICIDH-2. Geneva : World Health Organization. 5 Palisano R., Rosenbaum P., Walter S., etal. (1997) Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 39: 214– 223. 6 Beckung E., Hagberg G. (2002) Neuroimpairments, activity limitations, and participation restrictions in children with cerebral palsy. Dev Med Child Neurol 44: 309– 316. 7 Eliasson A C., Rosblad B., Krumlinde-Sundholm L., Beckung E., Arner M., Ohrwall A-M, Rosenbaum P. (2006) Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. DevMed Child Neurol 48: 549– 554. 8 Bartlett DJ, Purdie B. (2005) Testing of the Spinal Alignment and Range of Motion Measure: a discriminative measure of posture and flexibility for children with cerebral palsy. Dev Med Child Neurol 47: 739– 743. 9 Gorter JW, Rosenbaum PL, Hanna SE, Palisano RJ, Bartlett DJ, Russell DJ, Walter SD, Raina P., Galuppi BE, Wood E. (2004) Limb distribution, type of motor disorder and functional classification of cerebral palsy: how do they relate? DevMed Child Neurol 46: 461– 467. 10 Ashwal S., Russman BS, Blasco PA, et al. (2004) 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. Neurology 62: 851– 863. i. Cans C. (2000) Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Dev Med Child Neurol 42: 816– 824. ii. NINDS Workshop on Classification and Definition of Disorders Causing Hypertonia in Childhood. http:www.ninds.nih.govnews_and_eventsHypertonia_Meeting_2001.htm. iii. Sanger TD, Delgado MR, Gaebler-Spira D., Hallett M., Mink JW. (2003) Task Force on Childhood Motor Disorders: Classification and definition of disorders causing hypertonia in childhood. Pediatrics 111(1): e89– 97. iv. Sanger T. (2004) Toward a definition of childhood dystonia. CurrOpin PediatrMKG): 623– 627. v. World Health Organization (2001) International Classification of Functioning, Disability and Health (ICF). Geneva : World Health Organization. vi. Palisano R., Rosenbaum P. Walter S., et al. (1997) Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 39: 214– 223. vii. Beckung E., Hagberg G. (2002) Neuroimpairments, activity limitations, and participation restrictions in children with cerebral palsy. Dev Med Child Neurol 44: 309– 316. viii. Eliasson AC, Rösblad B., Krumlinde-Sundholm L., Beckung E., Arner M., Ohrwall A-M, Rosenbaum R. (2006) Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Dev Med Child Neurol 48: 549– 554. ix. Bartlett DJ, Purdie B. (2005) Testing of the Spinal Alignment and Range of Motion Measure: a discriminative measure of posture and flexibility for children with cerebral palsy. Dev Med Child Neurol 47: 739– 743. x. Gorter JW, Rosenbaum PL, Hanna SE, Paiisano RJ, Banlett DJ, Russell DJ, Walter SD, Raina P., Galuppi BE, Wood E. (2004) Limb Distribution, Type of Motor Disorder and Functional Classification of Cerebral Palsy: How do They Relate? Dev Med Child Neurol 46: 461– 467. xi. Ashwal S., Russman BS, Blasco PA, et al. (2004) 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. Neurology 62: 851– 863. Citing Literature Volume49, Issues109February 2007Pages 8-14 ReferencesRelatedInformation